What is Sex Therapy?
Dossie Easton, author of what is commonly known as the polyamory bible, The Ethical Slut, recently told me that, back in the 70s, she was the only ‘out-of-the-closet BDSM therapist in San Francisco.’ “I even got written up in the Chronicle about it,” she said. “And now there’s tons, which makes me very happy.”
It’s true—cities like San Francisco and New York City nowadays have lots of kink-positive, LGBTQIA+ allied sex therapists.
This is all to say that sex therapy, as we know it today, is a newish field. Many people don’t even know what sex therapy is.
When I was in graduate school for marriage and family therapy, for example, I was surprised when I learned that I could have an emphasis in Sex Therapy. I was thrilled about it, as well as a little embarrassed. I remember sheepishly telling my internship advisor, “I know that it’s weird, maybe, but I’d like to focus on sex therapy.”
“It’s not weird,” she said to me.
And, of course, it’s not. But I had somehow been enculturated to believe that I shouldn’t want to spend my days reading and talking about sex—I should keep that to myself.
I’m so grateful that I followed my instinct, not my fear or shame, because I really love conducting sex therapy.
Which brings me to the question I’m posing here: What is sex therapy? And who should go see a sex therapist?
While there are credentials a sex therapist can have—AASECT Certification is pretty much the highest level, though you can also get a PhD in Human Sexuality or a related field—my sense is that a sex therapist (or a good one, at least) is a licensed therapist who has the following: significant training and education in human anatomy, sexual attitudes, practices, and beliefs; an open-minded attitude about all of the above; years of supervised experience conducting sex therapy; and skill and comfort in constructively discussing sex and all that comes with it.
That education and experience is important. Personally, I have trained and consulted with some of the biggest names in the field including Ian Kerner, Suzanne Iasenza, and Daniel Watter. I also continue to get sex therapy supervision with renowned sex therapist, Jillien Kahn. Sex therapy is intimate and delicate, and, on the part of the therapist, it requires a lot of knowledge, experience, and tact. We need all the training we can get.
People seek sex therapy for so many different reasons. They might want sex therapy because of a sexual challenge they’re facing. That might include having a low libido, erectile unpredictability (more commonly known as erectile dysfunction), vaginal dryness, desire discrepancy (one partner wants sex more than the other.) Sometimes people want to explore their kinks and fantasies, and they don’t know how to share them with their partner. Sometimes people want to explore consensual non-monogamy, and they don’t know how to get started.
I think that at the core of many of the sex therapy cases I see is, in one sense or another, some desire to better understand one’s sexuality and some guidance in doing so. So much of my work is about being present with people as they explore, discuss, and consider who they are sexually.