How Is Sex Therapy Different From General Therapy?

The training behind the title

Last week, I became an AASECT-certified sex therapist! To earn this certification, I completed 165 hours of continuing education, 300 clinical hours of sex therapy, and 50 hours of supervision. I’m also required to complete 20 continuing education credits every few years, on top of everything required to maintain my clinical social work license…Phew!!

I’m incredibly excited, not just because this certification represents years of training, but because it allows me to better support clients navigating concerns related to sexuality and intimacy.

What’s the difference between a general therapist and a sex therapist?

The straightforward answer is that sex therapists receive specialized training in sexual health, intimacy, desire, communication, sexual functioning, and the psychological, relational, and emotional patterns that shape our sexual lives. 

That training equips me to treat concerns like pain during sex, erectile difficulties, desire discrepancies, disability and sexuality, perimenopause and menopause, anorgasmia, sexual shame, and many other sexual health concerns.

But I usually like to give the long answer too, because when people ask this question, they often want to know what the difference means in practice.

Nothing is too awkward to talk about

In many ways, sex therapists are not so different from other therapists. I still support folks through things like anxiety, depression, stress, life transitions, and relationship challenges. A general therapist may be a great fit for many relationship or mental-health concerns. But when sexuality, intimacy, desire, sexual confidence, communication about sex, or sexual functioning is a central concern, a certified sex therapist brings specialized training and attention to that part of your life.

As a sex therapist, I’m extremely comfortable talking about all things having to do with sexuality. Seriously, I don’t think you can say anything I haven’t heard some version of before. I will never minimize your concerns or treat sexuality as an uncomfortable side topic. I also understand that there is no single “normal” level of desire, frequency of sex, relationship structure, or way to experience intimacy. My role isn’t to pathologize your sexuality or tell you what it should look like, but to help you understand yourself and build a sexual life that feels authentic to you.

Seeing the whole picture

In general therapy, conversations about sex often only happen if a client brings them up. In sex therapy, sexuality is considered a normal part of being human. Rather than avoiding the topic or treating it as separate from the rest of our mental health, I intentionally make space for those conversations whenever they’re relevant.

I take a holistic approach because sexuality is deeply connected to the rest of our lives. Stress, grief, identity, disability, body image, trauma, and culture all shape our sexual selves. Sometimes people come to therapy because of a sexual concern and discover that other parts of their life are affecting their intimacy. Other times, people come in for something seemingly unrelated and realize that their sexuality is connected to what they’re experiencing. Exploring those connections can bring a deeper understanding of what’s really going on.

Pleasure-centered healing

Sex therapy can help you put words to what you want, what you don’t want, and what helps you feel emotionally and physically secure. It offers a safe place to discuss subjects that can feel too vulnerable, embarrassing, or complicated to talk about with friends, family, or even a partner.

I help people explore their relationship to pleasure, both erotically and non-erotically: what feels good, what doesn’t, what feels uncertain, and how their life experiences shape those feelings. Sex therapy can help you understand yourself with more compassion, communicate more confidently, and build a life that feels authentic and pleasure-centered.

What actually happens in a sex therapy session?

One of the biggest misconceptions about sex therapy is that it involves nudity, sexual touch, or watching people have sex. It doesn’t. 

Sex therapy is a form of talk therapy, so we’ll probably be talking a lot! But sex therapy isn’t just talking about sex. Depending on your goals, we may use structured exercises, communication practices, mindfulness, values exploration, or other interventions that are specifically designed for your sexual concerns. Sometimes I’ll suggest exercises or conversations to try between sessions, but everything we do is always collaborative and at a pace that feels doable for you.

Sex therapy is for everyone

Anyone can benefit from sex therapy. You might be partnered or single, allosexual or on the ace spectrum, exploring your sexuality, or feeling disconnected from it.

Many of us grew up in a sex-negative culture that taught us to feel shame around our bodies, desires, and boundaries. This can be especially true for folks who hold marginalized identities. Sex therapy offers a space to question those messages and build a relationship with sexuality that feels more informed and affirming.

Individuals and partners come to sex therapy to feel more connected, communicate more openly, understand their desires, work through shame or anxiety, or rebuild intimacy after a change in life, health, or their relationship.

You don’t need to know exactly what’s wrong or have the right words before starting sex therapy. Many people come in just knowing something feels “off” and we figure it out together.

An invitation

If working with a certified sex therapist sounds like something that might help, I invite you to reach out. I work with many kinds of clients in sex therapy, and I especially enjoy supporting queer, trans, and neurodivergent folks.

I’m licensed to see clients online anywhere in Illinois or Colorado.

In solidarity,

Marlee