- Sep 5, 2025
- 4 min read
Updated: Sep 22, 2025
I remember asking a family therapist once - someone who works with couples as part of their broader practice - whether she talked about sex with her couples.
Her answer was:
“My couples have bigger issues to worry about.”
It was clear the topic made her slightly uncomfortable. And I get it. Before I trained as a sex therapist and studied sexual and reproductive health, I didn’t find it easy to bring up sex in the therapy room either.
In those early days, saying certain words out loud was hard. Penetration. Masturbation. Vagina. Penis. When I did, my voice didn't sound confident, giving away my discomfort to the clients. It took time, practice, and conscious effort to say those words without flinching — to make it feel as natural as talking about communication, trust, or conflict.
Why It’s Hard for Practitioners Too
We’re not blank slates. Every practitioner has their own history, beliefs, and emotions about sex - shaped by family, culture, religion, education, and personal experience.
In my own Russian-Armenian family, sex was never openly discussed. I knew, through observation and a few clues, that my mother and grandmother both had a healthy interest in sex. I even discovered erotic books tucked away on my grandmother’s shelf. But no one ever talked to me about it.
My mother’s version of “the talk” was to hand me a couple of brightly coloured books on puberty and genital development when I was 11. The books were illuminating, intriguing - and scary. That was the extent of my sex education at home. I suspect her reasoning was similar to many parents: that talking about sex might somehow encourage more sexual activity. And they certainly were not ready for that.
The Research Says Otherwise
This fear - that discussing sex will “put ideas in someone’s head” - is common, but decades of research show the opposite. A 30-year review published in JAMA Pediatrics found that when parents talk frequently and openly with adolescents about sexual health, teens are more likely to delay sexual activity, use contraception, and make safer choices, resulting in fewer STIs and unintended pregnancies (Widman et al., 2016).
Similarly, a UNESCO review of 87 international studies concluded that comprehensive sexuality education does not increase sexual activity among adolescents. Instead, it delays initiation, reduces the number of sexual partners, and improves contraceptive use (UNESCO, 2018).
In other words: openness protects. Silence doesn’t.
What I See in the Therapy Room
Even now, in what we believe to be less conservative and more sexually progressive times, I meet clients who struggle to talk about sex - not just with me, but with each other. Regardless of whether you are 20-something or 60-something, it is still hard for many.
And yet, I haven’t met a couple for whom sexual intimacy wasn’t an important part of their relationship. Sex is deeply woven into trust, connection, self-esteem, identity, and love. Avoiding it doesn’t make the issues go away; it just allows them to pile up quietly, in a box no one dares to open.
How Couples Can Practise Talking About Sex
Normalising sexual conversations takes practice — and sometimes it starts with the simplest thing: saying the words.
The brilliant Emily Nagoski, in her work on sexual wellbeing, suggests an exercise I often use with clients:
Pick the words — vagina, vulva, penis, clitoris, masturbation, orgasm.
Say them out loud — not in a whisper, but in your natural speaking voice.
Say them with different tones — casually, with delight (as if greeting an old friend you haven’t seen in ages), and with pride (as if talking about something you value).
Repeat until the awkwardness fades — the goal is to strip away the “charge” so they become everyday language.
Conversation Starters for Partners
Try these prompts to ease into more open conversations:
“What’s one thing you wish I knew about your desires?”
“What’s a sexual memory of ours that still makes you smile?”
“Is there something you’ve never told me that you’d like to try?”
“How do you feel about our sexual connection right now?”
“When do you feel most desired by me?”
These don’t need to lead to immediate changes in the bedroom - sometimes the win is being able to say out loud what you have been thinking of, or to feel that your partner cares about your needs.
The Moral of the Story
We need to normalise conversations about sex - in therapy rooms, in relationships, and in families. For practitioners, that means doing our own work: becoming comfortable with the language, learning to ask clear, non-judgmental questions, and modelling openness.
Because the more we avoid it, the heavier the silence becomes. And the more we practise talking about it, the easier it gets to own our sexuality and intimacy - instead of hiding them away and hoping the problems inside that box will somehow resolve themselves.
Reflection Question:
When was the last time you talked about sex openly - with your partner, your client, or your child? What made it easier, or harder?
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