Sex Therapy in New York | Paula Kirsch, LCSW, CST

New York skyline — telehealth therapy for New Yorkers

New York State · Telehealth

Sex & Couples Therapy for New York — Where You Can Finally Say the Thing

Virtual sessions. Clinical depth. A space where nothing needs a disclaimer before we begin.

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Does any of this sound familiar?

If something brought you here, that's usually enough to start.

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You look like you have it together. Your private life is a different story.
You've thought about therapy for this. You haven't made the call.
Sex is painful. You've been working around it for long enough that it's started to feel normal. It isn't.
You want a clinician who won't make you explain why this matters. Who already knows.
Sex has become something you avoid, manage, or worry about. That's not what you wanted.
You're not sure your relationship can survive what's happened. You're also not sure it can't.

Who This Is For

You don't need to have it figured out before you call

If you're here, something in your intimate life — or your relationship — isn't sitting right. Maybe you've been carrying it for a while without anywhere safe to take it. Maybe you've thought about getting help before but couldn't find someone who actually specializes in this. Maybe the logistics always got in the way.

That's what virtual care is for. Whether you're in the city or upstate, you meet with me from wherever you are — no commute, no waiting room. Just a real conversation, from the first session.

I'm Paula Kirsch, a Certified Sex Therapist and Licensed Clinical Social Worker licensed to work with individuals and couples across New York State.

No Commute Required

Join from home, your car, wherever you have privacy. For this kind of work, where you are matters.

Fully Confidential

No shared waiting rooms. Sessions are private and conducted on a secure, HIPAA-compliant platform.

Actual Specialization

Sex therapy is the center of my practice — not an add-on. You can see a specialist no matter where in New York you are.

What to Expect

What sex therapy actually looks like — because most people aren't sure

Sex therapy is entirely talk-based. There is no physical contact, no nudity, and nothing that looks different from any other therapy appointment on a video call. What makes it different is the focus and the depth of training behind it.

It's a conversation. A structured one that moves.

Sessions start with what's actually going on — not the version that's easiest to say, but the real one. From there the work is specific and goal-oriented: building language for what you need, practicing clearer communication with the people you're close to, and making real changes in how you experience intimacy.

Depending on what you're working on, sessions often include education, structured conversation, and practices to try between appointments that we process together. It is goal-oriented without being rigid.

For most people, being at home for this kind of conversation turns out to be exactly right. There's no waiting room, no commute, no performance. You're in your own space talking about the things that actually live there.

Where I Practice

Serving New York clients from NYC to upstate

Manhattan Brooklyn Queens The Bronx Staten Island Westchester Rockland Nassau County Suffolk County Albany Buffalo Rochester Hudson Valley East End

Wherever you have privacy and a connection.

New York clients come from across the state: Manhattan, Brooklyn, and the outer boroughs; Westchester and Rockland counties; Long Island from Nassau to the East End; and upstate from Albany to Buffalo. Telehealth means geography isn't the obstacle it used to be — you're not limited to whoever happens to have an office nearby.

The people I work with in New York come for a lot of different reasons. Some are navigating desire discrepancy or sexual disconnection that's been quietly straining a relationship for years. Some are women dealing with painful sex, postpartum changes, or perimenopause-related shifts in desire that their doctor mentioned but didn't have time to address. Some are in relationships that don't fit a standard template — ENM, kink-aware, mixed-orientation, or same-sex partnerships — and they've spent too long trying to find a clinician who doesn't need a lot of explaining to.

If any of that sounds familiar, this is exactly where that conversation belongs.

Specialized Care

What We Can Work On Together

Sex Therapy

Desire discrepancy, painful sex, intimacy avoidance, sexual trauma, low libido, questions about identity — if it lives at the intersection of sexuality and relationship, it belongs here. Nothing requires a justification before we begin.

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Couples Therapy

Communication that's broken down, distance you can't close, trust that needs rebuilding, or a decision you're not ready to make alone. I work with couples at all stages — including those who aren't sure what comes next.

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LGBTQ+, ENM & Kink Affirming

All orientations, identities, and relationship structures are part of the everyday practice here — not accommodations. You won't spend session time explaining why your relationship is valid. We can get to the actual work.

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Commonly Overlooked

Medication & Sexual Health

SSRIs, antidepressants, and other medications commonly affect desire, arousal, and the ability to orgasm. If your sex life changed when your prescription did, that's not in your head — and it's rarely addressed in a 15-minute medical appointment. This is exactly where that conversation belongs.

Your Therapist

Paula Kirsch, LCSW, CST

I became a sex therapist because it's where the most important — and most avoided — conversations happen. Sexuality, intimacy, identity, and desire sit at the center of how we experience ourselves and our closest relationships. Most people never get a real place to talk about any of it.

I'm a Licensed Clinical Social Worker licensed in New York, Connecticut, and Michigan, and a Certified Sex Therapist through both IBOSP and IAPST. I'm currently a PhD student in Sexology at MSTI, which keeps my clinical work grounded in current research. I also incorporate Brainspotting when trauma or emotional blocks are part of the picture.

My practice is genuinely affirming of LGBTQ+ identities, ENM, kink, and polyamorous relationships — not as a specialty niche, but as part of how I work every day.

LCSW — Licensed in NY, CT & MI

Certified Sex Therapist (CST) — IBOSP & IAPST

PhD Student in Sexology — MSTI

Gottman Level II Trained

Brainspotting Trained

ENM, Kink & Polyam Affirming

Getting Started

Book Your Free 15-Minute Consultation

We'll meet for a free 15-minute consultation to make sure this is the right fit. Most new clients are in session within a week. You'll complete intake paperwork through the secure client portal before we begin.

Meet Online

I'll send you a secure link. All you need is a private space and an internet connection.

Do the Real Work

We start where you actually are — not where you think you should be. Sessions are substantive from the first appointment.

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Questions

Things People Ask Before Reaching Out

About telehealth sex therapy in New York.

Yes. I'm a Licensed Clinical Social Worker (LCSW) authorized to provide therapy to clients anywhere in New York State. All sessions are conducted virtually through a secure, HIPAA-compliant telehealth platform, so you can meet from home, your office, or wherever works best for you.

Yes. As a Certified Sex Therapist, I have specialized training in these areas and can help you work through the emotional and relational impact — including the shame or frustration that often comes with it. I also partner with pelvic floor PTs, OB/GYNs, and urologists when coordinated care is part of the picture.

Yes. SSRIs and other medications — antidepressants, hormonal treatments, blood pressure medications — commonly affect desire, arousal, and orgasm. This is one of the most undertreated issues in sexual health because it rarely gets adequate attention in a medical setting. Sex therapy addresses both the physical reality and the relational impact it often creates.

Communication that's shut down, trust after infidelity, emotional distance, desire discrepancy, sexual disconnection, and the hard question of whether to stay or go. My practice is affirming of all relationship structures — LGBTQ+, kink-affirming, and ENM partnerships included.

No. Sex therapy is entirely talk-based. Sessions focus on conversation, psychoeducation, and skill-building. There is no touching, no nudity, and nothing that resembles what people sometimes imagine. It's clinical work conducted the same way any other therapy is — just with topics most therapists avoid.

Not at all. I'm licensed to see clients anywhere in New York State — from the five boroughs to Westchester, Long Island, the Hudson Valley, and upstate. All you need is a private space and an internet connection.

Start with a free 15-minute consultation to make sure we're a good fit. Most new clients are in session within a week. You'll complete intake paperwork in your own encrypted portal, then receive a secure link for your first session. All you need is a quiet space and an internet connection.