Gay couples therapy, from a gay therapist
Jon Prezant, LCSW, MA, CST — AASECT-Certified Sex and Couples Therapist
Gay couples therapy is couples work that takes the sex as seriously as the conflict. I’m a gay, AASECT-certified sex therapist. I work with gay and queer male couples on desire that faded, the fight that keeps repeating, agreements about openness, and repair after broken trust – online in New York, New Jersey, New Hampshire, and Florida.
For some couples, having a gay therapist doesn’t matter. For most of mine, it matters a lot at the start: a shared baseline, no translating, no wondering whether your therapist privately judges you. What matters most over time is the quality of the work. The shared starting point buys speed and trust.
What I actually treat: erectile difficulties that show up with a partner but not alone, low or mismatched desire, performance anxiety, pain with receptive sex, broken agreements, and the slow erosion of intimacy that happens over the course of a long relationship. My approach is direct and evidence-based – emotionally focused therapy to get at the attachment patterns driving your conflicts, psychodynamic work to surface what’s underneath, and sex therapy techniques grounded in decades of clinical research. My clinical insights have been featured in Men’s Health.
I hold an MSW from Yeshiva University, an MA in Trauma and Crisis Studies from Tel Aviv University, and certification in sex therapy through AASECT and the Modern Sex Therapy Institutes. I live in Brooklyn with my husband and our dog, Bernie.
What gay couples actually bring to therapy
The Repeating Fight
The argument that wears different costumes but runs the same loop, or the silence that replaced it. We get underneath the choreography to the attachment cycle driving it, and interrupt it there.
Open Relationships & Agreements
Monogamous, open, or disagreeing about which to be. I have no agenda about your structure. What I care about is whether your agreements are honest and whether the structure serves the relationship or hides from it.
Desire & Sex
Desire that faded and the fear of what that means. Sex that became routine, infrequent, or a tension neither of you names. I treat the sexual side of your disconnection in the same room as the emotional side, not as a separate referral.
Trust & Betrayal
An agreement violated, and the question of whether it counts as cheating and what happens now. Concentrated repair work, including the conversations that are impossible to have at home.
Your Questions, Answered.
Everything you need to know about starting your journey with me.
How Does This Work?
How do you approach couples work?
I ground it in emotionally focused therapy and differentiation-based approaches: understanding the attachment cycle underneath your recurring conflict, then building each partner’s capacity to stay themselves while staying connected. Sessions are direct and structured. You’ll leave with something to do differently, not just insight.
Is sex actually part of couples therapy here?
Yes, explicitly. Most couples therapists steer around the sexual relationship because they were never trained in it. Desire discrepancies, erectile difficulties, and sexual avoidance get treated here with the same directness as everything else.
What happens in our first session?
The first session runs 60 minutes and you both come. I’ll ask what brought you in now – not what’s been wrong for years, but why this month. We’ll cover how each of you understands the problem, what you’ve already tried, and what a good outcome would actually look like to each of you, since those are often different. I won’t ask for explicit sexual detail in a first session; that comes later, and only where it’s useful. You’ll leave with my read on what’s driving the pattern and a clear sense of whether this is the right fit. If it isn’t, I’ll say so and point you somewhere better.
What does gay couples therapy cost, and do you take insurance?
Couples sessions are $250 for 60 minutes. I’m an out-of-network provider: payment is due at the time of service, and I provide a superbill you can submit to your insurance for potential reimbursement. Many plans reimburse a portion of out-of-network mental health care under CPT code 90847. You can check your own out-of-network benefits by clicking here, and full details are on my Rates & FAQ page.
My partner won't come. Can I do this on my own?
Yes, and a fair number of gay men start that way. Individual work makes sense when your partner isn’t ready, when you want to sort out your own position on something – openness, a broken agreement, whether you still want this relationship – before putting it in the room, or when the first thing you need is to say something out loud that you haven’t said to anyone. Often when one partner starts shifting his own patterns, a resistant partner gets more willing to join. Sometimes he doesn’t, and the work is still worth doing.
Is This For Us?
One of us wants to open the relationship and one doesn't. Can therapy help?
This is one of the most common reasons gay couples call me. The work isn’t me refereeing toward a verdict. It’s getting underneath what openness means to each of you, what the wanting and the fear are actually about, and finding a decision you can both genuinely live with – including the possibility that the answer is no.
We're not in crisis. Is this still worth it?
The couples who get the most from this work often aren’t in crisis. They’ve hit a plateau, sexually or emotionally, and want more than stability. That’s a growth project, and it’s good work.
We already tried couples therapy. Why would this go differently?
Ask yourselves whether sex was ever honestly on the table in that treatment. If it wasn’t, you may still be circling the thing that brought you in. Sex is often the crucible for the deeper relationship concern, not a side issue to get to once communication improves.
We haven't had sex in years. Is it too late?
No, and a long sexless stretch is one of the most common presentations I see in established gay couples. It usually isn’t that attraction died. More often it’s avoidance that calcified, a sexual difficulty one of you stopped raising, or a rejection cycle that made initiating too expensive to keep attempting. Those are workable problems. How long it’s been matters much less than whether you’re both willing to look at what put it there.
We're at different HIV statuses. Is that something you work with?
Yes. Serodiscordant couples bring a specific set of things into the room: anxiety about transmission that persists even when the science says it shouldn’t, disclosure decisions, PrEP, and the way one partner can end up managing the other’s fear on top of his own health. U=U is well established, but knowing something intellectually and feeling it in bed are different problems. The resentment and caretaking dynamics that build up around all of it are workable too.
Where I work
NYC and all of New York State, New Jersey, New Hampshire, Florida. All sessions online.
Work With Me
Jon Prezant, LCSW, MA
Gay Couples Therapist in NYC
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- Free 15-minute consultation
- AASECT-Certified
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My Blogs
Ready for a Relationship? Why That’s the Wrong Question
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Couples Therapy and the Growth Edge: Rethinking Low Desire, Erectile Dysfunction, and Sexual Boredom
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Sexual Performance Anxiety: Why “Just Relax” Never Works
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