Sex Therapy
All sessions are via telehealth. Based in San Diego, I work with couples throughout California, Florida, Idaho, and Vermont.
Most people who find their way to this page have been carrying something alone for a while – a question they haven’t known how to ask, a concern they’ve minimized, something about their sexual experience that’s felt too private or too loaded to say out loud.
Maybe you recognize yourself here:
- Desire has quietly disappeared and you don’t know why
- Something shifted – hormonally, physically, relationally – and what used to feel natural no longer does
- You’ve never fully connected with your own sexuality and you’re only now giving yourself permission to look at that
- Sex has started to feel like pressure, obligation, or something you dread
Most people find they’re far more normal than they imagined. And there’s almost always a story underneath worth understanding. That’s where the work begins.
Who Comes to Sex Therapy
For Individuals
Unpacking Your Personal Journey Explore your own desire, heal from past relational patterns, navigate body changes, or work through performance anxiety in a completely confidential, supportive space. You don’t need to be in a relationship to benefit from sex therapy.
For Couples
Navigating the Shared Space Address mismatched libidos, break the cycle of sexual avoidance, rebuild trust after a rupture, or learn how to talk about intimacy without it turning into a defensive argument.
What’s Actually Going On
Here’s what I’ve learned after 23 years of this work: sexual problems are almost never really about sex.
They’re about resentment that never got named. Bodies that are exhausted or in pain. Relationships where something important stopped being said. Old experiences that shaped what feels safe – or unsafe – in intimacy. The sex is usually the last thing to go wrong and the first thing people notice. Starting there and working backward is where the real shifts happen.
What We Work On
- Mismatched libidos. Desire differences can quietly reshape an entire relationship – who initiates, who avoids, who feels rejected, who feels pressured. We work on understanding the dynamic between you, not just negotiating the numbers.
- Difficulty with orgasm. Incredibly common and rarely talked about honestly – and most of the reasons it happens are addressable. We look at what’s actually getting in the way and work toward change practically, without pressure.
- Painful or uncomfortable sex. Pain has both physical and psychological dimensions. I work the psychological piece – anticipatory anxiety, avoidance patterns, intimacy starting to feel unsafe – and collaborate with gynecologists and pelvic floor PTs for the rest.
- Performance anxiety. When worry about how things will go becomes its own obstacle, something has shifted that’s worth understanding. We work on creating conditions where sex feels less like a test and more like something you can actually be present for.
- Desires or questions you’ve never voiced. Things you’ve never said out loud because you weren’t sure how they’d land – curiosities pushed aside, questions about who you are sexually and what you actually want. Nothing is off the table and nothing will shock me.
- Behavior that feels out of control. When sex feels compulsive, secretive, or at odds with your values, that’s worth exploring carefully – without shame and without judgment.
- Past experiences affecting intimacy now. Old experiences, including ones never labeled as trauma, can shape how safe your body feels in intimacy. We go slowly here, at whatever pace feels manageable.
Midlife, Menopause, and Intimacy Changes
This is territory I know well and work in specifically.
Perimenopause and menopause can change desire, arousal, physical comfort, body image, and the entire experience of intimacy – sometimes gradually, sometimes all at once. Many women arrive feeling confused by what’s happening in their bodies, or quietly grieving a version of their sexuality they’re afraid is gone.
It isn’t gone. But it may need to be rediscovered on different terms.
Men experience their own version of this too – shifting testosterone, changing arousal patterns, concerns about erections, a body that no longer responds the way it once did. These changes are real and worth addressing directly rather than pushing aside.
Bodies change throughout adulthood and sexuality changes with them. That’s not the end of a sexual life. For many people it’s the beginning of a more honest one.
What Sex Therapy Actually Looks Like
Sex therapy is talk therapy. Nothing physical happens in session and nothing is required of you that feels unsafe or uncomfortable.
We talk openly, directly, and without the shame or avoidance that usually surrounds these conversations. Many people tell me it’s the first time they’ve spoken honestly about their sexual experience with anyone.
Beyond the conversation itself, I often suggest structured exercises to do outside of session – guided experiences designed to help you reconnect with your body, rebuild intimacy gradually, or practice something we’ve been working on together.
I often think about sexuality like a menu. When relationships are new we tend to explore widely – trying things, staying curious, discovering what we like. Over time most couples narrow that menu down to a handful of familiar options. Then bodies change, life gets complicated, and even those options start to feel harder to reach. Part of the work is asking: what’s on your menu now? What could be? What have you never brought up because you didn’t know how?
For individuals the same question applies – just turned inward. What do you actually want? What would your sexual life look like if you designed it for yourself rather than around everyone else?
How I Work
I’m Dr. Kristin Zeising, a licensed clinical psychologist and AASECT certified sex therapist with 23 years of experience helping adults and couples navigate desire, intimacy, and sexual wellbeing.
AASECT certification requires specialized training and supervised clinical hours specifically in human sexuality – it’s a meaningful distinction in a field where anyone can claim to do this work.
I’m direct. I use clinical language without being cold or distancing. I won’t flinch at what you bring in and I won’t make you feel like you should have kept it to yourself. I also work collaboratively with medical providers when the picture calls for it -gynecologists, urologists, pelvic floor physical therapists, prescribing NPs – because sexual health doesn’t exist in isolation from physical health.
I work via Zoom with clients throughout California and am also licensed in Florida, Idaho, and Vermont. I see clients internationally as well, including through a virtual office in Hong Kong. Sessions are 50 minutes.
Frequently Asked Questions
+ What actually happens in a sex therapy session?
We talk. Just like traditional therapy, we explore what’s going on, but we focus specifically on your relational, emotional, and sexual history. You will leave sessions with insights to consider or practical exercises to try at home at your own pace.
+ Do I come alone or with my partner?
Both options are highly effective. If the issue is primarily a shared relational dynamic (like mismatched desire), coming as a couple is ideal. If you are wanting to explore your own relationship to pleasure, trauma, or anxiety, individual sessions are a beautiful place to start.
+ How long does sex therapy take?
Because sex therapy is highly focused and goal-oriented, many clients see meaningful shifts within a few months. However, the timeline entirely depends on the complexity of what you are navigating.
Ready to Talk?
I offer a free 15-minute consultation – enough time to get a sense of how I work and whether this feels like the right fit.
Dr. Kristin Zeising, PsyD, CST | Licensed Clinical Psychologist | AASECT Certified Sex Therapist | San Diego, CA | Telehealth via Zoom
