02.29.24
12 Things Sex Therapists Want You to Know
Your past can play a huge role in your current sex life.
At the risk of jinxing things, it seems to finally (finally!) be super normal and chill to talk about being in therapy. But sex therapy? That still remains hush-hush—not to mention underutilized.
Hey, we get it. Sex and sexuality can be deeply personal, and there’s still plenty of stigma to go around. Plus, most people don’t realize that the struggles they’re dealing with can be addressed in sex therapy at all—which, spoiler alert, they often can.
So, if you’re curious about sex therapy but still have questions or hesitations, you’re not alone. To help demystify the process, we asked a few sex therapists what they wish people knew, the worries that come up time and time again in their offices, and the go-to tips they always share with clients. So let’s talk about sex (therapy), baby.
1. Let’s get this out of the way: Sexy stuff doesn’t happen at sex therapy.
A common misconception that everyone I spoke to pointed out: Some people think sex therapy involves, er, hands-on intervention, whether that’s with a partner under a therapist’s supervision or including the therapists themselves. That is absolutely not the case.
“I always like to make sure people know it's still very much talk therapy,” says Taylor Kravitz, LMFT, a therapist who specializes in sex therapy. That said, your sex therapist might send you home with some hot homework. “There are exercises I'll give clients to do between sessions to slowly build a physical intimacy menu that really works for them.”
2. You don’t have to have a Big Problem to address.
“In the same way that we see doctors for physical problems or therapists for mental health difficulties, sex therapy provides a safe, accepting environment in which to discuss and work through sexual issues,” says certified sex therapist Aliyah Moore, PhD. And just like you don’t only go to the therapist when you’re having a mental health crisis or the doctor when you’re gravely ill, you can go to sex therapy for a huge spectrum of struggles—big and small.
You don’t even have to be unsatisfied with your sex life at all. “Even if there’s not an inherent problem, there’s always more opportunity to grow if you’re open to it,” says Kravitz. Sex therapy can be a space to “expand what it looks like to connect with your sexuality and just to feel more sexually empowered in general.”
3. That said, you shouldn’t be ashamed if you are addressing sexual dysfunction.
It’s hard to overstate how much inadequacy, guilt, and embarrassment people can feel when they struggle with physical issues like pain during intercourse, erectile dysfunction, vaginal dryness, or the inability to come. And, despite what your mean brain might try to tell you, grappling with these issues doesn’t mean something is broken with you or your partner.
“When it comes to experiencing sexual dysfunction, many people feel isolated,” says Dr. Moore. “However, it affects people of all ages and genders and is far more common than most people know.”
4. You also don’t need a partner.
Even if you have one, you don’t need to bring them along. Sex therapy can function similarly to individual talk therapy, just… sex-themed! “Individuals who are struggling with body image issues, sexual trauma, or navigating their sexual orientation or gender identity might benefit significantly from engaging with a sex therapist,” says Dr. Moore. That can also include exploring the possibility that you might be asexual or aromantic, adds relationship and sex therapist Natasha Camille, LCSW.
Solo sex therapy can also help you take a deep dive into your past, much like you might in traditional talk therapy. “We can dig into your sexual history, like how you learned about sex, what messages you received, and sexual experiences you’ve had in your life,” says Kravitz.
5. You can talk about things unrelated to sex too.
Obviously, your main goal should be sex-related, but that doesn’t mean you can’t bring other stuff to the table too. In fact, you might be surprised at how seemingly unrelated things still wind their way back to the bedroom.
“I've had clients say, ‘Can I talk to you about what's going on in my job? Is that allowed?’ and it very much is,” says Kravitz. “We actually spend a lot of time talking about things that are not sex. Our daily stresses, our emotional experiences, our relationship dynamics, our sense of self, our identities—they all intersect with sex. If we're not talking about those other layers, then we're often missing pieces of the puzzle that we need to address the thing that someone came into therapy for.”
6. Your past can play a huge role in your present sexual experiences.
You’ve probably picked up on this with all the talk of your sexual history, but it bears repeating. You’ll likely spend time sifting through baggage, unpacking old patterns, or processing negative or traumatic encounters, though positive experiences will come up too (why was sex with your ex the best sex you ever had?).
“You're not alone if you've had past traumatic sexual and relationship experiences that make sex and intimacy feel challenging,” says Camille. “Trauma can cause you to feel unsafe in your own body and to have trouble staying present. These factors naturally might make it harder to share physical or even emotional intimacy with another person.”
On that note…
7. Your mind and body are more connected than you might realize.
When it comes to physical issues related to sex, your first stop might be a doctor to see what’s “wrong.” And while that can sometimes lead to solutions, there’s often a huge mental component that won’t be found in a gynecologist’s stirrups or a primary care doctor’s office.
Say you grew up in a sex-negative environment, whether you were surrounded by purity culture or just didn’t talk about sex, period. Or maybe you have a lot of negative thoughts about your body or judge yourself for your kinks. “You might feel a lot of shame or anxiety when you have sex, making your muscles tighten up and leading to pain and discomfort,” says Kravitz. “There might be a physical issue you can address through pelvic floor physical therapy. But that likely won’t lead to truly lasting change unless you address the underlying emotions around sex that are manifesting in your body.”
8. You’re not alone if your mental health is killing your sex drive lately.
Speaking of that mind-body connection… “The effect of stress and mental health issues on sexual function and enjoyment is one surprising problem,” says Dr. Moore. “Arousal and libido can be significantly impacted by mental health issues such as anxiety, depression, and others.”
Because of that connection, Dr. Moore, Camille, and Kravitz all find themselves working with clients on general mental health and stress—especially in These Unprecedented Times. “In recent years, and particularly following the pandemic, people are struggling with their mental health more than ever,” says Camille. “We've collectively, as a society, experienced mass layoffs, inflation, changes in our relationships with friends and family, and hypervigilance around illness.” And, for a lot of people, that’s showing up in the bedroom.
9. Mismatched libidos are a common complaint.
As awesome as it would be to be exactly as horny as your partner, wanting more or less sex than one another (by a lot or a little) comes up all the time. “Many people feel alone and ashamed because they think it indicates a serious weakness in either their relationship or themselves,” says Dr. Moore.
On the contrary, though, it’s something couples can work through, and it’s definitely not a sure sign your partnership is doomed. “Sometimes it does look like, ‘Maybe we aren't sexually compatible, and we need to talk about what that means for us,’ but I'd say that's the minority of cases in my experience,” says Kravitz. “Most of the time when I do this work, as we start to unpack all the layers that are impacting each person's relationship to sex and sexuality, they find that they actually are more aligned than they realized.”
10. Another typical struggle? Performance anxiety.
Have you ever gotten really in your head during sex, hyper-aware of what’s going on, and unable to lose yourself in the moment? What does my body look like right now? What face am I making? Should I switch positions? Is my partner enjoying themselves? “Many people get stuck in that anxiety,” says Kravitz. “Instead of being in the moment and connected to pleasure, you're performing and spectating.”
If this is something you deal with, sex therapy might look like talking about where these anxieties come from. Sex therapy might also entail doing more somatic work to help you stop overthinking during sex and actually stay present. “I often recommend clients to practice mindfulness as a way to have a closer relationship with their body and senses,” says Dr. Moore. “Simple techniques like mindful masturbation, body scans, and deep breathing exercises can be used for this.”
11. Having sex isn’t the only way to engage with your sexuality.
Remember that homework we talked about? You might be surprised by all the ways sex therapists encourage you to explore and experiment. “To get creative and broaden your erotic repertoire, I suggest reading sexy literature or creating your own sexual fantasies on paper,” says Dr. Moore.
Speaking of literature, Kravitz notes that many of us didn’t get positive, comprehensive sex education, and it’s never too late to learn. “There are a lot of resources out there geared toward helping people connect with their bodies and experience more sexual pleasure,” Kravitz says, recommending the educational (and explicit) sex education site OMGYes.
12. That thing you’re afraid to say? They’ve for sure heard it before.
A lot of people wonder if their interests, kinks, or problems are weird. But, believe us, whatever’s on your mind is probably more common than you think. “There's nothing a client has told me that I haven't heard from someone else before, whether that's the kinkiest thing they can imagine, an experience around sexual trauma, or something else they think they’d be judged for,” says Kravitz.
Ultimately, sex therapy can be the perfect space to open yourself up to new possibilities, discover more about your sexual self, and cultivate self-acceptance. “I always want people to know that human sexuality is so multidimensional,” says Kravitz. “For as long as humans have been around, they have been sexual in a variety of ways. So, whatever it is you enjoy or struggle with, you’re definitely not alone.”
Wondermind does not provide medical advice, diagnosis, or treatment. Any information published on this website or by this brand is not intended as a replacement for medical advice. Always consult a qualified health or mental health professional with any questions or concerns about your mental health.
