As a sex therapist, I see people every week who have been sitting with something quietly for a long time — sometimes months, sometimes years — before they finally reach out. And almost always, the first thing they say is some version of: “I wasn’t sure if this was bad enough to get help for.”

It always is.

My name is Kai. I’m a counsellor and psychotherapist in private practice in Goodwood, Adelaide, specialising in trauma and sex therapy. I work with individuals — people navigating something on their own, whether they’re in a relationship or not — and I bring a trauma-informed lens to everything I do.

Sexual difficulties are rarely just about sex. They’re usually about safety, history, shame, the body, connection, and self-worth. That’s the territory I work in.

Here are the things I most commonly see people for — and what the work of addressing them can actually look like.

1. Painful Sex and Genital Pain

As a sex therapist, I see people experiencing painful sex far more often than most would expect — and almost all of them have waited much longer than they needed to before coming in.

Vaginismus, dyspareunia, and chronic pelvic pain can make intimacy feel frightening, defeating, or simply impossible. Vaginismus — where the vaginal muscles involuntarily tighten, making penetration painful or not possible — has a clinical prevalence of 5–7% worldwide, though many more cases go undiagnosed because people assume pain during sex is just something they have to live with (Lahaie et al., 2010; Omodele-Palmer et al., 2024). It isn’t. Beyond the physical experience, research finds that people with vaginismus often carry a deep sense of isolation and disruption to their identity — the pain reaches much further than the body (Clark et al., 2023).

What I find in this work is that pain during sex is almost always tangled up with anxiety, fear responses, and a nervous system that has learned to brace. Therapy is gentle and goes at your pace — we work on understanding those responses, rebuilding a felt sense of safety in your body, and finding a gradual, unhurried path back toward intimacy. I also collaborate closely with pelvic floor physiotherapists and GPs across Adelaide, because this kind of care works best when it’s joined up.

If sex has become something you dread or avoid, you don’t have to keep managing that alone.

2. Low Sexual Desire

As a sex therapist, I see individuals who have lost touch with their own desire — and who feel confused, ashamed, or quietly grieving about it.

Low desire is one of the most common reasons people come to see me on their own. It’s not always about a partner wanting more. Often it’s simply that somewhere along the way, sex stopped feeling relevant, appealing, or safe — and the person doesn’t quite know why.

Stress, burnout, hormonal shifts, antidepressants, postpartum changes, perimenopause, chronic illness, unprocessed trauma, or just the slow accumulation of life can all quietly suppress desire in ways that feel hard to name. Research suggests low sexual desire and desire discrepancy affect 25–30% of adults in relationships, and the numbers are likely higher for people carrying it without acknowledgment (Arenella et al., 2024; Vowels, 2022).

There is no correct level of desire. My work here isn’t about getting you to want more sex — it’s about understanding what has shifted and why, and finding your way back to a relationship with your own sexuality that feels like yours. That might mean exploring what desire actually means for you, what conditions it needs to show up, and what might be quietly standing in the way.

3. Intimacy After Sexual Trauma

As a sex therapist, I see people who are doing everything right in their lives — and yet intimacy remains a place where something goes wrong, shuts down, or just feels impossible.

Sexual trauma — whether in childhood, adolescence, or adulthood — leaves an imprint on the body and on our capacity for closeness. For many people, the effects don’t fully surface until they’re in a relationship or trying to connect sexually, and that’s when old wounds can resurface in ways that feel confusing, destabilising, or hard to explain to a partner.

Research confirms that sexual trauma has a wide impact on individual wellbeing and on how we experience intimacy — affecting desire, arousal, physical comfort, and our ability to feel safe with another person (Bogen et al., 2023). Studies show that people who develop PTSD following sexual assault experience significant difficulties across multiple aspects of sexual functioning (Bird et al., 2022; Martinson et al., 2013). Crucially, it’s the presence of PTSD symptoms — not just having experienced trauma — that most strongly shapes these ongoing difficulties (Bird et al., 2022).

This is the work I was trained for and care about most deeply. Trauma-informed sex therapy understands that the body holds memory, that shutdown and hypervigilance are protective responses that made complete sense at some point, and that healing doesn’t happen on a schedule. There is no pressure here, and nothing is expected of you.

We might work on building a felt sense of safety in your body, finding words for your needs and boundaries, untangling shame from what happened, and exploring — very gently, very much on your terms — what intimacy can look like for you now.

You don’t need a diagnosis. You don’t need to have “been through enough.” If past experiences are affecting your present, that’s reason enough to reach out.

4. Sexual Confidence, Body Image, and Performance Anxiety

As a sex therapist, I see people who are so caught up in how they look or how they’re performing that they’ve stopped being able to actually feel anything.

Body image and sexual confidence are not separate issues — they live right in the middle of our sexual experience, and the research reflects this clearly. People with greater body satisfaction report higher desire, more pleasure, and a stronger sense of connection during intimacy (Gillen & Markey, 2019; Woertman & van den Brink, 2012). When body image is negative, the pattern reverses — avoidance, self-consciousness, reduced pleasure, and a pull toward what researchers call “spectatoring”: mentally stepping outside the experience to watch and judge yourself, rather than simply being present (Hamzehrad et al., 2025).

This affects men just as much as women, though it’s talked about far less. Negative body attitudes in men are linked to negative sexual experiences, and concerns about physical appearance — including genital self-image — are significantly associated with performance anxiety and sexual dysfunction (Cedro et al., 2022; Wilcox et al., 2015). Research specifically on male genital self-image has found that poorer genital self-perception is associated with shame, anxiety, reduced satisfaction, and higher rates of ejaculatory difficulties (Çelik & Şahin, 2024).

Erectile Dysfunction (ED)

ED is one of the most common things I see men for — and it often comes with a great deal of silence and shame before they arrive. While ED can have physical causes, the relationship between ED and psychological distress runs in both directions: anxiety and depression contribute to ED, and experiencing ED significantly raises the risk of depression in return (Allen et al., 2023). Performance pressure, body image concerns, and unrealistic expectations create an anxiety cycle that directly interferes with arousal — and once that cycle is established, it can be hard to break without support (Allen et al., 2023; Jacobs et al., 2021).

Premature Ejaculation (PE)

PE affects an estimated 20–30% of men and is closely tied to performance anxiety (Çelik & Şahin, 2024; Rowland, 2016). The cycle tends to be self-reinforcing — worry about ejaculating quickly activates the sympathetic nervous system, which makes it more likely to happen, which generates more worry. Body image dissatisfaction and self-esteem are consistently identified as central psychological factors in both lifelong and acquired PE (Rowland, 2016), and the effects ripple into relationships over time (Bettocchi et al., 2016).

Orgasm Difficulties, Delayed or Inability to Orgasm (Anorgasmia)

Difficulty with orgasm — whether delayed, absent, or inconsistent — brings both men and women to see me. For men, delayed or absent ejaculation often involves disconnection from sensation, performance pressure, or a gap between how arousal happens privately and what’s available with a partner (Perelman, 2004). For women, orgasm difficulty is extremely common and is typically rooted in a combination of anxiety, shame, inadequate stimulation, difficulty staying present, and unspoken gaps in communication. In both cases, the work is about understanding what’s happening and creating the conditions for something different.

What I want people to know before they come in is this: none of this is a character flaw. These are patterns — shaped by pressure, by shame, by unrealistic ideas about how bodies and sex are supposed to work. Therapy offers a way to understand those patterns and, gradually, to change them. Sensate focus, mindfulness-based approaches, and honest, non-judgmental conversation are all part of how I work in this space.

Sex isn’t meant to be a performance. You deserve to experience it as something that actually feels good.

5. Attachment Patterns and the Way We Learned to Connect

As a sex therapist, I see people who are surprised to discover that the way they relate sexually has roots going all the way back to how they learned — or didn’t learn — that closeness was safe.

Attachment theory tells us that the relational patterns we develop in childhood create internal templates for intimacy — templates we carry into our adult relationships and sex lives whether we’re aware of them or not (Shaver & Mikulincer, 2006). Research consistently shows that insecure attachment — whether anxious (fear of abandonment, needing constant reassurance) or avoidant (discomfort with closeness, pulling away emotionally) — is linked to lower sexual satisfaction, less presence during sex, and greater difficulty being emotionally open with a partner (Lafortune et al., 2022; Pedneault et al., 2025).

For people with anxious attachment, intimacy can become tangled with fear of rejection or being left. For those with avoidant attachment, emotional closeness during sex can feel uncomfortable or threatening — even when they want connection. Neither is a flaw. Both are learned responses.

The link with trauma matters here too. When sexual trauma happens in childhood or adolescence, it doesn’t only affect the event itself — it often disrupts the formation of secure attachment, making trust, bodily safety, and emotional closeness in adulthood much harder to find (Riggs & Kaminski, 2010). Research has found that sexually abused children with insecure attachment experience significantly more PTSD and trauma symptoms than those with a secure base (Hébert et al., 2021), and large-scale studies confirm that the effects of childhood maltreatment on adult intimate relationships are largely shaped by the insecure attachment patterns it creates (Spinhoven et al., 2021).

Understanding your attachment patterns — and beginning to build something more secure — is often the real foundation beneath sexual healing. It’s quiet, careful work. It’s also some of the most meaningful work I do.

6. Cultural Identity and Sexual Wellbeing

As a sex therapist, I see people whose experience of sexuality has been shaped — sometimes profoundly — by the culture they grew up in, and who need a space that actually understands that.

Sexuality doesn’t exist outside of culture. The messages we absorb about bodies, gender, desire, and what sex is for are shaped by where we come from — and those messages don’t just disappear when we walk into an adult life. For people from diverse cultural backgrounds, these layers can add real complexity to sexual difficulties that a standard Western framework of sex therapy doesn’t account for.

Research in cross-cultural sex therapy is clear: the same presenting concern — painful sex, low desire, sexual shame — can have very different cultural roots, and effective therapy has to respond to context, not just symptoms (Bhavsar & Bhugra, 2013; Newlands et al., 2019). In many cultural contexts, women’s sexual pleasure has been minimised or ignored across generations, contributing to higher rates of sexual difficulties and deep reluctance to seek help. Cultural expectations around gender roles, family, and what sex is supposed to mean can shape how someone understands their own desire — and whether it feels safe to voice it at all.

Seeking help itself is shaped by culture. Research consistently finds that shame, stigma, and the belief that sexual difficulties should stay private are major barriers to reaching out — barriers that are often stronger in communities where mental health support carries its own weight (Darnell et al., 2023).

I don’t bring a single standard of “healthy sexuality” into the room. I try to understand your world — where you’ve come from, what you carry, what feels possible — and work from there. Adelaide is one of the most culturally diverse cities in the country, and I welcome clients from all backgrounds. My job is to meet you where you are.

7. LGBTQ+ Identity, Sexuality, and Intimacy

As a sex therapist, I see LGBTQ+ clients who are often carrying not just the thing that brought them in, but years of having to navigate a world that wasn’t built with them in mind.

Whether you’re questioning your orientation, exploring intimacy in a queer relationship, processing internalised shame, working through the effects of coming out later in life, or simply wanting a space where you don’t have to explain yourself before the real work begins — this is a space I hold with genuine care and without judgment.

Research is consistent on this: LGBTQ+ people face elevated rates of anxiety, depression, and psychological distress, driven largely by minority stress — the chronic burden of stigma, discrimination, and concealment that comes with navigating a world that isn’t always affirming (Meyer, 2003; Moagi et al., 2021). Therapeutic approaches that directly address minority stress have shown meaningful benefit for LGBTQ+ clients (Tudor-Sfetea & Topciu, 2024).

Finding a therapist who is genuinely affirming — not just non-judgmental, but actually on your side — makes a real difference. I work from a celebratory stance when it comes to diverse sexualities and gender identities. You shouldn’t have to spend your session time getting me up to speed.

Things that often come up include intimacy after coming out later in life, internalised homophobia, relationship structures outside the mainstream like ethical non-monogamy, and the ways minority stress quietly shapes desire and sexual confidence over time.

You deserve support that sees all of who you are.

Working With Me

I offer individual therapy sessions from my practice in Goodwood, Adelaide — accessible to clients across Adelaide, South, North, West and the rest of the state. Online sessions are also available.

I bring a trauma-informed, psychotherapeutic approach to all areas of sex therapy. That means I’m not handing out worksheets or running through techniques in isolation — I’m interested in the whole picture: your history, your nervous system, your relational patterns, and what has shaped your experience of intimacy. Sessions are confidential, non-judgmental, and genuinely collaborative.

You don’t need a referral. If you’d like to get a feel for whether working with me might be right for you, then maybe its time to book your first session with me.

To book your first session with me [click here].

Frequently Asked Questions About Sex Therapy in Adelaide

References

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