What counts as sex therapy and what’s off-limits?

A sex therapist in Minneapolis, MN deep dives into what to expect from sex therapy as well as limitations in a sex therapy session.

 

Sex therapy can incorporate a wide range of therapeutic material- from your relationship with your own body and others’, to facets of your identity, pleasure, psycho education, past traumas, desires and so much more. 

I am a trans-affirming and trauma-informed sex therapist and I’d love to give you, dear reader, some insight into what you can expect from a sex therapy session.


It’s quite common to have the pre-therapy jitters prior to meeting your new therapist. Hell, it’s also normal to have pre-therapy jitters after meeting your therapist, when you’re wanting to bring up a new topic that hasn’t been discussed before or when you’re about to go deeper into something you’ve been discussing in past sessions. Maybe talking to someone about your issues and desires regarding sex can feel exhilarating and also absolutely nerve-wracking. What counts as sex therapy? What doesn’t? I’m here to tell you that all concerns that center sex/sexuality/sexual identity count as sex therapy and deserve the same attention in the therapy room as topics that are removed from it.


Sex Therapy ain’t that Different 

Sex therapy is not so wildly different from plain ol’ mental health therapy. Sex is just a more taboo subject due to longstanding systems that continue to devalue sex and label it as deviant. Hence the topic of sex feeling more elusive and nebulous. I’ll get off my soapbox. My primary goal as a sex therapist is to help you feel good about yourself and the choices you are making around your sexual identity. This could mean receiving support and validation around the ways you may (or may not) have sex on a variety of levels (with yourself and with others). 

If you are experiencing some sort of sexual dysfunction in your life, you will likely work with your sex therapist via learning/implementing coping mechanisms to improve sexual responses in the future, creating a sex life that feels more aligned with you. There is no one size fits all for coping mechanisms! Every body is different and every body deserves individualized care. I believe in respecting and validating all aspects of sexual and erotic identity. In session, you should expect your sex therapist to meet you where you’re at. It is so important to have a space that can be inviting to all questions. And a sex therapist should truly welcome all of them. 


Disclaimer!

When searching for a sex therapist, I believe it to be incredibly important to find someone who is explicitly anti-racist, anti-sexist, and anti-transphobic. It’s important to find someone that practices from an anti-oppressive and social justice framework. It’s imperative to find a space that is truly welcoming of all types of folks. I would even argue that it is more important to find a therapist who is inclusive and anti-racist than someone who has extensive training in many different types of therapeutic modalities. It can be great (to an extent) if you find a clinician who fits your therapeutic profile of what an accomplished therapist is. However, if your therapist cannot respect the wide range of social identities that people can hold, they are not worth your time, energy and money. 

The Beauty of Sex Therapy

Sex therapy is a trauma-informed and pleasure-focused space to celebrate you and develop deeper self-awareness with curiosity and understanding. In sex therapy sessions, one may process previous sexual experiences as well as present and future-focused desires and interests. One may receive behavioral assignments to try out (ie masturbation technique, sensual practices that incorporate mindfulness, etc). One may also interweave topics already addressed in therapy, however focusing on sexual and erotic identity (ie using EMDR to focus on a sexual abuse traumatic memory). 


Topics in Session can Truly Run the Gamut, Including—-

Orgasm difficulties 

Dissociation during sex

Open relationship and non-monogamy trouble-shooting

Trauma related to sexual experiences 

Infidelity 

Chronic illness and how it relates to one’s sexual identity (medication side effects, pain with sex, STIs) 

Desire discrepancies (low sexual desire, mismatched couple desire, increased sexual desire)

Consent and communication

BDSM and kink best practices and lifestyle affirmation

Sexual orientation development and integration

Support for sexual abuse

Purity culture 

Compulsive sexual behaviors

Body-related issues around gender transition

Masturbation difficulties

Erectile dysfunction

Sexual anxiety

See that list above! That’s a wide range of issues one could focus on during a sex therapy session. It’s also just the tip of the iceberg and not a complete or exhaustive list. 


Sex and Trauma


Within the realm of sex therapy, one can also process and explore past traumatic memories that involve sexual trauma or traumatic memories centering sexuality. The relationship between our sexual identities and traumatic pasts can often be very intertwined. A lot of my own professional development has focused on trauma and trauma-informed care. 

In my clinical practice, I utilize EMDR and Sensorimotor psychotherapy when exploring trauma with clients. EMDR can be incredibly helpful with lowering the distress of a traumatic memory leading to more positive beliefs about oneself in the world. As well, Sensorimotor Psychotherapy can focus on sexual relational issues (ie issues between people). Sensorimotor centers the body as a vehicle for trauma healing and approaches a person through a multi-faceted approach via somatic (body sensations), emotional (feeling state), and cognitive (thoughts/headspace) states for processing and integration. Trauma processing from the bottom-up helps clients get out of their heads and into their bodies, allowing for fast and comprehensive healing. Slowing down a memory and focusing on body sensations can be transformational and allow ourselves to heal from past relational wounds. 


Some Limitations of Sex Therapy

Although sex therapy can incorporate so much in the office— it does have its natural limitations. Sex therapy does not incorporate any sexual contact between therapist and client. In a sex therapy session everyone keeps their clothes on. As a sex therapist, I do not have sexual relations with my clients nor do I show anyone how to have sex. I am a sex-worker friendly therapist and believe that sex work is work. As a sex therapist, I work with sex in a clinical and not first-hand experiential manner. 


Wrap-Up

Sex therapy can sometimes feel quite daunting for someone starting their therapy journey. However, it doesn’t have to be. Again, I strongly recommend finding a therapist who is affirming of all genders, sexualities and erotic identities. If the potential sex therapist is not explicitly trans-affirming and queer-affirming, please find a different sex therapist. As well, I find it particularly helpful to look for a sex therapist who has had extensive training via a sex therapy certificate program. These types of programs are taken as a postgraduate program. If you can find an AASECT-certified sex therapist, even better! 

The world of sex therapy is quite expansive. Sex therapy can truly help with ALOT. With any therapy focus there will be some limitations. However, I believe that anyone can benefit from working with a sex therapist. 

If you’re looking for a sex therapist in the Twin Cities, please reach out to me. I have quite a referral list of great clinicians who do excellent work. As well, if you’re out of the area and would like recommendations— please hit me up! I’ll do my best to refer you to someone in your area who can point you in the right direction. 

Below I’ve added a free checklist if you’re ready to find your next sex therapist. This list explores what I would find important and helpful to know when finding a new sex therapist.


meghan@temperancetherapies.com

612.367.7286

Meeting clients at the Ivy Building (2637 27th Ave S, Suite 216 B, Minneapolis, MN 55406)

in the Seward neighborhood of South Minneapolis

—-and——

Offering online therapy within greater Minnesota

 
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