What Is Sex Therapy, Really? Dispelling the Myths for Denver Couples and Individuals

By Bozhena Evans, LCSW · BE Therapy, Wheat Ridge, Colorado (Serving Denver, Arvada, Lakewood and the NW Metro Area) · Sex Therapist Denver

When people first call to ask about sex therapy, there is almost always a pause before the question–a brief hesitation. Sometimes I get the question: “My partner and I need help with physical intimacy.” There is often uncertainty of what sex therapy actually entails, and it is one of the most misunderstood forms of mental health treatment available. This is unfortunate, as we know physical connection is so important in romantic relationships. The gap between what people imagine sex therapy to be and what it actually is keeps many people from seeking help they genuinely need, for issues that are genuinely treatable.

This post is for anyone in Denver, Colorado, or beyond, who has quietly wondered whether sex therapy might help them or their relationship, but has not quite been able to get past the myths long enough to find out. Let us clear the air.

What exactly is sex therapy and how does it work?

Sex therapy is a specialized form of mental health individual and couples counseling that focuses on sexual concerns, intimacy challenges, and the emotional and relational dimensions of a person’s sexual life. A sex therapist is a licensed mental health professional like a licensed clinical social worker, or licensed marriage and family therapist, who has received additional training specifically in human sexuality, sexual dysfunction, and sexual health.

What happens in sex therapy sessions looks, from the outside, like any other form of psychotherapy. You sit with your therapist, you talk, you are asked questions, you explore feelings, patterns, and histories. Sometimes, like with a certified Brainspotting such as myself, you do deeper nervous system or somatic work. For couples, both partners are in the room, and the therapist works with the relationship as the primary client. For individuals, the work centers on that person’s experience, history, and goals around intimacy and sexuality.

What does not happen in sex therapy is equally important to understand. Sex therapy does not involve any physical contact between the therapist and the client. Ever. This is an absolute and non-negotiable ethical boundary in the profession, and any practitioner who suggests otherwise is not practicing legal sex therapy that is currently overseen by licensure boards. There are other resources that are currently illegal where providers are able to model and even serve as surrogates to help individuals with sexual blocks overcome those, however again, those professionals are not sex therapists.

Sex therapy is often talk therapy, however as mentioned, I integrate somatic and deeper nervous system work to help individuals heal emotional wounding and trauma that can block sexual connection and/or sexual pleasure. Much of the work happens in conversation, reflection, honest examination of what has been difficult, avoided, or unnamed.

Does a sex therapist touch you during sessions?

Does sex therapy involve physical touch? This is the question that sits underneath many people’s hesitation, and it deserves a direct answer: no.

No physical touching happens in the sex therapy sessions. Licensed sex therapists do not engage in any physical or sexual contact with clients. The therapy is entirely verbal, relational, or somatic. What may be assigned as therapeutic homework, to be practiced privately between partners outside of sessions, might involve physical exercises, but these are completed in the privacy of the couple’s own home and are not observed, facilitated, or participated in by the therapist unless they are of a non-sexual nature like breathing or muscle relaxing exercises.

One well-known set of exercises that sex therapists frequently assign is called sensate focus, a technique developed by pioneering sex researchers William Masters and Virginia Johnson. Sensate focus involves a structured series of touching exercises that partners practice at home, designed to reduce performance anxiety, increase body awareness and pleasure, and rebuild physical connection without the pressure of sexual performance or achieving a certain outcome like orgasm. The therapist guides the process through conversation, assigns the exercises, and processes the experience in subsequent sessions. The couple does this work together, on their own, in their own time.

If there is any confusion about physical touch in sex therapy, it likely stems from several sources: outdated depictions in popular culture, the existence of separate and controversial practices as mentioned earlier called sexological bodywork and surrogate partner therapy, both of which are distinct from sex therapy and not practiced by most licensed therapists. On rare occasions, a sex therapist will refer to one of these providers for sexual treatment, but the research is limited for benefits of direct physical contact between provider and therapist as these practices are still illegal at this time. Vast cultural and religious discomfort with sex as a topic also leads people to project all manner of assumptions onto the treatment, and unfortunately inhibits many individuals’ comfort level to discuss their sex lives with a stranger–even a skilled professional. That being said, I do find that being a stranger often works in my favor as a professional who can objectively listen to folks’ sexual issues without judgment, with curiosity, and with a warm validating demeanor.

A note on surrogate partner therapy:

Surrogate partner therapy is a separate and distinct practice from sex therapy. It involves a trained surrogate, not the therapist, who works with a client on physical intimacy under the direction of a therapist. It is controversial, is not widely practiced, and is not what most people encounter when they seek out a licensed sex therapist. If you are working with a licensed mental health professional who identifies as a sex therapist, the work is talk-based or somatic-experiencing only and involves no touching by the therapist.

What problems can a sex therapist actually help with?

Sex therapy Colorado clients seek help for a wide range of concerns, some of which people might not immediately think of as within the scope of sex therapy. The field is broader than most people realize.

Among the most common reasons people seek out a sex therapist in Denver:

Low or mismatched desire. One of the most frequent concerns couples bring to sex therapy is a significant difference in when and how often each partner wants to be sexually intimate. This is sometimes called desire discrepancy, and it is extraordinarily common in long-term relationships. It is not a sign that someone is broken or that the relationship is failing. It is a signal that something in the system needs attention, and partners need to understand each other’s desire responses better in order to work through the misalignment.

Performance anxiety. Whether it manifests as difficulty with erection, premature ejaculation, difficulty reaching orgasm, or the more general experience of dreading sexual encounters rather than looking forward to them, performance anxiety is one of the most common and most treatable sexual concerns. Sex therapy approaches this from cognitive, relational, and somatic angles, helping clients understand the cycle of anxiety and avoidance, as well as their nervous systems in order to help interrupt the block.

Intimacy after trauma. Sexual trauma, including childhood sexual abuse, sexual assault, and other experiences, can profoundly affect a person’s relationship to their own body and to physical intimacy. A trauma-informed sex therapist helps clients heal from the trauma and reclaim their sexuality on their own terms, at their own pace, without pressure or performance.

Sexual concerns related to health changes. Menopause, postpartum recovery, cancer treatment, chronic illness, disability, and aging all affect sexual function and intimacy. Sex therapy helps people and couples navigate these changes honestly and with practical tools, rather than grieving in silence or assuming that this part of their lives is simply over.

Exploring identity and orientation. Sex therapy is an affirming space for people who are exploring questions about their sexual orientation, gender identity, relationship structure, or sexuality in general. There is no agenda in sex therapy around what a client’s sexuality should look like. The goal is that whatever it looks like, it feels honest, free, and genuinely theirs.

Exploring polyamory or consensual non-monogamy (CNM), also referred to as ethical non-monogamy (ENM). Polyamory, or the ability/desire to have romantic connection and/or love with more than one person at a time has become more visible in recent years, though still often misunderstood and not legally recognized. Sex therapy or couples therapy with a poly-affirming and knowledgeable therapist is a safe space for individuals and partners to work through issues associated with their multiple relationships that may or may not include sexual-specific issues.

Exploring kinks, fetishes, and non-normative sexual desires. Sexuality is a vast landscape with varied individual sexual preferences and ideas of what turns people on and leads to more sexual fulfillment. There are more normative sexual activities and preferences, while others are less so. A skilled sex therapist can help clients understand their sexual desires and their ability to get those desires met in a safe non-judgmental space.

Compulsive sexual behavior. Some clients come to sex therapy concerned about patterns of sexual behavior they feel they cannot control, whether that involves pornography, affairs, or other behaviors that are causing harm to themselves or their relationships. A sex therapist approaches this with compassion and without moralism, working to understand the function of the behavior and address the underlying needs it is serving.

Sexual pain. Painful sex, which can include conditions like vaginismus, dyspareunia, vulvodynia, and pelvic floor dysfunction, brings many people to sex therapy. A sex therapist often works in coordination with pelvic floor physical therapists and/or gynecologists to address the psychological dimensions of sexual pain, although sometimes the physical dimension as well. The emotional or psychological component, particularly anxiety, avoidance, and the impact on relationship intimacy, is where the therapist’s work is essential.

Is couples therapy or sex therapy better for intimacy problems in a relationship?

Many couples in Denver seek out general couples therapy and find that their concerns are predominantly sexual or intimacy-related. There is significant overlap between couples therapy and sex therapy, and many therapists work fluidly across both. That said, many couples therapists are not fully equipped with the extensive sexual knowledge required to support the variety of clients’ sexual concerns.

General couples therapy addresses the full landscape of the relationship: communication, conflict, trust, family dynamics, parenting, finances, and yes, often intimacy as well. A couples therapist may or may not have specialized training in sexual concerns.

A sex therapist in Denver who also works with couples brings additional depth to the sexual and intimacy dimensions of the relationship. They have specific training in sexual dysfunction, sexual medicine, the physiology of arousal and response, and evidence-based interventions for sexual concerns. If the presenting issue for a couple is primarily about their sexual relationship, working with someone who has this specialized background is often the more direct and effective path.

That said, sex therapists also need a solid understanding of relational and attachment work. Sexual concerns do not exist in a vacuum. They are almost always embedded in the broader relational context: how safe each partner feels, how honestly they communicate, how much resentment has accumulated, how connected or disconnected they feel outside the bedroom. A good sex therapist understands this and holds both the specific sexual concern and the relational system it lives within.

The bedroom is not separate from the relationship. What happens between partners emotionally, their trust, their resentments, their tenderness, lives in the body and in the sexual connection too. Sex therapy generally addresses both.

What actually happens in a sex therapy session — what should I expect?

For anyone wondering what to expect in sex therapy, the first session, often called an intake session, looks much like the beginning of any therapy. Your therapist will ask about what brings you in, your history, your goals, and what you have already tried. For couples, both partners will have the opportunity to share their perspective.

There is no pressure to share anything you are not ready to share. A skilled sex therapist creates a space that is warm, non-judgmental, and genuinely curious, not clinical or detached. Many clients describe their first session as a relief–the experience of talking openly about something that has felt too private, too complicated, or too embarrassing to bring anywhere else.

From there, sex therapy typically involves:

Psychoeducation. A significant part of sex therapy is simply providing accurate information about sexual anatomy, arousal, desire, and response. Many people carry myths, misinformation, or gaps in knowledge that are contributing directly to their distress. Normalizing what is typical and not abnormal is itself therapeutic.

Exploration of history and meaning. Our relationship to our sexuality does not begin in adulthood. Family messages about bodies and sex, early experiences, cultural and religious influences, media/tech, and past relationships all shape how we experience intimacy as adults. Sex therapy creates space to examine these influences with curiosity and compassion rather than shame.

Communication skills. Many sexual concerns are sustained by the inability to talk about them, with a partner, or sometimes even with oneself. Sex therapy builds the vocabulary and the courage for these conversations.

Structured homework. Depending on the concern, a sex therapist may assign specific practices or exercises to be completed between sessions. These are always introduced gradually and are always within the client’s comfort and consent.

Coordination with other providers when needed. For concerns that have a physical component, such as hormonal issues, pelvic floor dysfunction, or medication side effects, a sex therapist often collaborates with physicians, gynecologists, urologists, pelvic floor, occupational, or physical therapists to ensure the client is getting comprehensive care.

How long does sex therapy take to see results?

The length of sex therapy varies considerably depending on the nature and history of the concern, whether the client is an individual or a couple, and how much related emotional territory needs to be addressed alongside the presenting sexual issue.

Some focused concerns, particularly when they are relatively recent and the relationship is otherwise strong, can show significant improvement in eight to sixteen sessions. More complex presentations, particularly those involving trauma, long-standing relationship patterns, or significant medical complexity, typically require more time.

What most clients find is that progress comes in layers. There can be early relief simply from having a space to speak honestly. The deeper work of changing patterns and building new experiences can take more time. There is also the ongoing maintenance work, the practice of communicating about intimacy as a regular part of the relationship rather than a crisis conversation.

Sex therapy in Colorado is not a quick fix, but for the people who do the work, the changes tend to be lasting, because they are rooted in genuine understanding rather than performance.

You do not have to have a diagnosable sexual dysfunction to benefit from sex therapy. You just have to want something better than what you currently have, and be willing to do the honest work of getting there.

How do I find a good sex therapist in Denver?

When searching for a sex therapist in Denver, there are several things worth looking for. First, verify that the therapist is a licensed mental health professional, licensed clinical social worker, a licensed professional counselor, or licensed marriage and family therapist, with licensure in Colorado. Licensure means they are accountable to a professional board and bound by ethical standards.

Second, look or ask about additional training or certification in human sexuality. The American Association of Sexuality Educators, Counselors and Therapists, known as AASECT, offers a certification process for sex therapists who have completed specialized training, supervision, and continuing education in the field. AASECT certified sex therapists have lengthy training, however are also more costly. Not all sex therapists are AASECT certified and may still be highly trained and educated by experts in the field while also charging more affordable rates for their services.

Third, and perhaps most importantly, look for a therapist whose approach feels warm, non-judgmental, and genuinely curious. Sex therapy requires a particular quality of safety in the therapeutic relationship. After the initial session, you should feel at ease with your therapist, that this is a person with whom you can be honest, without fear of shame or judgment.

At BE Therapy in Denver, I offer sex therapy for individuals and couples in a space that is informed, affirming, and deeply relational. Whether you are dealing with a specific sexual concern, a loss of intimacy in your relationship, or simply the desire to understand your sexuality more fully, I would be glad to talk and support you on your journey to understanding yourself and/or your partner(s) better.

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About BE Therapy. Bozhena Evans is a Licensed Clinical Social Worker and the founder of BE Therapy, a Denver-based practice specializing in couples therapy, sex therapy, and brainspotting for anxiety or other emotional wounds or trauma. Bozhena brings warmth, clinical depth, and a deeply relational approach to every session, drawing on the latest research in attachment, neuroscience, and somatic healing to help couples and individuals build more honest, connected, and fulfilling lives. She works with clients in-person in the Denver metro area and via telehealth throughout Colorado and virtual in California.

Ready to take the next step?

If something in this post resonated with you, you do not have to navigate it alone. BE Therapy offers a free 20-minute consultation for new clients, a no-pressure conversation to explore whether working together feels like the right fit. Sex therapy is more accessible, and more effective, than most people expect. The first step is simply reaching out.