What actually happens in sex therapy?
Myths vs. reality
Sex therapy is one of the most misunderstood forms of mental health support. Here's what it actually involves — and what it definitely doesn't.
When people hear "sex therapy," the reactions range from nervous laughter to timid curiosity to full alarm. Pop culture hasn't been kind to the field — sex therapy in movies and television tends to be played for awkward comedy or depicted in ways that bear no resemblance to how it actually works. The result is that a lot of people who could benefit from sex therapy never pursue it because they have no idea what they'd be walking into.
So let me be direct: sex therapy is talk therapy. There is no physical contact, no demonstration, no observation of sexual activity. It is a conversation — a skilled, informed, non-judgmental one — about your sexual and relational experiences. That's it.
Myth #1: Sex therapy involves physical activity or touch
This is the most persistent misconception. Sex therapy as practiced by licensed mental health professionals — therapists, psychologists, licensed counselors — is entirely verbal. Sessions take place in an office or, in my case, over a secure video platform. You talk. I listen, ask questions, offer frameworks and reflections, and we work together on whatever you brought in.
There is a different field called sexology or surrogate partner therapy that may involve physical exercises, but this is distinct from licensed psychotherapy and operates under different professional and ethical guidelines. I practice as a psychotherapist, and everything I do is talk-based.
Myth #2: Sex therapy is only for people with serious problems
Clients come to sex therapy across an enormous range of concerns — some acute, some simply curious. I work with people navigating desire differences in long-term relationships, people exploring their gender or sexual identity, couples wanting to deepen their intimacy, individuals processing past experiences that have affected their relationship with sex, and people who simply want to understand themselves better.
You don't need to be in crisis to benefit from this work. Many of my clients describe their primary feeling not as distress but as stuck — a sense that something in their intimate life isn't quite working and they don't have the tools or language to address it on their own.
Myth #3: Sex therapy is only for couples
I work with individuals as much as I work with couples and multi-partner relationships. Individual sex therapy can be valuable for processing how your history has shaped your sexuality, understanding your own desire patterns, exploring identity, preparing to have difficult conversations with a partner, or simply developing a more compassionate relationship with your own body and desires.
Myth #4: A sex therapist will judge me
I want to be honest about what I mean when I say non-judgmental, because it can sound like a platitude. In my practice, "non-judgmental" means that kink, non-monogamy, gender exploration, sexual orientation questioning, unconventional desires, and complicated histories are not treated as problems, red flags, or things to talk you out of. They are treated as the full texture of human sexuality — which is what they are.
Researcher and author Emily Nagoski writes in Come As You Are that nearly every aspect of human sexuality that isn't directly harmful to others exists on a normal distribution somewhere in the population. I keep that orientation close in my work. Your desires and experiences are more common than you've been led to believe.
What sex therapy actually addresses
To give you a concrete sense of what people bring to sex therapy, here are some of the areas I work with regularly:
Desire discrepancy and mismatched drives in relationships
Reigniting intimacy in long-term partnerships where sex has faded
Sexual anxiety, shame, or difficulty with arousal and pleasure
Gender dysphoria and identity exploration
Sexual orientation questions
Kink and BDSM dynamics — both starting out and navigating within relationships
Non-monogamy, polyamory, and relationship structure exploration
The relational aftermath of infidelity, major disclosures, or significant breaches of trust
The impact of religious trauma and purity culture on sexual freedom
Communication and intimacy skills, often using the Gottman Method as a foundation
What to expect in a first session
In an initial session, I'm mostly listening. I want to understand what brought you in, what you've already tried, and what feels most alive or most stuck for you right now. There's no pressure to share anything before you're ready, and nothing you say will change the quality of care I offer you. We move at your pace.
Most people tell me afterward that it felt less scary than they expected. That the thing they'd been carrying alone for months or years was actually speakable — and that speaking it to someone who wasn't rattled by it made an immediate difference.
That's what I'm here for.
Curious about what sex therapy could look like for you?
I offer a free, no-obligation consultation so you can get a sense of how I work before committing to anything. I practice via telehealth throughout California and work with individuals, couples, and relationships of all configurations.
