Women's sexuality? It's complicated

With comforting smile, therapist gets results

By Kate Pastor

Riverdale resident Bat Sheva Marcus explains female sexuality as an airplane cockpit with a multitude of dials and springs, and its male counterpart as a light switch with two settings — on and off.

“It’s just easier for men,” she says.

The analogy, she said, comes from power-point visuals at sexuality conferences she’s attended, and teaching women how to twist and turn each of their dials, has become her expertise.

“The more comfortable a woman is with her body, the more comfortable she is, for instance, to masturbate, the more she’s going to know what gives her pleasure, the more she’s going to be able to experiment with what’s sort of positive for her,” she said.

With master’s degrees in social work and public health, as well as a PhD in Human Sexuality from the Institute of Advanced Study of Human Sexuality, she takes a holistic approach.

She has offices in both Westchester and Manhattan, where she and her staff treat hundreds of women who are unhappy with their sex lives.

At first glance, the waiting room at the Medical Center for Female Sexuality in Westchester which she founded, is like any other. There’s a window behind which a receptionist sits, plastic document holders with laminated health information and information packets advertising various pharmaceuticals scattered about.

Upon closer inspection, the plastic stands with medical literature contain laminated articles about sex from Cosmopolitan and the pharmaceutical packets are for male enhancers like Viagra, Cialis, and Levitra.

In her classily decorated consultation room, a brown wicker basket contains everything from classic back massagers, which she advocates being used for other purposes, to the Rabbit Vibrator, made famous by Sex in the City. In her examination room, cabinets are filled with samples, and bookshelves throughout the office contain titles from Guide to Getting it on, which has illustrations that make The Joy of Sex look PG-rated, to the old-school how-to guide itself.

Women who come to see her, she says, usually fall into one of four categories. They either suffer from low-desire, problems with arousal (“you don’t get lubricated and you don’t get tingly,” she explains), pain from intercourse or trouble having orgasms.

“More often than not, they’re interconnected,” said Ms. Marcus.

For example, she explained that pain decreases the desire to have sex and low-desire may cause a woman to tighten and then feel pain.

Ms. Marcus believes every woman is entitled to a great sex life, so to break the vicious cycles that threaten some women’s ability to enjoy it, she approaches the complicated arena of female sexuality with what she deems are all the necessary tools: vibrators, dilators, dildos, lubricant, hormones and other medications — but also an understanding of how female sexuality is intertwined with psychology, culture and upbringing.

A feminist Orthodox Jew, mother and sex therapist, Ms. Marcus is a self-proclaimed anomaly who no longer manages to shock anyone. And she isn’t trying.

In fact, it’s quite the opposite. Part of her role, she says, is to get women to open-up about sex even though they may have been taught since childhood not to.

What she calls “a mommy image,” plus a personal comfort level with sex, help her get fearful women to open up and surprise themselves by saying, “oh my god, this is so easy to talk about,” said Ms. Marcus.

Her initial consultations last for an hour-and-a-half. First, she takes women’s psychosexual history, and then spends about a half hour on a physical examination.

Women, she said, often want to believe that the problems they face are entirely mental, when often hormone imbalances or other conditions, also play a large role in women’s low desire.

“It’s almost like a woman sitting here and saying “I can’t smell” and I’m saying, “You have no nose,” she said.

Another condition she finds commonly in patients is Vaginismus, a condition that makes it impossible for a woman to fit a penis — and in severe cases, anything — into her vagina.

Ms. Marcus saw one woman who had been married for nearly a decade and had not yet been able to consummate her marriage because she suffered from it.

“The husband had an affair and that finally got her in here for treatment,” she said.

Treatment includes inserting dilators and then dildos, increasing the size as progress is made, and the condition, said Ms. Marcus, is a perfect of example of how many different issues intersect to create sexual dysfunction in women.

In her experience, it often arises in females who have phobic and strong “Type A” personalities, and many of the women she treats for it come from similar backgrounds.

“Strikingly,” she said, “about 30 percent of our Vaginismus patients are Orthodox [Jewish] women. Approximately 30 percent are Indian woman.”

She noted that women of both backgrounds tend to share certain cultural traditions, such as an emphasis on covering the female body and sex only becoming acceptable once a couple is married.

As an Orthodox woman herself, she said, “there’s a certain level of irony because Judaism always likes to talk about sex being very positive.”

With that in mind, she has been called on by the Hebrew Institute of Riverdale, where she is a member, to give classes on sexuality to Orthodox women.

“If women are having an issue, they shouldn’t just feel like they have to live their whole lives with it,” she said.