When to Enlist a Sex Therapist

Netflix's show Sex Education has provided a phenomenal representation of sex therapy and shined a light on the world of intimacy and relationship concerns. Although season two introduced the term "sex addiction," which is problematic, I can not speak more highly of this show. Having said that, the field is still shrouded in mystery and is often misunderstood and underutilized.

Whenever I ask someone to define what they think a sex therapist does, it always boils down to them saying, "a sex therapist talks to people about sex." While this is true, it is only about half (maybe less) of what a sex therapist ACTUALLY helps individuals, couples, and polyam people work on in therapy. Below is a list of common reasons why someone would seek out a sex therapist.

Difficulties with intimacy

One of the main reasons people seek out a sex and relationship therapist is when trouble occurs in the bedroom. Arousal and desire are not linear in nature. They are dynamic and ever-changing. As humans, we love novelty, especially when it comes to sexual intimacy. We have all heard of the phrase, The Honeymoon Phase, before. This is the phase at the beginning of the relationship where there are few to no problems. It can typically last anywhere from six months to two years. Eventually, we get to know our partners and the novelty wears off. We see them at their most, and least desirable. Boredom and staleness set in and we can feel stuck. A sex therapist comes in handy during these moments because we can help explain the ever-changing nature of desire and introduce new ways of enhancing it.

Sexual dysfunctions

Sexual dysfunctions, or clinically diagnosed issues relating to sexuality and intimacy, are way more prevalent than people may think. Also, on a side note, I absolutely detest most of them as they presume that there is only one correct way of how a body part is supposed to "work" when that could not be farther from the truth. What follows is a list of what the Diagnostic and Statistical Manual of Mental Disorders (DSM 5) lists as possible sexual dysfunctions:

Delayed Ejaculation | Erectile Disorder | Female Orgasmic Disorder | Female Sexual Interest/Arousal Disorder | Genito-Pelvic Pain/Penetration Disorder | Male Hypoactive Sexual Desire Disorder | Premature (Early) Ejaculation | Substance/Medication-Induced Sexual Dysfunction | Other Specified Sexual Dysfunction | Unspecified Sexual Dysfunction

So whether it is Erectile Disorder or Female Orgasmic Disorder, A sex therapist comes in handy because they are trained specifically to help with each one no matter the severity. They also work in tandem with PCP, pelvic floor therapists, and OB-GYNs to create a continuum of care for each client.

*Sex Addiction, which is not a real term or diagnosis, falls into the category of an impulse control issue most of the time. Sex therapists are utilized here as well and they can help create a safer, sex positive environment for the client to understand their concerns.

Sex education

I don't know about you, but the sex education I had in grade school was non-existent. Growing up Catholic, I think there was a day in like 7th grade (correct me if I am wrong St. Ann alums) when the principal came in and talked about abstinence, and that was it. I left the classroom having more questions than when I went into it. So like most people, I had to learn about sex and intimacy on my own. Oh, and did I mention I am gay? So that adds ANOTHER layer on top of things.

Because most of you probably had the same or a similar experience as I did, a sex therapist comes in handy because we help you rewrite what is considered to be healthy intimacy and sexuality. This world is filled with sex negativity. From social media to movies and television, we are all led down paths that can end up being destructive for us and our relationships. Allow a sex therapist to help you stop the bleeding, heal, and move forward with a healthier and more accepting headspace.

Exploring shame around desires

Speaking of sex negativity, let's talk more about it. Sex negativity can be defined as messaging and media that promotes shame and confusion relating to sexuality. This could take many forms, including a specific religion promoting abstinence-only sex education, parental figures chastising us if we are caught exploring our bodies as children, and even actors in a movie being grossed out by BDSM play. This can all lead to us feeling conflicted with our wants and desires.

A sex therapist comes in handy during these moments to help you challenge, process, and reflect on all this information you have gathered over the years around sexuality and physical intimacy. In therapy, you will unpack all the shame and anxiety you have around intimacy and sexuality and attain a whole new sense of freedom and clarity.

Exploration of kinks

We all have kinks. All of us. Even you, the person in the corner judging your friends for liking to be talked down to in the bedroom. BDSM and kink play are two of the most misunderstood areas within sexuality. People fear what they do not know, and when pain or humiliation comes into play, we automatically turn to the notion that the individual must be "damaged" in some way to want to enjoy these things. People think this because, you guessed it, sex negativity stating that there is only one way to have sex and that is vanilla and penetrative. So let me reiterate, everyone has a kink. You like your hair pulled? Kink! Dirty talk in bed? Kink! Using sex toys? Kink (and also highly encouraged)!

A sex therapist comes in handy during these moments because they will tell you that as long as you are with another consenting person or group of people, what you are doing is perfectly healthy and normal. Exploration is a part of life. We explore careers we may want, foods we want to try, and new relationships. Why not explore what you may enjoy in the bedroom?

Consensual non-monogamy

As with most things that take a sex negative view, our society finds it hard to validate consensual non-monogamy (CNM) as a healthy relationship style. Whether you are polyam, open, practice solo poly, or any of the other many forms of CNM, sex therapists are trained to help you navigate the roadblocks faced by starting a consensually non-monogamous relationship.

A sex therapist comes in handy during these moments because they understand how toxic monogamy can manifest within all of us. A sex therapist will help you open up a new lens when viewing your relationship. One that navigates jealousy and compersion so that no matter the obstacle, you and your partners feel safe and heard.

While this list is not exhaustive by any means, I hope it provides you with a good snapshot of why individuals seek the support of a sex therapist. I only focused on a few areas in this post, but that does not mean that you can't reach out and do a consultation with one to see if they will be a good fit. It is okay to feel nervous. Reaching out for support no matter the topic can be scary. Just know that you are not alone in your journey through sex negativity. There are people out there who can help you navigate it in a safe and non-judgemental way.


Cleveland Sex Therapy is owned by Matt Lachman, a licensed mental health therapist who specializes in working with individuals, couples, and polyam folx on their concerns relating to sexuality, intimacy, and overall sexual health. The goal of Cleveland Sex Therapy is to promote inclusivity and nurture sex positivity. For more information, feel free to contact him at Matt@ClevelandSexTherapy.com