Sex Therapy On Call

Biggs acknowledged, however, that since the study was based on patient surveys and not observations, there was no way of knowing whether the clients actually benefited.

Until more studies are done, there's no way to know if distance sex therapy is effective, said O'Donohue. In the meantime, he said, sex therapists shouldn't charge for distance services.

Ultimately, he said, there should be a federal regulatory group to oversee distance sex therapy. That way, the agency could monitor the transition from office to online the way the Food and Drug Administration makes sure drugs for one ailment aren't blindly sold for another. "Just because a pill works for one type of problem," he said, "someone can't put it in liquid form and sell it for another problem."

And yet, none of these concerns have fazed Michael, Brame's client in California. He said he knows distance sex therapy isn't taken as seriously as traditional sex therapy, but he believes a therapist-client relationship can thrive as long as the two parties understand each other. That, he said, has nothing to do with whether they're sitting in the same office.

He said he's had his share of therapists who didn't understand him or his desires, and he had grown frustrated after terminating therapy with several California therapists. At this point, he said, he's happy to have found someone he can connect with -- even if she's thousands of miles away.

What he hopes to get out of the therapy, he said, is the ability "at some point [to have] a normal relationship with someone that has kink aspects as well as a general respect for another person, and just having the kinky stuff being a normal part of my life." But to get to that point, he said, he has to "come to terms with who I am and other people accepting who I am." He feels he's made progress, and so, he said, does Brame.

"I guess the real thing is, if you talk to an intelligent person who gets inside your head in the right way, who has interesting ways of looking at the world, and you're open to them," he said, "then I find that more important than someone standing there with a tape measure measuring my waist every three weeks."•

Jason Feifer is a freelance writer in Massachusetts.