Why should I see a sexologist?

Personally, I wanted to pursue Sexology when I started my journey in Psychology. I never saw myself as a mental health professional that would only end up discussing topics around everyday life struggles. I was always excited to delve into the nitty-gritty parts of people. I wanted to talk about SEX. The good stuff, the bad stuff and even the ugly stuff. I wanted to talk about the subjects that no one wanted to talk about. The kind of topics that might seem “unladylike”. The stuff that makes you cover your eyes, but also tempts you to peak through your fingers. I wanted to speak about the most intrinsic part of being human.  

Because I was curious, and I knew my friends were curious… and I assumed that others would be curious too! So, I started doing my research on becoming a sexologist and I introduced myself to Professor Elna McIntosh (a well-known clinical sexologist in South Africa). I also binged watched the series called Masters of Sex. Here is to the researchers who started it all – William Masters and Virginia Johnson. I really recommend this series, but please do not confuse sexologists with professionals watching others having intercourse or practising masturbation. In the early days of human sexuality research, this seemed to have been what Masters and Johnson predominantly spent their time doing through experimental observation. However, to highlight what sexologists actually do in modern society, I have kindly asked Prof McIntosh to provide me with credible information on all you need to know about the field of Sexology, how to become a sexologist in South Africa, as well as what services sexologists provide, and for you to decide whether you would like to utilise these services.

What is a sexologist? 

A sexologist is engaged in the scientific study of sex and is interested in understanding what people do sexually and how they feel about what they do. A sexologist learns about the broad spectrum of human sexual behaviour and the many factors that influence people’s behaviour and feelings about their sexuality. Sexologists work predominantly in the field of research, education, and counselling. For the purpose of this blog, we will be focusing on the services provided by a psychologically trained sexologist, more commonly known as – a sex therapist. 

A sex therapist is a sexologist who offers sex counselling to help people understand and accept themselves as sexual beings and meet their sexual goals. Sex therapists are sex-positive and maintain a broad perspective by taking factors such as biological, psychological, sociological, anthropological and historical into consideration when addressing sexual issues. They use an educational approach to help clients meet their goals and are non-judgmental, which means that they do not have any preconceptions of what a client’s sexuality “should” look like. Thus, sex therapists are trained to have a sex-positive outlook and provide a warm, non-judgmental space for their clients.

How do sex therapists work?

Sex therapists facilitate clients’ sexual growth by helping them to identify their sexual goals and by offering education, resources, tools, and techniques to help them meet those goals and ultimately manage their own sexual growth. 

The process entails the following steps:

  1. Helping clients to identify where they are when they arrive and where they want to be when they finish their work with a sex specialist. 
  2. Helping clients identify the factors that allow them to feel safe and those that prevent them from meeting their sexual goals
  3. Helping clients to identify the factors that allow them to feel safe and those that prevent them from meeting their sexual goals. 
  4. Designing and suggesting exercises to help clients progressively expand their sexual comfort zones until they reach their goals. 

This is considered “brief therapy,” which is goal-oriented counselling. It is also considered ‘talk therapy/counselling. Sex therapists WILL NOT physically engage with couples or individuals, or “watch” people have sex. If sexual difficulties appear to be rooted in deeper issues that require intensive therapy, a practitioner will refer clients to a relevant professional. If a sex therapist feels that a client requires medical attention before or during counselling, the practitioner will do his or her best to provide a referral. 

What types of sexual concerns can a sex therapist help with?

The following are common concerns that a sex therapist helps individuals and couples address. Addressing feelings around feeling ‘abnormal’ (in terms of sexual behaviour, fantasy, capability, physique, etc.), feeling uninformed or misinformed about sex, feeling inexperienced, unskilled, ashamed of their sexuality or sexual desires, and feeling negative about one’s body. Addressing desire discrepancy between/ among partners. Sexual orientation identity (LGBTQIA+). Navigating sexual relationship structures (monogamous, polyamorous, polysexual, open, swinging, etc.). Discussing issues around infidelity. How to negotiate kinky relationships. Psychoeducation and talking through concerns around the lack of or reduced desire or arousal, difficulty maintaining arousal, erectile difficulty, difficulty reaching orgasm, ejaculatory control difficulties, fear of or aversion to touch, intimacy, penetration or pain, unconsummated marriages or relationships. Moreover, sexologists often address relational challenges such as the difficulty identifying satisfying activities for both partners, difficulty communicating sexual needs, desires and intimacy, finding satisfying sexual activities after surgery, a health crisis, ongoing health challenges or limited mobility and sexual compulsion, as well as concerns around pornography use. Lastly, sexologists aid in building supportive networks by seeking resources (including finding like-minded people) 

Sex therapists can help clients address all of the above issues and have coordinated care with medical and mental health practitioners in offering support. Sex therapists also offer sex education and sexual enrichment programs for individuals and couples who want to improve or enhance their sexual relationships. Some common goals include recapturing lost sensuality; adjusting sexually to life changes such as health challenges (disability and chronic ailments), menopause, change in relationship status, or motherhood; and becoming comfortable with one’s own or a partner’s sexuality.

What kind of training do sex therapists have?

Sexology is currently an unregulated and unrecognised field in South Africa, which means that people can call themselves sexologists/sex therapists without earning credentials in the field. When searching for a sex therapist or sexual wellness counsellor, it is important to ask what kind of training a practitioner has in the area of human sexuality. Board certification by the American College of Sexologists or the American Board of Sexologists is one indication that a practitioner has completed a course of study in human sexuality that includes an experiential component. 

Most sex therapists have a PhD in Human Sexuality and certificates in sex education and clinical sexology from an accredited Institute and board-certified by the American College of Sexologists (ACS). Training consisted of studying the many facets of human sexual behaviour and participating in experiential courses to learn about beliefs and feelings about those behaviours. This training has prepared the practitioner to work with a broad range of sexual issues and the awareness gained by experiential courses enables one to confront your personal biases in order to maintain a non-judgmental space for clients. This formal training is offered overseas- mostly in the US and Australia. Since professionals working in this field are limited, it is important to determine if someone is qualified to help you with your sexual concerns- ask about their training and approach to treating sexual concerns, and ensure their approach is empowering, non-judgmental, and sex-positive. 

What I have learned in my time through reading, researching, and training in this field, is that communication between partners is always crucial – as well as our internal dialogue, inside and outside of the bedroom. Human sexual health is a complex phenomenon that requires compassionate and adequate care when people raise concerns or require a safe/non-judgmental space to share their experiences. Sexual wellness is a kaleidoscopic part of human nature that branches out into every aspect of human life. Therefore, it is just as important as looking after your physical wellbeing and mental health. So, let us open the line of honest communication. If you feel you need help, if you feel you are peaking through your fingers in curiosity… then reach out to a trained professional near you. 


Lounette Els is a registered ASCHP Specialist wellness counsellor with a Masters in Social and Psychological Research (Wits) and has a special interest in sexual wellness. She is currently pursuing her Doctorate in Sexualities and Reproduction at Rhodes University. She further holds training from the Integrative Sex Therapy Institute (ISTI) and is a member of the Southern African Sexual Health Association (SASHA).

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