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Ask A Therapist: What to expect the first time you go to sex therapy.

Discover what sex therapy is and why it might be right for you. It's less intimidating than you might think.

A certified sex therapist answers your questions about sex therapy.

Have you ever wondered what it’s like to go to sex therapy? Are you curious about whether your personal concerns qualify for  sex therapy? Well you’re in luck, because The Expansive Group (TEG)’s clinical manager and AASECT-certified sex therapist, Leah Hoane, LCPC, CST, is here to answer your burning questions about sex therapy.

What exactly is sex therapy? 

Sex therapy is a therapeutic intervention primarily focused on intimacy, identity, and a client’s relationship to sex and their body. As Leah explains, “It’s important to define sex therapy because it’s a common misconception that sex therapy strictly involves talking about sex. Overall, sex therapy is psychotherapy with a provider who is trained and specializes in human sexuality.”

Why might someone decide to see a sex therapist?

Many people may think that you should only see a sex therapist if you’re having “problems” with sex; however, sex therapy can also be a place to expand and explore your sexuality and your identity. 

Leah shares that some of the common reasons clients may seek sex therapy are: “exploring gender, sexual, and affectional identities; discussing relational dynamics, nonmonogamy, or kink; exploring the many facets of desire and attraction; navigating play, intimacy, or sexual challenges; or processing trauma and past experiences.” While sex-related discussions may be part of your work with a sex therapist, you may also seek to understand how sexual health and identity impact your life more broadly. 

So does that mean sex therapy isn’t that different from normal therapy?

In a typical therapeutic response, it depends. As Leah explains, “Outside of the sex therapy realm, it’s not uncommon for providers to avoid the topic of sex altogether—whether due to graduate programs not offering adequate courses in human sexuality or general discomfort”.

An unfortunate reality is that many therapists lack adequate training in sexuality, particularly around queer and trans sexualities. Many clients at TEG come to our practice because it is sex positive and queer-centered. We’ve heard countless stories from our clients who have been motivated to connect with our practice because of unaffirming or harmful experiences with previous therapists who didn’t have adequate training about sex, sexuality, or LGBTQ+ experiences. If you’ve had therapists or medical providers who invalidated your identity, experiences, pain, or needs, or met you with shame, it may be valuable for you to find a qualified sex therapist who has an informed and non-judgemental approach to addressing sexuality-related topics. 

What qualifications should I be looking for in a sex therapist?

The American Association of Sexuality Educators, Counselors and Therapists (AASECT) is the major accrediting body for sex educators, counselors, and therapists in the United States. If a therapist is AASECT-certified, you’ll see the letters “CST” in their professional credentials, which stands for “Certified Sex Therapist.” 

Being AASECT-certified means a therapist has completed AASECT’s continuing education and supervision requirements, and submitted for certification. If a therapist isn’t AASECT-certified, this doesn’t necessarily mean they aren’t knowledgeable around issues related to sexuality. In this case, you can ask your therapist what formal education or training they have that qualifies them to provide sex therapy services.

It’s also important to consider your specific needs. Just because someone is a CST doesn’t mean they have particular expertise in working with people who share your identities or needs. For example, if you’re hoping to explore your trans identity, look for clinicians who have particular experience supporting trans clients and gender exploration. If you and your partner/s want support navigating differences in desire and ways to reconnect intimately, look for clinicians who work with people in relationships. Seeing the “CST” letters may give you information that someone is certified, but the best way to decide if someone is a good fit for you is by reading their bio and asking to have a consultation call to learn more about how they work and who they work with as a sex therapist. 

What can I expect at my first sex therapy session?

Below, Leah shares about their personal approach to sex therapy and what to expect in your first session:

"My approach to sex therapy is sex-positive, queer-celebratory, and kink-aware. When seeing a new client, I typically start by asking what they are looking to get out of the first session, making sure to hit points that feel important to them from the start. Oftentimes, folks bring in experiences that make it difficult to reach for support, and my mission is to create a space that feels collaborative, safe, and liberating. We’ll explore their goals, steps that led them to seek services, and previous experiences with therapy and/or medical care. 

With sessions typically being 45-50-minutes long, we often just scratch the surface of the concern in the first meeting, so I like to leave clients with something to reflect on outside of the session,  whether that’s a reflection question, an activity or tool to practice, or an assignment to maintain connection with themself or their partner(s), all depending on the context of the session and the needs of the client.

Regardless of what clients are experiencing, I invite and encourage them to embark on the tender journey that is sex therapy – to explore the complexities of sexuality and break free from narratives of shame, loneliness, and stigma. "

If your interest has been piqued and you’d like to connect with Leah or another member of our team for sex therapy (or a different form of therapy!), please fill out our
intake form.

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