Is there a profession more misunderstood than sex therapy? Well, maybe undertakers and spies. But that’s about it.
TV portrays us as sex-starved libertines. The internet shows us as relentless advice-givers: how to use handcuffs. How to give her endless orgasms. And too many sex therapists themselves encourage unrealistic expectations: basically, the greatest sex in the history of the world.
No, that’s not who we are. And our personal lives are definitely not as glamorous as people seem to think.
Maybe you’re interested in seeing a sex therapist, but these wild stories turn you off. So let’s name and bust a few myths about sex therapy.
* Myth: We help women understand men, and help men understand women
I’m afraid there are some sex therapists who do this, but I think that makes them part of the problem rather than part of the solution.
Most of us don’t do that. We tell people some version of “you don’t need to understand men or women better, you need to understand George or Mary better.” Unless, of course, you’re having sex with a million men or a million women.
There are very reliable ways to learn more about your partner. It’s not by learning about a category that has three billion people in it (“men”, “women”), and extrapolating out to your partner. It’s by learning more about your unique, real-life partner. To do that, talk with him or her. In my experience, people like being asked questions about themselves, even if they’re a little embarrassed.
If almost every guy in the world likes fingernails on his balls during oral sex, and your guy doesn’t,
–wouldn’t you rather know?
–does it matter what all other guys like?
* Myth: We tell people how to make love
There’s no one right way to make love. It would be foolish to think we have a magic formula, and that everyone just needs to follow it.
Actually, people do ask us for that formula all the time. Our job is to gently encourage people to stop looking for it, and to instead figure out what they want from sex at this moment in their lives—and explore how to create it.
Yes, that’s harder than following a formula.
We do sometimes talk about the wrong way to make love: to create an event filled with pressure, shame, and disappointment.
Showing people the ways they’re doing this, and helping them understand how that leads to the symptoms that have brought them to therapy, is an important part of our job.
* Myth: If someone was molested as a child, they probably can’t have sexual desire or good sex as an adult
This belief started innocently enough, when society (and sex therapy) started to grapple with the truth of how many adults were molested as children, and how that can (note: can) affect people’s adult sexuality.
But the whole process of understanding this phenomenon eventually got completely out of hand. Bizarre beliefs like “children never lie” and “lack of evidence can be evidence” and “any child who’s interested in sex has been molested” were popularized in books, on Oprah, and by a trauma recovery industry that somehow sees molestation in virtually every unhappy person.
Our job is to help all people—including those who have been sexually exploited as children—locate their authentic sexuality, determine their values, and make sexual decisions that fit those values. We help people recover or pursue their interest in pleasure, closeness, and their own body.
* Myth: We give out Viagra like candy
Most sex therapists can’t prescribe medication because we’re not MDs.
But even if we could, most of us wouldn’t encourage it half as much as many physicians (and patients) do. Sex therapists know that a lot of erection difficulties aren’t penis problems; they’re the result of either relationship problems or the well-known shame-guilt-anger-ignorance axis.
We take a complete history of every patient who comes in. So we’re the ones who discover that your case of “E.D.” is really a matter of you wanting to get erect when you’ve had 5 or 6 drinks, or when you’re resentful at your girlfriend.
Your M.D. may give you Viagra in such a situation, but we don’t advise it. We know it probably won’t help, and we know what will: less alcohol, more self-awareness, more communication, and better choices.
* Myth: The gender of the sex therapist is crucial
Many people about to start sex therapy specify that they want either a male or female therapist. This is a common consumer mistake. And no, consumers don’t necessarily know what’s best for them in this regard.
A real professional has expertise that goes way beyond their personal experience. I am expected to empathize effectively with someone who has had a miscarriage, even though I’ve never had one. I need to know how cancer drugs affect desire (I don’t have cancer), and how using Tinder, Bumble, and Grinder affect people (I don’t use them).
I am expected to support people making decisions I’d never make, with handicaps (or advantages) I don’t have, with goals I don’t think are sound.
That takes a lot of skill and insight. And that’s what we bring to every case. When people say “I’ll feel more comfortable with [this or that gender therapist],” or “I’ll be better able to open up with [this or that gender therapist], or “I’ll feel more understood with [this or that gender therapist],” I rarely agree that they should limit themselves to half their community’s therapists.
Sex therapy is a formalized way of challenging yourself. A highly skilled professional can help you do that regardless of their gender. If they do so effectively, you’ll feel uncomfortable, possibly even angry or confused—regardless of the therapist’s gender.
Besides, working with the “wrong” gender therapist is a great way of challenging one’s gender-based prejudices—which may actually be an important part of the work.
* Myth: We sometimes have sex with patients
No legitimate sex therapist has sex with patients. Or kiss passionately, or go on dates.
Sex therapy is actually unregulated in the US. Fields like psychotherapy, nursing, medicine, and social work are regulated, and those are the home disciplines of many sex therapists.
So my own clinical work is not regulated as “sex therapy,” but I’m licensed as a marriage and family therapist. As such, I am subject to clear ethical standards, laws (like no sex with patients), financial procedures, and continuing education requirements. But this is as a marriage counselor, not as a sex therapist.
Except in Florida, anyone can hang out a shingle as a sex therapist. And, unfortunately, many unqualified people do. Some think it’s easy (it isn’t), or it’s a way to make a quick buck (well, for some quacks it is), or it’s primarily about sex (it isn’t), or that their vast sexual experience, enthusiasm, and non-judgmental attitude qualifies them (it doesn’t).
Sex therapy involves a unique relationship between professional and client(s). It is cleverly constructed so the therapist’s wisdom can never be construed as self-serving. This helps the patient consider input they might otherwise dismiss. Once a patient believes that our advice or our insight mostly benefits us (for example, “Leave your horrible wife—and have sex with me”!), the therapy is pretty much over.