Sex Therapy and Affirming Care
Across Michigan
Thoughtful, clinically grounded therapy for individuals and couples navigating sexuality, identity, and intimacy. Fully virtual. Available statewide.
Schedule Your Deep DiveYou don't have to have it figured out to begin
If you're here, something in your intimate life isn't sitting the way you hoped it would. Maybe it's a distance between you and your partner that keeps widening no matter how much you love each other. Maybe it's something you've never said out loud to anyone — questions about desire, about your body, about who you are or what you want. Maybe it's pain that nobody has taken seriously, or a relationship that doesn't fit the mold and deserves real support anyway.
You don't need the right words for it before you call. You don't need to justify why it matters or worry about what I'll think. Whatever brings you here, nothing requires an explanation or an apology before we begin.
I work with individuals and couples — including LGBTQ+ folks, people in ENM, kink, and polyamorous relationships, and women whose OB/GYNs have referred them for sexual health support. All sessions are fully virtual and HIPAA-compliant, so you join from wherever feels most comfortable.
Specialized training. Genuine affirmation.
Sex Therapy as a Specialty
Sex therapy is a distinct clinical field, and it is the center of my practice, not an add-on. I hold active certification through IAPST and IBOSP as a Certified Sex Therapist, and I incorporate Brainspotting when trauma or emotional blocks are part of the picture.
Actually Affirming
LGBTQ+, ENM, kink, polyamorous, mixed-orientation — these are not edge cases here. You won't spend session time educating me on your relationship structure or defending its validity. We can get to the actual work.
Telehealth Across Michigan
All sessions are fully virtual and HIPAA-compliant. Detroit, Ann Arbor, Grand Rapids, the Upper Peninsula — wherever you are in Michigan, access is the same.
What therapy with me actually looks like
Sessions are private, talk-based, and fully confidential. This is a space where you can say the thing you haven't been able to say anywhere else — without managing my reaction or preparing a justification for it first.
My approach is sex-positive and clinically grounded. I'm not here to guide you toward any particular version of a healthy relationship or sex life. I'm here to help you figure out what that looks like for you, and to help you get there.
Getting to what's really going on. Not the surface version — the thing underneath it. Shame, grief, avoidance, disconnection. We work with what's actually true, and we do it with care.
Building language for the hard things. Communication isn't just conflict resolution. It's being able to ask for what you need, hold your limits without guilt, and stay in honest contact with the people you're close to.
Creating change that holds. Not a way to get through the week. Real shifts in how you relate to yourself and the people you love.
Paula Kirsch, LCSW, CST
I became a sex therapist because it's where the most important — and most avoided — conversations happen. Sexuality, intimacy, identity, and desire sit at the center of how we experience ourselves and our closest relationships. Most people never get a real place to talk about any of it.
I'm a Licensed Clinical Social Worker licensed in New York, Connecticut, and Michigan, and a Certified Sex Therapist through both IBOSP and IAPST. I'm currently a PhD student in Sexology at MSTI, which keeps my clinical work grounded in current research. I also incorporate Brainspotting when trauma or emotional blocks are part of the picture.
My practice is genuinely affirming of LGBTQ+ identities, ENM, kink, and polyamorous relationships — not as a specialty niche, but as part of how I work every day.
Book Your Deep Dive Intake
Schedule through my secure client portal. I typically have availability within a week, and you'll complete intake paperwork in your own encrypted portal before we meet.
Meet Online
I'll send you a secure link. All you need is a private space and an internet connection.
Do the Real Work
We start where you actually are — not where you think you should be. Sessions are substantive from the first appointment.
Your first session is substantive,
not a get-to-know-you call.
We start where you actually are. With compassion and without judgement. No rushed 15-minute consultations — just real work, from the first appointment.
Schedule Your Deep DiveA few things people ask before starting
Is this practice actually affirming, or just inclusive-sounding?
Actually affirming. LGBTQ+ identities, kink, ENM, polyamory, and non-traditional relationship structures are not edge cases to navigate around — they're part of the everyday practice. You won't need to spend session time explaining why your relationship is valid.
Does sex therapy involve any physical contact?
No. Sex therapy is entirely talk-based. Sessions focus on conversation, psychoeducation, and skill-building. There is no touching, no nudity, and nothing that resembles what people sometimes imagine when they hear the words "sex therapy." It is clinical work, conducted the same way any other therapy is.
What kinds of issues does this work address?
Desire discrepancy, vaginismus, painful sex, sexual trauma, low libido, arousal difficulties, intimacy avoidance, communication breakdown, infidelity recovery, identity exploration, and the complexity that comes with kink, ENM, or non-traditional relationship structures.
How do virtual sessions work in Michigan?
Sessions are held via a secure, HIPAA-compliant platform. You'll need a quiet space, a device with a camera, and a reliable internet connection. Many people find that attending from home makes it easier to get into the deeper material, faster.
Do you work with women's sexual health issues?
Yes. I work with a range of women's sexual health concerns, including vaginismus, painful sex, low desire, and postpartum sexual changes. I collaborate closely with OB/GYNs and pelvic floor physical therapists to provide coordinated, whole-person care.