Where do I even begin?
Sometimes finding a good therapist can feel a little bit like trying to find the “right one” by swiping through Tinder. How do you decide who you’re going to trust with some of your most vulnerable experiences simply by reading an online bio? Don’t worry, I’m here to help you out. Here is some guidance for choosing the right sex therapist. Let’s start by talking about sex therapy.
What kinds of sex and sexuality issues can be addressed in therapy?
Sexual issues can be really specific and personal. Therapy might be helpful if any aspect of sex or sexuality is causing you ongoing emotional or physical pain (the latter may require some medical intervention as well).
Here are some reasons that people might seek sex therapy:
- Dissatisfaction with level of sexual desire
- No longer attracted to partner
- Desire to explore and develop sexual self
- Processing shame related to sex
- Dissatisfaction with sex/sex drive after pregnancy/children
- Mismatch in sexual desire between partners
- Questioning sexuality and/or gender identity
- Processing sexual assault, trauma, or unwanted sexual touch
- Chronic pain that inhibits sex
- Anxiety, depression, or other mental health issues that inhibit sex
- Inability to orgasm
- Erectile dysfunction
- Premature ejaculation
- Sex is physically painful
What are my options for sex therapy?
Though most licensed therapists have training in human sexuality, there are some different options to consider when choosing someone to help you work on sex-related issues.
Individuals who brand themselves as sex therapists will likely have more training in sex-related topics. If you’re looking for a reliable accreditation, The American Association of Sexuality Educators, Counselors, and Therapists (AASECT) certifies therapists who have completed extensive training in sexuality. An AASECT certified sex therapist will have received extra education in areas of sexual dysfunction, sex and gender identity concerns, trauma, and partner intimacy issues. Compared to general therapists, they will have more experience with diagnosable sexual dysfunctions such as erectile disorder, female orgasmic disorder, genito-pelvic pain, early ejaculation, etc. They may be a good choice when you have a concern about sexual function.
A couples therapist should be able to address sexuality issues that are likely to come up between romantic partners such as a mismatch in sexual desire, unsatisfying sex between partners, difficulty balancing sex life with other relational/family responsibilities, etc. However, couples therapists may not have extensive training in specific sexual dysfunctions, individual sexual concerns, or sexual trauma. It’s a good idea to ask a potential couples therapist about their approach to sexual issues.
A general therapist who is competent in your area of concern and who you have a good connection with can be as helpful as a specialized sex therapist. Just make sure you look for someone who markets themselves as having experience in addressing sex and sexuality. Then ask them questions (examples below!) about how they would treat your concern.
A Note on Sex Surrogates
On occasion, sex therapists are confused with sex surrogates. Sex therapy never includes nudity, sex, or any type of sexual touching in the presence of a therapist. A sex surrogate is a trained professional who does engage in sensual and sexual touch with the client in addition to communication and relaxation coaching. Sex surrogates predominately work in tandem with a therapist who helps the client process the sex surrogate experience.
How do I know if a therapist is qualified to help me with sex and sexuality?
Therapists are incredibly diverse in how they practice. Asking potential therapists questions can give you a sense of their experience, their approach to human sexuality, and their personality. A good therapist will be comfortable and happy to answer your questions.
First, ask yourself these questions:
- What are my goals in therapy? If therapy is successful, what concrete changes will I see in my life that will let me know therapy worked?
- What characteristics tend to make me feel safe and supported when I am being vulnerable? This will be very personal. Some therapists are warm and fuzzy. Some are very direct. Some will share their personal experiences with you while others remain strictly professional. Some will have identities that intersect with yours and, of course, others will not. Think about what personal characteristics will create an open space for you to share.
Once you’re ready to speak to a therapist, here are some questions for finding a good fit:
- What types of clients do you typically work with? and/or What types of problems do you typically treat?
- What is your approach to working with [my concern]?
- What do you think of as healthy sexuality?
- Would you be able to suggest any resources that would give me more info on [my concern]? A therapist who has experience and knowledge in a certain topic should be familiar with and able to suggest quality online and/or community resources.
- Finally, ask any other questions that are important for you to answer about a potential therapist.
In general, you are looking for a therapist who focuses on clients that you can relate to and describes an approach that makes sense to you. If they have a lot of experience addressing your specific concern, that’s great! However, if they have a lot of experience in the general area of your concern (for example: relationships, sexual function, or anxiety), that’s probably enough. Finally, you want to make sure that you work with someone who shares your values around sexuality. In general, as long as sexuality is expressed in a way that is consensual and not causing unwanted pain, there is absolutely nothing wrong with it! Be wary of therapists who seem to have very specific ideas of what types of sex/sexuality are “right” or “healthy.”
Evaluate the Fit
Once you meet with a therapist in person, check in with how they made you feel. Uncomfortable emotions and challenges are part of therapy, but you should feel supported by your therapist. After your first session, ask yourself if you felt a connection with your therapist and whether you would get value out of going back. If the answer to either of those questions is no, move on and look for someone else.
Header image illustrated by Marcy Gooberman