The right questions help you find a sex therapist who is qualified, a good fit for you, and someone you can actually talk to. If the idea of that first call makes you nervous, you're in good company. Most people feel a little awkward talking about sex with a stranger, and good therapists expect that.
Sex therapy is talk therapy. It focuses on sexual concerns such as low desire, mismatched libido, pain during sex, erectile or orgasm difficulties, sexual shame, recovery after trauma or illness, and questions about identity or relationships. There is no physical contact or nudity in sex therapy, ever.
Below are the questions worth asking, grouped by when they matter most: before you book, during your consultation, and once sessions begin.
Questions about credentials and training
In many places, "sex therapist" is not a protected title, so anyone can use it. Start by confirming the person is a licensed mental health professional with specific training in sexuality.
Are you licensed, and in which state or country? Look for a license such as LMFT, LCSW, LPC, psychologist (PhD/PsyD), or psychiatrist. You can usually check it on your licensing board's website.
Are you certified in sex therapy? In the US, the most recognized credential is AASECT certification (American Association of Sexuality Educators, Counselors and Therapists). Other countries have their own bodies. Certification means extra coursework, supervised hours, and a code of ethics.
If you're not certified, what sexuality training do you have? Some excellent therapists are in the process of certifying or trained elsewhere. Ask how many hours of training and supervision they've had.
How long have you worked with sexual concerns? Ask what share of their caseload is sex therapy versus general counseling.
Have you worked with my specific concern before? Whether it's vaginismus, porn-related worries, erectile difficulties, or desire discrepancy, experience with your issue matters.
Questions about their approach and fit
Credentials get you a qualified therapist. Fit decides whether therapy works. Research on therapy outcomes consistently points to the relationship between client and therapist as one of the strongest predictors of progress.
How would you describe your approach? Common methods include cognitive behavioral therapy (CBT), sensate focus exercises, mindfulness-based approaches, emotionally focused therapy for couples, and trauma-informed care. A good therapist can explain theirs in plain language.
What does a typical session look like? Most sessions are conversation. Many therapists also assign homework, like reading, journaling, or private exercises to try at home.
How long does sex therapy usually take? Many concerns improve within 6 to 20 sessions, but it varies. Ask how they'll track progress with you.
Are you affirming of my identity and relationship? If you're LGBTQ+, trans or nonbinary, kink-involved, polyamorous or ethically non-monogamous, asexual, or from a specific cultural or religious background, ask directly. You deserve a therapist who won't treat who you are as the problem.
Do you work with doctors or other specialists? Some concerns have physical causes. A good sex therapist knows when to refer you to a urologist, gynecologist, pelvic floor physical therapist, or endocrinologist, and may coordinate with them.
What are your values around sex? You're not asking for their personal life. You're checking that they don't bring judgment about masturbation, porn, frequency, or what "normal" sex should look like.
Questions about cost, scheduling, and privacy
Practical details can make or break your ability to stick with therapy, so ask about them up front.
What is your fee, and do you offer a sliding scale? Sex therapy is often private pay. Some therapists offer reduced rates based on income.
Do you take my insurance, or can you provide a superbill? A superbill lets you request out-of-network reimbursement. Note that insurance usually requires a diagnosis on your record.
Do you offer online sessions? Telehealth widens your options a lot, especially if few specialists practice near you. Therapists generally must be licensed where you are located during the session.
How often will we meet? Weekly is common at first, then sessions may space out.
How do you protect my privacy? Ask how records are stored, what platform they use for video sessions, and what the limits of confidentiality are. Licensed therapists must break confidentiality in narrow situations, such as risk of serious harm.
What is your cancellation policy? Knowing this upfront avoids surprise charges.
Questions to ask if you're coming as a couple
Many people start sex therapy with a partner. A few extra questions help everyone feel like the therapist is on the relationship's side, not one person's.
Do we need to attend together, or can one of us come alone? Both options are valid. Some concerns are best worked on individually first.
Will you meet with us separately at any point? Many couples therapists hold one individual session with each partner early on.
What is your policy on secrets? If one partner shares something privately, will the therapist keep it confidential or require it to be shared? Ask before it comes up.
How do you stay neutral? It's common for one partner to feel like "the problem." A skilled therapist frames the issue as something you work on together.
What if our goals are different? One of you may want more sex and the other may want less pressure. Ask how the therapist handles mismatched goals.
Questions to ask once therapy starts
Asking questions doesn't stop after you book. These keep therapy focused on what you came for.
What do you think is going on? Ask for their understanding of your concern and what may be contributing to it.
What are our goals, and how will we know we're getting there? Clear goals make progress easier to see.
Why are you suggesting this exercise? You can always ask the reason behind homework, and you can say no to anything that feels wrong.
Is this normal? Ask freely. Therapists hear this question constantly, and the answer is often more reassuring than you expect.
Should I see a doctor too? Especially for pain, erectile changes, or shifts in desire after a medication change, pregnancy, or menopause.
Is this still working? Check in every few sessions. If it isn't, a good therapist will adjust the plan or refer you elsewhere.
Good signs and red flags
Their answers tell you a lot. Here's what to listen for.
Good signs
Red flags
Answers credential questions openly and points you to where you can verify them
Gets vague or defensive about licensing or training
Explains their approach in plain, non-judgmental language
Shames your desires, identity, or relationship structure
Asks about your goals before suggesting a plan
Promises a quick cure or guaranteed results
Refers you to a medical provider when a physical cause is possible
Dismisses physical symptoms as "all in your head"
Keeps clear professional boundaries
Suggests any physical contact, nudity, or meeting outside sessions
Respects your pace and your right to say no
Pressures you into exercises or disclosures you're not ready for
Any suggestion of physical or sexual contact with a therapist is an ethical violation. If it happens, end therapy and report it to their licensing board.
Taking the first step
You don't need to ask every question on this list. Pick the three or four that matter most to you, write them down, and bring them to a free consultation call if the therapist offers one. Notice how you feel during the conversation: comfortable, heard, and not judged is what you're looking for.
Reaching out is often the hardest part. Asking good questions makes sure that step leads somewhere helpful.
If you would like to set up a consult for individual or couples therapy, please contact me or schedule a consult call.