How to Become a Sex Therapist: A Grounded Look at the Journey, the Work, and the Community
If you’ve been wondering how to become a sex therapist, you’re not alone. It's a question more and more therapists are starting to ask—often from a place of wanting to support pleasure, reduce shame, or simply work more openly with a part of people’s lives that most therapy ignores.
I’ve walked that path. I’m a certified sex therapist through AASECT (the American Association of Sexuality Educators, Counselors, and Therapists), and what I want to offer here is more than a checklist. This is a real-world reflection on the process, the weight of the work, and why I chose this path over others like sex education, sexology, or sex surrogate therapy. If you'd like to learn more about me and my background, visit the About Sean page.
Let’s Start with the Basics: What is a Sex Therapist?
A sex therapist is a licensed mental health professional—often a marriage and family therapist, counselor, psychologist, or social worker—who has pursued additional, advanced training in human sexuality and intimacy. Unlike sex educators or sexologists, a sex therapist is trained to treat mental health and relational issues that intersect with sexual functioning, desire, shame, trauma, and identity.
We don’t just talk about sex—we support people in reclaiming their sexuality after years of silence, harm, or confusion. And we do so from a clinical, trauma-informed, and ethically regulated lens.
What Is a Sexologist vs. a Sex Therapist?
Sexologists are typically scholars or educators who study human sexuality from academic, sociological, or scientific perspectives. They often have degrees (sometimes PhDs) in human sexuality or public health. Their work may involve publishing research, consulting on policy, or educating communities.
However, sexologists are not always trained therapists—and thus, they don’t provide psychotherapy. They’re experts in sexual knowledge, but not necessarily in therapeutic intervention. That’s one of the reasons I chose sex therapy certification over sexology: I wanted to work directly with people in the room, not just speak about sexuality in theory, but help people live it more freely.
What Is Sex Surrogate Therapy?
Sex surrogate therapy involves experiential work with trained surrogates who collaborate with clients—typically alongside a therapist—to address specific challenges around intimacy, touch, or sexual functioning. This work often includes guided physical experiences meant to foster connection and comfort in a client’s body. For some, it can be profoundly healing.
That said, sex surrogacy is distinct from psychotherapy. Surrogates are not licensed mental health professionals, and their work takes place within a very different framework than what most therapists are trained to provide. While I respect the intention behind this modality and acknowledge that it has supported growth for some individuals, it’s not a path I’ve pursued professionally or one that aligns with my clinical focus.
My training and practice remain grounded in talk-based, trauma-informed sex therapy. That’s where I’ve found the most depth, nuance, and capacity to support long-term healing, especially in the context of identity formation and relational repair.
Why I Chose Sex Therapy Certification Through AASECT
My journey started in the familiar way: undergraduate degree in psychology, then a Master of Science in Marriage and Family Therapy. From there, I spent years becoming a licensed clinician—first as an associate, then as an independently licensed marriage and family therapist. Only after that could I begin the sex therapy certification process through AASECT.
That process was rigorous by design. It required 160 hours of sexuality education—ranging from anatomy to kink-affirming clinical treatment—and 500 direct client hours working specifically with sex therapy concerns. These included issues like out-of-control sexual behavior, desire discrepancy, sexual trauma, identity development, and more.
What I realized quickly was that becoming a sex therapist wasn’t just about accumulating knowledge. It was about becoming someone people could trust with the parts of their life that no one else sees. That’s a responsibility I don’t take lightly.
A Moment That Changed Everything
I still remember the shift: when I started asking clients more openly about their pleasure, their body image, or how they experience desire. I had always assumed these topics were off-limits unless clients brought them up. But once I started asking the right questions, the responses poured in. People told me things they had never said out loud. Not because I was an expert—but because I was curious, safe, and unshocked.
That’s when it really hit me. The value of this work isn’t just in what we treat. It’s in how we hold space for people’s shame without judgment, how we offer structure without rigidity, and how we invite people to rediscover parts of themselves they thought were too messy, too confusing, or too broken to name.
How to Become a Sex Therapist: The Path in a Nutshell
- A master’s or doctoral degree in a mental health field
- Licensure (or associate licensure) in your state as a therapist
- Completion of a sex therapy certification program (like AASECT), which includes:
- 160+ hours of sexuality education
- 500 hours of sex therapy clinical practice
- 50 hours of supervision with an AASECT-approved supervisor
- A commitment to ongoing personal and professional development
This isn’t a quick certification—it’s a transformational one. And that’s why it matters.
The Salary of a Sex Therapist: What Can You Expect?
People sometimes ask about the salary of a sex therapist, and the truth is, there’s no standard answer. There are relatively few certified sex therapists in the United States, which means the market is wide open—but your income will largely reflect your choices.
If you work in private practice, your salary will depend on your location, your fee, and how many clients you see. But the real earning potential comes from how you choose to shape your professional identity: through supervision, training, writing, speaking, or leading within the field. In other words, once certified, your income can scale in proportion to how you define your role in the sex therapy community.
Final Thoughts
Becoming a sex therapist is not the easy road—but it is one of the most deeply rewarding. You’ll hold people’s secrets. You’ll hear their fears, their pleasure, their doubts. You’ll see the things they thought were unlovable. And if you do it well, you’ll become someone who helps them reclaim their story—not by fixing them, but by standing with them in the places they didn’t think they could be seen.
If your motivation is to reduce shame, support embodied pleasure, and bring clarity to a part of life most people feel alone in—then I hope you consider taking the step.
The world needs more sex therapists. Real ones. Trained ones. Grounded ones. Maybe it needs you.