What questions do sex therapists ask? A guide from leading DC sex therapists.
If you’re considering seeing a sex therapist, you may wonder what to expect at first and, more specifically, what you’ll be asked to talk about. For many, sex and intimacy are tough topics to process and discuss aloud, and it’s normal to feel a mix of emotions as you begin your journey. At the Center for Intimacy and Relationships, our licensed sex therapists guide all conversations with curiosity and respect, and ask questions with the intention of gaining a holistic understanding of each person or couple. It’s okay to feel nervous answering personal questions - in fact, it’s a good idea to talk about that with your therapist.
Keep reading to hear some of the most common themes and questions that may be explored by your sex therapist during sessions.
Understanding your goals for therapy
The first step in any new therapeutic relationship is to ensure all parties are on the same page regarding your goals for treatment. This conversation often begins by clarifying what brought you in and prompted you to seek professional help in the first place. To achieve this, your sex therapist might prompt you to consider the following questions:
“Tell me more about your decision to seek out sex therapy. Why now?”
“What goals or objectives are you bringing with you to therapy?”
“What concerns are you hoping to address through sex therapy?”
“Have you ever seen a sex therapist before?” “If so, how do you hope this experience will be similar to or different from your previous experiences in sex therapy?”
As trivial as it may sound, these sorts of questions help to break the ice and begin the rapport-building process between client and therapist. The simple act of beginning the conversation can sometimes feel very daunting. By ensuring that all parties are equally aligned and agreeable to the stated goals and concerns for work, a strong foundation is built, which will aid in the overall success of your therapy experience(s). The above questions will help your therapist understand your baseline functioning and what success means for you based on your sexual and relational history and needs.
You may not have the answers to these questions immediately, and that’s okay! Sometimes, clients know that they need professional support, but may not know where to start or how to verbalize their needs. In these instances, the power of the therapeutic relationship becomes very important, as your therapist will help you explore past sexual experiences to determine underlying concerns and treatment goals.
Exploring relationship dynamics
Whether you are seeking out sex therapy while single, in a committed relationship, or find yourself somewhere in between, your sex therapist is interested in exploring your relationship and intimacy dynamics, both past and present. If you’re in a relationship, a sex therapist will likely ask you to discuss your connection with your partner or partners, including sexual, emotional, and relational patterns. For example, questions geared at uncovering the linkages between varying relationship dynamics may include:
“How do you and your partner(s) usually communicate?
“How [often] do you and your partner(s) talk about sex and intimacy (even if you’re not having it)?”
“How do you express and account for each other’s individual wants and needs?”
“How do you reconcile disagreements or tensions related to sex and intimacy?”
Open and honest communication with your sex therapist is an essential component of effective sex therapy. Although some of these questions may feel anxiety-inducing, these sorts of questions are not about assigning blame, but are instead intended to deepen understanding and uncover unspoken or undiscovered challenges within communication and intimacy patterns. For instance, if you and your partner(s) are struggling with mismatched expectations surrounding the frequency of sex or intimacy, by exploring these patterns aloud, your sex therapist can help you and your partner(s) build greater awareness and work towards aligned expectations in which each party feels equally satisfied.
Exploring relationship dynamics in sex therapy is just as important for couples as it is for those entering therapy while single or in non-traditional relationships. Instead of inquiring about current relationship dynamics, your sex therapist may explore your past relational experiences and aim to connect those experiences with your current concerns and goals. For example, your sex therapist may ask you to share more about your past relationships and sexual experiences in an effort to understand your current sexual desires, or to discuss past traumas that are negatively impacting your sexual life.
Addressing psychological factors
Although issues related to physical functioning, such as premature ejaculation or vaginismus, are major reasons why people seek out sex therapy, sexual experiences are influenced by many other factors. Sexual experiences are deeply connected to our internal feeling states, self-image, interpersonal dynamics, and past experiences. For example, questions geared at connecting the emotional, psychological, and physical factors of sexual experiences with physical functioning may include:
“How has your sexuality impacted your relationship with sex and intimacy?”
““How have past relationships, if any, affected your thoughts and feelings about sex?”
“How comfortable [or uncomfortable] do you feel talking to your partner about sex?”
Our experienced clinicians understand the complexity of sexual well-being and aim to address sexual concerns from a holistic point of view, which includes examining the psychological factors or barriers that may be negatively contributing to difficulties in physical functioning. For example, cognitive factors, such as negative self-talk and unrealistic standards for sex, are commonly associated with sexual dysfunction.
Addressing biological and medical factors
Similarly, psychiatric and mental health-related challenges may impede your sexual functioning. Research highlights the interconnectedness of psychological distress and sexual functioning, and highlights the importance of addressing all relevant bio-psycho-social-emotional factors that may be impacting your sexual well-being in therapy.
Additionally, because sexual challenges can be biologically or medically rooted, it’s common for sex therapists to also assess these factors, if relevant. Hormonal imbalances, side effects from psychiatric medications, and other pre-existing health conditions are commonly associated with certain sexual issues. A sex therapist may ask:
“Have you noticed any changes with your body or sexual satisfaction?”
“Are you taking any medications that produce side effects, such as medications for birth control or anxiety and depression?”
“Do you have any pain or discomfort related to touch or sex?”
“Have you discussed these concerns with a medical provider?”
Specific questions about sex
As part of the assessment process, a sex therapist will usually ask about the types of sex you are having, or want to have. A good sex therapist will always go at your pace, and you are never required to disclose anything you don’t want to. Some questions they may ask:
“Are you having sex?”
“What kinds of sex do you have, or want to have? Please share as much or as little detail as you would like.”
“How often do you have sex?”
“How do you feel about that?”
Your therapist may follow up with more specific questions about sex, such as questions about orgasms, kink, or BDSM, if that is relevant to you. If it is not relevant to you, then the therapist will move on. There are no right or wrong answers. Your therapist is asking to understand, not to judge.
Sex therapists help people from all walks of life, including people who don’t have sex at all, people who have very active sex lives, and everyone in between. These questions are meant to guide your therapy, not assess if your sex life is “normal.” [Pro tip: there is no normal!]
Confronting beliefs, identity, and culture
A sex therapist may also ask questions to gauge how religion, family, culture, and other influences have shaped one’s views on sex and intimacy, such as:
“How was sex or intimacy discussed in your family growing up?”
“How do your personal identities help shape your experiences and views surrounding sex?”
“What cultural or spiritual messages regarding sex and intimacy have you received throughout your life?” “Have these messages influenced your sex views?”
Humans are influenced by their surrounding environments. Environmental influences can significantly impact how you think about sex, your comfort level with sex, and your sexual behaviors. Although talking about identity, family, religion, culture, and sex may invoke anxiety in some, these kinds of questions can provide great insight for your sex therapist.
Sex therapy thrives on individualized approaches to treatment, depending on your presenting symptoms, concerns, and past experiences. Sex therapy is not a universal process, and at the Center for Intimacy and Relationships, we recognize and celebrate that each person’s journey is different and unique. Therefore, our licensed sex therapists ask questions and utilize interventions that are intentionally tailored to best fit your needs and desired outcomes. Every question asked during a session serves a specific purpose, whether that purpose is to deepen mutual understanding or to instill empowerment.
If you’re curious about what sex therapy could look like for you or how it may benefit you, consider taking the first step and having a conversation; it may serve as the beginning of lasting change.
Take the next step
Our experienced clinicians are ready to help you navigate therapy and your journey of healing and improved well-being.
If you’re in the DC area and looking for trauma-informed, sex-positive therapy, reach out now. Sessions are available in-person or online throughout the DMV. Schedule a free video introduction with one of our therapists at the Center for Intimacy and Relationships to get started.
