What is sex therapy?

In recent years, popular TV shows like Sex Education and Sex Love & Goop have brought the concept of sex therapy into the limelight. But beyond the screen, what exactly is sex therapy? In this blog post, we delve into the specifics of this unique form of psychotherapy, designed to address a myriad of concerns related to sexual function, intimacy, and romantic relationships.

What is Sex Therapy?

Sex therapy falls under the umbrella of psychotherapy, targeting issues such as sexual function, intimacy, and romantic and sexual well-being. It goes beyond the bedroom, addressing concerns like painful sex, erectile dysfunction, fear of intimacy, lack of desire (for those who do not identify as asexual), and challenges in identifying or communicating sexual and relationship needs and boundaries. Consider making an appointment with a sex therapist if sex does not feel pleasurable or is painful, if you’ve never felt “comfortable” during sex, if you have concerns around orgasm, or frustrations with wanting to last longer during sex. These are some of many considerations that can be addressed in sex therapy. 

Embrace Sexual Wellness has a team of therapists that specialize in sexuality-related concerns as well as a blog and an extensive resources page covering sexuality topics and mental health. If you reside outside Illinois, the AASECT certified professionals directory can help you connect with a qualified sex therapist.

Sex Therapy Certification and Professional Standards

The American Association of Sexuality Educators, Counselors, and Therapists (AASECT) is the certifying organization for sex therapists. Sex therapists, as per AASECT, are licensed mental health professionals specializing in psychotherapy for clients dealing with sexual issues and concerns. Importantly, sex therapists adhere to strict ethical guidelines and do not engage in sexual contact with their clients.

What is the Role of Sex Therapists?

Contrary to common misconceptions, sex therapists primarily provide talk therapy. Sex therapists, surrogate partners, and sex coaches play distinct roles in supporting individuals or couples within the realm of sexual health and well-being. Sex therapists address psychological and emotional aspects of sexuality, utilizing therapeutic techniques to help clients explore and resolve sexual issues, such as communication problems, intimacy concerns, or past trauma. Surrogate partners, working closely in collaboration with a licensed therapist, engage in hands-on, experiential work with clients to address both physical and emotional aspects of sexual difficulties, providing a safe space for the exploration and practice of interpersonal and sexual skills. Sex coaches focus on education, empowerment, and the implementation of goal-oriented strategies to enhance overall sexual satisfaction. They can offer guidance, information, and skill-building exercises to help individuals or couples achieve their desired sexual goals. Each of these professionals contributes uniquely to the broader field of sexuality by providing distinct approaches to address a range of concerns. The scope of this blog is referring specifically to sex therapists.

Who is sex therapy for?

Sex therapy, whether individual or couples-based, addresses a range of concerns. The duration of therapy varies based on the nature of the issues, offering tailored solutions. It helps individuals with sexual dysfunctions like erectile dysfunction or low libido. Couples experiencing challenges with communication about desires or facing relationship challenges, including infidelity or trust issues, can also benefit from sex therapy. Those who've experienced sexual trauma seek therapy to rebuild a healthy relationship with sexuality. Couples with differing sexual desires can learn to understand one other's needs. Individuals or couples may seek therapy to explore and enhance their sexual experiences. Additionally, sex therapy supports LGBTQ+ individuals facing challenges related to sexual identity and relationship dynamics, as well as those dealing with gender identity issues, including gender transition.

What happens in sex therapy?

The structure of sex therapy varies, adapting to the specific needs of the client(s). Therapists often assign home exercises aimed at managing concerns effectively. These exercises may include dedicated time for partner connection, self-exploration activities, and other assignments tailored to the individual or couple. Many therapists also offer free consultation calls where you can further discuss your concerns and determine if sex therapy, or that therapist, is a good fit for you.

Understanding the Minority Stress Model

One’s identities (race, gender, religion, and more) and their according privilege or lack thereof affect how they are treated in society. Those who belong to marginalized groups such the LGBTQ+ community and BIPOC communities, for example, are at risk for experiencing minority stress. The minority stress model is a theory that provides insight into the relationship between minoritized/marginalized and dominant groups that result in a contentious social environment for the minority group members. 

The first person to coin the term was Dr. Virginia Rae Brooks in her book, Minority Stress and Lesbian Women in 1981. Ilan Meyer’s 2003 study, Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations advanced Brooks’ research. Beyond this study, there are dozens of additional studies providing the existence of minority stress. The contentious social environment, especially prejudice and discrimination, has detrimental effects on the wellbeing of minority group members. The five types of minority stress are victimization, discrimination, heteronormative cultural norms, stereotyping and prejudice, and systematic bias. These ongoing stressors are what cause the detrimental effects of minority stress as a whole. It’s important to note that minority stress is distinct from general stress, which everyone can experience. Unlike general stress, minority stress is chronic and socially-based. The overarching social structures that create prejudice and discrimination in the first place are staples of society which means they are unending and inescapable.

Intersectional theory demands that we are, among other things, context specific. This means that people and, in the context of therapy, patients all have different needs, access, and privilege that all need to be taken into account when assessing one’s stress levels. There are a variety of theories about integrating treatment strategies to specifically target minority stress. 

One such theory is the ESTEEM model which aims to address mental, sexual, and behavioral health needs. It’s important to note that the study underlying the ESTEEM model was done on sexual minority men so while the information it generated is important, the research scope was limited. The ESTEEM model includes ten treatment modules to be conducted in one-on-one settings that range from tracking instances of minority stress in a patient’s life, discussing learned emotional responses and consequences of minority stress, and exploring the concept of emotion avoidance and emotion-driven behaviors. 

Minority stress is vital to understand for the general population and healthcare practitioners alike. The day to day effects of minority stress have significant effects on wellbeing and health which needs to be taken into account when assessing various health problems that may arise. While minority stress is unavoidable, there are self-care and professional treatment options to help work through its effects. If you’d like to speak with a professional therapist, contact the ESW team here.

Sexuality Professionals Series: An Interview with Haley Hasen

Embrace Sexual Wellness is conducting a multipart spotlight series of interviews with sexuality professionals. If you missed the previous installments, check them out on our blog. For the final installment in our interviews, we spoke to Haley Hasen, educator and erotic laborer (Haley/Haley’s).

Haley Hasen is the founder of Haleyhasenuncensored, LLC. Haley is an artist, sex educator, certified crisis interventionist, erotic laborer, and sex toy enthusiast. Haley is involved with a federal work-study with RAINN, and is an art therapy intern at the nonprofit Clean and Sober Street based in DC. Haley is studying to receive a Master’s Degree in Art Therapy at George Washington University through a trauma-informed lens. 

Erotic labor refers to any kind of sex work. This could be stripping, full service sex work, selling erotic photographs and videos, or any other kind of work that involves sex or eroticism in some capacity. The word “prostitution” is an outdated and generally disparaging term which should be avoided unless someone explicitly identifies themself as such. Erotic labor is highly stigmatized which can make these careers risky because of the lack of safeguards and regulation. At the end of the day, everyone under capitalism has to sell some part of themselves and erotic laborers are no different. Erotic labor is an entirely legitimate and valid career that does not deserve the flack it receives.

What inspired you to pursue your career path? 
I feel I came about this career path while working on healing and unlearning my sexual trauma. I really appreciate Carl Jung's idea of being a "wounded healer." I hope to create a safer space for individuals to be able to process, heal and unlearn aspects of themselves. I decided to do erotic labor as a way to reclaim my autonomy and sensuality after my sexual trauma. I wanted to have full control over that identity and I feel empowered by this aspect.   

How does your field differ from that of other sexuality professionals?
My field is different due to what I choose to disclose, educate, and advocate for. I am working within the here and now framework. I am also transparent in certain spaces about my identity as an erotic laborer; however, in most spaces I keep this identity hidden due to societal views and protection of myself. I feel I overlap in all aspects of myself and I try to formulate a truer self with one identity instead of being a multi-hat person. 

What is the most rewarding part of your career?
Empowering and creating a safer and healing space for sex workers and individuals who have and are experiencing sexual trauma. I enjoy learning from others and how they present themselves in these spaces. 

What's the most misunderstood thing about what you do?
I am not always turned on and I do not only think about sex. Furthermore, while I have gone through trauma that is not the reason I entered this space. I entered it to empower and reclaim aspects of me that were taken away without my consent. 

What's the most common question you receive from others about your career?
”Can you teach me how to have sex?” is usually peoples’ go-to question on various dating apps and it always makes me roll my eyes. 

What advice would you want to share with aspiring sexuality professionals?
You cannot educate everyone! I learned this from a dear colleague, Lindsay Wynn. 

If you had to describe your work in one sentence, what would you say?
Relevant.

Is there anything you’d like to add? 
Pay, support and uplift Black and Brown Trans Sex Workers; they are the foundation of the sexuality field and are rarely credited. 

Thank you to Haley for sharing their knowledge and expertise with us! We encourage you to visit Haley’s social media and websites, linked below. 

• Instagram: @haleyhasenuncensored

• Website: haleyhasen.com