The future of sex therapy: specialization or marginalization?

Sex therapy's claims to specialization may be exaggerated and ultimately damaging to the integrated treatment of sexual dysfunction. In fact, sex therapy does not have a unified underlying theory, a unique set of practices, or an empirically demonstrated efficacious treatment outcome. Paradoxically, the practice of sex therapy has gained widespread professional and popular acceptance since the publication in 1970 of Human Sexual Inadequacy by Masters and Johnson. Consequences of the widespread acceptance of this supposed specialization include the marginalization of sex therapy from other forms of treatment and the perpetuation of the notion that sex therapy is a special form of therapy requiring highly specialized training. This specialization focus also helps to perpetuate societal discomfort with sexuality. The very modest empirical success of most so-called sex therapy interventions and the lack of theoretical development suggest that sex therapy needs a recalibration in order to survive. It is suggested that the treatment of sexual dysfunction be integrated into the general psychotherapy enterprise and into a multidisciplinary biopsychosocial framework.