15 Things Sex Therapists Really Want You To Know
1. Sex therapy isn’t for learning new positions or hot sex tips.
“Some people think sex therapy involves getting naked, having sex, being touched,” says Kerner. “But certainly it’s talk therapy.” A sex therapist is different from a sex coach, sex educator, or sex surrogate. For starters, they won’t be touching you, and they probably won’t tell you how to give a better blow job.
It’s actually a type of psychotherapy that can treat sexual and relationship issues from a biopsychosocial perspective. It’s usually problem-focused, where a therapist considers all the factors that might be at play in a situation. “Sex therapy is understanding what the root of the problem is,” says Fleming.
2. Single people can go to sex therapy, too.
Really, it’s not that weird. Engler has seen patients who want to address patterns in their sex lives — like feeling numb during hookups, losing interest after they have sex with someone, or feeling like they can’t comfortably give or receive love. Or someone might see a sex therapist to deal with urges, fantasies, or sexual behavior that they’re worried about, says Kerner. And hey, you can experience erectile dysfunction, orgasm issues, or sexual anxieties whether you’re coupled up or not.
3. If something is up, go sooner rather than later.
“If you have a specific sexual dysfunction, then absolutely sex therapy is the quickest, most efficient way to get that taken care of,” says Castellanos. Waiting too long to deal might end up making things worse by adding even more anxiety to the situation.
That’s because as time goes on, it’ll suck more and more if you’re not able to fix something on your own. And that can lead to lots of negative connotations around sex and bleed into your relationship. “The longer you have the problem, the harder it is to resolve,” says Castellanos.
4. Don’t be surprised if you talk about way more than just sex.
Like your job, your family, your mental health, your relationship history. “Your sex life doesn’t exist in a vacuum,” says Kerner.
“Some of the issues may be related to other anxieties,” says Castellanos. “Sometimes it seems like the session has nothing to do with the actual sex act, but the therapist is actually dealing with how that person deals with sex.”
5. If you’re having a specific problem during sex, they can help with that.
Things like premature ejaculation, inability to orgasm, delayed ejaculation, arousal issues, erectile dysfunction, changes in libido, vaginismus or other pain during sex, and many others. In some cases it might be a purely biological issue where they’ll refer you to a gynecologist or urologist. But usually there are a few factors at play, says Kerner.
Take, for instance, someone who’s having trouble getting an erection. That could be a sign of a medical problem, or it might be an issue of performance anxiety, or maybe it has something to do with your relationship. Sex therapists look at the whole picture — not just the logistical sex stuff.
6. You don’t need to bring your partner in with you — but you probably should.
Maybe you’re embarrassed about your issue or you feel like this is your thing to deal with. Or maybe your partner feels like it’s your thing to deal with. Regardless, sex therapy works better for couples when both people participate. “If you’re in a relationship, a sexual problem is really a relational issue and so much more can happen if both people are involved,” says Kerner.
That said, you don’t need to worry about your therapist going behind your back to ambush you. “I let them decide when they’re ready for it,” says Engler.
7. Sex therapy can also just help you have a really fucking awesome sex life.
“Most couples should try it at some point,” says Engler. Especially if you notice any big changes in your sex lives or if you just think it could be better. “In our culture, ‘work’ is a dirty word, but the things you put effort into are the things you can count on,” says Fleming.
One of the most common complaints Castellanos gets from couples is that they want things to be more spontaneous and exciting. Her biggest tip: Forget spontaneity. “Good sex requires planning. Making space for the erotic means both mental space and physical space — devoting time for sex to happen.”
8. It can also make talking about sex way less terrifying.
Basically you’re getting a dedicated, safe, nonjudgmental space to talk about your sex life…with a trained professional as your referee. So if you felt like it was impossible to say that you want to go to a sex club or experiment with kink or teach them how you actually like oral sex, now is your chance.
“If you feel that you’re not able to communicate about sex in your relationship, sex therapy is definitely doing to help with that,” says Castellanos. Even some of her patients who are pretty open about sex end up being surprised by the stuff their partners bring up during therapy.
9. Most people feel a huge relief in sex therapy.
Engler says that although people’s nervousness is definitely heightened when they come in for sex therapy, the relief and relaxation they feel almost immediately is tangible. Fleming agrees: “I feel a palpable difference from when they walk in to when it ends. It’s like a huge exhale.”
“My sense is that they come out feeling less anxious, like it was much easier than they thought, that it was actually really nice to start talking about sex,” says Kerner. “They feel like a valve has opened on a pressured situation.”
10. Sex therapists won’t judge you or your interests.
They have literally heard it all. “Sometimes people will come in, feel shy, and they think the thing they’re about to tell me will freak me out. They’re bracing for a judgment,” says Engler.
But it’s not their job to tell you that something is wrong or broken or immoral or unsafe. A good sex therapist is there to normalize, not pathologize, says Kerner. “We believe in pleasure and helping people feel alive and connected and have a vibrant sexual relationship,” says Fleming.
11. There will probably be homework.
Most sex therapists will give homework during most (if not all) sessions to put into practice some of the things you talked about in the room. It might be something to do by yourself (like relaxation exercises or breathing techniques during masturbation) or something you do with your partner (like writing out your fantasies or trying a sex act you talked about in therapy). Since sex therapy doesn’t actually involve taking your clothes off, home is usually where the real progress happens.
12. Sex therapy is usually a short-term commitment.
In some cases, an issue might be resolved in just one or two sessions, says Castellanos, especially if it’s just a matter of educating someone about an issue and what they can do for it — like decreased lubrication, premature ejaculation, or hormonal changes after pregnancy. But if there are other factors at play, it could certainly take longer, says Kerner (though still probably not more than eight to twelve sessions).
“It’s generally based on results, whereas general psychotherapy can go on for however long someone wants,” says Engler.
13. It probably won’t be covered by your insurance.
Womp womp. You can certainly check with your provider to see if they can refer you to someone who would be covered, but most sex therapists don’t take insurance. That said, sex therapy is generally a much shorter commitment than other forms of psychotherapy, so the overall cost might not be as bad as you think. “Think of it as an investment in your health and wellbeing,” says Fleming.
14. It’s smart to be picky when looking for a good sex therapist.
All of the experts stressed the importance of finding a licensed sex therapist — since you don’t necessarily need to be licensed to practice sex therapy. So be sure to ask for a person’s credentials before making an appointment. The American Association of Sexuality Educators Counselors and Therapists (AASECT) is a great place to start looking (though not all licensed sex therapists participate in it).
Also keep in mind that lots of different experts can be sex therapists: psychologists, psychiatrists, social workers, marriage and family counselors, nurses, or physicians. So depending on what you’re dealing with, you may want to look for someone with a particular background. And if you’d prefer a therapist who is well-versed in your sexual orientation, race, religion, gender identity, or lifestyle, make sure to be up front about that.
15. The opportunity to talk opely about sex and sexuality can be incredibly rewarding.
Where else are you going to get into your deepest fantasies, your biggest curiosities, and all of that other stuff that’s hiding in your browser history? “I’ve gone to sex therapy and found it to be a very cathartic experience, and it really inspired me to become a sex therapist,” says Kerner. “It’s a really liberating, freeing space to discuss something that we do a whole lot, but don’t always think about.”
“I want to open people’s minds to the idea of it,” says Engler. “It’s a pathway to knowing yourself better. I think a lot of people associate sex therapy in the localized, mechanical sense, like ‘I have to fix my erection.’ It’s going to change your life in a much bigger way, actually.”