Incest and other forms of sexual abuse introduce a child to sexual functioning and sexuality in ways that are psychologically and physically overwhelming. Survivors may have distorted or negatively influenced body responses and perceptions such that they are literally alienated from themselves. The alienation may extend to reproductive issues, sexual preferences, sexual responses, and the ability to function sexually. Helping professionals must become aware of the various ways in which sexuality can be affected by incest experiences and must be prepared to treat sexual concerns as part of incest therapy. Standard sex therapy techniques need to be modified for adult survivors of incest to include a heavy emphasis on education and cognitive mastery before moving on to sexual exercises. Survivors must be encouraged to face the effects of abuse and to reclaim their sexual functioning at a pace that is comfortable and manageable for them. Partners of survivors must be included when possible to enhance sexual functioning and intimacy as the stated goal of treatment. Research regarding the impact of incest on sexual attitudes and functioning of adult incest survivors and their partners is reviewed. 41 references