For pelvic floor physical therapists
When to bring a sex therapist onto the pelvic floor team
I’m Joseph Maron, MS, LPC, a sex therapist seeing Pennsylvania adults by telehealth. While you treat the pelvic floor, I work alongside you on the fear, avoidance, and strain around sexual pain.
Immediate openings
Telehealth only · Adults in Pennsylvania · $195 per 50-minute session · Private pay, superbills provided
The consult is for your patient. The call button is for you. More practice details
Consider a referral when your patient…
Fears pain enough to avoid sexual touch.
Pain and fear of pain can keep each other going.
Struggles to start or stay with dilator or internal work.
Fear or anxiety about penetration gets in the way.
Describes a relationship strained by the pain.
This can look like pressure, withdrawal, guilt, or lost physical closeness.
Measures recovery by intercourse, or feels pressure to “get back to” penetration.
Widening what counts as sex takes the pressure off.
Has past experiences that affect how safe touch feels.
Pacing is trauma-informed; nothing happens that they haven’t agreed to.
Carries shame that keeps them from intimacy.
The shame may be about leakage, surgery, birth, or other body changes.
Common reasons to refer
- Vulvar and vaginal pain
- Vaginismus / genito-pelvic pain
- Painful receptive anal sex
- Erection, ejaculation, or orgasm concerns, including early ejaculation
- Incontinence during sex
- Sexual changes after pelvic surgery, birth, or cancer treatment
- Sexual changes after gender-affirming hormones or surgery
Tandem care, not a hand-off
Your PT care
The pelvic floor treatment stays with you: muscle tone and coordination, manual therapy, biofeedback, dilator progression, and patient education.
Sex therapy
I work with your patient on the cycle of pain and fear, talking with a partner, and widening what counts as sex beyond penetration. Your patient sets the pace.
A first conversation can simply be about whether a referral might fit. Please wait to send records or identifying details until we’ve set up a secure way to share them.
To refer
Your patient requests a free 15-minute consult at JosephMaronLPC.com. Or call 215-804-9315. Want to talk a referral through first? Call me at the same number.
Telehealth only · Adults in Pennsylvania · Private pay, superbills provided
Tell your patient: sex therapy is talk therapy. No touch, no exam.
Doctoral student in human sexuality, Widener University · Certificate in Affirmative Therapy for Transgender Communities · ADHD-CCSP · LGBTQ+ affirming
A referral does not confirm availability or establish a treatment relationship. This practice is not an emergency or crisis service. Call or text 988, or call 911 for an emergency.
Handouts to print or share
One page for you and a two-sided handout for your patient. The patient handout is also a web page, so you can send a link instead of printing.
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For people in pelvic floor physical therapy
When sex hurts — or you’re afraid it will
Pelvic floor physical therapy treats your body. Sex therapy can work alongside it, on the fear, stress, and relationship strain that often come with sexual pain.
Why it fits
Genital pain often has organic causes and should never be treated as purely psychogenic.1 Physical therapy is first-line care for provoked vestibulodynia.2 In a 20-person pilot trial, CBT and PT each reduced pain; sexual function improved only with CBT, though the two groups differed little overall.3 Psychological treatments, including CBT and mindfulness-based approaches, improve sexual function and sexual distress compared with no treatment in controlled trials.4 After gender-affirming genital surgery, pelvic floor PT can help, and patients often want mental health aftercare too.5 Most evidence is from women with vulvovaginal pain.
1 Gambescia et al., A Clinician’s Guide to Systemic Sex Therapy, 3rd ed., 2021. 2 Morin et al., AJOG 2021. 3 Goldfinger et al., J Sex Med 2016. 4 Frühauf et al., Arch Sex Behav 2013; Liu et al., J Sex Med 2026. 5 Dominoni et al. 2025; de Brouwer et al. 2021, both J Sex Med.
What I tell your patient about sex therapy
Sex therapy is talk therapy about sexuality, intimacy, and relationships. There is no touch, no exam, and nothing physical happens in sessions.
Sex therapy does not replace medical care or the care you provide. New or sudden changes deserve a medical check. If a medication seems to be affecting someone’s sex life, I ask them to talk with their prescriber before making changes.