What Sex Therapy Is — And Isn’t

What isn’t sex therapy?

When I tell people I am a sex therapist, a lot of the time people give me a confused look. Many people think that sex therapy is having sexual intimacy with the clients to help them improve their sexual abilities. As a counselor, sexual intimacy is NEVER ethical or legal to have between my clients and I, so this perception can be harmful if not just very, very awkward.

Sex therapy is not sexual surrogacy or sex work. Sex surrogacy — the act of physical intervention to help clients learn and practice intimacy and sex — is the way sex therapy is often portrayed in popular culture and the media. An example of this is the movie The Sessions, a fabulous movie about a man in an iron lung who goes to a sex therapist (very briefly in the movie) and gets referred to a sex surrogate. This surrogate is Helen Hunt’s character who has a set amount of sessions with him and sets up some great boundaries with him. Sexual surrogacy is an example of sex work that insurance will cover and is usually limited to about 6 sessions.

Sex therapy is not a live Cosmopolitan or Men’s Health magazine. Sex therapists may give sex education and give ideas to clients to try, but therapists in general leave the advice-giving to friends, family, and other sources. This is one of the ways that therapy is different than relationships outside of session.

Okay, so what is sex therapy?

Sex therapy utilizes the more traditional skills of counseling (goal setting, empathy, reflection, connecting meaning, etc.) to whatever the client and counselor define as sex related. The outcomes can vary widely depending on what topics are important to the client. Sometimes this includes LGBTQ, body image, sexual empowerment, healthy relationships, gender diversity (which is different than sexuality or sex), sometimes it does not. It really depends on the values of the counselor and their subspecialty.

Sex therapy looks different with every therapist because usually sex therapists have subspecialties within the very broad and vague umbrella of “sexuality.” Some examples of all the different topics sex therapists can specialize in are: erectile dysfunction, sex after infidelity, couples counseling and sex addiction (which the field of sex therapy is split on what this is and if it is real).

My subspecialties are: talking frankly and nonjudgmentally about kink/BDSM and polyamorous relationships, consent, communication, healthy relationships, tackling sexual shame and body image issues, recovery from religion, increasing sexual empowerment/freedom and where LGBTQ+ factors into all of the above.

Above all, I am a very sex-positive counselor, which means that I will never shame you or judge you for whatever you bring to the room. I believe sex, intimacy and desire (whether you are asexual or hypersexual) are normal and natural parts of life that can impact us dramatically.

Comment below if you have questions, comments or want to share your perception of sex therapy.

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