Time Out New York / Issue 575: October 5–11, 2006
Real sex
On the couch
Sex therapists serve up the lowdown on New Yorkers’ libidos.
By Clare Lambe

“There was a time when people thought that a sex therapist was a prostitute with a Ph.D.,” says Dr. Liz Goren. But in the 30 years Goren’s been practicing in New York, she has seen a shift in attitudes about sex therapy—and in the reasons why people arrive at her office.

The most common problems are still premature ejaculation, inability to achieve orgasm and low or mismatched libidos. But over the past ten years or so, many new dilemmas have emerged.

Online dating and Internet porn have brought about questions of virtual infidelity; erectile-dysfunction medications (Viagra, Cialis and Levitra) seem to be creating as many problems as they solve (psychological addictions are common, and a man can be raring to go while his partner is unwilling or unable to keep up); and antidepressants can decrease sex drives and make achieving orgasm difficult.

“One of the biggest problems is goal-oriented sex,” says Dr. Joy Davidson, a sex therapist and the author of Fearless Sex. “Getting to the orgasm becomes much more important than having or prolonging pleasure.”

Indeed, porn, Sex and the City and even TV ads for erection-enhancing medication have fostered unrealistic expectations. “I call it the pornification of our sexpectations,” says Ian Kerner, sex therapist and the author of DSI—Date Scene Investigation: The Diagnostic Manual of Dating Disorders. “There’s a condition called spectatoring,” he explains, “where you’re so involved in your own performance during sex that you don’t enjoy it.”

So how does sex therapy help, and what exactly does it involve? Well, although it is a form of psychotherapy, the process is generally much shorter—16 sessions is about average. Patients talk about their issues, they’re given information, and then they’re assigned homework. And despite what some may think, there’s no hands-on treatment.

“Some people expect a bearded guru to jump right out of the hot tub and lead them into a group-sex orgy,” Kerner says. “I’ve had couples in my office where I’ve gone out for a moment, and when I come back, they’re naked and ready for sex.” And don’t expect your therapist to send in a sub, either. These days very few New York therapists use sexual surrogates. According to Vena Blanchard, president of the International Professional Surrogates Association, there are no certified surrogate partners in NYC. “And I should know,” Blanchard says. “We are the only professional body for sexual surrogates.”

To avoid embarrassing mix-ups—or a session with a prostitute posing as a surrogate (it happens)—potential clients should look for a therapist accredited by the American Association of Sexuality Educators, Counselors and Therapists (AASECT; aasect.org). Some therapists, like Dr. Barbara Bartlik of Cornell’s Weill Medical College, are psychiatrists, gynecologists and/or M.D.’s, and as such they are able to check for physical causes of sexual problems and write prescriptions when necessary.

In fact, Bartlik regularly prescribes erection-enhancing medication to women. “Women have as much erectile tissue in their genitalia as men do—once you’ve corrected for body mass,” she says, adding that her female clients report stronger arousal, better lubrication and more engorgement courtesy of the little blue pills.

Tristan Taormino, a sex educator and the author of The Ultimate Guide to Anal Sex for Women, points out that there are plenty of alternatives to traditional sex therapy, including coaching, workshops and retreats. “If you’re questioning your sexual orientation, if you’re into S&M, if you’re a swinger, whatever it is you’re into there’s a workshop or group for it.”—Additional reporting by Rebecca Shore