Couples Therapy for Mismatched Sexual Desire & Desire Discrepancy ● AASECT-Certified Sex Therapist ● Practicing Therapy Since 1988
Sex Therapy for Rochester, NY Couples with Sexual Desire Discrepancy
Online sex therapy for New York couples in Rochester, Pittsford, and across Monroe County
Mismatched sexual desire: Sex therapy for Rochester partners
One of you wants sex more often than the other, and both of you feel guilty about wanting more sex or less.
If you’re the partner who wants less sex, you feel guilty every time you turn your partner down. Some nights, you say yes so you won’t have to say no again. Other nights, you stay up late answering email, so you won’t have to say anything at all. In the kitchen, you keep kisses short, in case a long kiss leads to a request for sex.
If you’re the partner who wants more sex, you feel guilty for wanting sex at all. You can tell when your partner isn’t in the mood, so you wait, hint, and try not to ask too often. When your partner says yes, you wonder whether your partner really wants to.
From the outside, the two of you look happy. On Saturday mornings, you walk the canal path in Pittsford and stop for coffee. But at home, you feel lonely and disconnected from each other.
Because both of you are trying to be understanding, neither of you talks about how much sex each of you wants. So each of you thinks the other partner is fine.
Desire discrepancy is the clinical name for an ongoing difference in how much sex two partners want.
A difference in desire is common, and neither of you is a bad partner for wanting more sex or less. There’s hope. Many couples start enjoying sex together again in sex therapy, and the two of you can, too.
Kate McNulty, LCSW, LICSW | AASECT-Certified Sex Therapist & Certified Gottman Method Couples Therapist
I help Rochester-area couples talk about a difference in desire without guilt.
I’ve been a therapist since 1988. For more than fifteen years, I’ve focused on sex therapy for couples.
I’m an AASECT-certified sex therapist and a certified Gottman Method couples therapist. I also train other therapists: I’m an AASECT Approved Supervisor and a Gottman Method trainer. With both certifications, I can help with your sexual desire discrepancy and your relationship at the same time.
I’ll assess what’s contributing to your differences in sexual desire, including how each of you experiences arousal, sexual pleasure, physical health, and satisfaction in your relationship.
I’ll also use my couples therapy training to help you discuss sex without guilt or blame. The partner who wants more sex can learn to express sexual interest without apologizing, while the partner who wants less sex can feel comfortable saying no and saying yes only when they genuinely want to.
I see both partners together because I want to understand how the difference in sexual desire affects each of you. I’ll help you address the sexual concerns and the difficulties that have developed between you, while recommending additional medical or individual care when appropriate.
Here’s what you can expect from me as your sex therapist:
We talk about sex directly, in plain words, and sex stays at the center of our sessions.
I’ll use what we learn during the assessment to recommend treatment suited to your relationship. That may include addressing concerns about arousal or sexual enjoyment, working on difficulties within your relationship, or introducing structured touch exercises when appropriate. We’ll decide together what to try.
I take both of your experiences seriously, whether you’re the partner who wants more sex or the partner who wants less. The partner who wants more sex won’t be told that wanting sex is the problem, and the partner who wants less sex won’t be asked to say yes when they don’t want to. Together, we work toward sex you both look forward to.
We meet by secure video, and you’ll both need to be in New York State during each session.
How your relationship changes after sex therapy with me
Without help, a difference in how much sex each of you wants tends to get wider. The less the two of you talk about sex, the more distance both of you feel.
In our first sessions, I ask each of you what wanting more sex or less sex has been like for you. Many people have never said the answer out loud, so I help you find the words while your partner listens without getting defensive. When you understand each other, a no feels less like rejection, and the wait feels less frustrating. After years of keeping quiet about sex, neither of you has to face mismatched desire alone.
Next, I’ll assess how sexual desire works for each of you and what may be contributing to the difference. Some people experience spontaneous desire, meaning sexual interest arises without much immediate stimulation. Others experience responsive desire, where sexual interest develops in response to appealing experiences. Both are normal, and either partner can experience either kind of desire.
I’ll also look at sexual satisfaction, physical health, stress, and relationship difficulties. If kisses or cuddling have become associated with pressure to have sex, we’ll address that concern without assuming it caused the original difference in desire.
Once I understand what’s contributing to your difficulties, I’ll recommend treatment appropriate for your relationship.
When physical touch has become stressful, structured exercises can help you explore affection and intimacy without expectations about sex. If other concerns are affecting desire, arousal, or sexual satisfaction, we’ll address those directly.
We’ll also discuss how to express sexual interest and respond when one partner wants sex and the other doesn’t. I’ll help you practice changes between sessions and adjust our approach based on what both of you experience.
If you’re the partner who wants more sex, you can express sexual interest without hinting or apologizing. When your partner says yes, you can feel confident that they genuinely want the sexual experience you’re sharing. You can enjoy intimacy together without constantly wondering whether your partner is participating out of guilt.
If you’re the partner who wants less sex, you can better understand what makes sexual intimacy appealing or unappealing to you. You can explore experiences that bring you pleasure, express what you want, and say no without feeling responsible for your partner’s disappointment. When you choose to have sex, you can do so because it's something you genuinely enjoy.
In the kitchen, the partner who wants less sex leans in for a long kiss, because a kiss doesn’t have to lead to sex. For the partner who wants more sex, the kiss is the first time in months that you didn’t have to make the first move.
At 10pm, the partner who wants less sex closes the laptop, and the two of you go to bed at the same time. As part of the plan, the two of you have agreed that cuddling before sleep doesn’t mean sex. On a night when the partner who wants less sex says “not tonight,” the two of you cuddle until you fall asleep. The partner who wants more sex doesn’t lie awake wondering what went wrong.
Talking about sex comes more naturally, too. Either of you can say that you’d like sex this weekend or that you’re too tired tonight, and neither of you ends up feeling hurt.
A no is easier to say and easier to hear, and a yes leads to sex both of you enjoy.
Who is a good fit for sex therapy for Couples with desire discrepancy?
Sex therapy for desire discrepancy works best when both partners come to sessions. Both of you also need to want more satisfying sex together.
You don’t have to agree on what caused the desire discrepancy, or feel equally ready to work on the difference. Many couples start with one partner more doubtful than the other. You only need to be willing to try sex therapy together.
I also work with LGBTQIA+ couples, couples in open or polyamorous relationships, and couples where one or both partners are autistic or have ADHD.
If there’s ongoing domestic violence in your relationship, sex therapy isn’t the right place to start. Individual therapy is safer.
A certified sex therapist and couples therapist with more than 15 years treating differences in sexual desire
I’m Kate McNulty, LCSW, LICSW
I’ve been a therapist since 1988, and for more than 15 years, I’ve helped couples whose differences in sexual desire have become a source of frustration, hurt, or uncertainty about their relationship.
As both an AASECT-certified sex therapist and a Certified Gottman Method Couples Therapist, I bring two areas of specialized training to your treatment. I can assess how sexual desire, arousal, physical health, sexual satisfaction, and relationship difficulties influence one another, including concerns that aren’t immediately obvious to either partner.
Couples can spend years trying to improve their sexual relationship without understanding why their desires differ. I’ll help you identify what’s contributing to the problem and address those issues so you can build a sexual relationship that feels satisfying to both of you.
If the description on this page sounded like your relationship, I’d like to help.
Logistics
Pricing, scheduling, and online Sex Therapy sessions
All sessions are conducted by secure, HIPAA-compliant video. I work with couples in the Rochester area and Western New York.
Sessions are private pay, billed at $500 per hour and $750 for 90-minute sessions. Extended sessions (3+ hours) are available for couples who want to make faster progress.
I am not in-network with insurance and cannot bill them directly. For more information about pricing, please see the pricing page.
How to get started in sex therapy
To schedule your first appointment, please choose a day and time on my secure, HIPAA-compliant calendar using the button below.
After I approve your request, typically within one business day, you and your partner will receive new client forms via email, which you’ll both review and digitally sign before we meet.
Rochester Areas Served
I’m licensed in New York as a Licensed Clinical Social Worker (LCSW #086198), and I work with couples by secure, HIPAA-compliant video across the Rochester area.
I work with couples in Rochester and surrounding communities, including Brighton, Pittsford, Penfield, Fairport, Perinton, Webster, Henrietta, Victor, and Canandaigua. My services are also available to couples in Buffalo, Niagara Falls, and other communities throughout Western New York.
Because sessions take place online, you and your partner can attend from anywhere in New York State, including from separate locations when appropriate.
Questions about sex therapy for Rochester Couples with desire discrepancy —
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Yes, for both of you. If you’re the partner who wants less sex, I won’t push you to have more sex. We start by finding out what has made sex hard to want, and then we work toward sex you want to have, at a pace that feels okay to you.
If you’re the partner who wants more sex, wanting sex with your partner is normal, and I take your experience as seriously as your partner’s. We work on how to ask for sex, how to hear no without feeling hurt, and how to feel wanted again.
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Some couples take a break from sex early on while we work on taking the pressure out of physical touch and affection. The three of us together can talk about what fits your relationship.
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Yes. One of you can join from home and the other from work, and you’ll both sign on to the same secure video link. Each of you will need a private space and reliable internet.
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I’m not in-network with any insurance company, and I don’t provide superbills for couples sessions. If you have a FSA or HSA card, you’re welcome to use it for our sessions.
Still have Questions about sex therapy for desire discrepancy?
Please contact me using the button below. I will respond within 2 business days.