“Can I talk to you about sex?” 

It’s a common question I get asked in therapy—and my answer is always a resounding yes! Of course you can. 

Not only because I enjoy working with clients on sex-related concerns and helping bring clarity and levity to an area where many people carry shame or embarrassment. But also because sex impacts our quality of life, and so sex-therapy is really just quality of life therapy. 

It’s a way to enhance a sense of freedom, confidence, pleasure, embodiment, connection—or whatever it is you personally value sex for.

I’ve worked with clients navigating mismatched desire in long-term relationships, to healing from past sexual trauma, to simply learning how to communicate what feels good or doesn’t.

It’s normal for these conversations to feel hesitant at first, but they can lead to profound shifts in confidence, understanding, and quality of life.

I also can’t blame clients for being unsure whether it’s okay to bring sex up in therapy, and I think there are a couple reasons for this.

Why This Question Comes Up So Often

1) Cultural taboo still lingers. We live in a culture that tends to put sex in a different category than just about every other topic. Despite strides in recent years toward Western culture becoming more open to discussing sex, the topic can still feel very much taboo in many settings.

2) What about sex therapists? There’s an idea that because there are specialized “sex therapists”, that means anything sex related needs to be handled by a specialist. However, I’ve also heard from such specialists clients often end up coming to see them who really don’t require specialized sex-therapy services at all (which can be scarcer, more expensive, and have longer waitlists).

3) Variation in counsellor training. I was fortunate in my training to have a supervisor who emphasized this important area of client’s lives, and was able to provide additional training in it. However, many counsellor training programs neglect to address sex in therapy at all- and it’s a short coming. It seems that most therapists would benefit from having at least some fundamental training in sex therapy, while specialization could then be used to address more complex concerns.

If You’re Ready to Talk About This

If you already have a therapist you’re working with, ask them about their approach to addressing sex-related concerns. At the very least, they should be able to help you identify if your concern is something that they can address, or refer you to someone who can.

Here are some of the areas I support clients (individuals and couples) with as a Registered Clinical Counsellor:

• Low sexual desire
• Sexual shame, guilt, or anxiety
• Desire differences in relationships
• Mindfulness & sex
• Asexuality
• Performance anxiety
• Body Image
• Boundaries
• Sex communication
• Sexual orientation and identity
• Ethical non-monogamy 
• Trust
• Past infidelity
• Pleasure
• Confidence
• Pornography Use
• Sexualized violence recovery
  

More than anything, just know that whatever you are experiencing is probably normal. If you need support in this area- support is available. Sex concerns are just human concerns, and caring for that part of your life is an act of self-love and courage.

If you’re feeling nervous or embarrassed about bringing this up, that’s also totally normal. You don’t need to have it all figured out or perfectly articulated. Even starting with “This feels awkward to talk about, but…” is more than enough—a good therapist will help you from there.

Alyx Monteith (M.A., RCC) is a Registered Clinical Counsellor with additional training in the fundamentals of sex therapy.

October 26th, 2025