MWR’s Ask Me Anything: What About Talking About Sex in Therapy?

by Kathy Fox

In life, and in therapy, the topic of sex can be complex. People can have a broad range of thoughts and emotions related to sex – with some people feeling very ready and interested in addressing it (and maybe wondering if it’s okay to bring up), while others may feel reluctant to do so. 

No topics are off limits in therapy, so although sex can feel like a very private matter, I am available and comfortable talking with you about it if it relates to what you want to work on. 

But, for those of you wondering if you have to talk about sex, especially if you’re coming in for couples therapy, the short answer is, no, you don’t have to. Whether we talk about sex (or anything else) is completely up to you! Couples therapy and sex therapy are different. Sex therapists help individuals and couples work through sexual problems specifically, so if you see a sex therapist, definitely plan to talk about sex. 

As a couples therapist, I help partners work through many different relationship problems. Some of my clients choose to talk about problems in their sex life, while others prefer to work on other issues, like emotional intimacy and conflict management, finding that this work also greatly benefits their sexual relationship. 

If a couple I am working with shares a concern about a specific sexual dysfunction, I will likely refer them to a medical doctor for an evaluation to either rule out or treat any physical or biological cause. Once a medical cause is ruled out, I will evaluate the problem to make sure it seems like something the clients can work through as part of their treatment in couples therapy with me. In most cases, this is possible, but if not, at that point I will make a referral to a sex therapist for more targeted work. For couples that choose to address their sexual relationship as part of our work together, I have some helpful tools and interventions to facilitate that work. 

~Kathy