Let's just get the awkward part out of the way: most people who need a sex therapist wait way longer than they should to find one. The reasons are pretty predictable. It feels embarrassing to search for. It's hard to know what questions to ask. And the internet is full of therapists who list "sexuality" on their profiles because they took one continuing education course five years ago and feel comfortable with the subject.
So here's the thing. Sex therapy is a clinical specialty. It requires specific post-graduate training, and the gap between a therapist who has it and one who doesn't shows up pretty quickly in the room. Whatever you're dealing with, whether it's low desire, vaginismus, compulsive sexual behavior, sexual shame, performance anxiety, or something you haven't quite named yet, you deserve someone who actually knows what they're doing with it.
This is how you find that person.
The credential question you actually need to ask
The gold standard in the field is AASECT certification, which stands for the American Association of Sexuality Educators, Counselors and Therapists. AASECT certification requires graduate-level training, supervised clinical hours, and an exam. It's meaningful. Not every excellent sex therapist has it, but it's the clearest signal available.
Beyond AASECT, look for therapists who have completed graduate-level coursework specifically in human sexuality, not just a weekend training or a CE unit. Ask directly: what is your training in sex therapy, beyond your base therapy license? A therapist who can answer this specifically is worth continuing the conversation with. A therapist who gets vague or pivots to talking about how open-minded they are is also telling you something.
Specialty fit: "open to discussing sex" is not a specialty
This is the one that catches people most often. A lot of therapists are genuinely comfortable talking about sex. That's a starting point, not a qualification.
If you're dealing with desire discrepancy in a long-term relationship, you want someone who works specifically with desire issues, understands the research on why desire patterns change in partnerships, and knows how to work with both partners even in individual sessions. If you're dealing with vaginismus or pelvic pain, you want someone who understands the intersection of physical and psychological components and can coordinate with a pelvic floor specialist if needed. If you're dealing with sexual shame related to religion or upbringing, that's a different clinical skill set again.
The question to ask every prospective therapist: how many clients with my specific concern have you worked with in the past year? Not "do you work with this." How many, specifically, in the past year. That's where you get real information.
A note on LGBTQ+ affirming vs. kink-aware
These are two different things and they're often conflated on therapist bios. LGBTQ+ affirming means the therapist will not pathologize your identity. That's a baseline, not a specialty. If your concern relates to queer relationship structures, gender-affirming care, or identity-related sexual shame, you want to ask what percentage of their current caseload identifies as LGBTQ+ and what specific training they've completed beyond a general affirming stance.
Kink-aware means the therapist understands that consensual non-normative sexual practices are not pathological and won't treat them as something to fix. Some therapists hold both designations. Many hold only one. Know which one you need.
Virtual sex therapy is appropriate for most people
You don't have to be in the same room as your therapist for sex therapy to work. Virtual sex therapy is available from New York-licensed therapists and is appropriate for most presenting concerns, including desire issues, sexual anxiety, sexual shame, and relationship concerns. Concerns with a significant somatic or physical component may benefit from coordination with an in-person pelvic floor specialist alongside telehealth therapy. A good therapist will be direct about which format fits your situation.
At The Boundary, we have an actual sex therapist
Liat Fruman is a licensed clinical social worker and PhD candidate in clinical sexology. She works with individuals and couples on desire issues, sexual dysfunction, shame, affair recovery, and sexual identity. She's kink-positive and LGBTQ+ affirming in the clinical sense of actually knowing how to work with those presentations, not just listing them. She's the real thing. Free phone consultation to get started.
Frequently asked questions
How do I verify a sex therapist is actually qualified?
Check for AASECT certification through their directory. Verify the base license through the New York State Office of the Professions. Ask directly about specialty training and supervised experience with your specific concern. Self-report is the only available check beyond those, which is why asking directly matters.
What's the difference between a sex therapist and a couples therapist?
A couples therapist focuses on relationship dynamics and communication. A sex therapist has specific clinical training in sexual function, sexual health, and sexuality-related concerns. The scopes overlap, and some therapists hold both. If your concern is primarily sexual, a sex therapist with couples training is usually a better starting point than a couples therapist who is generally comfortable with the topic.
Is virtual sex therapy effective?
Yes, for most presenting concerns. Desire discrepancy, sexual anxiety, sexual shame, and relationship issues all translate well to telehealth. Concerns with a significant somatic component may benefit from in-person coordination with a pelvic specialist. Ask your therapist directly which format fits your situation.
How much does sex therapy cost in NYC?
Out-of-pocket rates typically run $175 to $350 per session. Most sex therapists are out-of-network providers, but many will provide documentation for out-of-network reimbursement if your plan covers it. Ask about superbill during your initial inquiry.
I've tried therapy before and my sexual concern didn't move. What should I look for this time?
Usually this comes down to a mismatch between your concern and the therapist's actual training. A therapist who is generally good at therapy is not automatically equipped to treat something like sexual avoidance, performance anxiety, or desire discrepancy. Ask specifically what training and supervised experience they have with your concern. Comfort with the topic is a starting point. Clinical competency is what you're looking for.
I'm dealing with low desire. Who should I see?
Low desire has multiple possible contributors: hormonal, relational, psychological, medication-related, and situational. Start with a sex therapist who has specific experience in desire discrepancy or hypoactive sexual desire. Depending on what emerges, they may coordinate with a physician or other specialist. Starting specific gets you to the right answer faster.
