Miami · Miami-Dade · 12 min read

Sex Therapy in Miami

AASECT-certified sex therapy for individuals and couples across Miami-Dade — in person and by secure video anywhere in Florida.

Written and clinically reviewed by Vanessa Cushing, LPC, NCC, MS — AASECT-Certified Sex Therapist, licensed in Virginia, DC, Maryland & Florida.

What an AASECT-certified sex therapist actually is

Almost any licensed therapist in Florida is allowed to say they work with intimacy. Very few have completed AASECT certification, which is a separate credential on top of the licence: supervised clinical hours specifically in sexual health, coursework in sexual function and dysfunction, and a supervision process focused on this work rather than on general counselling.

The practical difference shows up in the first session. A generalist will often take a careful relationship history and step gently around the sexual detail, because that is what their training prepared them for. A certified sex therapist asks the specific questions — what happens, when it started, what is different about the times it does not happen — because those answers are what treatment is built from. Clients who have already tried couples counselling usually recognise the gap immediately.

Who we work with in Miami

People arrive here with a sexual problem that has usually been going on for a while and has already been managed privately, sometimes for years. The most common presentations:

• Couples where one partner wants sex noticeably more often than the other, and the conversation about it has become the problem in its own right
• Men dealing with erectile difficulty or ejaculating sooner or later than they want to, particularly where the medical workup came back normal
• Women and people with vulvas experiencing pain with penetration, or difficulty reaching orgasm with a partner
• Couples rebuilding after infidelity, where sex has become either impossible or compulsive
• Individuals whose religious or family messaging about sex is still running the show years after they stopped believing it
• New parents whose sex life did not survive the first year and who are quietly afraid it is not coming back

What Miami adds to this

Miami is loud about sex and quiet about sexual difficulty. It is a city organised around appearance — the gym, the boat, the beach, the posted version of your relationship — and admitting that something is not working in the bedroom can feel like a status loss rather than a health issue. A meaningful number of first sessions here open with some version of an apology for being there at all.

There is a second local pattern worth naming. South Florida has a dense market of men's clinics, wellness centres and med spas selling ED medication, testosterone and shockwave treatment, often without much of an intake. Those services help some people. They do not touch the anxiety loop that keeps a difficulty running, which is why people frequently arrive here after a prescription worked once and then stopped mattering.

And the cultural scripts around sex in Miami's Cuban, Colombian, Venezuelan, Brazilian, Haitian and Caribbean communities are real, specific, and usually never discussed out loud. They are not an obstacle to therapy. They are often the content of it.

Where sessions happen

We see clients in person in Miami and by secure video anywhere in Florida. In-person clients typically come from Brickell, Downtown, Coral Gables, Coconut Grove, Miami Beach, Key Biscayne, Doral, Kendall, Aventura, Pinecrest and the rest of Miami-Dade. Video clients are anywhere in the state — Fort Lauderdale, West Palm Beach, Naples, Orlando, Tampa, the Keys.

Therapy is licensed state by state, so the state you are physically in during the session is the one that has to be covered. Florida is covered, along with Virginia, Washington, D.C. and Maryland — which matters more often than you would expect in a city where a lot of people split their year between two places.

A Spanish-speaking clinician can be requested when you book.

The clinical models this work is built on

Sex therapy is not improvisation, and it is not advice. It is a small set of well-established clinical models applied to your specific pattern. Naming them is worth doing, because it is how you tell a specialist from someone extending general couples work into unfamiliar territory.

• Sensate focus (Masters and Johnson, refined since) — graded, non-demand touch that takes performance out of the equation so arousal has room to return. Practised privately at home, reviewed in session.
• The dual control model (Bancroft and Janssen) — arousal as an accelerator and a brake running at the same time. Most people arriving here do not have a broken accelerator; they have brakes nobody has looked at.
• Responsive desire (Basson's circular model) — for the very common partner who does not experience desire ahead of time but does once things are already warm. Treating that as a disorder is one of the most damaging misreadings in general therapy.
• Good Enough Sex (Metz and McCarthy) — replacing a perfect-performance standard with variable, realistic, mutual sex. This is usually the single biggest change in couples stuck in a demand-and-avoid loop.
• Cognitive and behavioural work on the anxiety loop — the spectatoring, monitoring and pre-emptive avoidance that keeps an erectile or orgasm difficulty running long after any physical cause has been ruled out.
• Internal Family Systems for the shame and protective parts underneath — particularly where religious or family messaging, or an earlier experience, is still doing the driving.
• Medical coordination against current sexual-medicine standards, with a urologist, gynaecologist, menopause clinician or pelvic floor physical therapist where the picture calls for it.

How the work runs

Read next

Five Miami-specific pieces that answer the questions people ask before they book:

Frequently asked questions

Keep reading

• How to Choose a Sex Therapist in Miami — Credentials, red flags, and the questions to ask on a consult call.
• Sex Therapy vs Couples Therapy: Which One Do You Need? — Why general couples counselling often leaves the sexual problem untouched.
• Before You Book a Men's Clinic in Miami — What ED medication does and does not fix, and when the problem is the anxiety loop.
• Machismo, Marianismo and the Bedroom — The sexual scripts South Florida couples inherit, and how they show up in therapy.
• Online Sex Therapy Anywhere in Florida — How video sessions actually work, and why they suit this work better than most therapy.
• About Vanessa Cushing, LPC, NCC, MS — AASECT-Certified Sex Therapist, licensed in Florida, Virginia, D.C. and Maryland.
• Sex Therapy in Florida — The state-wide page — who is licensed here and how video sessions run.
• Sex Therapy in Coral Gables — Minutes from the Miami base, where in-person sessions are genuinely available.
• Sex Therapy in Fort Lauderdale — For Broward clients who would rather not drive into Miami-Dade.
• Sexual Trauma Therapy in Miami — When the difficulty traces back to something that happened, not to technique.
• LGBTQ+ Affirming Therapy in Miami — Affirming sex and relationship work, including non-monogamous and trans clients.
• What to Expect in Sex Therapy in Miami — Session by session, from the consult call through the first month.
• Sex Therapy Cost in Miami — What South Florida sessions run, and how out-of-network reimbursement works.

Also on this site

• Schedule a free consultation — The booking page — pick a time with whoever is taking new clients.
• Sex Therapy: the complete guide — The clinical pillar — what sex therapy is and how it treats each concern.
• Erectile dysfunction counselling — The service page for erectile difficulty and performance anxiety.
• Sexual trauma therapy — Trauma-informed work when sex is bound up with something that happened.
• IFS therapy in Miami — Internal Family Systems, the model much of this work is built on.
• Fees and out-of-network benefits — Session rates and how out-of-network reimbursement works.
• Contact — Phone, email and the Miami base.

Clinical resources this page draws on

• AASECT — American Association of Sexuality Educators, Counselors and Therapists — The certifying body behind the CST credential, and its published standards for certification.
• ISSWSH — International Society for the Study of Women's Sexual Health — Consensus terminology for desire, arousal and genital pain concerns.
• Sexual Medicine Society of North America (SMSNA) — Where the medical side of erectile and ejaculatory concerns is set out — useful when coordinating with a urologist.
• International Pelvic Pain Society — Interdisciplinary framing for pain with penetration, including pelvic floor physical therapy.
• Florida Department of Health — licence verification — Verify any Florida therapist's licence, including ours, before you book.