In this month’s Ask a Therapist, we’re joined by The Expansive Group therapist and coach Mary Hellstrom, MA, LMFT, CST (she/her), who shares her process in becoming a Certified Sex Therapist. Please note that the responses on our blog segment “Ask A Therapist” are not therapy, medical advice, or crisis management.  

A reader reached out with a question:

I want to know how to become a sex therapist. I am a therapist already but I am not clear about the steps to becoming a sex therapist or even all that it entails. I would love to do what you all do, but I am not sure where to turn for insight.

Dear Reader,

It’s so fun to hear that you’re intrigued by and looking into sex therapy. Congrats on getting closer to finding your niche! You’re a therapist, so I’m sure you’re familiar with the fact that there’s certifications and licenses and training and formal titles and specialties, and out-of-scope topics, etc. etc. etc. 

Sex therapy falls into this pool of logistics. There’s a difference between a therapist providing sex therapy and a therapist being a Certified Sex Therapist (CST). Let’s explore the difference together. 

I’m joined by one of our Certified Sex Therapists, Mary Hellstrom, who’ll lay out her reasoning and process in becoming a CST. She’ll also share the perks and downfalls of pursuing formal certification.

Some therapists provide sex therapy even if they’re not Certified Sex Therapists. 

When it falls in line with their scope and skillset, mental health therapists who address sex therapy topics in sessions are technically providing sex therapy, even if they aren’t formally certified. A therapist that completed formal AASECT (The American Association of Sexuality Educators, Counselors, & Therapists) certification is a Certified Sex Therapist. 

In other words, a therapist can provide sex therapy without completing full certification, they just can’t be using that formal title! 

Mary shared an important reminder: 

“Sex therapy certification should be viewed as a tool for connection and serving clients, not as a badge signifying that a therapist certified in sex therapy is any more knowledgeable or skilled than a sex therapist who is not certified.” 

Mary explained to me that sex therapy is a super broad specialty. It includes anything a client may want to discuss related to sexuality or gender. These topics can go in so many directions! Sex therapy sessions may cover topics about:

• partnered sex
• solo sex
• gender identity and expression
• bodily autonomy
• exploring sexual identity
• sexual trauma 
• shame
• unwanted pain
• sexual challenges 
• and sooooo much more

Therapists who provide sex therapy also provide standard mental health therapy. Most of the time, clients who pursue sex therapy end up talking about and exploring things that aren’t directly related to sex, too._‍

_{Becoming an AASECT Certified Sex Therapist takes a minimum of two years.}

‍ASSECT is the only board that governs this type of licensure so, no matter what, you’d be going through them.

AASECT has three certification types: 

1) AASECT Certified Sexuality Educator

2) AASECT Certified Sexuality Counselor

3) AASECT Certified Sex Therapist

Mary pursued the Sex Therapist certification and, while this takes a minimum of two years, she slowed down the process for herself and spent three and a half years completing this process. During this time, post-licensure therapists complete coursework training, supervision, experience with clients, and final approval by AASECT. 

To find the most up to date information about the requirements to become a CST, visit the AASECT website.

The Pros and Cons of Becoming a Certified Sex Therapist: 

A big pro: The process of becoming a CST gives therapists a place to connect with like-minded colleagues.

“The main benefits consist of community and connection,” Mary told me. Naturally, through all the coursework and supervision, people pursuing their CST end up surrounded by fellow Certified Sex Therapists (and CSTs-to-be). Mary and her cohort still share resources, provide therapeutic support, and even vacation together once a year!

Being a part of the CST network exposes students to many of the leading therapists, authors, and researchers in the field of sex therapy, which can lead to real enriching educational opportunities. 

When it comes to diversifying where you find your therapy clients, Mary shared that “becoming certified will also land you on some great referral lists associated with the certifying body, AASECT.” Some therapists decide to pursue certification with the main purposes of being more appealing and approachable to potential clients.

A real downfall: Certification can take a toll on your finances, time, and energy!

Taking the required courses and attending the required supervision adddddds up! Becoming a CST definitely isn’t feasible and accessible for everyone. It costs *thouuuusands* of dollars to pay for all the courses, supervision, application fee, and renewal fees. Which is why it’s important to remember that there are lots of therapists who aren’t Certified Sex Therapists but are still experts in the field.

In addition to the resources needed to get this certification, Mary reminds us “sex therapy certification exists within the realm of our society’s flawed mental health industrial complex.” In other words,  this formal process definitely includes elitism and a curriculum that’s influenced by heterocentric and eurocentric ideas sprinkled in with some patriarchy and white supremacy.  It’s important to call out that you may learn perspectives that are not multicultural and anti-oppressive.

Finding supervisors, authors, and consultation groups who prioritizes decolonial perspectives and practices is super helpful and important!

So, You Want to Become a Certified Sex Therapist? Here’s How: 

This checklist is for folks who are already certified therapists with a master’s degree + two years of post-grad professional experience or a doctoral degree + 1 year of clinical experience.

• Read the certification FAQ
• Become an AASECT member
• Take 90 hours of AASECT approved academic coursework (read “Alternative Method of Acquiring Hours” on this link to see other ways you can fill some of these hours)
• Complete a minimum of 60 hours of sex therapy skills training
• Complete 14 hours of “Attitudes and Values Training,” which is done in a structured group setting
• Complete 50 hours of supervision with an AASECT Certified Supervisor, for a minimum of 18 months
• Submit your application 
• Once accepted, you’ll be on the AASECT Membership Directory and you’ll need to renew your application every three years

This list was created in June 2025. Check the AASECT website for the most accurate guidance.

Looking for Queer-Affirming Therapy or Coaching? We’re Here to Help.

If you’re looking for extra support, we’ve got a team of therapists and coaches who can provide the tools and space to explore this further. All of our offerings are affirming of neurodiversity and multicultural identities, are affirming of sex and non-traditional relationship structures, and are supportive of queer and trans identities.

You can connect with one of our therapists or coaches using our intake form. We offer individual and relationship support. In addition, check back regularly for support group openings where you can be in community while healing. 

Have questions for a therapist? Want to see it answered in our Ask A Therapist column? Submit your question here!

Photo Credit: Sex Education