As psychotherapists, we often see names followed by a trail of acronyms that can at times be challenging to decipher.  EMDR, CSAT, PACT, PCIT, to name a few. Personally, my name (after the LMFT part) is followed by CST-S. So what does that mean exactly? It means I’m a Certified Sex Therapist (CST) and approved Supervisor (-S). Aside from adding to my post-name alphabet soup, you may still be wondering what exactly does that even mean?

If you have spent any time researching therapists who specialize in sexual concerns, you have probably come across the letters CST attached to a clinician’s name. While you have by now gathered that CST stands for Certified Sex Therapist, it’s important to understand where this designation came from. In actuality, the label CST is granted by the American Association of Sexuality Educators, Counselors and Therapists, widely considered the gold standard credential for sex therapy in the United States. But what does that designation actually mean, and what does it take for a therapist to earn it? Understanding both can help you feel more confident about who you are trusting with such a personal part of your life, and it can also shed light on why this particular credential carries so much weight in the field.

What an AASECT Certified Sex Therapist Actually Is

An AASECT Certified Sex Therapist is, first and foremost, a licensed mental health professional. This is not a credential someone can pick up through a weekend course or an online certificate program with no clinical training. Every certified sex therapist already holds an independent license to practice psychotherapy in a recognized discipline such as psychology, social work, counseling, marriage and family therapy, medicine, or nursing. The AASECT certification is earned in addition to that license as a specialization, signaling that the clinician has gone through an additional, rigorous training specifically focused on human sexuality and the treatment of sexual concerns.

In practice, this means a certified sex therapist is equipped to work with the full range of issues that can show up in this area of life: desire discrepancy between partners, difficulty with arousal or orgasm, pain during sex, the aftermath of infidelity or betrayal, the impact of trauma on intimacy, and the ways that medical conditions, medications, or major life transitions can affect a person’s sexual wellbeing. They are trained not only in psychotherapy broadly, but specifically in the assessment, diagnosis, and intervention of sex specific concerns often working with individuals as well as couples.

Why the Credential Matters

Sexuality is one of the more underserved areas in graduate mental health training. Most therapists complete their degree having received only a few hours of coursework on the subject, if that. My graduate program included one full term course focused on sexuality, some offer as few as a one-day seminar on the subject. AASECT certification exists precisely because of this gap. It requires therapists to seek out specialized education and clinical supervision well beyond what their original degree provided, and it holds them to an ongoing code of conduct specific to this work.

For clients, this translates into a level of assurance that the person sitting across from them has both the clinical foundation and the specialized training to handle sensitive material with skill and care, rather than discomfort or guesswork.

The Path to Becoming AASECT Certified

Becoming an AASECT Certified Sex Therapist is a multi year process built around four main pillars: education, licensure, attitudes work, and supervised clinical experience.

A Clinical Degree and an Independent License

The starting point is an advanced clinical degree from an accredited program, paired with state licensure that allows the clinician to practice psychotherapy independently. Someone with a master’s degree needs two years of clinical experience after earning that license before applying, while someone with a doctorate needs one year. This requirement keeps the certification anchored in established clinical competence rather than treating sex therapy training as a substitute for foundational psychotherapy skill.

Ninety Hours of Core Sexuality Education

Applicants must complete ninety clock hours of academic coursework covering core knowledge areas in human sexuality. This spans topics such as sexual and reproductive anatomy, the impact of culture, religion, and identity on sexual values, sexual orientation and gender identity, the effects of illness and medication on sexual function, sexual trauma and exploitation, and the history of the field itself. At least fifteen of those hours must take place in a live, synchronous setting rather than entirely through self paced study.

Sixty Hours of Sex Therapy Skills Training

Beyond general sexuality education, applicants need sixty additional hours focused specifically on how to do sex therapy: techniques for assessment and diagnosis, intervention models for couples and relationship systems, the medical side of treating sexual dysfunction, and ethical decision making. Half of those hours must also be completed in a live format.

Fourteen Hours of Attitudes and Values Work

This is one of the more distinctive parts of the process. Candidates must take part in at least fourteen hours of structured group work, often called a Sexual Attitude Reassessment, designed to help them examine their own personal beliefs, discomforts, and assumptions about sexuality. The goal is to make sure a therapist’s own reactions and biases never interfere with a client’s experience in the room. Applicants also write a one page reflection on how this work shaped their approach to the field.

Fifty Hours of Supervision Across at Least Eighteen Months

The heart of the certification is supervised clinical experience. Candidates must complete a minimum of fifty hours of supervision with an AASECT Certified Sex Therapist Supervisor, spread across at least eighteen months, while actively treating clients who present with sexual concerns. Over the course of that supervision, they must log at least three hundred hours of direct clinical work in this specialty. Letters of recommendation from the supervisor and from professional colleagues round out the application. I completed my supervision in 2014 working with two pillars in the field of sex therapy: Alexandra Katehakis, LMFT, PhD and Tammy Nelson, PhD. Further yet, I underwent an additional 30 hours of supervision with Dr Stephanie Buehler to become an AASECT approved supervisor myself, allowing me the opportunity to supervise and mentor other fellow sex-therapists-in-training.

Application and Ongoing Renewal

Once all of these pieces are documented, the application goes to AASECT’s certification committee for review. Certification is not a one time achievement either. It must be renewed every three years, and requires completing ongoing continuing education units in the field of sex therapy. This keeps certified sex therapists engaged with evolving standards and ongoing education in the field.

The Bigger Picture

Taken together, the requirements add up to several years of focused training layered on top of an already established clinical career (I believe it took me from 2011-2014 to complete my initial AASECT application!). That is by design. Sexuality intersects with so much of a person’s emotional life, relationship dynamics, physical health, and sense of self that working in this space responsibly requires more than good intentions. It requires structured education, honest self examination, and substantial supervised practice before a therapist ever earns the right to call themselves AASECT certified.

If you are considering working with a sex therapist, or if you are a clinician thinking about pursuing this specialty yourself, understanding what goes into those letters can make the decision feel a lot less abstract. It is a credential built on specialized training, supervised learning, and a code of ethics to support healthy sexuality, and that is exactly what makes it meaningful.

Curious about starting sex therapy? Our team are all AASECT Certified Sex Therapists, and we’re here to help you with your sexual concerns.