What is Gay Sex Therapy?

By Adam Blum, MFT, Founder and Director of the Gay Therapy Center

Will my partner shame me or leave me if I tell them my fantasies?

Why can’t I get it up anymore?

Is it okay if I want monogamy over Grindr hookups?

Are my kinks normal?

These questions might make you squirm, but they’re part of daily conversations for Dinko Zidarich, a male sex therapist at Gay Therapy Center.

Croatian-born Zidarich always planned to be an engineer, and after graduating from MIT, he found his place in the tech world. But the fast-paced, always-traveling lifestyle became too stressful.

He found a passion for psychology, and after self-work in therapy and pursuing education in Jungian psychology, he had a realization: he could blend his science background with the emotional by becoming a therapist. He made the leap a decade ago, and a few years later, began to focus on human sexuality — particularly helping gay men talk about sex without shame and have better and healthier sex.

I interviewed Zidarich to get his perspective on the common concerns gay men have around sex, why communication is vital, and why yes, you very likely are normal.

Why would someone consider getting gay sex therapy?

I work with couples and individuals, both in and out of the LGBTQ+; everyone can benefit. Some people think sex therapy isn’t relevant if you’re not currently in a relationship, but you don’t have to have a partner to work on sexual issues.

Sex is rarely brought up in traditional therapy, and regular therapists get very little training in sexuality. I have clients who might have seen multiple therapists before, or been in therapy for 10 years, and haven’t ever addressed their sexual challenges.

Something unique about our minority community is that we generally are not raised by our own.

What I mean is, in most minority communities, like those in racial or religious minorities, are raised by parents in those same minorities. It’s possible a gay man will have a gay male parent, but often, gay men are raised by straight, cisgender people who don’t have similar experiences.

This means they likely never get psychoeducation — what we call the birds and the bees talk — and if they do, it’s likely heterosexual-focused. They may have never learned about sexual health, healthy practices, and so on.

Sex therapy is a kink friendly and poly friendly place where we normalize talking about sex and desires and improve communication in ways that help someone well beyond the bedroom. I help people with issues related to sexual dysfunction, desire discrepancy, consensual nonmonogamy, aging, problematic sexual behaviors, and more. A good sex therapist can also help with psychoeducation on sexuality, like recommending books to read or recommending products to try.

Sexual issues are often there due to other underlying issues, like larger communication problems, or underlying sexual trauma that was never addressed. I see clients who have been in therapy before but never realized many of their problems stem from sexual trauma from early in life.

Men in particular might not conceptualize their experience that way until they start therapy and look at their challenges in adulthood, and then realize many of those come from unresolved sexual trauma from formative experiences in childhood or early relationships.

How do you help people learn how to get more comfortable talking about sex with others?

In our culture, sex is like money; it’s something everyone wants, but having it can be viewed negatively, and nobody wants to talk about it. The messaging is that sex is bad, but gay sex is even worse. On top of that, religious communities often establish values that sex has to be a certain way.

Even with my straight clients, talking about sex with someone else for the first time is a big deal. LGBTQ+ people can have an even harder time due to our heteronormative culture, especially if they grew up with certain values or religious influences.

A big part of sex therapy is normalizing talking about sexuality.

With individuals, sometimes I’ll ask what their top three search terms are on porn sites.

Many go into a shame spiral and can’t even imagine saying that to someone else. But by saying it to me, a trained professional, they start to get over that and build and develop the skills to bring it home to a partner.

When I work with couples, I ask them to create their own list of sexual interests. Then I speak with them in front of their partner to experience learning how to talk about it with someone else. The goal is for them to go home and develop the skills to communicate about it with each other.

It’s not just about building skills to communicate about sex in the moment, but also outside of the bedroom. You develop the ability to negotiate boundaries and explore your values, concerns, and fantasies.

It’s also important to learn how to receive information from a partner. If my partner is talking to me about something sexual they want to try, it’s a sensitive topic, and they’re taking a risk by communicating with me. If even one micro-muscle in my face changes in reaction, they could shut down and never talk about it for another five years unless we go to therapy.

If someone is honest and vulnerable with you, it’s important to know how to respond, even if what they want to do isn’t your thing or isn’t something you’re interested in. In the kink community, there’s the term “don’t yuck my yum” about not shaming others.

So is it common for people to wonder if they and their desires are “normal”?

Oh yes; we tend to think the things we like are a complete aberration but are actually right in the middle of the bell curve, according to research.

There can be so much shame for people about what they are or aren’t into. For example, more recently, ‘sides,’ or gay men who are not into penetrative sex, have been shamed and bullied by other gay men. Saying your wants aloud can feel risky.

Sex therapy is a process where you talk about your sexuality and gain insights; when the other person responds and doesn’t shame you, and you continue discussing it, it can help normalize things that make you worry aren’t normal.

This isn’t only about kinks. It could be that someone feels shame about wanting to hold hands in public. But holding hands is also a form of affection and sexuality, and it helps to recognize when it’s something you want.

Similarly, I have gay men come to my office feeling shame for being “vanilla,” because they don’t want to hook up with everyone on Grindr like all of their friends. They don’t fit the gay narrative since they actually want to know the person’s name and desire monogamy. I’ve seen clients be ashamed and feel like they’re not cool enough or keeping up with the community.

I remind people that most research shows it’s actually about 50/50 in terms of open vs. closed relationships. It’s okay to accept your inner monogamous person or come out as vanilla!

On that note, what do you often see around sexuality and open relationships? 

I work with both straight and LGBTQ people on this, and they often handle it differently. It’s less common in straight couples, so to them it’s a big deal. They might spend six months in therapy preparing for all the potential issues that could happen with consensual nonmonogamy.

Some gay men will come to me for sex therapy to help them prepare to open the relationship or maintain an open one — but more often than not, I’m helping them after their relationship has royally imploded in a big way.

That’s because gay men who have been in a closed relationship for a few years tend to suddenly decide to open it up and go out on a sex app over a weekend without much preparation or communication first. It sometimes massively implodes emotionally and they end up in therapy to repair things.

What are some common issues for gay men and their partners around desire? 

I often see a desire discrepancy, which is when one person wants sex more frequently than the other. It may be that the couple has been together for many years and the sex and desire went away.

This can be related to sexual dysfunction, like erectile difficulties or low libido. Some people have erectile issues when they try to engage in casual sex, like they may struggle to maintain erections due to performance anxiety or not knowing what to do.

It may also just be something that happens in couples over time without dysfunction. Someone wants sex more than the other, and it doesn’t matter what the frequency is; there’s no right or wrong. Couples should work together on negotiating what works for them.

This isn’t easy for most people, so the challenge is when a desire discrepancy leads to communication problems within relationships.

Think about sexuality like a strand of Christmas lights. With the old lights, removing one meant it wouldn’t work. With the modern ones, you can remove two, and it will still work, but three or more and it stops working.

If there are relationship challenges in other areas, they will show up sexually. Sexual difficulties for a couple will often be related to the lack of communication in other parts of life and can show up in the bedroom even if it seems unrelated to sexuality. For example, maybe someone is holding a huge resentment for a long period of time. It’s possible they will retaliate against that resentment and use sex to control the situation.

It sounds like getting older can be a time when desire changes; what are some other common issues you see among gay men and aging? 

Aging is a really big topic in LGBTQ-affirming intimacy therapy. It’s very common to have concerns about identity and sexuality as people age.

It could be that someone who was sexually viable for a long time and considered sexy and handsome or beautiful reaches a certain age and suddenly feels invisible. But they might still be attracted to people who are younger; maybe they used to have a lot of people hitting them up on Grindr and now it’s crickets. For many gay men, it happens in their forties, but it’s especially common by the time they reach their fifties.

They don’t have the skills to transition into the reality of aging. In therapy, we can address this by working on accepting this life change, rebuilding identity, and finding other ways of meeting people.

In closing, what have been some of the most rewarding aspects of being a gay friendly sex therapist? 

One thing that drew me to this field is that in human sexuality, nobody agrees on anything, whether it’s clients, other clinicians, or others. There’s definitely a science behind it, but people all have different opinions, and this really speaks to me since I love controversial thought areas.

I also was drawn to the field since it’s more about adding something positive to our lives rather than subtracting. In other therapy, you might come in to fix depression or reduce anxiety. It made me feel really engaged and wanting to help people since I’m not there to get rid of symptoms, but to help them have a bigger, better sex life.

A big part of sex therapy is really developing that muscle and resilience to talk to somebody — maybe for the first time — about sex in that much detail and then bring that into the rest of their life. With their therapist, a client might experience someone validating that their sexuality is not wrong for the first time in their lives.