Interview with Sex Therapist Dr. Rose Hartzell (Part 1)

interview with sex therapist Dr. Rose Hartzell - when sex hurts there is hopeI recently had the honor of interviewing Dr. Rose Hartzell, PhD, EdS, CHES, LMFT. She is the resident Sex Therapist at San Diego Sexual Medicine, the premier center for sexual health, and is responsible for addressing the sexuality, relationship, and intimacy concerns of individuals and couples who attend the clinic, many of whom suffer from sexual pain.  Here are some of the insights she shared.


1.  What made you decide to become a sex therapist?

I took a roundabout way of getting there.  I started off as a sex researcher and then realized that, although doing research was interesting, I found that a lot of people would come to me with questions.  I decided that I really like helping people better.  Research is helping people, but helping people as a therapist is more one-on-one, or two-on-one.  So I went back to school and while I was working on my PhD I added a Masters and then an EdS in therapy.

On a more global level, I like talking to people about things that they can’t talk about with anyone else.  Sex is something that is really important to people, but often times they have difficulty talking about it.  And for some reason God granted me the gift of feeling comfortable talking about sex, so I like to help other people feel more comfortable talking about it and have more satisfying sex lives.

2.  You are part of the team at San Diego Sexual Medicine. What type of work do you do there? How does your role fit into the larger goal of the center?

Here at San Diego Sexual Medicine we take a bio-psycho-social approach or a holistic perspective.  The kind of people I see here is usually different than the average sex therapist would see because a lot of times the people that we see here are people that have a physical component. So I often see people who have some type of physical issue that has affected them psychosocially.  My role here is for both men and women, to help them to see how whatever happened to them (erectile dysfunction, low sexual desire or whatever it is) is impacting themselves and their relationships, and how to get what they want out of their sex lives.

I have been working in this office for four and a half years and I love my job.  I can’t think of anything cooler.

3.  How does sex therapy differ from other types of psychotherapy or counseling?

Honestly, I think it is different in the fact that as a therapist I am just comfortable talking about sex.  I mean a lot of the stuff that you talk about in sex therapy—the relationship concerns—is just like anything that would be in any therapy.  We could just be talking about laundry, it’s just the fact that it happens to be sex for that couple.  So I don’t think it is that different except that it oftentimes has to do with a physical part of the body and that it affects two people.  I don’t think it is that different except that it’s about an issue that most people are uncomfortable talking about.

4.  What could someone dealing with painful sex gain from seeing a sex therapist like yourself?

If the person is in a relationship there is often a lot of work to be done because the couple is usually dealing with an altered sex life.  It’s painful, so now what can we do to still have pleasure in our sex lives and still get our needs met.  For the individual, I would say that a lot of times when people come to me they say that they feel “broken” or I often hear a woman will say that they don’t feel like a woman.  Coming to a sex therapist can provide support and connect them with resources, such as the National Vulvodynia Association support group here in San Diego.  A sex therapist can also help a person if they want to start a relationship to figure out how to navigate that, and just feel better about themselves and themselves as a sexual being.  Also, oftentimes women who experience pain also develop low sexual desire just because if it’s painful you don’t want to do it.  And then it turns into a more generalized low desire, so helping with that as well.

5.  What should someone expect in their first appointment with a sex therapist, or specifically with you? Do you have any recommendations or words of advice for someone who is looking for or trying to choose a sex therapist?

First, if they were looking for a sex therapist I would recommend that they go to the American Association of Sex Educators, Counselors, and Therapists (AASECT).  There is a locator provider list and they can find a sex therapist in their area (here is a link to their website).  I think a good thing with any therapist is that you want to find someone that’s a good fit for you.  Although the person’s training and experience matters, part of it is a relationship.  So if it doesn’t feel right, or if something feels off to you, that probably is a sign that there’s a better therapist out there for you.

Usually the first appointment looks different than any other appointment because the sex therapist would probably want to get to know them better.  So they are just going to be asking a lot of questions and it will be probably a little less interactive than follow up sessions would be. Oftentimes a sex therapist is going to ask them about the issue, how it’s affecting their relationship and themselves.  They will probably ask for a little bit of their mental health history, alcohol and drug use history and about their family history.

So if you as the therapist are asking a lot of questions during the first appointment, what’s a good way for them to be able to recognize if there is a better connection? Is it better for them to wait until the second appointment to get a better feel?

There’s a joke friends might say that “I’m going to give him three dates,” so you could do the same with a therapist.  Some therapists offer a free meet and greet session so you can see them before the actual session.  Also if you look at someone’s website sometimes you can get a feel for them.  However, if you could, I would give them a couple sessions just to see.

For more information about Dr. Hartzell and San Diego Sexual Medicine, check out their website You can also contact the center directly at (619) 265-8865. People travel to San Diego Sexual Medicine from all over the world to receive treatment for their sexual health concerns. You can also learn more about Dr. Hartzell on her website

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