Why Therapists Need to Get Comfortable Talking About Sex
Sexual concerns don't only show up in sex therapy offices. They show up everywhere — wrapped up in presenting complaints about anxiety, depression, low self-esteem, and relationship conflict. Research suggests that up to one in three people experience sexual dysfunction at some point in their lives, with real effects on their mental health and relationships.
Most of them will never see a certified sex therapist. They'll see you.
When therapists aren't equipped to engage with these topics, clients learn to leave that part of themselves at the door. They don't stop struggling — they just stop mentioning it. The therapy continues, but only with part of the person in the room.
This isn't a personal failing. Most graduate training programs do very little with human sexuality. One study of psychology programs found that sexual orientation and identity were covered in about 95% of programs — but actual sex therapy practice appeared in fewer than 13%. Reproductive health, diverse sexual experiences, and clinical approaches to dysfunction were largely absent.
The Sexual Health Alliance put it plainly: "Professionals receive little to no education in sexuality in graduate training programs, and it is a significant issue."
What we don't learn, we tend to avoid. And what we avoid sends a message — even when we say nothing at all.
The Sexual Health Alliance put it plainly: "Professionals receive little to no education in sexuality in graduate training programs, and it is a significant issue."
What we don't learn, we tend to avoid. And what we avoid sends a message — even when we say nothing at all.
Clients are perceptive. They notice a subtle shift in posture, a slightly too-quick response, a topic that gets quietly moved past. Research on graduate training has found that when therapists aren't comfortable discussing sex, they inadvertently communicate that these topics are off-limits — and clients adapt accordingly.
There's also a safety dimension here. Studies suggest the vast majority of therapists experience attraction to a client at some point in their careers — estimates range from 70% to 90%. That's a normal human experience. But without training to recognize and manage it, it can become a source of shame, avoidance, or worse. Cases where therapists crossed sexual boundaries with clients show devastating outcomes: approximately 90% of those clients were harmed, with some attempting suicide. Ignorance in this domain isn't neutral.
Training doesn't just protect clients — it protects therapists too.
There's also a safety dimension here. Studies suggest the vast majority of therapists experience attraction to a client at some point in their careers — estimates range from 70% to 90%. That's a normal human experience. But without training to recognize and manage it, it can become a source of shame, avoidance, or worse. Cases where therapists crossed sexual boundaries with clients show devastating outcomes: approximately 90% of those clients were harmed, with some attempting suicide. Ignorance in this domain isn't neutral.
Training doesn't just protect clients — it protects therapists too.
Getting comfortable with sex doesn't mean becoming a sex therapist or having answers to every question. It means being able to stay present when a client goes there. It means asking about sexual wellbeing in intake the way you ask about sleep. It means recognizing your own reactions and knowing when to bring them to supervision.
It does mean being willing to learn. Pick up a book on human sexuality, find a podcast, or complete a Sexual Attitude Reassessment intensive to examine your own assumptions.
If you're looking for a great place to start, our new CEU course, Introduction to Sex Therapy for General Therapists, is designed for exactly this — general clinicians who want to show up more fully for their clients, no prior background required.
It does mean being willing to learn. Pick up a book on human sexuality, find a podcast, or complete a Sexual Attitude Reassessment intensive to examine your own assumptions.
If you're looking for a great place to start, our new CEU course, Introduction to Sex Therapy for General Therapists, is designed for exactly this — general clinicians who want to show up more fully for their clients, no prior background required.