Negative attitudes about sex and sexuality and many types of sexual dysfunction are common effects of child sexual abuse and incest. Traumatic sexualization, the modus operandi of the abuse, results in particular dynamics and specific psychological and behavioral repercussions. Traumatic sexualization posits sexual contact that is nonconsensual and used to meet the needs and desires of the abuser. The child's introduction to sexual activity is coerced and thus results in the association of sexuality with negative or ambivalent emotions and memories, or with overwhelming physical/sexual sensation. The psychological impact of traumatic sexualization can be profound, including confusion about sexuality, sexual norms, and sexual identity; the identification of sex with love and care-getting or care-giving; negative associations with sexual activities and physical sensations; and avoidance of and aversion to sex and intimacy. Standard sex therapy techniques must be modified for incest survivors to include an emphasis on education and cognitive mastery before moving on to sexual exercises. Survivors should 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 should be included whenever possible, with enhancement of sexual functioning and intimacy as the stated goals of treatment. 41 references