What's the difference between a couples therapist and a sex therapist?

A couples therapist works on the relationship. A sex therapist works on the relationship and what's happening, or not happening, in your sex life. Most couples therapists weren't trained to talk about desire, arousal, pain, or mismatched libidos in detail. A certified sex therapist was.

What is desire discrepancy?

Desire discrepancy is when two partners want sex at different frequencies or in different ways. It's one of the most common reasons couples come to sex therapy, and it's rarely about one person wanting too much or too little. The work is understanding what drives each person's desire, then building something that fits both of you.

Do both partners have to come to sex therapy?

No. You can start sex therapy on your own, even when the concern involves your relationship. Sometimes one partner comes first and the other joins later. Sometimes the work stays individual.

Does insurance cover sex therapy?

Ilana Grines, LMFT is an out-of-network provider and does not bill insurance directly. She can provide a superbill, an itemized receipt, that clients can submit to their insurer for possible out-of-network reimbursement.

How do I know if I need a sex therapist?

If sex, desire, or intimacy has become a source of stress, distance, or avoidance, that's reason enough. You don't need a crisis to qualify. Common reasons people come in include mismatched desire, low libido, pain, difficulty with arousal or orgasm, the slow fade after years together, recovering after infidelity, and questions about their own sexuality.

Sex Therapy in Los Angeles

Sex is one of the most human things there is, and one of the hardest to talk about.

If you're reading this, something isn't working.

Desire's gone quiet, sex has gotten complicated, or you've never had the language for what you actually want.

That's what I'm here for.

My practice is sex-positive and affirming.

I work with clients of all genders, identities, and relationship structures, including queer clients, and people in ethically non-monogamous or kink-involved relationships. You won't have to explain or defend who you are before we get to the actual work.

You don't need a partner to start. Plenty of people begin sex therapy on their own, even when the concern is about a relationship.

Ilana Grines is a Licensed Marriage and Family Therapist (LMFT #116296) and Certified Sex Therapist based in Los Angeles. She sees clients in person here and virtually throughout California.
It's talk therapy. No physical exam, no touching, nothing happens in session beyond conversation. What it is is a place to say the thing you've never said out loud: about desire, about your body, about what's not happening in bed and why.
Most therapists weren't trained for this conversation. I was. Through Modern Sex Therapy Institutes, I've done advanced clinical training in desire, arousal, and the emotional layers underneath them.
I work with individuals and couples navigating:
- Desire discrepancy (one partner wants sex more, or differently, than the other)
- Low libido and the anxiety that builds around it
- Sexual dysfunction, pain, or difficulty with arousal and orgasm
- The slow fade that happens after years together
- Questions about your own sexuality or identity
- Rebuilding intimacy after infidelity

A couples therapist works on the relationship. A sex therapist works on the relationship and what's happening, or not happening, in your sex life. Most couples therapists weren't trained to talk about desire, arousal, pain, or mismatched libidos in detail. A certified sex therapist was.
When two partners want sex at different frequencies or in different ways. It's one of the most common reasons couples come to sex therapy, and it's rarely about one person wanting too much or too little. The work is understanding what drives each person's desire, then building something that fits both of you.
No. You can start on your own, even when the concern involves your relationship. Sometimes one partner comes first and the other joins later. Sometimes the work stays individual.
If sex, desire, or intimacy has become a source of stress, distance, or avoidance, that's reason enough. You don't need a crisis to qualify.

Book a free 30-minute consultation →