Most forms of therapy focus on exploring and resolving mental, emotional, or relational struggles. Sex therapy does the same thing, but specifically focuses on the struggles that relate to sex, sexuality, and gender. Other than that, the experience of sex therapy is very similar to traditional talk therapy.

The umbrella of sex therapy covers many, many things. Because of this, sex therapists often specialize in a particular subset of topics. Issues that I tend to focus on with my clients include (but are not limited to):

• Kink, fetish

• Non-monogamy, polyamory, swinging, open and other forms of non-traditional relationship structures

• Gender identity, transgender identity, navigating transitioning

• Sexual identity, sexuality

• LGBTQ+ identity

• Sexual shame

• Sexual difficulties or dysfunctions (erectile dysfunction, pain during sex, vaginismus, premature ejaculation, low libido, orgasm difficulty, etc.)

• Desire discrepancy in relationships (ie, one partner wants sex more than another)

• Affairs, infidelity

• Out of control or compulsive sexual behavior

• Performance anxiety during sex

• Intimacy issues in relationships

• Sex & dating

• Self-acceptance

• Increasing pleasure during sex

• Improving sexual function

• "Purity Culture" recovery

• Sexual values

• Communication, conflict in relationships

• Sex work

• Lack of desire, low libido

• Mismatched desires or fetishes in relationships

• Fear or anxiety regarding sex, intimacy, or relationships

• "Am I normal?", "Is this normal?" concerns regarding sex

The average therapist is given little to no training or education related to sexuality or gender, even those who specialize in working with couples/relationships. Unfortunately, this is true for most healthcare professionals. In addition to the typical education and licensing process undergone by all therapists, sex therapists pursue multiple additional years of extensive coursework, training, and supervision specifically for sex therapy. This includes required trainings designed to prompt  sex therapists to identify and process any areas of ingrained judgement or bias related to sexuality, fetishes/kink, relationship structures, sexual practices, etc. While sex therapists are still fallible humans affected by their own experiences in sex negative cultures, the typical sex therapist is much better equipped to competently and compassionately navigate matters of sex in a therapeutic context.

Absolutely not. One of the benefits of sex therapy is the opportunity to better understand who we are as sexual beings within the larger context and systems that make up our lives. While sex therapy work does primarily relate to matters of sex, gender, and relationships, many other topics are relevant to taking a holistic approach to well-being and mental health.

This depends on the issue and the individual (or relationship) in question. Some topics are quickly resolved with some education and/or troubleshooting. Others may take more time and processing to navigate through. There is no one-size-fits-all approach, as a person seeking sex therapy is as unique as the issue they are hoping to address. Early in working together, we will talk in depth about your goals and expectations for therapy, as well as our shared plan of approach.

In most cases, the first session is an opportunity for me to learn more about you (and your partner(s), when applicable) in general, similar to the start of any other form of talk therapy. We’ll also talk in a bit more depth about what brings you therapy and what you are hoping to explore or work on. After the first session, I will send you a history questionnaire. This questionnaire covers many topics related to your life and background, especially those related to sex, identity, and relationships; you can fill it out on your own during the next week. Over the next one or two sessions, we’ll go through some of the questionnaire together and talk about any themes or important elements that came up. If you are participating in therapy with a partner(s), each partner will individually complete their own questionnaire and then meet with me individually to go over it. After that, we will establish goals and a plan going forward for reaching them.

This is an understandable concern! From low quality to non-existent sex education, pervasive societal messages of purity and sex negativity, and a general cultural bashfulness on the subject, most of us know (or can imagine) what it is like to be met with judgement in response to self-disclosure about sex, if we have dared to open up about it at all. Very few of us have had the opportunity to experience what it is like to have such private parts of our lives welcomed with acceptance, validation, and curiosity. Regardless of what brings you to sex therapy, that experience alone can be transformative. 

Even though I have been highly trained to respond non-judgementally to virtually anything that might come up, it is normal and understandable to feel hesitant to open up about such vulnerable and personal topics. It may take time to feel safe to trust me with these parts of your experience, and that is okay! Many people find that this gets easier with time, and even discover a tremendous amount of relief and self-acceptance through the process of opening up as they feel safe and ready to do so.

No, you will not be required to do, discuss, or disclose anything in therapy that you do not want to. Your own autonomy and self-determination are important elements of both therapy and healthy sexuality, and will be honored (and encouraged!). That said, therapy–perhaps sex therapy in particular–often involves engaging with uncomfortable, difficult, and/or awkward subjects for the benefit of continued growth, well-being, and reaching your therapy goals. Please know that when or if that situation arises in therapy, it will be approached with sensitivity, with your full consent and input, and at a pace that feels safe and manageable to you.

By far, the number one underlying question that brings someone to sex therapy is: “Am I normal?”. The truth of the matter is that when it comes to sex, there is no “normal”. If everyone in the world was fully transparent at all times about their sexuality and sex life, none of us would feel abnormal. We would instead see that whether we are looking at frequency of sex, libido levels, our most secret kinks and fantasies, our deepest longings and desires, what an orgasm is like (let alone what causes one), or any other topic regarding sexuality, our experiences are so incredibly diverse as to render the concept of “normal” practically irrelevant. As the great sex researcher and educator Emily Nagoski writes, “Your sexual response is as unique as your fingerprint; embrace it fully and celebrate your individuality.”

When someone comes to sex therapy with an “am I normal?” question, they typically find that we spend little time answering that question (since the answer will be a quick and easy “yes!”) and instead focus on approaching things through a lens of non-judgement and curiosity, learning what shapes and informs sexuality, understanding their own unique version of “normal”, making peace with themselves–or their partner(s)–and establishing intentionality in sexual practices that reflect their personal values.

It is true that sex therapy may lead to unexpected discoveries about yourself or your partner that might feel surprising or uncomfortable at first. If that happens, we will explore those feelings with compassion and curiosity, with the goal of greater acceptance of yourself and/or your partner. 

Sexual fantasies (mental image/narrative/idea that is sexually arousing or erotic to an individual) …

• can take the form of virtually anything.

• can feel contradictory to your personal values/ethics/morals.

• may differ substantially from choices you would make or things you would want to do or experience "in real life".

• do not always have a clear source or origin.

• are not a measure of or commentary on your character or judgement.

In therapy with me, your sexual fantasies …

• will be viewed and approached non-judgmentally and morally-neutral.

• will not be pathologized.

• will not result in assumptions made about your behavior. 

In regards to sexual practices or behavior, I believe …

• in sex as a form of play, self-expression, individuality, and creativity. 

• sexual play is limitless in scope or possibility.

• legally consenting individuals can explore, express, experience,  and enjoy their sexuality in whatever ways they wish, so long as it does not infringe upon the rights, autonomy, or safety of those who have not given their consent to participate.

For more information about my approach, please see:

• The Harvey Institute: “Six Principles of Sexual Health”

• The American Association of Sexuality Educators, Counselors, & Therapists (AASECT): “Vision for Sexual Health”

Many people struggle at some point in life with behaviors or thoughts that feel out of control, intrusive, or unmanageable. This can be very distressing in any context, but tends to be saddled with a great deal of extra shame and anxiety when it relates to sex. Sex therapy can be a very useful tool in exploring, understanding, and managing these sorts of struggles and I encourage you to reach out if this is something you are experiencing.

Yes, that is possible. In cases where there is little overlap between your work with a sex therapist and the work you are doing with another provider, this can be helpful. In these sorts of situations, it is sometimes appropriate for me to consult with your other provider(s) in order to ensure appropriate coordination of care, though this is something you and I would first discuss together.

No. Sex therapists are licensed, professional clinicians and therefore are held to the same ethical and legal practices as all mental health practitioners.