24 Brutally Honest Confessions From A Sex Therapist

Yes, your genitals are perfectly normal, and no, we're not unshockable.

1. We don't watch couples have sex.

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We're therapists, not sexual-technique coaches. Our work is basically problem-solving: helping couples communicate about sex, helping individuals feel more confident sexually, and working through deeper issues around love and relationships. We certainly don't stand in the corner of bedrooms with a clipboard.

2. And we don't have sex with our patients either.

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You're thinking of sex surrogates, and that's a very different thing. Surrogates work closely with individuals who are having sexual problems, and part of that work can involve having sex with their clients. We just talk about sex – we don't do it.

3. People have absolutely no idea how to react when we tell them what we do.

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And the responses we do get tend to be inappropriate, e.g. "Ooh, I could do with some help from you!" or "Well, a sex therapist is the last thing I need, I get laid all the time." Come on, we just met you at a party, we don't need to know that.

4. We sometimes use explicit photographs to help us explain concepts and reassure people.

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Sometimes, the only way to explain something clearly is to use quite graphic photographs. Some couples aren’t happy about seeing them, but realising what a broad range of genital sizes, sexual positions, sexual acts, options, and body shapes there is out there can help them feel better about themselves.

5. We also use sex-ed charts and diagrams to help people get to grips with their partner's anatomy.

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Occasionally we might use 3D models as well. It's hard to pleasure someone else if you're not sure how their equipment works. A lot of men think the cervix is on the outside of the vagina, for example, which can cause quite a bit of confusion.

6. We do a lot of work with older people.

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A lot of retirement age couples find their sex life has been gradually dropping off for years, and worry they might never have sex again if they don't fix it. We tend to give these couples exercises to help them reconnect, starting with holding hands and cuddling, then moving on to kissing and sexual touching.

7. We also see a lot of couples whose sex lives have taken a dive after having kids.

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Just because the doctor says it's OK to have sex again six weeks after childbirth, that doesn't mean things immediately snap back into place. A woman might find she's too sore, or self-conscious, or both parents might simply be too tired. We often end up comforting new parents and reassuring them that the situation is normal.

8. Lots of couples we work with have issues that can be solved with just a bit of communication.

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Many couples can have sex but can't bring themselves to talk about the details, i.e. what they enjoy most. This in turn can put people off sex, because they find it unsatisfying but they can't face asking their partner to change their technique. Our sessions help people open up about what really gives them pleasure.

9. Other clients have never explored their bodies, so they're not sure what they do enjoy.

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Masturbation and self-exploration (sometimes involving looking at your genitals in a mirror) can help you get to know your body and learn about what feels good for you. In turn, this will help you guide your partners to those sweet, sensitive spots.

10. A sexless relationship is seen as a massive taboo.

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But if both partners are comfortable with that, why should it be? It's seen as the worst thing in the world, but some very loving relationships do end up being nonsexual for various reasons, and we can help people come to terms with this.

11. Fifty Shades of Grey caused us lots of problems.

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Suddenly couples were showing up in our offices, often upset because one partner had tried to act out their Fifty Shades fantasies and the other didn't want to. The novels don’t contain much clear or helpful information about how to start experimenting with BDSM. It should be approached very carefully and sensitively.

12. You have to have a good sense of humour to do our job.

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We do find some of the stuff our clients say pretty darn funny, especially the misconceptions about anatomy ("I fingered her ovaries!"), and we do talk about some of the funniest things outside work, but we'd never tell anyone your name, or go into loads of detail about the ins and outs (heh) of your sex drive and habits.

13. And sometimes we really don't know what to say.

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Just when we think we've heard it all, someone will always surprise us with a new fetish. Even though we're pretty unshockable, we might still need a second to gather our thoughts if you tell us you love sticking wooden spoons up your butt while masturbating to old episodes of Gordon Ramsey's Kitchen Nightmares.

14. It can be really emotionally draining as well.

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Obviously sex problems don't just appear from nowhere, and sometimes we hear some really traumatic things that have happened in people's pasts. We're trained to deal with this, of course, but it can be a daunting, painful process.

15. We don't ask people to tell us their fantasies.

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We might suggest you write down your fantasies and discuss them with your partner if you feel comfortable with that, but you don't have to tell us your deepest, darkest, most unusual desires. Unless you really want to, of course.

16. Women often say they're disappointed that they can't orgasm the "real" way.

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And by that, they mean penetrative intercourse. But the reality is that the clitoris and the opening of the vagina aren't always positioned in a way that makes it possible, and a lot of women feel self-conscious pleasuring themselves during sex. We work hard to explain there's no real, right, or (particularly) wrong way to do things.

17. Men tend to present with problems about erections and ejaculation.

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Porn makes it seem like every man has a massive dick and has no problem at all keeping an erection, lasting for hours in bed, and ejaculating at the end of it all. There's also a feeling that you're less of a man if you don't perform as expected. We might end up referring some clients to a doctor if their problems are medical.

18. And as women get older, dryness and related pain during sex can start to be an issue.

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Again, this is perfectly normal and doesn't mean you don't find your partner attractive, or feel horny, but it can take a while to come to terms with these physical changes and understand what's causing them. Thankfully, lube exists.

19. Mismatched levels of desire are common too.

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If one person in a relationship wants sex more than their partner, they often end up feeling very hurt whenever they're turned down. Learning to compromise can really help in this situation, as can finding ways to take the sting out of rejection: like kissing, cuddling, and finding other ways to be intimate with each other.

20. There's a lot of pressure to have a "perfect" or generally amazing sex life.

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There are so many strange ideas floating around about how much sex "typical" people should be having. Some people book appointments in a panic because they're only having sex four nights a week and it used to be seven. Yes, we're sex therapists, but we'd be the first to admit that sex isn't the be-all and end-all.

21. Which means the most common question we get asked is: "Am I normal?"

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Meaning "Do I/we have a normal amount of sex?" or "Do I last for the normal amount of time?" There's an easy answer to this – nothing is normal! Instead of trying to fit in with what you've seen on TV, in magazines, or in porn films, explore what you want, what you enjoy, and what your specific desires are.

22. Also, your genitals are perfectly OK, honestly.

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A lot of clients feel self conscious about their vagina or penis and decide it looks "weird", especially compared to porn. We have diagrams, drawings, and photos that show how vastly different people's hoo-hahs and willies are, which helps.

23. Laughter and sex don't have to be incompatible.

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Once sex starts to become "serious" or "an issue", i.e. something you're going to therapy for, it feels more pressured. Laughter can help diffuse that tension and get things back on track. Sex games, roleplay, and toys are fantastic ways to start, but don't take it too far and dress as a clown (unless you really want to).

24. And we feel genuinely delighted when we work our sex magic and help people past a problem.

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We can tell that things are going well thanks to the spring in their step and the smile on their faces when they come back to see us. Congratulations, guys! Keep it up.

This post was put together with the help of a trained relationship and couples therapist, as well as this AMA on Reddit.