1. Sessions are more about feelings than sex positions
‘Clinical sexology’ might sound like I know every sex position under the sun, but what I do is actually pretty similar to couples’ therapy. In my practice, sessions are rarely about how to have more orgasms, or how to last longer in bed, or techniques to have better sex, though some sexologists might touch on those topics regularly. What I do is more like traditional talk therapy, except we’re talking about sex and relationships. You have to know the fundamentals of psychology and counselling in addition to knowing about sexuality. If you want to do hands-on work, become a sex surrogate or a dominatrix. Being a clinical sexologist is all talk, no action.
2. People will assume you’re a sex freak
Call it an occupational hazard, but when you have a PhD in clinical sexuality, people make assumptions about your sex life. When I was single, this came up all the time — men assumed I had no boundaries, that I was totally uninhibited, or that I did it all the time. In some ways, it actually made my dating life easier, because the people who were intimidated got ruled out very quickly. Now I’m happily married to someone who is very supportive of — and isn’t intimidated by — my work.
3. Potential clients may try to use you for phone sex
When I first started out, I would get calls from people who basically wanted to talk on the phone with a sex therapist while masturbating. I’m not a phone sex operator; I’m a therapist. Now, I have prospective clients fill out an intake questionnaire before I’ll chat with them on the phone, and the guys who just want to do the heavy breathing don’t call me anymore.
4. Most of the time, clients are there for totally relatable reasons
I’ve been doing this for 25 years and I’ve seen every sexual issue under the sun, but most of the time, the reasons people are coming to see me aren’t nearly as salacious as you’d imagine. Half of my practice is couples with young children who come to see me to work sex back into their lives. I also see a lot of couples where one person wants more sex than the other, or couples dealing with infidelity issues. I’ve only been shocked a few times in my career — and those were cases of horrendous sexual abuse or sexual violence, never by details of someone’s sexual preferences or their kinks.
4. It’s always about more than just sex
Clients will make an appointment because they’ve had an affair, or their wife won’t have sex with them, but that’s never what it’s really about. Like any therapist, I have to get to the bottom of what’s actually going on for this person. Repeat cheating might be about self-esteem issues that go back to childhood, for example, or someone might not be able to experience orgasm because they’re uncomfortable with what turns them on.
6. You don’t need an advanced degree, but it’s a good idea to get one
It seems like there are a lot more sexologists now than there were 25 years ago, when I trained, but there still aren’t regulations on what kind of training you need to do this work. I have a master’s in psychology and a PhD in clinical sexology, and I am certified by two professional organisations — the American College of Sexologists and the American Board of Sexology. But unlike mainstream therapy, you don’t need these certifications in order to call yourself a sex therapist. You don’t even need to get licensed like mainstream therapists do, so it’s on you to get adequate training in the field.
7. You’re running a business, not just giving sex advice
You have to invest time in putting your name out there, otherwise you won’t have any clients. I have a website and several social media pages; I also recently wrote a book and delivered a TED Talk, which both help get my name and my work out there. When I was first starting out, I had to be very diligent about keeping up my web presence and improving SEO to drive new clients to my website.
8. Insurance probably won’t cover your sessions
If you’re a mainstream therapist and you’re licensed, you can usually bill insurance companies for your sessions. But sex therapy doesn’t work like that. As of right now, my clients can only get reimbursed if they have a health savings account. I try to be realistic with how I price my sessions, since I know my clients are paying my fee out of pocket.
9. Clients won’t typically see you every week for months on end
Most of my clients come in to resolve a particular issue, and once it’s resolved, they stop seeing me. Those who can afford it will sometimes come to see me every four to six weeks for a relationship ‘tune up,’ or a client might come back when there’s another issue. But in general, my style is very direct. This isn’t like psychotherapy, where you go weekly for years on end. I constantly have to market myself and find new clients.
10. You have to let go of your judgment
Everyone is vulnerable, but especially so when it comes to sex. Whether someone’s visiting me because they’ve never had an orgasm, or because they’re uncomfortable about what turns them on, or they’re exploring cross-dressing, they all ultimately want the same thing: to be accepted. As a sex therapist, it’s my job to give that acceptance and help people accept themselves as sexual beings.
Claudia Six is a clinical sexologist and the author of Erotic Integrity: How To Be True To Yourself Sexually.
This article originally appeared on Cosmopolitan.com.