Sex Therapy Might Not Be As Sexy As You Think

Photographed by Natalia Mantini.
On an episode of Broad City from last season, Ilana visits a sex therapist for a very understandable reason: She hasn't been able to orgasm since Trump was elected. During her session, Ilana frustratedly uses a vibrator as her sex therapist watches and shines a flashlight on her genitals. After some time, the very woke sex therapist helps Ilana rise above the trauma that "a sexual assault-bragging steak salesman has become our president," and eventually, Ilana orgasms.
It's pretty progressive to show both masturbation and therapy (at the same time!) on TV, but Broad City doesn't paint the most realistic picture of what actually goes down in sex therapy. So, what is sex therapy, anyway? Simply put, sex therapy is therapy that focuses on your sex life, which can include sexual orientation, sexual function, arousal, kink, sexual health, relationships — and everything in between. Sex therapy sessions are different for everyone, because sex is different for everyone. And while some people do go to sex therapy for reasons like Ilana's, her experience is just one person's.
Given that, we asked real sex therapists to share the biggest misconceptions people have about sex therapy, and what really goes down in a session.
1 of 7
There's usually more to it than just sex.

While sex therapists are specially trained to assist with sexuality issues, they typically end up talking about other aspects of life that influence your relationship to sex, says Kristen Lilla, LCSW, an AASECT-certified sex therapist and sexuality educator. "There are usually more layers to the problem, and we have to work through other things, too," Lilla says. "It's rarely just about the sex." At the end of the day, a sex therapist is a therapist, so they're usually comfortable helping you with other emotional issues you may be dealing with.
2 of 7
There's no hands-on component.

Though Ilana's sex therapist observed her masturbating, professional sex therapy should only ever include talking, says Vanessa Marin, a sex therapist who specializes in teaching women how to orgasm. "There are sexual surrogates who do hands-on instructional work, but that's different from sex therapy," she says. That said, a sex therapist may recommend specific exercises or techniques to try outside of the sessions. But in the office, you can keep your clothes on and simply talk.
3 of 7
You don't have to wait until there's a problem.

It's important to remember that you can seek sex therapy in positive contexts, Marin says. For many people, it provides a safe setting to explore different aspects of sex. "Unfortunately, sex therapy isn't totally mainstream yet, so most people don't seek it out until things are at a breaking point," she says. Sex therapy can help you learn how to develop a better connection with yourself or partner, have more fun in the bedroom, come up with new ideas, or feel more authentic, she says. And the good news is that, when it comes to sex, there's always room for improvement.
4 of 7
Sex therapists won't make you do anything.

Many prospective clients worry that a sex therapist is going to recommend alternative sexual practices or force new sexual values onto them, explains Shannon Chavez, PsyD, a clinical sex therapist. But that's far from the case, and discomfort and shame are often the first things that a sex therapist will help reduce, she says. Sex therapy is a collaborative process, meaning a therapist will meet someone where they are, discuss steps of treatment, and consider multiple options if something makes them uncomfortable or doesn't seem like a fit, she says.
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You don't have to be kinky.

Some people associate sex therapy with fetishes and extreme kinks, but Marin says the vast majority of her clients have pretty run-of-the-mill concerns. For example, they may be curious how to make the time for sex, or may just feel self-conscious of their bodies while naked. If you are interested in exploring fetishes and kinks, sex therapy would certainly provide a safe outlet to do so, she says. But it's not a requisite.
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There are myriad reasons for seeing a sex therapist.

A few common reasons for seeking sex therapy include erectile dysfunction and low libido, performance pleasure, not being able to orgasm, shame and guilt, sexual trauma, body image, and/or decreased sexual frequency — but there are so many more. Most sex therapists will provide a consultation, which includes a sexual health assessment, so they can make sure sex therapy is the right fit, Dr. Chavez says. And if you decide sex therapy isn't for you, they can help refer you to other options.
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Going to sex therapy is not a sign of weakness.

Just like going to regular therapy doesn't mean you're "bad at handling emotions," going to sex therapy doesn't mean you're "bad at sex." "Sex is something that we all struggle with in one way or another," Marin says. "It's important to recognize that we all have our challenges when it comes to sex, and there's no shame in wanting advice, resources, or guidance."

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