Why Sex Education in Therapy Training Matters for Client Safety

Understanding the necessity of sex education in therapy training is crucial for developing competent therapists.

1. It Challenges Personal Discomfort—Not Just Client Shame

Sex education in therapy training isn’t just missing from most programs—it’s controversial when it shows up. A recent Wall Street Journal opinion piece written by a graduate student at Santa Clara University, recounts her decision to walk out of a Human Sexuality class after encountering course content that challenged her comfort zone. She described being shown a BDSM video, asked to reflect on genital shame, and assigned a sexual autobiography. Her objections were rooted in personal discomfort and religious beliefs.

Incorporating sex education in therapy training can enhance the therapeutic process and client outcomes.

Here’s the part that rarely makes it into public conversation:

2. It Fills a Dangerous Gap in Clinical Education

Most therapists aren’t actually taught how to talk about sex.

It’s evident that sex education in therapy training needs to be prioritized for effective psychotherapeutic practices.

Many practitioners lack comprehensive sex education in therapy training, which can hinder their effectiveness.

Enhancing sex education in therapy training is vital for addressing various client issues.

Investing in sex education in therapy training allows therapists to better serve their clients.

It’s not covered in undergrad.
It’s missing from most master’s programs.
And it’s rarely included in the foundational training required for licensure in many countries.

The need for sex education in therapy training has never been greater in today’s diverse society.

Programs focused on sex education in therapy training can dramatically shift therapist-client dynamics.

Understanding sex education in therapy training is foundational for ethical practice.

Extensive research across North America shows that sex education in therapy training is often excluded overlooked or minimized. Psychologists can graduate from doctoral programmes without taking a single course in human sexuality. When training is offered, it’s often superficial—maybe a one-credit online module or a short segment on diversity.

Unfortunately, sex education in therapy training is still treated as peripheral, despite being central to many clients’ presenting issues.

This matters. Because sexuality is not just “a specialty area.” It’s a core part of human functioning. And when therapists haven’t been invited to examine their own discomforts, biases, or beliefs about sex, those blind spots show up in the therapy room.

Exploring sex education in therapy training is essential for fostering a nonjudgmental approach.

They show up in silence. In body language. In the way we avoid eye contact or change the subject.
Clients feel that.

And for those of us who can sit in the complexity of sexual shame, arousal, performance anxiety, kink, or orientation? That capacity didn’t come from our graduate programmes. It came from self-directed education, often at great personal and financial cost.

Programmes like SAR (Sexual Attitude Reassessment) were designed for this very reason—to help therapists develop the self-awareness and nonjudgmental stance needed to navigate sexuality in a safe, effective, and client-centred way.

If we want to practise ethically—if we want to avoid doing harm—we can’t afford to keep treating sex as a “bonus topic.”
It’s foundational.
And it deserves to be treated that way in every therapist training programme.

3. It Builds Ethical Awareness Through SEUS

Sex education in therapy training is crucial in understanding client backgrounds and experiences.

In clinical training, we’re taught the importance of Safe and Effective Use of Self (SEUS). This means knowing how your beliefs, reactions, and experiences shape the therapy process—and learning to use that awareness ethically.

SEUS isn’t about neutrality. It’s about self-awareness. It’s how we ensure we don’t unconsciously project shame or judgement onto clients, especially when they bring in stories of kink, pleasure, pain, or sexual struggle.

My own experiences with sex education in therapy training have shaped my therapeutic approach.

If you’re uncomfortable with a client’s sexual practices, if you tense up when you hear the word “masturbation,” or if you freeze when a trans woman talks about desire—you can’t offer a safe space for healing. SEUS is what keeps therapists grounded in ethical presence.

And when I read the student’s article? It wasn’t just discomfort I saw. It was disgust and judgement. Disgust and judgement for the kink community. Contempt for the idea that these conversations belong in therapy training. That’s not just ethically questionable—it’s a liability.

4. It Expands Therapist Capacity Through SAR

Without adequate sex education, therapists can inadvertently harm clients—but comprehensive training helps eliminate misunderstandings, and examples of effective programs show what’s possible.

I wasn’t assigned a sexual autobiography in graduate school. But I did complete a Sexual Attitude Reassessment (SAR), and it fundamentally reshaped how I show up as a therapist.

SAR isn’t about exposure for shock. It’s about confronting your own edges. It’s an experiential process that uses images, films, and stories to expose therapists to a wide range of sexual expressions—inviting reflection, not reaction. I don’t know the specific curriculum at Santa Clara, the professor, or what exactly happened in class that day. But I do know that when SAR is done with consent and care, it has the power to challenge disgust and judgement—not reinforce them.

We were fully informed about what we’d see, encouraged to step out if needed, and given space to process. That’s informed consent. That’s what ethical sexuality training looks like.

SAR exists for one reason: to ensure that therapists don’t unconsciously harm clients by clinging to unexamined biases or inherited shame. And for anyone planning to work with sexuality—and yes, that includes every Marriage and Family Therapist—it should be non-negotiable.

Exploring the necessity of sex education in therapy training is essential for future professionals.

5. It Prevents Harm When Religion and Sexuality Collide

Furthering discussions about sex education in therapy training enhances understanding across the board.

Addressing the gaps in sex education in therapy training is critical for competent care.

I respect religious beliefs. But if that discomfort prevents you from learning about sexual health, diversity, and ethics—you may not be ready to work with clients in this area.

Religious accommodation should never shield therapists from clinical responsibility.

I’ve worked with clients who were re-traumatised by therapists who carried unresolved sexual shame rooted in personal beliefs. These therapists didn’t mean to harm—but harm still happened.

If you’re not willing to learn how to hold space for erotic complexity, this might not be the right career path.

I also want to be clear: I have esteemed colleagues with deeply held religious belief systems—Christian, Jewish, Muslim—who do not let those beliefs get in the way of offering ethical, client-centred care. If you’re curious how this can look in practice, check out these GETSOME podcast episodes:

• Christian & Pro-Sex: Jesus Loves You and Your Orgasms
• Sex in the Orthodox Jewish Community

Debunking the “Gimp Suit Video” Controversy

The article’s most telling moment? The disdain expressed toward a BDSM video featuring a person in a gimp suit. For some therapists, this may seem extreme. But in sex therapy? It’s just another story. Just another client. Just another human.

People come into therapy with all kinds of sexual identities. Some are vanilla, others polyamorous. Some wear latex; others are still figuring out what they want.

And what they don’t need is a therapist who thinks: “Ew.”

You’re not there to judge. You’re there to listen, to witness, and to support. That’s what SEUS demands. That’s what SAR prepares you for.

Why Comprehensive Sexuality Training Matters

Ethical sex education isn’t about ideology. It’s about protecting your clients from untrained therapists.

Ultimately, sex education in therapy training is key to ethical and effective practice.

It’s not unethical to teach therapists about kink. Nor is it unethical to explore how cultural messages about genitals and sexuality have shaped us. In fact, developing awareness of our own discomforts is key to ethical practice—especially when clients bring stories shaped by shame, confusion, or silence.

And yet, many therapists graduate without ever having that mirror held up.

What is unethical? Graduating therapists who avoid the topic entirely. Therapists who freeze, redirect, or shame their clients—not because they’re cruel, but because they’ve never been challenged to explore their own discomfort or sexual shame.

Discomfort isn’t the problem. Judgement is.
SEUS and SAR help us tell the difference—and keep clients safe.

On the Assigned Book

The student mentioned being assigned The Guide to Getting It On by Paul Joannides. I completely understand why it was chosen—it’s brilliant at normalising conversations about consent and pleasure. The book is well-regarded in the field for its accessible tone and comprehensive, often humorous, breakdown of sexual health topics. That said, our field has advanced significantly since its first edition. Recent books like What Every Mental Health Professional Needs to Know About Sex directly teach how to assess dysfunctions using DSM-5-TR criteria, while Systemic Sex Therapy shows how to apply couples counselling models to sexual issues. Could we explore integrating these alongside Joannides’ work to ensure trainees get both accessibility and clinical depth, along with current best practices?

Looking for Tools to Support This Work?

If you’re a therapist supporting clients who struggle with performance anxiety, shame, or unexamined sexual beliefs, I’ve created several tools to help:

• Easing Erection Anxiety Audio Series:
  A guided resource to help clients move through anxiety with compassion, embodiment, and clarity.
• Shame Detox Masterclass Video Series:
  A foundational unshaming process for clinicians and clients alike—ideal for anyone navigating internalized sexual judgment.

Michelle Fischler, MSW, RSW, RP is the Resident Sex Therapist at GETSOME, an education and advocacy platform. The views expressed here are her own and do not constitute clinical advice or services. For psychotherapy, please consult a licensed professional directly. This article emphasizes the importance of sex education in therapy training.