Sex is a fundamental part of human experience, yet it’s often the hardest thing to talk about—even with a partner, and especially with a therapist. If you’re facing sexual challenges, whether on your own or in your relationship, sex therapy can help. Our sex therapist has extensive training in sexual health and works with individuals and couples to address sexual dysfunction, improve sexual satisfaction, and build a healthy sex life.

Sex therapy is a specialized form of talk therapy focused on sexual health, intimacy, and relationships. It does not involve any physical contact or sexual activity with the therapist. Instead, sex therapists help you explore the emotional, psychological, and relational factors affecting your sex life—and develop practical strategies to address them.

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What Is Sex Therapy?

Sex therapy is a specialized form of psychotherapy that focuses on sexual problems, intimacy concerns, and overall sexual well-being. Sex research spanning decades supports the effectiveness of this approach for treating sexual issues. Sex therapists and sex counselors are licensed mental health professionals with additional training in human sexuality, sexual function, and the treatment of sexual dysfunction.

Modern sex therapy addresses far more than just physical function. While sex therapists do help with concerns like erectile dysfunction, low libido, premature ejaculation, and painful sex (dyspareunia), they also treat the psychological factors that affect sexual experience—including anxiety, stress, trauma, body image, and relationship dynamics.

Sex therapy can be conducted as individual therapy or with couples. Whether you’re working through personal barriers to a fulfilling sex life or addressing sexual concerns within your relationship, a qualified sex therapist can help you understand what’s getting in the way and find a path forward.

Sex therapists are licensed mental health professionals—such as psychologists, licensed professional counselors, or clinical social workers—with specialized training in sexual health, sexual medicine, and reproductive health. Some hold certification through the American Association of Sexuality Educators, Counselors and Therapists (AASECT), which requires a master’s degree or doctoral degree, extensive supervised experience, and ongoing education in human sexuality. Others complete rigorous training through other programs. What matters most is finding a therapist with specific education in sexuality and experience treating sexual concerns.

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How Does Sex Therapy Work?

Sex therapy sessions look much like other forms of talk therapy and counseling. You’ll meet with your therapist to discuss your sexual concerns, explore the factors contributing to them, and develop strategies for change.

The First Session

Your first sex therapy session typically involves a comprehensive assessment. Your therapist will ask about your sexual history, current concerns, relationship dynamics (if applicable), and overall mental health. This helps identify whether your sexual difficulties have physical, psychological, or relational roots—or some combination.

If your therapist suspects that sexual dysfunction may have a physical cause, they may recommend you see a medical doctor or sexual medicine specialist to rule out medical conditions affecting sexual function.

Ongoing Treatment

Sex therapists work with a variety of evidence-based approaches depending on your specific concerns:

• Cognitive-behavioral techniques to address negative thought patterns about sex and your body
• Emotion-based therapy to explore feelings of shame, fear, or disconnection affecting intimacy
• Mindfulness-based interventions to increase awareness and presence during sexual activity
• Couples communication techniques to help partners talk openly about sex, needs, and desires
• Psychoeducation about human sexuality, sexual behavior, and what’s “normal”

Your therapist may also assign practical exercises or “homework” to practice between sessions—focused on building intimacy, improving communication, or developing mindfulness skills. These exercises are always talk-based or self-directed; sex therapists do not have sexual contact with their clients or observe sexual activity.

Duration

Sex therapy is often short-term, with the length of treatment depending on the nature of your concerns. Some people see significant improvement in just a few sessions, while more complex sexual issues may benefit from longer-term work.

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What Sexual Concerns Can Sex Therapy Address?

Sex therapists treat a wide range of sexual issues affecting individuals and couples. Common concerns include:

Desire and Arousal

• Low libido or lack of sexual desire
• Desire discrepancy between partners
• Difficulty becoming aroused
• Loss of sexual interest over time

Physical Function

• Erectile dysfunction
• Premature ejaculation or delayed ejaculation
• Difficulty reaching orgasm (anorgasmia)
• Vaginal pain or painful sex (dyspareunia)
• Female sexual dysfunction

Psychological Factors

• Performance anxiety
• Body image concerns affecting sexual confidence
• Anxiety, depression, or stress impacting sex life
• Shame or guilt about sexual desire or sexual behavior

Trauma and Past Experiences

• Sexual abuse or sexual trauma affecting current intimacy
• Processing past experiences that impact sexual feelings
• Rebuilding trust and safety in sexual relationships

Relationship and Communication

• Difficulty talking about sex with your partner
• Mismatched expectations about sexual activity
• Emotional disconnection affecting physical intimacy
• Rebuilding sexual connection after infidelity or life changes

Identity and Exploration

• Questions about sexual orientation or sexual behavior
• Exploring sexuality in a safe, non-judgmental space
• Concerns about pornography use or pornography addiction
• Navigating changes in sexuality across the lifespan

Concerns Specific to Women Many women experience sexual challenges that go unaddressed for years—including low desire, difficulty with arousal, pain during sex, or trouble reaching orgasm. Research shows these sexual issues often have psychological, relational, and physical components. Sex therapy helps women understand what’s affecting their sexual function and develop strategies for greater sexual satisfaction and a healthier sex life.

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Is Sex Therapy Right for You?

You might benefit from sex therapy if you:

• Experience persistent sexual difficulties that cause distress
• Feel disconnected from your body or unable to enjoy sex
• Have difficulty talking with your partner about sexual needs
• Notice that anxiety, stress, or past trauma affects your sex life
• Want to improve sexual satisfaction in your relationship
• Have questions about your sexuality you’d like to explore
• Feel shame or embarrassment about sex that limits intimacy

Sex therapy can be conducted as individual therapy or with couples, depending on your needs. Research shows that many people find working on sexual behavior patterns and building a healthy sex life requires both personal reflection and improved communication with a partner.

When should a couple go to sex therapy?

Couples often seek sex therapy when sexual problems are creating tension in the relationship—when one partner wants more or less sex, when physical intimacy has faded, or when sexual concerns are going unaddressed. Sex therapy can help partners communicate openly, understand each other’s needs, and rebuild their intimate connection.

You don’t need to be in crisis to benefit from sex therapy. Many individuals and couples use therapy proactively to enhance their sex life, deepen intimacy, and develop a healthier relationship with sexuality.

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Our Approach: Affirming Care for All

At Therapy Group of DC, we believe everyone deserves access to compassionate, informed care around sexual health. Our sex therapist creates a non-judgmental and affirming environment for all clients, including those from LGBTQIA+ communities.

Sex therapy has historically focused on cisgender, heterosexual experiences, but we recognize that sexuality is diverse. We work with women and men, clients of all gender identities, sexual orientations, and relationship structures. Whether you’re in a long-term marriage, a newer relationship, or exploring your sexuality as an individual, you’ll find a safe space to address your concerns.

Sexual- and gender-minority clients often face added layers of discrimination and marginalization—even in healthcare settings. Our therapist is committed to affirming your identity and adapting treatment to be relevant to your lived experience.

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Our Sex Therapist

Our Washington DC practice includes therapists with specialized EFT training who are experienced in helping couples transform their relationships. They understand the principles of attachment theory and the techniques that help partners create stronger bonds.

Xihlovo Mabunda, MS, LPC

Xihlovo is a Licensed Professional Counselor with extensive training in sex therapy, EMDR, and psychodynamic therapy. She helps individuals and couples address sexual difficulties, rebuild intimacy, and develop a healthier relationship with their sexuality. Xihlovo creates a collaborative, supportive space where clients can talk about sex without shame and work toward greater sexual satisfaction and well-being. She works with women and men facing concerns including low desire, performance anxiety, sexual trauma, intimacy disconnection, and communication about sex. View Xihlovo’s full profile →

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Ready to Work On Your Relationship?

Taking the step to talk about sex in therapy takes courage. Our sex therapist provides compassionate, expert care in a confidential setting. Contact us today to schedule your first sex therapy session in Washington DC.

Get Started →

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Frequently Asked Questions

How does sex therapy work? Sex therapy is a form of talk therapy focused on sexual health and intimacy. You’ll meet with a sex therapist to discuss your concerns, explore contributing factors, and develop strategies for improvement. Treatment may include cognitive-behavioral techniques, mindfulness practices, communication exercises, and homework assignments—all talk-based, with no physical contact with the therapist.

Would I benefit from sex therapy? If sexual difficulties are causing you distress, affecting your relationship, or limiting your quality of life, sex therapy can help. Common reasons people seek sex therapy include low desire, performance anxiety, painful sex, difficulty with orgasm, trauma affecting intimacy, and trouble communicating about sex with a partner. Research supports the effectiveness of sex therapy for a wide range of sexual issues.

When should a couple go to sex therapy? Couples often benefit from sex therapy when sexual concerns are creating distance or tension—such as desire discrepancy, loss of physical intimacy, difficulty talking about sex, or rebuilding connection after infidelity. You don’t need to wait until problems are severe; many couples use sex therapy to strengthen intimacy before small issues become larger.

What types of sex therapy are there? Sex therapists use various evidence-based approaches depending on your needs, including cognitive-behavioral therapy, emotion-based therapy, mindfulness-based sex therapy, and couples-focused interventions. Your therapist will tailor treatment to your specific concerns and goals.

Is sex therapy confidential? Yes. Sex therapy follows the same strict confidentiality standards as all psychotherapy. Your therapist will explain patient confidentiality and any limitations during your first session.

Do I need to bring my partner? Not necessarily. Sex therapy can be conducted as individual therapy for personal sexual concerns or with couples addressing shared issues. Your therapist can help you determine the best approach for your situation.

Is sex therapy the same as sex counseling? Sex therapists and sex counselors both work with sexual concerns, though the terms are sometimes used differently depending on the professional’s background and training. What matters most is finding a qualified professional with specific training in human sexuality, sexual health, and experience treating sexual issues similar to yours.

How do I find a qualified sex therapist? Look for a licensed mental health professional with specialized training in sexual health and human sexuality. Some therapists hold certification through the American Association of Sexuality Educators, Counselors and Therapists (AASECT), while others complete rigorous training through other programs. The most important factors are specific education in sexuality and research-backed approaches to treating concerns similar to yours.