What Sex Therapy Actually Is

When people hear the words sex therapy, many of them picture a medical clinic with exams and demonstrations, and others picture a couple on a couch being told how often they should be having sex. Neither of those happens in my office.

Sex therapy is talk therapy. We meet in person or by video and we talk with each other. Nobody undresses, nobody is touched, and nothing sexual takes place during a session. The work happens through conversation and through whatever you choose to try in your own life afterward.

What we talk about

People bring all kinds of things to sex therapy. Some want to understand why their desire differs from a partner's, and others are dealing with sex that hurts or that stopped feeling good a while ago. Some have trouble reaching orgasm or reach it sooner than they would like. Others carry shame from what they were taught growing up, or live in a body that changed after an illness, a birth, a transition, or a breakup. Porn use that feels out of hand comes up often, and so does sex that looks fine from the outside and feels flat from the inside.

Most of the time several of these overlap, and the sex itself often turns out to be where something larger becomes visible, such as resentment, fear of being seen, or a relationship that went quiet without anyone saying so.

A good deal of my work is helping people find words. Many have never told anyone what they like or what hurts, and saying it out loud to a therapist who stays steady makes it much easier to say to a partner later.

What a first session is like

Your first session is mostly a conversation. I'll ask what brought you in, what you hope will change, and what you have already tried, and you can share as much or as little as you like. I never ask anyone to describe anything explicit, and you don't need to feel comfortable before we begin. We'll also use that time to see whether we work well together, which matters more than any particular technique.

Who it's for

Sex therapy is open to people of any gender, orientation, or relationship structure, whether you come alone or with partners. Wanting sex or closeness to feel different is reason enough to begin, and no diagnosis or crisis is required.

Sometimes the cause is partly physical because pain, medication side effects, and hormones can all play a role. If I think that might apply to you, I'll say so and suggest seeing a doctor or a pelvic floor specialist while we continue working together.

Plenty of people arrive saying only that something feels off, and that is a perfectly good place to start. If you would like to ask questions first, I offer a free 15-minute consultation.