Psychotherapy had unfortunately earned a bad reputation decades ago when the prevailing view in the field was that the only form of “healthy’ sexual activity was penetrative sexual intercourse between a man and a women. Any deviation from this was considered an expression of psychopathology and carried such derogatory labels as “perversions.”
Indeed it wasn’t until 1973 that the American Psychiatric Association would even allow for the fact that not all people who enjoyed having sex with someone of the same sex were sick and in need of treatment to “cure” them. Fortunately, much has changed over the years in the attitudes of society, and there is much greater room for sexual expression than in previous years.
Still because of this painful history, and because to this day there is far too much ignorance in the field, people who may not identify as specifically gay or straight, or for that matter fall neatly in line with being either 100% male or female, fear that should they seek help from a psychotherapist, or a sex therapist, that they will be told that they are “abnormal” and that the very things they take pleasure in doing, or how they experience themselves will be what the therapist wants to change.
Each of us, no matter where we appear on the spectrum of gender or sexual expression, are vulnerable to the same sexual concerns that people work on productively in sex therapy.
For example, heterosexual women are not the only ones who may experience difficulty achieving an orgasm, or pain during orgasm or intercourse. Similarly, it’s not only straight men but rather anybody with a penis who may experience difficulty maintaining erections or orgasming much sooner than they would like to. Sexual concerns that are amenable to sex therapy can and do affect all types of people regardless of how they identify, or what particular likes or dislikes they have when it comes to having sex.
I wish that I could report that things have changed so much in the field of Psychology and Sex Therapy that no one needs to worry about being labeled “disturbed” based on their sexual interests or their experience of themselves. But unfortunately, that is not universally the case.
Even in this day, there are professionals who would see you as disturbed if you didn’t simply identify as either a man or a woman, and plenty who if you, for example, you enjoyed BDSM or a kink that they were not comfortable with, who would try to help you “get rid of the problem.”
There are no shortages, for example of therapists who is you liked having sex very frequently would label you a “sex addict.” Conversely, if you weren’t particularly interested in sex, you might be seen as having a disorder of sexual desire. There is an old joke in the sex therapy field in which the definition of “hypo-sexuality” is that your therapist is having more sex than you do, and being labeled “hyper-sexual” means that you are getting it more than your therapist. As we all know most jokes would not be funny at all if there wasn’t a grain of truth in them.
And although fortunately a number of states have outlawed trying to change a minor’s sexual orientation, in most of the United States it is perfectly legal to do so, and in every state it is legal. for an adult to go into therapy to try to change their sexual orientation, even though there is absolutely no evidence that any type of therapy can change one’s orientation.
We now understand that there really isn’t any relationship between the nature of one’s experience of their gender or the nature of one’s sexual expression and psychopathology.
In a good sex therapy, or in a good psychotherapy, the goal is for the person in therapy to gain increasing comfort with the nature of their own sexuality. To be able to embrace it and to overcome obstacles to sexual enjoyment. And this is true for everyone, not just people who identify either as solidly male or female or are free of any “kinks.”
So as a consumer, it is important that you seek a sex therapist who can work with you and not against you.
If you are interested in benefiting from sex therapy, here are some important things you should do to ensure that you will be engaging in a treatment that will be helpful.
The first thing that you want to look for is the therapist’s credentials.
Do they have a doctorate in psychology, and if so is it in Clinical Psychology? Are they licensed to practice psychotherapy in the state in which you live? Unfortunately many of the titles that people use such as “sex therapist” and “psychotherapist.” are unregulated in most localities meaning that anyone can call themselves a sex therapist or psychotherapist with any training.
Next, see if they are certified as a Sex Therapist or Sex Therapy Supervisor by the American Association of Sexuality Educators Counselors and Therapists (AASECT).
At the moment this is the only national organization that offers certification in Sex Therapy. So the combination of and advanced degree and certification by AASECT as a sex therapist is usually a pretty good indication that the person has been well trained.
The next thing you should look for is what professional organizations does the therapist belong to?
For example, if they belong to the National Coalition for Sexual Freedom (NCSF) it is usually a pretty good indication that they are comfortable with a broad range of sexual expression. If however they belong to an organization for “addiction therapists” it may be, but not necessarily so, that they will view your sexual interests as an addiction, and prescribe abstinence.
If the above checks out, if you are comfortable letting others know that you are interested in Sex Therapy, you might ask friends if they might recommend someone with whom they’ve had a positive experience.
But at the end of the day as long as the person you are considering as a therapist is properly credentialed, the most important thing is the goodness of fit. By goodness of fit I mean that they are someone you feel comfortable speaking to about intimate details of your life. And that they seem to understand you and are not judgmental about your interests. I don’t think that there is any good way to ascertain that other than meeting the therapist in person.
You can call and schedule an “initial consultation.” That is you haven’t yet decided to see this person for psychotherapy or sex therapy, but rather that you would like to meet with them to see if you feel that you will be comfortable working with them.
Be prepared to tell them briefly about your concerns. They may have questions for you so that they might understand you better, but remember that you are the consumer, and be sure that you are comfortable with the answers they give you.
All of the above considerations apply whether you are seeking sex therapy as an individual, or as is often the case, as a couple. A good place to start your search would be on the websites of organizations such as AASECT or NCSF, or popular find a therapist websites such as Psychology Today. I wish you the best of luck with your search, and remember that good sex therapy is available to everyone, you just need to be an educated consumer.
And of course, if you're in the New York City area and in need of a sex therapist, you can always reach out to me. My case load is often full, but I'm very happy to speak with new inquiries and if I can't work with you, I'm happy to refer you to other qualified sex therapists in the NYC metro. You can reach me directly at 212-242-2219.