Top-Rated Sex Therapy in San Francisco at California Couples Counseling
Intimacy challenges can create profound distance in your relationship, leaving you feeling disconnected, frustrated, and alone. Whether you're struggling with desire differences, recovering from betrayal, or navigating trauma that impacts your intimate connection, you deserve compassionate support.
At California Couples Counseling, we help couples rebuild sexual and emotional intimacy through evidence-based therapy tailored to your unique needs. Contact us when you’re ready to begin.
Meet your San Francisco sex counselor
Tammie Makely, LMFT
Tammie Makely is a Licensed Marriage and Family Therapist specializing in couples therapy, sex therapy, affair recovery, and trauma-informed care. With training in the Gottman Method and EMDR, she creates a safe, judgment-free space where individuals and couples can get to the root of their intimacy issues and cultivate a thriving sex life.
Offers sex therapy ✓
Credentials: Licensed Marriage and Family Therapist, Certified Anger Management Specialist
Clientele: Adults & couples
Location: San Francisco, CA 94102
Virtual therapy? Yes, online only across California
What to expect from the therapy process
1. Start with a free consultation
We begin with a complimentary call to understand your concerns, answer your questions, and determine if we're the right fit for your relationship and intimacy goals.
2. Create a safe space for exploration
In your initial sessions, we aim to establish a comfortable, non-judgmental environment where you can openly discuss sensitive topics around sexuality, intimacy, and any challenges you're experiencing.
3. Identify patterns & rebuild connection
As our work progresses, you'll explore what's affecting your sexual wellbeing—whether it's past trauma, communication issues, desire concerns, shame, or trust challenges—and develop personalized strategies for healing and growth.
4. Build lasting intimacy skills
Through evidence-based techniques like the Gottman Method and EMDR, you'll learn practical tools to enhance self-awareness, deepen emotional connection (with yourself or your partner), and create the fulfilling intimate life you deserve.
Common reasons why people seek sex therapy
Mismatched libidos or desire differences causing tension and resentment
Difficulty discussing sex openly with a partner or understanding your own needs
Loss of sexual desire or feeling disconnected from your sexuality
Pain or discomfort during sex that's creating avoidance
Recovering from infidelity or betrayal that's impacted intimacy
Past sexual trauma affecting your ability to feel safe and connected
Pornography use or sex addiction creating personal distress or relationship strain
Feeling pressure, obligation, or anxiety around sexual performance
Shame or guilt around sexual needs, preferences, or orientation
Confusion about your sexual identity or desires
Navigating changes in sexuality after major life transitions or medical issues
Rebuilding trust and physical connection after emotional distance
Processing religious or cultural messages that create sexual shame
Difficulty achieving arousal, orgasm, or satisfaction
How sex therapy can help
Improve sexual communication and self-awareness
Many people struggle to understand their own sexual needs or communicate openly with partners. Sex therapy provides a structured, supportive environment where you can explore your sexuality without shame or judgment. Whether working individually or as a couple, you'll develop deeper self-awareness, learn the language to express desires and boundaries, and create understanding that strengthens both emotional well-being and intimate connection.
Heal from sexual trauma
Past experiences of sexual abuse, assault, or coercion can profoundly impact your ability to feel safe in your body and during intimacy. Using trauma-informed approaches like EMDR, sex therapy helps you process these wounds at your own pace. We work to separate past pain from present experience, rebuild safety and agency, and reclaim sexuality as a source of joy and connection rather than fear or disconnection.
Rebuild trust & intimacy after betrayal
Infidelity or sexual betrayal creates deep wounds that extend into every aspect of well-being and relationships. Sex therapy addresses not just the betrayal itself but the underlying patterns that contributed to disconnection. Through the Gottman Method and affair recovery protocols, you'll learn to process pain, rebuild emotional safety, address attachment injuries, and gradually restore physical intimacy grounded in renewed trust, honesty, and commitment.
Address sexual dysfunction & desire concerns
When sexual challenges arise—whether related to desire, arousal, performance, or satisfaction—they often reflect complex factors including stress, relationship patterns, trauma history, medical concerns, or internalized shame. Sex therapy helps you understand the multiple influences affecting your sexual wellness and develop practical strategies to reduce pressure, address underlying issues, and cultivate a healthier, more fulfilling relationship with sexuality and intimacy.
FAQs about sex therapy
-
A sex therapist is a licensed mental health professional who specializes in helping individuals and couples address sexual concerns within the context of emotional well-being and relationships.
Sex therapy sessions are talk therapy sessions that focus specifically on intimacy and sexuality challenges. Your therapist will use evidence-based techniques to improve communication, heal trauma, address dysfunction, and restore sexual wellness without judgment. No physical touch takes place between therapist and client within sessions.
-
A sex therapist is a licensed mental health professional (such as an LMFT or LCSW) trained to address psychological, emotional, and relational factors affecting sexuality. Sex therapists can diagnose and treat mental health conditions, trauma, and relationship issues.
A sex coach typically provides education and guidance but is not licensed to treat clinical concerns or underlying mental health conditions that may be impacting intimacy. A therapist can provide coaching services in addition to counseling, but not all sex coaches are also licensed therapists.
-
Yes, insurance often covers sex therapy services, though exact coverage depends on your specific plan. California Couples Therapy is a private-pay practice, though many clients choose to submit claims for out-of-network reimbursement using a superbill we provide. We recommend contacting your insurance company to understand your specific out-of-network benefits for mental health services and what portion might be covered.
-
Both individuals and copules can benefit from sex therapy.
Individuals often seek sex therapy to heal from trauma, address concerns about desire or functioning, work through shame or anxiety, explore sexual identity, or develop a healthier relationship with their sexuality.
Couples seek sex therapy to address shared intimacy challenges, improve communication, navigate desire differences, or rebuild connection.
Our sex therapy services are open to both individuals and couples. We also have experience providing polyamory therapy.
-
Finding the right therapist is a key part of effective sex therapy. Our practice may be the right fit if you're seeking:
Evidence-based treatment using the Gottman Method and trauma-informed approaches
Specialized expertise in sex therapy, trauma recovery, and affair recovery
Flexible virtual therapy available throughout California for busy professionals
Compassionate, non-judgmental support from a licensed therapist with extensive experience
A collaborative approach that honors your personal values and goals
We offer a free consultation call so you can ask questions, share your concerns, and determine if our approach aligns with what you're looking for in therapy. Schedule yours here.