The 101 on sex therapy

What actually is it? How much is it? Is it worth it?

I’m by no means a perfect, well adjusted human being — if I was, I probably wouldn’t have anything to write about! — but I have done lots of different types of therapy over the years. I’ve had standard CBT to deal with my anxiety, general talking therapy to deal with grief, EMDR (Eye Movement Desensitisation and Reprocessing) to manage how I felt after my autoimmune diagnosis and operation, I’ve done the Hoffman Process (which some people think is a bit mad but changed my life), and I’ve had sex therapy to understand my complicated relationship with my body and, as a consequence, relationships.

By far, that last seems to intrigue people the most. I’ve been asked all sorts like, “Do they see you naked?” or “Do you have to do anything intimate in front of them?” (no and no, if you were wondering). But the most common question always is: What actually is sex therapy?

So here’s the 101 — from what I know and what I’ve experienced.

As alwayssss, I’m not a professional. These are my views and experiences and I recommend seeking out professional advice if this is something you’re interested in pursuing.

Ok so firstly, people who seek out the help of sex therapists are not broken or fucked up. Most of us will experience sexual concerns at some point in our lives. It could be around:

• sexuality,

• performance anxiety,

• exploring open relationships with a partner,

• erectile dysfunction,

• mismatched libidos or wants with a partner,

• postpartum anxieties or fears,

• struggles with past trauma,

• tiredness,

• change in drive,

• struggles with orgasms (anorgasmia),

• reliance on porn,

• moving on from infidelities,

• etc etc.

For underrepresented communities, sex therapy can be a place to seek affirming, non-judgemental spaces to talk about experiences — if you’ve never had a space to do that before, this on its own can be life changing.

I think it’s important to note sex therapy does not involve any physical contact between therapist and client. Therapists may assign homework or exercises (like journaling, mindfulness practices, and partner-based touch tasks) to be done privately but there’s nothing remotely sexual in the sessions. In the UK, therapists are bound by strict ethical guidelines that prohibit any form of physical touch during therapy sessions which even includes comforting touches like a shoulder pat. There are some practices or ‘intimate therapies’, especially in the US, where physical touch exists and and it is fraught with controversy. If you watched Netflix’s Sex, Love & Goop you might have already seen examples of this. But licensed sex therapists in the US are also bound by ethical guidelines that do not let them engage in physical sexual contact with clients.

So the Tl;dr: sex therapy exists as a way for individuals and couples to gain a better understanding of their bodies, find better ways of communicating (both to themselves and to others), and reframing beliefs about sexuality.

So what does sex therapy look like?

Modern sex therapy is a mixed bag of stuff, pulling from behavioural science, trauma work, and mindfulness. Some examples include:

• Behavioural techniques that help unlearn anxiety around sex

• Cognitive restructuring to reframe beliefs

• Mindfulness and somatic practices. These are ways that help you stay present instead of being in your head. Think breathwork, body scans, guided touch exercises, etc.

• Trauma informed approaches that mostly help survivors of sexual and gender violence

• Couples therapy

• Exploration of past experiences

• Integrating cultural and religious beliefs

• Understanding interpersonal dynamics

How long do you need sex therapy for?

It depends on how complex the issue is:

• Short-term therapy (6–12 sessions) is common for situational problems, like performance anxiety.

• Long-term therapy (several months - years) is often needed for childhood trauma, gender dysphoria, or deeply ingrained relationship struggles.

Sessions typically start weekly and then become less regular. I started weekly and then moved to biweekly sessions, before tapering down to once a month…until I stopped going.

What exercises might I be given?

Listen, I’m not a therapist so I can not give you a comprehensive answer so I’m not going to try. But one of the most known techniques is the Sensate Focus exercise created by two American researchers, William Masters and Virginia Johnson — legends in the field of sexology and therapy — even if they weren’t perfect — and even inspired the show Masters of Sex. Sensate Focus exercises see partners take turns touching each other without the expectation of intercourse, focusing purely on sensation. It’s designed to reduce pressure and rekindle intimacy.

There are also solo versions of this like guided self touch and body mapping for those who struggle with pleasure or have a history of dissociating from their bodies.
(We’re actually going to be running a webinar on this! Details coming ASAP)

I’ve also seen religiously relevant adaptations of this — I don’t have the science for it so I don’t feel comfortable sharing more at this time. I’ll let you do your own Googling/ChatGPTing. Come back to me if you find interesting stuff!

I would say here that the increased awareness in the public consciousness of sex therapy has led to a shit tonne of courses, books and influencer led content. There’s a difference between booking on to a course that does some of this stuff versus seeing a sex therapist and getting personalised support, advice, and guidance in a supported environment.

How much does it cost?

The range is mad. The cheapest I’ve seen in the UK is about £60 a session but ranges up to about £200. It’s cheaper for online sessions which I’ve seen sit at around £40. Don’t quote me, though! I’ve done both. I personally prefer online.

In the US, in person sex therapy sessions generally range from $100 to $250 per hour.

I know in the US and Canada, sometimes therapy can be covered by insurance. However, sex therapy feels like a grey area. Do ask, though, and report back!

Where can I find one?

southasiantherapists.org has a few like here and here and here.

In the UK, we have the College of Sexual and Relationship Therapists (COSRT) which is the national register of accredited psychosexual and relationship therapists.

In the US, there’s the American Association of Sexuality Educators, Counselors, and Therapists (AASECT). Just ensure you’re looking for the right type of practitioner, ie a therapist or a counsellor.

In Canada, there’s the Association of Sex Therapy in Ontario (ASTO). It’s probably worth noting here that sex therapy remains unregulated in most provinces.

In all three countries, you can sometimes get a referral from your GP/family doctor.

NB: In the UK, NHS psychosexual wait times can be VERY long, and the process of determining whether you qualify can be frustrating AF. I tried. I failed. I’m just privileged enough that I was able to go private.

Do I recommend it?

As I said before, sex therapy is gaining popularity — Netflix’s Sex Education definitely went a long way in making the case for it! When demand increases, supply surely will follow and I think we’ll see more people specialising.

What I found very hit and miss in my journey was the lack of understanding of my culture. I’ve felt being pitied for the boundaries my faith has given me. I’ve had to explain that we don’t all hate our faith or culture. Nor do we necessarily want to rebel from it or move to a more Westernised practice of love and sex. In therapy, I do not want to be defending by belief system and all its contradictions! I just needed ways of integrating all parts of myself.

Then, I found a therapist that truly got it. She was brown, brought up Muslim and saw all of me. Without judgement. Without questioning my grey areas.

There are people doing great work to bring together culturally informed therapists like southasiantherapists.org and talathrive.com.

For sex therapy to be truly inclusive, its frameworks must be decolonised — and that has to start at the very beginning of psychology curriculums. It can’t be an add-on only for therapists who want to work with South Asians. As with everything, when you serve the most marginalised, everyone ends up benefitting.

It also needs to become way more affordable! I don’t have a solution for this bit though!

With all those caveats out of the way — if you can afford it, have the time to research and find the right person for you (it might take a few attempts and you should definitely interview your potential therapists) — it can be a transformative experience. I know I couldn't have started writing Brown Bodies without it.