Patricia Yarberry Allen, M.D. is a Gynecologist, Director of the New York Menopause Center, Clinical Assistant Professor of Obstetrics and Gynecology at Weill Cornell Medical College, and Assistant Attending Obstetrician and Gynecologist at New York-Presbyterian Hospital. She is a board certified fellow of the American College of Obstetrics and Gynecology. Dr. Allen is also a member of the Faculty Advisory Board and the Women’s Health Director of The Weill Cornell Community Clinic (WCCC). Dr. Allen was the recipient of the 2014 American Medical Women’s Association Presidential Award.

by Patricia Yarberry Allen, MD

In 1982, when I was finishing my residency in obstetrics and gynecology at New York Hospital, I never would have imagined that almost 25 years later I would want to keep talking about sex — or that I would be inviting all of you to join me.

I grew up in a time and place where sex simply did not exist. At age 14, I was a new nurse’s aide, working under the supervision of 17-foot-tall Sr. Mary Barbara. She invited me into the labor room to witness my first delivery.

After I had survived the screaming and bleeding and birth, Sr. Barbara gave me a lesson in sex: She looked down at me from her considerable height, put her fingers under my chin, lifted my face to look directly into my eyes, and said, “SEE?”

There was no copy of “Our Bodies, Our Selves” to help me understand how the baby got INTO the mother’s tummy. On that day in the delivery room I found out that whatever sex was, it caused this. And, I had no interest.

Too bad Sr. Mary Barbara is not around to become the czar of the current abstinence craze.

~ ~ ~

Dr. Helen Singer-Kaplan, a pioneer in sex therapy and founder of the Cornell University Medical College Human Sexuality Program, spoke to our residency class when I was a chief resident in 1982. Until her death in 1995, Dr. Singer-Kaplan worked tirelessly to improve access to accurate information about sexuality and sexual disorders. Her important book “The New Sex Therapy: Active Treatment of Sexual Dysfunctions,” published in 1974, was the first of many books she wrote about sexual health.

Dr. Singer-Kaplan explained to the class how to take a sexual history and how to make patients comfortable with the discussion of sexual issues, and she gave a brief overview of some of the common sexual questions and problems that gynecologists should be aware of.

This was the first and only lecture we would have in our residency training before we began taking care of patients ourselves.

I have a special memory of her generosity and kindness from that lecture. I realized that I was unprepared to do what this important doctor had just directed the resident doctors to do.

So I asked: “Dr. Singer-Kaplan, what should a doctor do if the doctor is, um, maybe not quite certain about how to talk about sexual matters with a patient?”

“Well, Dr. Yarberry-Allen,” (we all had hyphenated names back then), she replied thoughtfully, “I am certain that if the doctor is not comfortable talking about sex, then the patient will be unlikely to be comfortable either. However, I am equally certain that with practice and with conversations with patients that the doctor will, in time, become comfortable discussing issues that will be important to her patients.”

“Time and practice, Dr. Yarberry-Allen, will give the doctor wisdom,” she added.

I had only five patients my first week in practice. I had the time to take the most thorough history and proceeded to do so, inquiring about every body part and system beginning at the scalp and ending with the toenails.

However, after careful inquiry into abdominal and pelvic issues and after obtaining all the information necessary for the gynecologic history to provide appropriate diagnosis and treatment, I moved from those facts directly to, “And, how about those knees, Mrs. Jones? Do you have pain, stiffness, or swelling?”

I moved right past sex.

But the good Dr. Singer-Kaplan knew her stuff. She knew that patients would not let me get away with this silly behavior. My sophisticated, lived-through-the-sexual-freedom-of-the-60’s-and-70’s patients would settle into our get-to-know-each-other talks and loved the obvious reaction I had — in spite of every effort I made to be dispassionate and professional.

“How did you get away with that?” I remember asking one of my first patient/teachers.

“Oh, come on,” this New York woman to the core responded. “You can’t be that naïve!”

Dr. Singer-Kaplan’s guidance in the delicate area of sexual counseling for both doctor and patient has remained with me. I took to the art of listening with great joy. You know the jokes about doctors “practicing” medicine … well, those aren’t jokes. The more we practice, the better we become.

I not only learned what I needed to know to become a better doctor and a novice at sexual medicine, but I moved quickly. I did not want to be on the receiving end of more disparaging remarks from big city girls who were having a great time in bed and out.

In 2004, I joined a sex therapy class led by Sandra Lieblum, Ph.D., director of the Center for Sexual and Relationship Health at the UMDNJ-Robert Wood Johnson Medical School. It is a personal tribute to Dr. Singer-Kaplan that I had not only become comfortable talking to patients about their sexual histories, but I wanted to become a sex educator. Dr. Singer-Kaplan changed the world of sexual medicine and she changed my life, too.

I believe that there are powerful political, religious and cultural forces at work both in the United States and across the world that want women to remain as ignorant as I once was growing up in the 1950s in rural America. Health information, contraception options and protection against sexual violence are all being silenced. Indeed, the very concept of sexual freedom is at stake.

Menopause itself has often been considered a time when women were no longer expected to have any interest in sex. Well, we know that is far from true.

I will be writing for Women’s Voices For Change about sex and inviting important clinicians, teachers, cultural thinkers, philosophers and women across America to join the conversation about our sexual history and future. Each of us will have personal, professional and cultural factors that will shape our voice.

Your voice is equally important. Please let us know about topics you want to see covered by sending an e-mail to [email protected].

If you have a specific sex-related question, please e-mail [email protected] (don’t worry; first names only will be published).

And check back often — answers will be published here each week. Let the conversations begin!

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