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Sex Therapy

Sex TherapySex therapy is the treatment of sexual dysfunction, such as non-consummation, premature ejaculation, erectile dysfunction, low libido, unwanted sexual fetishes, sexual addiction, painful sex, or a lack of sexual confidence, assisting people who are recovering from sexual assault, problems commonly caused by stress, tiredness, and other environmental and relationship factors. Sex therapists assist those experiencing problems in overcoming them, in doing so possibly regaining an active sex life.

The American Association of Sex Educators, Counselors and Therapists is an organization that oversees clinical training for a sexual health practitioner to become a certified sex therapist (CST).

The American Association of Sexuality Educators, Counselors and Therapists (AASECT) is a professional organization for sexuality educators, sexuality counselors and sex therapists. AASECT was founded by Patricia Schiller in 1967. AASECT publishes the peer-reviewed journals American Journal of Sexuality Education and the Journal of Sex Education and Therapy. They have also published a directory of sex therapists since 1976 and have initiated therapeutic options via phone and online. AASECT is the premier organization that certifies sexual health practitioners. AASECT offers certification of sexual health practitioners in four categories: sexuality educator, sex counselor, sex therapist ( CST) and supervisor (CST-S).

What is sex therapy?

Sex Therapy is a subspecialty of psychotherapy, focusing on the specific concerns related to human sexuality. People of all ages, creeds, health status, ethnic backgrounds, whether partnered or single, may benefit from working with a psychotherapist who specializes in this area. Certified Sex Therapists use specialized clinical skills and theoretical knowledge to help people solve their sexual concerns.

In most states and provinces, Sex Therapy is not a separately licensed or regulated profession, just as child psychotherapy or geriatric psychotherapy is not government regulated beyond granting the basic license to practice therapy. To assure the public of highly qualified practitioners, AASECT provides voluntary certification to those therapists who have completed the rigorous certification process. Only those therapists who have met these qualifications may designate themselves as “AASECT Certified Sex Therapists.”

What kinds of problems can benefit from Sex Therapy?

Typically people experiencing concerns about arousal, performance, or satisfaction are likely to benefit from Sex Therapy. Among these problems are decreased or increased desire for intimacy, or in the case of a couple, mismatched or discrepant desire or interest in sexual intimacy. Both men and women can experience concerns about arousal and there are many causes and options for solving these problems. At any age, performance or lovemaking skills can be of concern, just as can issues around orgasm and satisfaction.

Additionally concerns about sexual trauma in one’s background, medical conditions that affect one’s sexuality, sexual pain disorders, concerns about gender identity or sexual orientation, and issues around sexual compulsivity or addiction are frequent concerns that people discuss with a Sex Therapist.

Sexuality/Sex Therapy

Sexuality is a reality of life. People often seek therapy for issues related directly or indirectly to sex. Ambivalence about sex is as universal a human experience as human experiences can be. Talking about sex and sexuality is often part of the experience of therapy. Various difficulties related to sexuality may lead people to seek therapy or simply come up during the course of treatment. To name just a few examples:

What happens in Sex Therapy?

FlowersThe Sex Therapy process is very similar to that experienced with other mental health practitioners. The Sex Therapist will meet with the person as an individual or with a couple in an office setting where an extensive history of the concerns will be taken. The Sex Therapist will note both the psychological and the physical components and will establish one or more diagnoses. After this, a treatment plan will be proposed, usually with your involvement in its development. In some instances, the Sex Therapist may work closely with the person’s physician, nurse, or other therapist or counselor to establish causes and remedies for the problems.

Depending on the diagnosis, the Sex Therapist will educate the person or couple about the issue and about options for change. This educational process may occur through suggested reading material, through watching educational audio-visual materials, through discussion with the therapist, through attending workshops, or all of these therapy processes. Sometimes having more information will allow the problem to resolve. Sometimes more specific or intensive therapy will be needed.

If more specific therapy is needed, the Sex Therapist may suggest a regular schedule of office appointments. Often, homework exercises to be practiced individually or as a couple in the privacy of one’s home between office appointments will be suggested. The homework may be as general as communication exercises or as specific as actual sexual experiences, depending on the progress in therapy and the person’s level of comfort with accepting direction.

In no instances will a Sex Therapist engage in any kind of sexual activity with a therapy patient/client, whether in the office or in any location. To do so is a breach of ethics, and in some states and provinces is a crime.

Should I Choose an Opposite or Same-Sex Therapy?

Choosing which therapist will work best for your recovery will depend on your specific situation. Couples can work with male or female sex therapists as the work done in session is strictly instructive and verbal. All exercises and suggestions of a physical nature are to be performed by the couple outside of the session. If an individual chooses to enter sex therapy on their own, they may be more comfortable discussing their sexual issues with a therapist of the same gender. However, both male and female sex therapists are trained to address the emotional, physical and biological issues that can influence sexual activity in men and women.

Sexuality in Therapy

Even if no apparent sexual issues are present, sexuality plays an important role in our lives, our relationships, and, sometimes, in our conversations with a therapist. Sexual energy is powerful and can profoundly affect our mood, our thoughts, and our general state of being. Sexual fantasies and behaviors are not always deemed socially appropriate, and we may not feel comfortable talking about our deepest thoughts and feelings with friends or family. This can lead to anxiety, frustration, and even depression. Therapy is a safe place to talk about any difficulties, fantasies, fears, memories, or desires, sexual or otherwise.

Therapy for Sexual Experience Enhancement

Sexual intimacy can be one of the most satisfying and fulfilling experiences, but for many, sexual activity is void of pleasure. Sex therapists are trained to help individuals and couples enhance their sexual experiences by discovering what emotional fences are creating barriers to sexual enjoyment. Often, sexual issues are a result of negative feelings, traumatic experiences or even anger, that prevent one from being able to fully participate during sexual intercourse. Whether the physical symptom exhibits itself through inability to achieve orgasm or maintain arousal, or even through painful sex, a sex therapist can help one identify the psychological source of the physical symptom. By treating the whole person, psychologically and physically, a therapist can help a client enhance their sexual experience.

Common Medical Disorders Associated with Sexuality


Photographs courtesy of Polina Moro Photography.