Sex therapy is a kind of counseling that can help you or you and your partner resolve difficulties surrounding your sexuality and sexual relationships, according to the International Society for Sexual Medicine. You can either attend sex therapy sessions alone or with your partner to unpack everything from low libido (sex drive), dysfunction, and pain during sex to compulsive sexual behaviors, sexual trauma, and sexual abuse. Plus, you can also discuss sexual orientation and sexual health issues, like sexually transmitted infections. Whatever your questions or concerns about your sexuality or sexual life — physical, emotional, or psychological — you don’t have to navigate them alone.
But not all sex therapists work in the same ways, tackling the same issues with the same methods and the same policies at the same price points. That’s why it’s important to "shop around" for a sex therapist who is best-suited for your lifestyle and needs — and one who makes you feel like you’re in a comfortable and safe space to be vulnerable. After all, talking about sex is still very taboo in our society, and it’s not necessarily easy.
With that said, here are the questions you should ask sex therapists so that you can give informed consent before getting started.
Do you work with individuals or solely couples?
According to the Mayo Clinic, all certified sex therapists will have graduate degrees and credentials by the American Association of Sexuality Educators, Counselors and Therapists (AASECT). But it’s likely that some therapists will have more experience in certain ways of counseling than others.
Are you looking to talk to a sex therapist on your own or with a partner? It’s important to find a sex therapist who is willing to work with you in either case. Some sex therapists have more experience working one on one with individual clients, while others have more experience in couples counseling. Still others may have equal experience working with both individuals and couples alike. Ask your therapist about their experience. And note: If you are looking for a sex therapist for both you and your partner to visit together, it’s important that you both agree on the therapist (via TalkSpace).
What is your specific discipline?
While the American Association of Sexuality Educators, Counselors and Therapists (AASECT) offers certification to all kinds of sexual health practitioners in different disciplines, it’s important to understand the differences between these professionals. They may be accredited as sexuality educators, sexuality counselors, and sex therapists.
Educators teach and train about everything from sexual and reproductive anatomy and physiology to family planning, contraception, sexual and gender identities, sexually transmitted infections, and more. They may work in schools, corporate settings, and with faith-based organizations. Counselors, on the other hand, may work with organizations like Planned Parenthood, or they may work as nurses or other health professionals, like school counselors. Counselors work to resolve short-term issues more immediately through problem solving and communication.
Sex therapists, however, are licensed mental health professionals who are trained to diagnose clients — and they provide comprehensive, intensive psychotherapy, typically on an ongoing basis. Knowing how these professions differ will help you choose the right expert for your specific needs.
Are you trained in what I’m seeking?
Sexuality counselors are trained on the P-LI-SS-IT model for Sexuality Counseling, but they’re only trained to perform the first three steps (P-LI-SS). Sex therapists are the only ones who can also provide the last step (IT), according to the AASECT. This may be a bit confusing, so let’s break down this model.
The first step, denoted by the letter "P," stands for "permission." Practitioners must create a comfortable environment of permission for their clients to open up about their sexual concerns. The second step, LI, means "limited information." As such, practitioners must address specific sexual concerns and try to debunk any myths and misinformation about them. Next comes SS, or "specific suggestions." Practitioners must compile a sexual history of clients by defining clients’ issues and concerns, determining the evolution of those issues over time, facilitating clients’ understanding of their key issues and offering options to resolve those issues, and helping clients develop "realistic and appropriate goals" to tackle their problems.
Lastly, sex therapists cover IT, or "intensive therapy." As part of this therapy, practitioners must provide specialized treatment for complicated cases that are exacerbated by other complex issues like psychiatric diagnoses (depression, anxiety disorders, substance abuse, et cetera). When choosing a sex therapist, it’s important to make sure that they are trained on the entire model.
What is your area of expertise?
Even among sex therapists, there are various areas of expertise. According to the Modern Sex Therapy Institute, sex therapists can become certified in LGBTQIA therapy, alternative relationships therapy, medical sexology, and more. So while some might be specialized in sexual trauma and abuse, for example, others might be specialized in sexual dysfunction. That’s why it’s important that you look for a sex therapist who can help you tackle the specific issues you’re experiencing. And, of course, just because a therapist works for one person, that doesn’t necessarily mean they’ll be the best fit for you.
Zencare explained that "therapists differ in their approaches to addressing sexual health related concerns," though "a therapist who has training specifically in sex therapy and sexual concerns will likely have the knowledge and skills to help you through your challenges." Don’t be shy about asking your sex therapist about their credentials. And be sure to do your own research to better determine if a specific therapist will meet your needs.
What is your educational background and work experience?
Understanding your sex therapist’s educational background and work experience can also provide you insight into their expertise. While their title and credentials can say a lot, diving a little deeper could really benefit you.
While they may be certified in helping clients who’ve experienced sexual trauma and abuse but their work experience has largely been with heterosexual clients and you identify with the LGBTQIA community, they may not be the right sex therapist for you (via Gay Therapy LA). Sure, they may be qualified to help you, but you may simply feel more comfortable with another therapist who you feel just "gets" you more.
Also know that if you do begin working with a sex therapist and feel at any time that the sessions are not serving you, you can seek therapy elsewhere. Your therapist may even recommend other professionals that better fit your needs.
How will you handle my specific concerns or interests?
Just as the American Psychological Association comprehensively details the various ethical standards that therapists of all types should meet in its Ethical Principles of Psychologists and Code of Conduct, the American Association of Sexuality Educators, Counselors and Therapists (AASECT) follows a Code of Ethics. This code applies to all certified AASECT members, and "encompasses any activity that directly or indirectly relates to professional identity or training."
"Through setting forth standards of ethical conduct for practice-related conditions, qualities, skills and services, the Code is intended to assist AASECT certified members with judgments made in the course of their professional services," the Code of Ethics reads. "Certified members of AASECT, in the conduct of all aspects of their life that relates to their professional work and identity, are expected to honor the Code."
You’ll want to make sure the sex therapist you choose follows these ethical guidelines. It may be a good idea to ask your potential therapist how they work with particular aspects of sexuality. As Psychology Today explained, "An ethical therapist will never try to ‘rid’ you of your sexual identity or erotic interests. This is misinformed therapy and offensive."
How much do you charge per session?
The fact of the matter is that therapy isn’t cheap. "Depending on location, sex therapy costs $100 to $200 an hour," according to Psychology Today. You’ll want to know how much your therapy will cost you in order to make a more informed decision. And, of course, you’re entitled to learn all the fees and billing practices upfront.
If your therapist doesn’t share this information with you right from the start, you should absolutely ask them about the fees you can expect — as well as when and how often you can expect them. The Mayo Clinic recommends questions such as: "How much do you charge for each session? … Will I need to pay the full fee upfront?"
If you find the sex therapist’s fees unmanageable for you or their billing practices conflict with other billing schedules you already have, you may be able to work out solutions — or you may have to seek therapy elsewhere. Regardless, it’s best to find out the cost before you’re presented with the bill.
Do you accept my health insurance?
While some insurance providers and plans may cover sex therapy, not all do (via Psychology Today). If you have health insurance, you’ll want to ask your sex therapist if they accept yours. If they do, this can significantly cut down costs or even cover your therapy treatment entirely.
Depending on your sexual concerns and overall health, you may need to see your sex therapist in conjunction with other healthcare providers, like your primary care provider, a psychiatrist, a psychologist, a physical therapist, or other professionals, according to Columbia University. If this is the case, this may affect how your insurance provider does or does not cover your sex therapy sessions.
To make your search for a sex therapist within your insurance network easier, you can search for one through your insurance company. Many insurance providers offer online search tools to find healthcare providers in your area. Or, of course, you can call them up directly to ask for help in pointing you in the right direction.
What can I expect from sex therapy?
Sex therapy, as a whole, exists to help individuals and couples navigate issues regarding their sexual health or sexual relationships. Most first-time sex therapy sessions should start with questions about your health, sexual background, sexual preferences, sexual education, sexual beliefs, and sexual concerns.
After your therapist gets a good grasp on your overall situation, they may choose from a variety of different therapy methods to help address your concerns regarding sex, according to Zencare, a resource to find therapists near you. "In later sessions, you’ll dive into more contextual details," Zencare explained. "As you grow more familiar with your therapist, you can expect to talk about … subjects in more detail and delve into your feelings (and those of your partner[s]) about them."
It’s important to understand what you should expect from each of your sessions. You should ask your therapist how you should prepare for your upcoming sessions, how long and how frequently these sessions will be, as well as how they will be structured.
What approaches to sex therapy do you use?
According to Zencare, a resource for finding therapists, sex therapists use a number of different approaches to sex therapy. Typical approaches include cognitive behavioral therapy (CBT), mindfulness-based stress reduction (MBSR), interpersonal psychotherapy, and psychodynamic therapy.
If your therapist uses CBT, they may help you to identify your thinking and behavioral patterns, understand how they impact your mental health and sexual experiences, and incorporate techniques to improve it all. MSBR is the most common mindfulness practice treatment, according to Zencare. With this type of therapy, your therapist will help you incorporate exercises and activities to become more mindful of the triggers and patterns that are affecting you, which can help to alleviate the stress and anxiety surrounding them. In interpersonal psychotherapy, your therapist will focus on helping you build interpersonal and communication skills to strengthen your sexual relationships. And lastly, psychodynamic therapy is a kind of "talk therapy" with which you may be more familiar. Your therapist will help you dive into the unconscious factors that help shape your mental and physical health, including your sexual health.
Talk to your sex therapist about which approach or combination of approaches they use and why. It’s important that their approaches align with you.
What else can sex therapy help me with?
Contrary to popular belief, sex therapy isn’t only for helping couples have more fulfilling sex lives together. Sex therapy can help you navigate a whole host of curiosities and concerns about sexuality and sex (both solo and partnered sex!). According to the International Society for Sexual Medicine, sex therapy can also help people with hyper-specific experiences including anorgasmia (trouble reaching orgasm), sexual health management following surgeries like penis enlargement, sexual behavior, cancer-related sexual health issues like testicular cancer, and so much more.
Talk to your sex therapist about what kinds of conditions and concerns they’re used to helping clients resolve. You never know if they’re going to say something that resonates with you. Perhaps, for example, you seek a therapist to talk about your low libido, but you didn’t realize that you could also talk to your therapist about the desire discrepancies in your relationship that could be contributing to your low libido. Asking your sex therapist questions about their experience could lead you to getting even more out of your therapy.
How long should I expect to be in sex therapy?
Sex therapy certainly can be effective for anyone of any gender, age, or sexual orientation (via Mayo Clinic). In fact, research published in the Journal of Sex & Marital Therapy found that individuals who undergo sex therapy report enjoying sex more and experiencing lower levels of sexual dysfunction after treatment. Still, because sex therapy is such an umbrella term, it’s difficult to precisely assess just how effective it is.
And it might not be the right kind of therapy every person needs. If, for example, you’re dealing with depression that happens to be hurting your sex life, you may be better off talking to a therapist who can more comprehensively address depression’s impact on your relationships as a whole — not just the sexual aspect of them (via Healthline).
If sex therapy does seem like the best fit for you, you should know you won’t necessarily have to pursue therapy indefinitely. According to Columbia University, sex therapy usually lasts somewhere "between five to 20 hourly sessions, often scheduled twice per month." As the Mayo Clinic advised, ask your therapist, "How long might I expect treatment to continue?"
What is your availability?
Finding out your sex therapist’s availability is critically important, according to Taylor Counseling Group. If they’re only available in the evenings, but you or your partner (if you choose to go with a partner) cannot make their openings because of work or other obligations, you won’t be able to meet on a consistent basis.
Similarly, if they’re only available in the mornings but you just don’t want to go in the mornings simply because you’re not a morning person, you should probably find a therapist who has other time slots available. At the end of the day, you want to be sure that you can commit to your sex therapy sessions on a regular basis. Sure, things come up and life happens, so there may be times when you have to rain check an appointment here or there. But if you have any scheduling conflicts upfront, they’ll definitely pose problems.
However, even if you do find a therapist that fits your schedule perfectly, be sure to ask about the cancelation policy, advised the Mayo Clinic. This may help you avoid any surprise fees on the rare occasion when you do need to reschedule a session.
Schedule consultations to ask questions to multiple sex therapists
Confidentiality is so important when it comes to sex therapy. You’ll want to feel safe and secure in your sessions so that you can truly open up in a vulnerable way. Only then can you and your therapist work together to tackle your sexual concerns.
The American Association of Sexuality Educators, Counselors and Therapists’ Code of Ethics suggests that psychologists may only share the minimum necessary information. "The certified member shall, when providing professional services in a group context or to a couple or family, make a reasonable effort to promote safeguarding of confidentiality on the part of each consumer in the group, couple or family," the code stipulates. Confidentiality policies may vary depending on your situation. For example, a therapist may be required by the law in your state to disclose information if you or someone else is in "clear and imminent danger of bodily harm."
Even with these strict confidentiality practices in place, though, you’ll want to make sure you feel comfortable speaking openly with your sex therapist. "I personally think you should try to see two to three therapists for an initial consultation if possible," sex therapist Megan Fleming told Everyday Health, as multiple consultations can help you find the person you’re most comfortable with.