My Approach to Sex Therapy for Gay and Queer Men

Sexual health is a core part of life for gay and queer men*, and it gets pushed to the background far too often. Many men carry quiet shame about sex, whether that's desire that has gone quiet, anxiety about performance, a function concern like ED, or wanting things they have never said out loud. I work with all of these concerns and more. Open relationships, mismatched desire, sex that stopped feeling like yours. You don't have to walk in with the perfect words for it.

You also don't have to start by educating me. I'm a gay man and an AASECT Certified Sex Therapist, and I work primarily with gay and queer men. That means we skip the part where you explain what your life looks like before we get to the actual work.

Because no two men are the same, your sex therapy is built around you. We chart a course toward more confidence and a sex life that actually feels good to you. In the safe context of our work together, I help you unpack problems that feel too big to hold alone. Every part of your experience shapes your sexual confidence and function, so our work covers the physical, psychological, and interpersonal pieces together. Real change means paying attention to your body, your identity, and your interpersonal experience all at once.

Physical. After screwing up the courage to address a sexual function concern such as ED with a primary care provider (PCP), men can sometimes leave the provider’s office with a prescription in hand and a thousand unanswered questions on their mind. Comprehensive sex therapy almost always includes a referral to a PCP or more specialized provider such as a urologist. I can only do rudimentary assessment of medical concerns and rely on my medical colleagues to take a closer look at contributing medical factors including venous leakage and occlusion, sperm count, and testosterone levels. Medical providers can also help you understand impacts of the aging process or chronic illnesses such as diabetes. Sex therapy provides a space to fill the gap between the medical treatment and your daily implementation of it.

Psychological. Sexual function is a key component of most men’s identities. We often learn at a young age that to “be a man” is to be virile, confident, and have a lifetime of “hot sex.” For most men, this image gets established by junior high school, and adult reality can be quite different. As a result, men get caught up in anxious thought loops that inhibit sexual function. It’s physically impossible to get an erection when your brain is in fight/flight/freeze mode. Let’s get out of the anxiety loop and re-train your nervous system to approach sex with curiosity and excitement.

For some clients, ongoing anxiety, depression, or trauma sits underneath the sexual concerns and doesn't fully shift with talk therapy alone. In those cases, ketamine-assisted psychotherapy can be a useful addition to our work.

Interpersonal. Men coping with ED will often tell me that their inability to “perform” has disrupted their confidence and their relationship with their partner/s. Problems in relationship are still present when you are having sex. Learning to communicate with your partner/s about relationship difficulties, both related to sex or not, can help you relax into a renewed sexual connection. Let’s take the word “performance” out of our sexual vernacular and replace it with pleasure, playfulness, and meaningful connection with your partner/s.

Sex therapy is a valuable resource for addressing sexual concerns and enhancing overall well-being. If you're facing challenges in your sexual life, remember that seeking help is a proactive step towards improved self-confidence, sexual well-being, and overall wellness.

My office is in downtown Stamford, CT, and I see clients across Connecticut, New York, and Florida by telehealth. If you've been searching for a gay sex therapist near you, this is a good place to start.

*A note about language: I use the terms “man” and “men” inclusively to refer to all people who identify as men or masculine, including those who are transgender, non-binary, and gender diverse. Cisgender men and gender diverse men may have differing needs regarding sexual function. My experience with treating sexual function lies primarily with people with penises, as is reflected in the content of this page.