Should I Coordinate with a Sex Therapist? The Answer is YES!

in Clinical, Public News, Therapy


When I introduce myself as a sex therapist to other mental health providers and professionals in the medical field, I get a mixed bag of reactions. Some respond with enthusiastic curiosity about the strangest cases I’ve worked with in the past. More often; however, I encounter providers who give me a sideways glance and mutter an uneasy, “Oh, that’s interesting.” Unfortunately, graduate and medical schools don’t provide enough, if any, education or training to work with client and patient sexual concerns. That’s where coordinating care with a sex therapist might help.


What does a sex therapist do? The education, training, and work of sex therapists are not that different from other mental health professionals. In addition to treating various mental health concerns, they are specialized to evaluate and treat a wide range of sexual and relationship problems. Sexual therapy incorporates cognitive-behavioral therapy (CBT) as well as psychodynamic therapy, mindfulness, systems, interpersonal, relationship, and psychosexual educational interventions (e.g., reading, videos, illustrations/photos, sexual and reproductive anatomy models, etc.). Examples of some sexuality-related issues that sex therapists treat include:

  • Sexual dysfunction (e.g., erectile difficulties, sexual pain, anorgasmia, low sexual desire)
  • Sexual or romantic attraction, behavior, and orientation
  • Exploration of gender experiences, including non-binary identities and gender dysphoria
  • Compulsive sexual behaviors that cause distress and strain relationships (e.g., use of sex workers, pornography, or masturbation)
  • Chronic minority stress among LGBTQIA+ individuals
  • Explore sexual concerns for people with disabilities
  • Pregnancy, infertility, and pregnancy loss
  • Aging, illness, or medication effects on sexuality
  • Adjusting to a partner’s sexual changes
  • Exploring other sexual activities including kink and BDSM

Sex therapists also work with couples and those in multiple relationships in the following areas:

  • Communication skills training and conflict resolution
  • Premarital counseling or preparing for partnership
  • Navigating life transitions
  • Exploring varied relational orientations (e.g., monogamous, non-monogamous, polyamorous)
  • Addressing sexual concerns, discordant sexual desires, and increasing intimacy
  • Life after infidelity or loss of trust
  • Marriage, discernment, or divorce counseling

For those who work in medical settings, it’s important to consider how your patient’s health concerns can affect their sexual and relationship functioning. The following are a few examples of how sex therapists can work with various medical disciplines:

  • Cardiovascular: Provide education about basic mechanics of erectile functioning; correct dysfunctional sexual beliefs; examine unrealistic sexual expectations; expand sexual scripts, and assist with lifestyle modification
  • Urology: Pain management for urological chronic pelvic pain syndrome (UCPPS), restore sexual functioning, provide couples therapy to increase intimacy and expand sexual scripts
  • Gynecology: Cognitive-behavioral and pain management for genital/pelvic pain, decrease anxiety related to exams, and process sexual trauma
  • Pelvic Floor Therapy: Develop coping skills to manage anxiety and increase comfort with vaginal dilators
  • Oncology: Cultivate coping mechanisms after a cancer diagnosis. Process the impact of treatment on body image, sexual functioning, and include partners in couples and sex therapy
  • Endocrinology: Provide transaffirmative psychotherapy for trans and gender non-conforming individuals seeking various medical interventions

Effective comprehensive treatment often involves collaboration with other specialists. If you are considering coordinating care with a sex therapist, be sure to do some research into their education and training background. Unfortunately, anyone can call themselves a sex therapist without receiving any formalized in-depth training or supervision.  Currently, Florida is the only state that requires a provider to be certified to practice sex therapy. One of the largest credentialing organizations is the American Association for Sex Educators, Counselors and Therapists (AASECT). Furthermore, sex therapists who are certified through AASECT abide by a code of ethics.

Dr. Tracy Carlson is a licensed psychologist in Louisiana, Texas, and Minnesota. She is an AASECT Certified Sex Therapist and provides sex therapy through her private practice at Connections Psychotherapy + Wellness. If you are interested in learning more about Dr. Carlson’s work or would like to coordinate care, please contact her by email, or phone, 888-580-5995.