Three different formats for treating gay men with sexual dysfunctions are described, with emphasis on group therapy for men who are without partners. Clients present with general sexual anxieties, lack of sexual desire, secondary erectile dysfunctions, and difficulties with ejaculatory control, both rapid and inhibited. The process of selecting a program, and in particular the factors to consider when deciding if a client should work with a lover, with a partner surrogate or in a group format, are discussed. Primary procedures of sex therapy in each of these formats are described. Some trends in the frequencies of presenting complaints are noted, as well as possible reasons for reported differences between homosexual and heterosexual men. Other special considerations for working with gay men in sex therapy are discussed. Results of a self-report survey of change, administered 6 weeks and again 6 months following the end of 5 different 10-week sex therapy groups, are reported.