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Writer's pictureMelanie Greenberg

Why Do We Even Need Sex Therapists?




What do sex therapists even do?


Many people who have never experienced therapy ask me this. When the subject of work comes up with strangers, there is often a moment where people aren’t quite sure how to react to ‘sex therapist.’ It usually stems from curiosity, and I’m likely to answer questions from genuinely interested people. However, when I was in school training as a sex therapist, the most common joke I heard from cishet men was, “Do you need any research subjects,” or,  “Oh, so you have sex with your clients?” The assumption was that my clients would be participating in sex acts in front of me and I would then guide them. While services like that do exist, that is not what I do as a sex therapist.


Okay, so what do we do differently than other therapists? Let’s jump in.


After surrounding myself with sexuality topics and being a rather open person for years, I often forget that most people do not spend their days reading about, talking about, or learning about sex and intimacy. One of the first pieces of sexuality I often find necessary to present to clients is that sex is not just intercourse (thanks heteronormativity). Sex isn’t just an act that we do. Sex is really who we are. I’m not just talking mechanics with clients. We do the whole therapy thing. 


Tell me your family history, what were you like growing up, what were your religious influences, what was school like for you, did you have friends, did you like sports, did you like reading, what were your parents like, did they show each other affection, how was conflict resolved in your home, did you see your parents fight, did you see them make up, did you receive sexual education, was sex ever talked about openly, what were the attitudes around sex in your household growing up, what was your first introduction to sex and sexuality, what were your beliefs?


Of course, other therapists can do similar work. Still, sex therapists are specifically trained to understand how sexuality is intrinsically tied to who you are and how it can affect the other parts of your life. We are trained not to judge the desires that may exist. We are trained not to dismiss how gender, intimacy, and relationships can affect our daily lives. As a social worker, I am trained not to dismiss how current events and systems can affect our pleasure and desire. If someone is living in the 24 states where abortion is currently not a feasible option, how can sex be pleasurable and enjoyable when the fear of pregnancy is constantly looming? If someone is living outside of the 22 states that require factual and medically accurate sex education (meaning 28 states do not require sex education to be factually, technically, or medically accurate) how can they understand safe relationships and sex without that information?


Because here’s the thing, all of that matters. You may not immediately understand how it all comes together, but sex therapists are trained to look at attitudes and beliefs around sex and challenge you. As a systems-based sex therapist, I know many of those beliefs and stories people carry with them into adulthood about what love,


sex, and identity look like aren’t accurate representations of who they are or what they believe now. Former Catholics are a good example. Sex is a sin, your body is a sin, your desire is a sin, your existence is sinful, and don’t have sex before marriage (the general gist of Catholicism). But what happens when you do get married and commit your life to someone? Do those beliefs about your body and sex just disappear? It’s not a light switch. You can’t automatically turn it off because you’re married now. That’s where shame comes in, and it is very difficult to enjoy pleasure when there is shame enveloping your entire existence.


And what if you’re a Queer ex-Catholic? What if you’re a Queer ex-Catholic who likes BDSM? What does that mean about who you are, based on all the beliefs and ideas you’ve been taught since childhood? That’s where we come in. We are here to remind you that you are not shameful, that your pain is real, and that your identity is valid. You can enjoy sex and intimacy in whatever consensual way works for you. And I'm ready when you are.


Until then, I’d like to share this resource that changed my entire view on how sexuality is so much a part of us. 


Adapted from a model designed by Dennis Dailey, PhD.

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