How Counseling Can Improve Your Relationship

And, yes, you can keep your clothes on.

“Last night I looked at some cheese and got an erection,” Otis Milburn—amateur sex counselor and the teenage son of a sex therapist—tells his best friend Eric in the opening minutes of Netflix’s Sex Education season two.

Although you might not find yourself sexually aroused by dairy products, most people will face some sort of sexual concern (not entirely dissimilar to Otis’) in their lifetime. In fact, more than a third of the population reports some difficulty with sexual satisfaction, according to the Cleveland Clinic. So, if you’re having worries around sex, you’re not alone.

Sex has been a taboo topic for so long that even doctors—heck, even gynecologists and urologists—often hesitate to bring up sexual issues. But sexual health is an integral part of one’s overall wellbeing. “Sex is a basic need on Maslow’s hierarchy. But sex is about so much more than physical release,” says Donna Oriowo, PhD, an AASECT-certified sex therapist and founder of AnnodRight, a sex and relationships therapy practice specifically aimed at serving Black women in the Washington, D.C. area.“Sex can impact your mental health and also your physical health, both positively and negatively based on experiences you have had.”

And that’s where sex therapy comes in. Just like hiring a personal trainer can help you with your physical health and a therapist can walk you through any mental blocks you may have, a sex therapist can help you improve your sexual wellbeing.

Meet the experts:

Donna Oriowo, PhD, LCSW, CST, is an AASECT-certified sex therapist and founder of

AnnodRight, a sex and relationships therapy practice specifically aimed at serving Black women in the Washington, D.C. area.

Shadeen Francis, LMFT, CST, is an AASECT-certified sex therapist, couples therapist, and speaker based in Philadelphia, Pennsylvania.

Ahead, sex therapists explain what exactly sex therapy is, how it works, how to know if you need it, and how it can help improve your relationship with yourself and others.

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What is sex therapy?

There are a lot of misconceptions surrounding sex therapy—that it happens in the nude, that therapists watch their clients have sex, or that the therapist touches the clients. While these sensationalized perceptions make for clickbait-y headlines and engaging television, in the real world, “sex therapy is a form of talk-based therapy that helps people improve their sex lives,” explains Shadeen Francis, LMFT, an AASECT-certified sex therapist based in Philadelphia. Just like other forms of talk therapy, sex therapy “can help you explore your patterns, support you to better understand the past experiences that have helped shape you, and teach you new strategies to achieve your goals, with a central focus on sex and sexuality,” she adds.

Of course, sex and sexuality cover a broad range of topics. So, what areas can sex therapy specifically help you unpack? Oriowo clarifies that this form of therapy may involve “talking about anything from sexual functioning, your sex life and satisfaction, to sexual trauma, sexual scripts, and sexual esteem [meaning, a person’s overall confidence in their sexuality and ability to enjoy its expression].”

How does sex therapy work?

Sex therapy works like any other form of talk therapy. By talking about your experiences and your feelings, your therapist is able to guide you through the issues you find challenging. Every therapist is different, but some may even suggest homework for you to try on your own or with a partner.

Speaking of partners, that’s where a potential difference comes into play. Traditional therapy is often between a client and a therapist, but with sex therapy you may choose to attend with a partner. Going to therapy with your S.O. can provide unique benefits, as well as a few challenges. Why? “In individual therapy, you are the star of the show,” explains Francis. “Individual therapy is a space that is designed to allow you to dive deep and be focused on what you need for your wellbeing.” In couples therapy, however, the relationship is the client, she says. Each partner’s experience still matters, but it’s not the sex therapist’s job to decide who is right or wrong. Instead, their role is to “offer support by prioritizing ways for you to relate to one other with clarity, kindness, and respect.”

Having a neutral third party to facilitate difficult conversations can make all the difference for people who are having trouble seeing eye to eye. “The unique benefit of couples therapy is that folks get to work through things in real time, for example, getting to practice new communication strategies with your partner with the support of your therapist, or having help sharing delicate information in a safer emotional environment,” says Francis.

That said, many people still prefer to attend sex therapy solo—either because they’d like a bit more privacy when digging into sensitive issues or because they’re not currently partnered. After all, you don’t need to be dating (or having sex, even) to see a sex therapist.

You can enjoy the benefits of sex therapy and work through sex and sexuality-related challenges, regardless of your relationship status.

Do I need sex therapy?

The combined stigma around talking about sex and going to therapy can make some people reluctant to seek out a sex therapist. But reaching out to a professional doesn’t mean there’s something “wrong” with you. “Everyone could use some extra support,” says Francis. “Given the amount of stress most people face in their daily lives, the reality is that most people are living with the consequences of unresolved trauma.” This may be trauma related to unfulfilling and/or awkward sexual experiences in your past, or, in serious cases, may stem from traumatic experiences, such as sexual assault.

According to RAINN, “every 68 seconds, an American is sexually assaulted.” While that may seem like an extreme number, statistically, it’s more likely than not that someone has had an unpleasant sexual experience in their lifetime.

Plus, with many schools lacking comprehensive and inclusive sex education programs, “sex therapy would benefit a lot of people,” says Francis.

But sex therapy isn’t only for those who have experienced sexual trauma. Many people seek out support because they’re dealing with common issues, such as performance anxiety, low sexual confidence, or mismatched levels of desire within a relationship.

At the end of the day, sex therapy can be a huge help for figuring out how to deal with the stress of simply living in the world—especially if you embody one or more marginalized identity. For example, people who are asexual often receive pushback from friends, family, and potential partners trying to insist there’s something wrong with them, rather than accepting asexuality as a perfectly valid identity. (Which, spoiler: It is.)

Even in situations where you’re not actively engaging in sex, sex therapy can help promote self-acceptance as well as help you build tools for communicating your desires and needs with others.

If you experience little to no sexual desire, you may be asexual. Here are some other gender and sexuality terms to know:

How do I find a sex therapist?

Choosing a therapist is a big decision, so it’s worth doing the research to find someone who’s a good fit for your needs. A great place to start is looking through the American Association of Sexuality Educators, Counselors, and Therapists (AASECT) directory. Professionals who are AASECT-certified (like WH’s experts) have undergone additional training beyond their therapy licensure requirements and are more likely to be well-versed in a variety of sexuality topics. Psychology Today is another mental health professionals directory that allows you to search by keyword and specialty, helping you narrow down your options.

For folks who are kinky, queer, or non-monogamous, it can feel especially tricky to find non-judgmental professionals who won’t misunderstand you or require you to educate them. For these groups, the following resources can help you find a therapist who will recognize your identities and the nature of your most intimate relationships:

Moreover, when making a choice as personal as finding a sex therapist, a referral from someone who already knows you is often best. If you have a primary care provider, gynecologist, or another healthcare professional you like and trust, ask them if they have any people in mind.

And feel free to reach out to friends, too. Not everyone is open about seeing a therapist, but one of the best ways to shatter stigmas is bringing these conversations into the open. So why not solicit suggestions on Facebook? If posting to your wall feels too public, I suggest posting in private groups relevant to your identities, such as open relationship groups if you’re looking for a poly-friendly therapist.

How can sex therapy help my relationship?

Not only can sex therapy help you have better sex, but it can also help you develop a better relationship with yourself and your partner(s). According to Oriowo, sex therapy “helps you understand intimacy better, how your partner likes to give and receive intimacy, how sex plays into intimacy, and teaches you to communicate more effectively about your desires and needs.” And who doesn’t need that?

Here’s the thing: You don’t know what you don’t know. Even in relationships that are happy, healthy, and fulfilling, there are often small adjustments that can make a huge difference to your overall relationship satisfaction—especially in the bedroom. Sex therapy provides a safe space for you and your partner(s) to discuss any needs or desires that aren’t being met, and come up with a game plan, so you can enjoy even more Os.

If you’re still reluctant to get some extra support, remember these words shared by Francis, “You are deserving of peace and pleasure.” Because your satisfaction under the sheets is tied to your overall health and wellbeing, it’s worth prioritizing. And while talking about sex can feel scary (and, uh, awkward) at first, those conversations are worth having.

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