What Is Therapy For Sexuality And How Can A Sex Therapist Help?

Sexuality is a personal part of who we are, but talking about it isn’t always easy. Maybe you’re dealing with intimacy or sexual behavior issues, feeling unsure about your sexual identity, or facing challenges in a relationship. Whatever it is, carrying sexual challenges on your own can feel heavy and lonely. That’s where therapy for sexuality can help. It’s a space to be honest about your feelings—no judgment, just support and understanding from an accredited sex therapist.

What is therapy for sexuality? 

Modern sex therapy is a safe space to discuss sex, intimacy, and relationships. It's not just about solving issues like low desire, performance anxiety, or identity questions—it's about understanding how these experiences connect to your confidence, communication, and emotional well-being. Whether you're feeling stuck, confused, or curious, it's a judgment-free place to figure things out.

Working with a sex therapist isn't about getting a “quick fix.” They listen without judgment, ask helpful questions, and help you understand yourself and your sexual behavior. Rather than defining "normal," they help you build confidence, strengthen relationships, and feel more at ease in your sexual interactions. 

How does therapy for sexuality support mental health?

Sexuality is often tied to the emotional aspects of our relationships, along with relationship factors like shared values, open communication, and mutual respect. When an individual experiences sexual challenges, it can have a significant impact on personal, relational, and psychological well-being. Sexual therapy offers couples and individuals a space to explore, process, and cope with such challenges, creating a more holistic framework in which to support mental health. 

What is a certified sex therapist?

Sex therapists are typically certified professionals who may have training in fields such as psychology, social work, or medicine. They specialize in treating various sexual issues, including sexual dysfunction and sexual trauma. Sex therapists study the psychology behind human sexuality and use various evidence-based methods of treatment for sexual dysfunctions and sexual trauma. Most sex therapy combines psychotherapy (talk therapy) with other types of treatment, including homework assignments for clients to complete outside of sessions. Professional sex therapists provide a safe, inclusive, trauma-informed, and non-judgmental environment to discuss any sexual problems that may be impacting you. Many sex therapists are trained to work with individuals as well as couples. 

Training, credentials, and areas of focus

It is recommended to work only with sex therapists who have proper certifications and training.  While therapists must be licensed, there are no official rules for who can call themselves sex therapists. For this reason, it is important to be mindful of what training and certifications a potential therapist holds. Sex therapists may include licensed mental health professionals who are trained in sexual medicine, sex research, and therapy, with titles like Licensed Marriage and Family Therapist (LMFT) or Licensed Professional Counselor (LPC).

If a sex therapist violates your boundaries in any way, report them and stop seeing them. Most sex therapists do not prescribe medication or treat hormonal problems that can impact sexual function. For physical or sexual health conditions that may be affecting sexual function, seek medical advice from a healthcare provider. Talk therapy to improve sexual function can be used in conjunction with medical treatments from a general practitioner. 

American Association of Sexuality Educators, Counselors and Therapists

The American Association of Sexuality Educators, Counselors and Therapists (AASECT) certifies sex therapists and counselors in the US. 

Sex therapists and sex counselors are different because sex therapists focus on using psychotherapy to treat the psychological aspect of sexual dysfunction. In contrast, counselors offer sexual education and teach skills for improving sexual health in the short term. 

Sexuality educators take a more instructional and educational approach to sex therapy by teaching their clients specifics about sexual health and psychology in a class-like setting. 

Some sex therapists go through advanced clinical training in psychotherapy and sexual education that could take nine years or more. Training includes academic work and clinical experience. The AASECT requires participants to have an advanced degree and clinical experience – including 90 hours of sex education and 60 hours of sex therapy training. The certification can be renewed every three years with a minimum of 20 continuing education (CE) credits required.

Who can benefit from therapy for sexuality?

Although men and women may experience similar challenges, such as a lack of sexual desire or arousal, trouble having an orgasm, or pain during sex, women often have unique needs. As such, some therapists specialize in issues directly associated with women’s sexual health and female dysfunction. 

Additionally, you do not necessarily have to be experiencing a sexual dysfunction or problem to benefit from sex therapy. Expanding your sexual education can help you have more satisfying sexual experiences and practice better sexual health. 

Sex talk therapy can help with these sexual issues:

• Communication between sexual partners
• Sexual trauma 
• Sexual education 
• Anxiety, fear, or shame regarding sex
• Gender identity or sexuality issues 
• Cultural, religious, or societal issues regarding sex
• Poor body image
• Sex addiction 
• Porn addiction 

Sexual challenges related to relationships and identity

Sexual challenges associated with relationship factors and identity sometimes stem from a misalignment between internal desires, external expectations, and cultural or religious norms around sexual interactions. Key challenges include navigating shifting identities, managing mismatched desires, handling sexual dysfunction, and overcoming shame, particularly regarding sexual orientation or gender identity. 

Trauma and past experiences

The emotional aspects of sexuality can be particularly complex for sexual assault survivors. Sexual trauma is one of the reasons why some people experience persistent sexual issues, such as pain during intercourse due to female sexual dysfunction or anxiety about sex. Sexual dysfunction from trauma can contribute to anxiety, depression, and PTSD symptoms.

*If you are currently experiencing a crisis, text HOME to 741741 to reach the Crisis Text Line.

Medical and psychological factors in sexual health 

Research suggests that sexual health is influenced by a bidirectional interplay of biological and psychological factors, often requiring a comprehensive, multi-faceted approach to treatment. Key factors include chronic illnesses (such as diabetes or heart disease), hormonal imbalances, medications, anxiety, depression, past trauma, and relationship dynamics. Addressing both physical and mental components is key to improving sexual function and satisfaction. 

When a medical evaluation is part of sex therapy

A medical evaluation is often an initial part of sex therapy for those who experience sexual dysfunction, whose symptoms might be associated with medical factors, or when medication is a contributing factor. Sex therapists often collaborate with physicians in sexual medicine to ensure a comprehensive, holistic approach to treatment, including in specialized areas like women’s sexual health and gender-affirming care.  

What to expect in sex therapy sessions 

In sex therapy, you and/or your partner will communicate your concerns about relationship patterns, mental health issues, and the symptoms you’re experiencing.

During your first visit to the therapist’s office, you’ll work with your counselor to create a personalized treatment plan based on your goals, expectations, and unique medical and mental health needs. Your therapist may provide education about sexual function, teach communication skills, suggest exercises to practice at home, and help you process underlying emotional or psychological factors.

How sex therapy works

Sex therapy can help individuals and couples understand, work through, and resolve emotional, psychological, and relational issues connected to sex, intimacy, and relationships. It’s not physical treatment or sexual activity—it's talk therapy, guided by a trained professional. Therapeutic methods often used in treating sexual issues include cognitive behavioral therapy (CBT), emotionally focused therapy (EFT), trauma-informed therapy, and more. 

Modern approaches to sex therapy

Sex therapy is an evolving field of practice based on discoveries in sex research. Modern sexual therapy approaches used to help couples and individuals include, but aren’t limited to:

• Mindfulness-based therapy approaches  
• Improving inclusiveness 
• Using talk therapy to reduce the need for pharmaceutical interventions
• Focusing on the needs of the couple rather than the individual 
• Changing societal attitudes about sex and sexual behavior

Addressing emotional and relationship dynamics

Thoughts and emotions can impact sexual function and sexual satisfaction in relationships. That is why sex therapists use talk therapy to help people gain insight into the thoughts and emotional aspects behind any sexual issues that are impacting them. For example, anxiety about relationship factors, including sexual performance, can affect sexual desire and satisfaction. Treating the client’s anxiety with talk therapy and other interventions, like exposure therapy or medication, can help to improve sexual function. 

Confidentiality, safety, and ethics in sex therapy 

Confidentiality, safety, and ethics form the foundation of trust in sex therapy, ensuring a secure, non-judgmental environment for clients to discuss intimate, personal, and often sensitive sexual concerns. Therapists are bound by strict ethical codes laid out by the American Psychological Association (APA) and the American Association of Sexuality Educators, Counselors, and Therapists (AASECT). Legal regulations outlined in the Health Insurance Portability and Accountability Act (HIPAA) help neutralize patient confidentiality risk, with mandatory exceptions for danger to self/others, child/elder abuse, and legally mandated.

Creating a safe and respectful therapeutic environment

Creating a safe and respectful therapeutic environment in the therapist’s office is fundamental to facilitating healing. Sex therapy typically requires clients to discuss deeply personal, often taboo, and vulnerable issues around sexuality and sexual interactions. As such, a secure environment built on trust, confidentiality, non-judgmental acceptance, and specialized training is key for treating complex emotional and sexual concerns. 

What to expect in your first sex therapy session

During your first sex therapy session, you will have a discussion with the therapist about what your current sexual concerns are. You and the therapist can work together to come up with a game plan for treating sexual dysfunction. 

The questions that you may be asked during your first appointment include your medical history, sex education, personal beliefs about sex, and what sexual concerns are currently impacting you. Being open and honest with your sex therapist will enable them to best meet your needs. Talking about sex may be uncomfortable for some individuals, but sex therapists are trained to help guide you through the process. 

Sex therapists often assign “homework” for their clients to complete outside of their sessions. The therapist may have the individual or couple practice communication techniques, sensate focus exercises, or other techniques, and then report back. 

How BetterHelp supports therapy for sexuality

Some people may not feel comfortable attending in-person sex therapy sessions due to personal concerns. Thanks to the rise of telehealth many sex therapists offer treatment virtually, in which people can attend sessions from the comfort of their homes. You can find a licensed, experienced sex therapist online using an internet-based therapy platform such as BetterHelp. 

Benefits of online therapy for sexual health concerns

With online therapy, individuals and couples with sexual health concerns can receive professional help regardless of location. Attending sessions from home often means less travel time and costs, as well. With BetterHelp, financial assistance options are available for those who qualify. Additionally, BetterHelp therapy may be covered by insurance depending on your plan, provider, and therapist availability. 

Is modern sex therapy delivered online effective for treating sexual concerns? 

The current research on online therapy provides evidence that online talk therapy is just as effective as in-person sessions, with one 2022 study showing that an online CBT treatment course for pregnant women was effective for improving sexual function.