AILSA CHANG, HOST:
All right. We're going to spend the next several minutes talking about sexual health, so some of the content may not be suitable for all listeners. Just tune out for a little bit if you need to. Bat Sheva Marcus has been a sex therapist for decades, focusing in particular on women.
BAT SHEVA MARCUS: Female sexual dysfunction is a brand-new field. Like, I was in it 20 years ago as it was just starting. We are learning more and more every day. Nobody understood half of these things, and so I was looking for solutions with my patients.
CHANG: Marcus is the first to admit she hasn't always known the answers. She grew up in an Orthodox Jewish community and says for her, sex education was nonexistent. Over the years, she realized a lot of the questions she had about sex were the same questions other women had. And in 2000, Marcus co-founded what is now the largest independent women's sexual health center in the country. She is out with her first book, called "Sex Points." The book explores how women can take control of their sex lives. And she offers tools to overcome challenges like plummeting libido or physical pain during sex or how to tackle communication with a partner. And she says her patients, as well as the unfortunate myths they buy into, informed every page of her book.
MARCUS: I think the mythology is somehow that we should know the answers and that this should all kind of be a natural thing that we know. And if we don't, then we don't actually even know where to get answers.
CHANG: Yeah.
MARCUS: And I think the popular culture portrays things in such a distorted way, just regular movies and TV shows. I'm not even talking about porn.
CHANG: Yeah.
MARCUS: It just shows things in such a distorted way that people end up feeling like they're crazy when they're not crazy. They're actually quite normal, and their issues are normal. Their problems are normal. It's very normal to have road bumps and problems as you go through your sex life, and almost everything is fixable and solvable. But I feel like that's a message that nobody gets, so then nobody is willing to ask questions.
CHANG: I understand that you were raised in an Orthodox Jewish community, and the sex education that you got as a young woman led in many ways to you becoming a sex therapist today, right?
MARCUS: So I got no sex education - like, zero. And I was very upset about that as I got older. And I think it made me feel like, this is ridiculous. Like, this is something I really need to take control of. And so it sort of sat in the back of my mind as - I started a different career. And then when the opportunity to do this sort of presented itself, I grabbed it because I felt like my experience as an Orthodox woman, Jewish woman who had no sex education and came to sex very unprepared could be translated to so many people in so many ways.
CHANG: Yeah. Yeah.
MARCUS: It's not just the religious community. It's the secular community as well.
CHANG: Absolutely.
MARCUS: And so I think it was the deepest way to enter, but I think it's a really common experience.
CHANG: Yeah. Well, I want to talk about how your book is different from a lot of other books out there about sex because you seem to reject the idea that bad sex is either a medical problem or a psychological problem. Why do you reject that framing?
MARCUS: I reject the framing that it's either or. I embrace the idea that it's some variant and combination of the physical as well as the psychological. I feel like in general, medicine has not done a good job of understanding how complex we human beings are and that the brain and the body always are working in tandem and that in the end, if we approach sexuality understanding the physiological piece, the medical piece, the medications that we're on, the hormones that we have and acknowledge them as a real piece of our sex lives and, at the same time, we look at issues like the relationship, shame, you know, the behavioral things were involved in - if we can really look at all of those pieces, we will have a much, much better time solving people's sexual issues.
CHANG: Yeah.
MARCUS: And so that's why I wrote the book.
CHANG: Well, you try to dispel so many myths about sex in this book, and I want to take up one of them. It's a big one, and that is great sex should come effortlessly if you know what you're doing. Tell me why that is a lie.
MARCUS: Well, yeah. I don't actually have to tell you. You could just interview 10 people or 10 women in particular, and they will tell you their sex life doesn't work for them, right? Like, most of us sort of got started in sex in one form or another. For some of us, it went really quite easily and well. And for some of us, it was much more complicated. Some people never got out of that complication, and they're still stuck in it. But most people, I would think, for the most part have kind of figured out their sex life and then assume that their sex life will be static. But nothing could be further from the truth, Ailsa. Like, the reality is that your sex life changes constantly. It's always in flux...
CHANG: Yeah.
MARCUS: ...Because your body is changing.
CHANG: Even with the same partner.
MARCUS: A hundred percent even with the same partner because the hot new person that you met, you know, 10 years ago is someone you adore and still love but may not be so hot and new anymore because, you know, that hot new person has a back problem now or because you went on birth control pills or because you're older...
CHANG: Yeah.
MARCUS: ...And you have hormonal changes or because you have children knocking at the door. We're human beings that change all the time. And to suggest that our sex lives don't change as well is ludicrous. So the more that we understand that your sex life by nature will grow, develop, have road bumps - but if you understand where they're coming from, you can fix them all. And then your sex life can really last you in good stead for a long, long time.
CHANG: Yeah. Well, one thing I kept thinking about when I was reading your book is the way the quality of a couple's sex life and the quality of the relationship interact. Like, does a good sex life improve a relationship? Or does a really good relationship make the sex better? And it's sort of both, right?
MARCUS: Bless you for saying that, Ailsa. Like, that is - I feel like we're in a society right now that just privileges, you know, communication, talking communication so much over the physical - right? - so that so many times, you can go to a couples therapist and say, our sex life is just in the toilet. And what you'll hear back is, let's fix the relationship, and then the sex will improve. And that drives me bonkers because you can be in a perfectly good relationship. Like, no relationships are perfect, right? But you can be in a good, solid relationship, and the sex...
CHANG: Right, right.
MARCUS: ...Can still be and often is still a problem. So what's interesting is the dynamic of what happens to a person themselves and to a relationship when somebody is feeling confident and happy sexually. It makes us feel better about ourselves, and it allows us to be with somebody else in a different kind of way - playful, fun and deeply vulnerable.
CHANG: Well, that leads beautifully to my last question for you. And that is ultimately, Bat Sheva, why do you think it is very important for us to try to work on our sex lives? Like, why is a good sex life something that is worth dedicating attention to?
MARCUS: So at the risk of getting hate mail from other therapists, I feel like it makes a huge difference in a relationship. And even if you're not in a relationship, feeling good about your sexuality has a huge impact in who you are as a person. And I will say that largely I see either cracks developing in the relationship or this sense of isolation and the feeling that you're not part of a team. There's something about being able to connect sexually with somebody - like, being that open.
CHANG: And vulnerable.
MARCUS: And vulnerable - exactly. It does something to the tenor of the relationship that just - this is a way you are with somebody that you're not with anybody else. I mean, that's why I wrote the book - because I feel like you should have access to your sex life for your whole life, not - you know, not just in your 20s or 30s, like popular culture will let you believe, but all the way through. And if you're in a relationship for 30 or 40 or 50 or 60 or 70 years, like, you deserve and are able to maintain a good sex life.
CHANG: Bat Sheva Marcus is the co-founder and director of Maze Women's Sexual Health. Her new book is called "Sex Points: Reclaim Your Sex Life With The Revolutionary Multi-Point System." Thank you so much for being here. This was so fun.
MARCUS: Thank you so much for having me.
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