What Questions Might a Sex Therapist Ask You During Your First Session?

One’s mental and emotional health is just as important as their physical health when it comes to their sexual functioning. This is why urologists and urogynecologists often work collaboratively with sex therapists to offer their patients comprehensive care by addressing both the physiological and psychological aspects of sexual dysfunction. While a urologist focuses on managing medical conditions, a sex therapist can help patients navigate the emotional and psychological challenges associated with sexual dysfunction, such as performance anxiety, relationship conflicts, or trauma-related concerns.

Starting sex therapy can feel intimidating, but it’s a step toward improving your sexual health and relationships. Understanding what to expect during your first session can make it easier to open up and engage in the process. A sex therapist’s questions aim to understand your concerns and create a supportive environment tailored to your needs. Here are some common areas a therapist might explore during your first appointment.

1. Understanding Your Goals

One of the first things a sex therapist may ask is why you sought therapy. This could include questions like:

• “What specific concerns or issues are you experiencing?”
• “What would success in therapy look like for you?”

Your goals might involve improving intimacy in a relationship, addressing sexual dysfunction, overcoming trauma, or navigating changes in sexual health. Defining your goals helps the therapist develop a treatment plan that aligns with your needs.

2. Your Sexual History

A therapist may ask about your sexual history to understand patterns and experiences that may influence your current concerns. Questions might include:

• “How would you describe your sexual experiences in the past?”
• “Do you have any past traumas or negative sexual experiences?”

These questions are not meant to pry but to identify factors that could be contributing to challenges such as low desire, pain during sex, or difficulty reaching orgasm.

3. Your Relationships

If you’re in a relationship, the therapist might explore dynamics with your partner(s). Some questions could include:

• “How would you describe communication about sex with your partner?”
• “Are there any relationship challenges that affect your sexual connection?”

For individuals who are single, the focus might shift to exploring past relationships and how they influence your current feelings about intimacy and connection.

4. Medical and Health History

Sexual health is closely linked to physical health. A therapist might ask:

• “Are you experiencing any medical conditions that could affect your sexual functioning?”
• “Are you taking any medications or have you noticed side effects related to sexual health?”

This helps the therapist determine if medical factors, such as hormonal imbalances or side effects of medication, might contribute to your concerns.

5. Emotional Well-being

Emotional and mental health play a significant role in sexual health. Questions in this area might include:

• “Have you been feeling stressed, anxious, or depressed lately?”
• “Do you have a history of mental health conditions?”

Addressing underlying emotional challenges can be essential to improving sexual well-being.

6. Cultural and Personal Beliefs

Your cultural background, values, and beliefs can shape your perspectives on sex and relationships. A therapist might ask:

• “What messages about sex did you learn growing up?”
• “Are there cultural or religious beliefs that influence your views on sexuality?”

This helps the therapist work with you in a way that respects your identity and values.

7. Comfort and Consent

Finally, a good therapist ensures that you feel comfortable and in control of the session. They might ask:

• “Are you comfortable discussing this topic today?”
• “Is there anything you prefer not to talk about right now?”

These questions reinforce that therapy is a collaborative process where your boundaries are respected.

What to Keep in Mind

Sex therapists are trained professionals who approach these topics with sensitivity and care. While some questions might feel personal, they are asked to gain a deeper understanding of your concerns and create an effective treatment plan. You can always share only what you feel comfortable discussing and set boundaries where needed.

By addressing these areas, your therapist can help you identify the root causes of your concerns, set achievable goals, and guide you toward improved sexual health and satisfaction.

References:

American Association of Sexuality Educators, Counselors and Therapists. (n.d.). https://www.aasect.org

Rao, T. S. S., Tripathi, A., Manohar, S., & Tandon, A. (2024). Promoting sexual well-being. Indian Journal of Psychiatry, 66(Suppl 2), S262–S271. https://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_612_23

Zencare. (n.d.). What to expect in sex therapy. Retrieved January 30, 2025, from https://blog.zencare.co/sex-therapy-what-to-expect/