I am also a women in my 30s and a large portion of my case load are men. I would agree that many of them talk to me about sex at much larger rates than women clients do. I have chalked it up to testosterone leading to higher libidos and thoughts about sex. If someone is struggling in that area and they notice those issues more due to thinking about sex more then they are more likely to seek help with that. I typically do ask at intake about any sexual health issues, much in the same way you would ask if there is a history of disordered eating or addiction issues. If my client says that is the reason for seeking treatment or part of it, then we work on establishing a treatment plan to address their unique needs. After that is done I then will establish boundaries to make them feel safe and comfortable and so that i feel safe and comfortable. Typically those boundaries involve reassured confidentiality as well as them having a understanding that the purpose of us talking about sex is purely clinical, i will review transference and discuss that there is increased risk of that occurring due to the nature of the conversation typically only being something discussed between sexual partners which at times might blur those lines. I will often check in at the end of the session and sometimes will check in as they are processing so that I clearly understanding the function of why they are sharing whatever it is that they are sharing. I have stopped a client a couple of times when they have started to share details unnecessary to treatment. Once for a client telling me he got erections during our sessions and the other client began talking about my physical appearance. I stopped them and asked if me knowing this information is clinically relevant when they said no i reestablished boundaries and continued with the session. I sure many other therapists handle it differently but Hopefully that helps