Sexology, despite having been around for nearly sixty years, is still a relatively misunderstood area of health care. According to the World Association of Sexual Health (WAS), “sexologists work in a wide variety of disciplines” and they have specialist post-graduate training, but could have a background in psychology, medicine, public health, research or nursing.” In South Africa, the term sexologist is used according to this definition.
How to become a Sexologist
A sexologist must have an initial qualification that will lead to registration with reputable and accrediting healthcare bodies, such as the health professions council of South Africa (HPCSA).
In South Africa, a healthcare provider who has obtained specialist postgraduate qualifications in human sexuality can call themselves a sexologist, which entails training in the broad spectrum of human sexuality and includes the multiple factors that influence our behaviour and feelings about our sexuality.
A sexologist should also have undertaken sexual attitude reassessment seminars (SARs) as a fundamental part of their training.
They could have an initial qualification in psychology, medicine, nursing, public health or research, but they can only use the title of clinical sexologist if they have completed a postgraduate qualification, obtained the relevant accreditations to practice as a registered healthcare provider with a legitimate body and are practicing clinically.
Unfortunately, there is currently no postgraduate qualification available in human sexuality or sexology in South Africa that would enable a qualified and registered practitioner to become a sexologist. Therefore, a practitioner has to qualify internationally in order to become a sexologist at this time.
What does a Sexologist do?
A sexologist works to understand what people do sexually and how they feel about what they do. For example, a clinical sexologist may offer sex therapy (a form of talking therapy) to help people understand and accept themselves as sexual beings, overcome sexual challenges they might be facing and meet their sexual goals.
Sexology should never (and will never) involve patients interacting sexually with or in front of their sexologist.
It can be offered to individuals, to partners or in a group setting, and could take place weekly (for example for therapy) or less frequently depending on the patient’s needs (such as monthly for medical purposes).
When a patient consults with a sexologist, the sexologist should always maintain a ‘sex-positive’ and non-judgmental approach to their patient and their concerns. Like with any healthcare provider, the success of the patient’s treatment rests heavily on the dynamic between them and the practitioner. They should feel that they can trust their sexologist and open up to them about their concerns, without the fear of criticism, prejudice or rejection. A strong rapport between the patient and the practitioner has been found to be one of the single most important predictors of successful treatment.
A sexologist should uphold a broad perspective on sexuality by taking biological, psychological, sociological, anthropological and cultural factors into consideration when addressing a patient’s concerns. Education is a large part of process, and a sexologist should use an educational approach as part of treatment to help their patients meet their goals; without holding any preconceptions of what a patient’s sexual experience and sexuality ‘should’ look like. Sexual growth is facilitated by helping them to identify their sexual goals and by offering education, resources, tools and techniques to help them meet those goals and ultimately manage their own sexual development.
The PLISSIT model (Anon, 1976) is the foundation for sex therapy, but the treatment of sexual concerns by other healthcare providers also utilises this model. The PLISSIT model is based on the following premise: giving patients explicit and implicit permission to ask and explore their sexuality, offering the patients limited information regarding their specific concerns (often in the form of educational resources), making specific suggestions to the patient based on their needs and concerns, and either referring for or offering the patient intensive therapy when their concerns have psychology origins.
When should a Sexologist refer a patient?
If sexual difficulties appear to be rooted in deeper issues that require intensive therapy, a clinical sexologist with a background in psychology will be able to undertake this work with a patient. If they feel that a patient requires further treatment from another practitioner who is part of the multidisciplinary team, they will provide a referral to an appropriate specialist, and it is advised that this be someone whom the referring clinician has a working relationship with and who’s expertise are known.
In the treatment of sexual issues, it is common practice for a sexologist to work closely with a multidisciplinary team of healthcare providers. These might include, but are not limited to:
- A medical doctor practicing in sexual health
- A psychologist
- A pelvic floor physiotherapist
- A urologist
- A gynaecologist
- An endocrinologist
- A psychiatrist
Catriona Boffard (SASHA Member)
Clinical Sexologist, Psychotherapist, Sex Researcher & Educator and Speaker
BA (Hons) (WITS, SA)
MA Psychology (WITS, SA)
Masters of HIV, STIs & Sexual Health (MHSSH) – (USyd, AUS)
European Certified Psychosexologist – European Society of Sexual Medicine/ European Federation of Sexology.
Postgraduate Diploma in Cognitive-Behavioural Therapy – (RHUL, UK)