The longer I work as a psychotherapist the harder I find it to see any issues in simple terms.

Take this straightforward question: ‘How important is sex in relationships’?

I can’t start to answer it right away because I get immediately caught up with counter questions…

What type of relationships? Are we talking here about the importance of sex in heterosexual, bi or same sex relationships?

In couples or multiples?

And, if we had the relationship model clear, what exactly do we mean by sex?

And whilst we are at it, isn’t ‘important’ a relative term?

When I think about my work as a sex and relationship therapist I can say that, yes, sex appears to be important in relationships.

A common problem brought to therapy is low desire, where one partner seems to have lost interest in sex and the other feels sexually rejected. The raw human emotions of fear, anger, isolation and deep hurt that couples experiencing this problem show in therapy are a testament to how important the presence or absence of sex in relationships can be.

For others, the issue is the type of sex available in their relationship.

For couples who have a monogamy code, it can be devastating to discover an affair and affairs are often defined by whether or not the other relationship involved sex.

For people who don’t have a binary sexual identity of ‘straight’ or ‘gay’, a part of their sexuality may feel denied in any monogamous relationship, which may lead to relationship tensions and challenges.

People with specific sexual tastes, such as kink, BDSM or a particular fetish, may have difficulties finding a partner to fully share or even accept those preferences, leading to ‘secret’ sexual behaviour, feelings of shame and isolation.

But what is it about sex that makes it so important?

There is the ‘biological imperative’ argument, that sexual energy is fuelled by a fundamental drive to reproduce. For those clients I work with who are struggling with infertility, the raw anguish of not achieving this biological necessity is all too painfully evident … but it’s the children they are desperate for, not the sex.

And the importance of sex for people who don’t want children seems resolutely unaffected by the absence of a reproductive objective.

Is it the physical pleasure of sex that makes it important therefore, the transporting power and tension relief of an orgasm? Sex is undeniably physically gratifying for many, though not universally, and if it was just about pleasure or release wouldn’t masturbation be enough?

My view is that sex is as much about human relational needs as it is about biology and pleasure and, like all things human, it’s all in the meaning making.

If sex is going well it can mean that I/we are special, desirable, lovable, important, exclusive, wild, generous, edgy or alive.

Conversely, if it is absent or going badly, it can absolutely mean the opposite; I/we are dispensable, average, unattractive, worthless, weird, mean or vanilla.

Sex and relationships are inevitably intertwined

The state of our sex life can be determined by the quality of our relationship and state of our relationship can be determined by the quality of our sex life.

I’ve seen couples repair their sex lives by reconstructing their relationship, resolving past resentments, improving communication, developing an understanding of their partner’s world, overcoming the anxiety of their childhood attachment patterns … all quite typical therapy material.

Perhaps less predictably, I’ve seen couples repair their relationship problems by re-writing their sexual codes, acknowledging asexuality, embracing polyamory, or exploring less mainstream sexual practices.

So, back to our question of how important is sex in relationships…

The essential complexity of human experience means that each individual person will have a different answer within the unique dynamic of their specific relationship.

Knowing the answer in YOUR relationship and taking courageous action to rectify any issues is the key.

For help with sexual and relationship issues contact the College of Sexual and Relationship Therapists, COSRT,



Julie is a UKCP Registered Psychotherapist, COSRT Accredited Psychosexual Psychotherapist and Supervisor. As Chair of Ethics for the College of Sexual and Relationship Therapists, (COSRT), she is actively involved in the ethical and professional development of sex and relationship therapy at a national level. Julie represents COSRT on the national Memorandum of Understanding on Conversion Therapy group, working towards establishing standards of education and practice in gender, sexual and relationship diversity in the health professions across the UK.
As well as running her own busy private practice, Julie is Director of Local Counselling Centre, (LCC), a private counselling service and student placement agency based in Hertfordshire.
Julie is also Course Director for the Cambridge Institute of Clinical Sexology and a teaching faculty member and research supervisor for the BeeLeaf Institute of Contemporary Psychotherapy.

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