Integrated Counseling

When I tell people that I’m a sex therapist or that I specialize in sexual health, I am often met with shock or confusion.

“What is that?”

“A sex therapist – yikes!!”

“Oh, I thought you were joking!” 

My hope is to demystify what sex therapy really is, what it is not, and who might benefit from it. 

Sex therapy emerged as a profession in the 1960s. William Masters’ and Virginia Johnson’s groundbreaking research on human sexuality helped us understand the biology of sex more clearly. They developed popular interventions like sensate focus and the start-stop technique, and sex therapy was considered part of the medical field. It gained popularity through the 1980s, but unfortunately, the fear surrounding the AIDS crisis negatively altered the public’s perception of sex and sexual health. Sex therapy then declined until the late 90s.

Thankfully as attitudes have shifted again, sex therapy has seen a resurgence in popularity. Today sex therapy is less strictly a medical approach and is offered in regular therapy settings. Rather than solely focusing on biology, we now integrate the body, mind, spirit and consider relational dynamics for a more holistic version of sex therapy and sexual wellness. 

What is sex therapy?

Sex therapy is a type of psychotherapy or talk therapy that helps individuals and couples address psychological, emotional, relational and physical challenges to intimacy and sexual health. Common reasons for clients seeking sex therapy include:

• “I used to enjoy sex with my partner but I don’t anymore”
• “I’m ashamed of part of my sexuality”
• “Past sexual experiences are getting in the way of me enjoying sex now”
• “I find myself avoiding sex and I don’t want to”

Any issue at any stage of the sexual development lifespan is appropriate to bring for support from a sex therapist. A sex therapist helps clients deeply understand their current dilemma and collaborate to identify paths towards a healthier sexuality and overall life. Sex therapists offer education, resources and specific techniques to try when appropriate. 

Because sexual health is interconnected with mental, physical and spiritual health, a sex therapist will also ask about your broader life situation and experiences and connect the dots. For example, unresolved grief for the loss of a loved one will also affect your sexual well-being, even though they may not seem related. A sex therapist may be certified by a group like the American Association of Sexuality Counselors and Therapists (AASECT), but it is not required. 

What sex therapy is not

Sex therapy is not sexual surrogacy; meaning it does not involve any sexual contact between therapist and client. Surrogacy is a professional relationship that may involve physical and sexual contact between the surrogate and client to help with intimacy struggles. Sexual surrogates often work in conjunction with a licensed therapist to support their client.

In some cases, sexual dysfunction is due to an underlying medical issue. These are still appropriate to bring to sex therapy, however a sex therapist will also refer you to work with a medical professional.

Who might benefit

Whether you are an individual or partnered, if some part of your sex life is not working for you, or if you are simply curious about an aspect of your sexuality, you might benefit from working with a sex therapist. All of the following, and more, are wonderful reasons to seek out sex therapy:

• Exploring my sexuality – my sexual orientation, what I like or desire, my kinks, etc.
• Reconnecting with my sexuality – getting back in touch with this natural essence in myself that I feel distant from
• Working towards a more fulfilling sex life with my partner/s
• Healing past sexual trauma or abuse

Parents may also seek out a sex therapist for their child or adolescent if they have concerns about supporting their child’s healthy sexual development. For example:

• A teenager becoming sexually active
• A child acting out sexually in inappropriate ways
• A pre-teen exploring sexual orientation or gender identity

A sex therapist will provide developmentally appropriate support to you and your child in these situations. 

If you are actively experiencing sexual abuse or violence, there are resources for immediate help:

RAINN’s National Sexual Assault Hotline: 800-656-HOPE

Domestic violence shelters like Safe Connections or ALIVE (local to St. Louis)

A sex therapist can also support and work with you through active, ongoing abuse. If you need help, help is available to you. 

Whether curious, dissatisfied, unfulfilled, hurting or uncertain, sex therapy may offer a safe space for you to explore, reconnect and move towards a healthier, happier sexuality and life overall.

If you are interested in a consultation for therapy, you can reach Meredith at 314-827-4833 or wholenessandchoice@gmail.com. She is now accepting most major health insurance plans including Aetna, Cigna, Anthem Blue Cross Blue Shield, and Optum/United Healthcare coming soon. Meredith also accepts private pay clients and can work on a sliding scale with those who need financial assistance.

Meredith Rose is a sex therapist in St. Louis, Missouri. She works with adolescents, adults and couples in therapy. Meredith founded Integrated Counseling in 2023 with the goal of providing accessible trauma-informed therapy for women, sexual and gender minorities, and diverse clients of all backgrounds. With the right support we can all live authentic, integrated and healthy lives that we choose for ourselves and our communities.