A keyword search of "sex therapy" in the New York Times shows a rapid rise for articles covering the discipline in the 1970s, an equally rapid reduction in the 1980s, and further decline in the 1990s and into the 2000s. This surprising inflection, given that sex as a marketable construction did not decline in the late 20th century, opens room to examine sex therapy in the contexts in which it could and could not be successful. Sex therapy as a distinct intervention emerged in the 1960s, based on Masters' and Johnson's obstetric-gynecological research focus on satisfying, conjugal sex, and was boundaried by the optics of medical respectability. Sex therapy viewed sex as a bodily, visible, and behavioral phenomenon, with sexual problems conceived as overt and physiological symptoms and syndromes of the body. Correspondingly, sex therapy offered behavioral techniques to white middle-class clients to ameliorate dissatisfying sex. These conceptions were met with success and popularity in the 1970s, with thousands of sex therapy centers opening nationwide in just a few years. However, with the Reagan administration and AIDS crisis in the early 1980s, sex therapy quickly regressed as a respectable source of medical expertise about sex. Simultaneously, biomedical interventions more broadly replaced medicalized solutions for pre-conceived medical problematics. The introduction of Viagra in 1998 was a biomedical replacement of the medicalized sexual problems created by sex therapy, situated on the observable body. When a seemingly even more bodily and behavioral bio-medical solution to its problematics competed with sex therapy for its same white middle-class client base, sex therapy could not maintain public awareness of its disciplinarity.
Hannie Smolyanitsky (Sun,) studied this question.