At dinner parties, weddings, and other social engagements, the inevitable “What do you do?” question arises. I generally tell people, “I’m a clinical psychologist in private practice.” If the conversation progresses to the topic of my specialization, it can take a turn after they hear I’m a sex therapist.

I’ve experienced a range of reactions, from completely unfazed to visibly uncomfortable. Understandably, the latter reaction usually comes from a place of misinformation about what it is that I do (note: sex therapists address mental health and relationship concerns in the same way that other therapists do, but we use specialized training in sexual health for a more targeted approach that emphasizes talking openly about sexual feelings).

Regardless of the person’s reaction, the follow-up question is almost always, “So…how did you get into that?” I usually provide a quick, abbreviated response about how my training and clinical experience have led me down this path…

Here’s the whole story:

When I first decided to go to school to become a psychologist, I didn’t have a clue I’d become a sex therapist. If you had told me then, I would’ve been floored. It wasn’t until much later, after six years of graduate school, that I even considered it.

In my education and training to become a psychologist, my clinical focus was in behavioral medicine. I trained in hospitals, pain clinics, and cancer wellness centers. My internship and postdoctoral residency were through the VA, where I became the Health Psychologist for a Primary Care and Mental Health Integration Program. Essentially, I planned to spend my career helping patients cope with the emotional distresses caused by serious physical illness.

Throughout years of clinical experience with patients suffering from medical concerns, a common issue came up over and over again: sexual dysfunction. Patients with cancer, diabetes, heart disease, chronic pain issues, disabilities, and other medical problems were subsequently experiencing challenges with sexual desire, orgasm, performance, etc. Embarrassed to discuss these issues with their medical providers, these patients came to me. They felt shame over the changes to their body after medical treatment or surgery and expressed fear about the impact it would have on their sexual relationships.

I appreciated how much of a clinical need there was for treating these concerns and how few resources were available to help these patients. Colleagues who felt this area was outside their realm of expertise (or comfort zone) started referring these patients to me. I was happy to accommodate.

Eventually, I came to realize that these were my favorite patients. Their cases were challenging, sometimes heartbreaking; however, helping them improve their situation to the best of their ability so they could enjoy sexual intimacy again was tremendously rewarding.

After completing my post-doctoral residency, I went back to school again for specialized training at the University of Michigan’s post-graduate program in Sexual Health. Once there, I knew had found my place within the mental health profession. I started my own practice specializing in the treatment of sexual dysfunction in 2017 and completed the extensive training and supervision to become an AASECT-certified sex therapist. The rest is history.

Sexual intimacy can be one of the best parts of life. It can also be a source of frustration, anxiety, sadness, and disappointment. For many (more than you probably realize), sex will become challenging at some point due to relationship problems, mismatched desire, medical issues, stress, emotional concerns, aging, deep-rooted insecurities, or trauma.

These issues can be highly complex and deserve as much care and attention as any of the other struggles we may experience. Sex therapy is a valuable resource that can help you identify what is getting in the way of sexual intimacy, learn strategies for addressing these concerns, and improve sexual communication with your partner so that you can build a healthier, more sexually satisfying relationship.

Note: If you’re struggling with sexual health concerns and interested in sex therapy, I recommend seeking treatment with a qualified, licensed mental health professional and AASECT-certified sex therapist (visit aasect.org for more information).