When Erin was 22, she met a guy on a dating app, had her first real kiss and then her first sexual experience that same night. She was flattered by his attention — and then crushed the next day when she realized he wasn’t that interested in her.
That night started a cycle of hookups with various men she met on dating apps. “Even if the experience wasn’t great, I was always just really happy if the guy had a good time because I felt important,” Erin said. “I was so naïve.”
But after years of navigating unhealthy relationships, chasing the approval of men and feeling pressured to perform sexually, sex started to feel like a chore. Erin’s confidence dimmed, and she struggled with depression and anxiety.
Finally, after a two-year relationship dissolved, Erin made an appointment with Madelyn Esposito, LPC, a certified sex therapist and program manager of the UW Health Sexual Health Clinic. After a lifetime of trying other therapists who weren’t the right fit, Erin’s expectations were low. But she instantly clicked with Madelyn and her sex-positive approach.
“Therapy has been a grueling experience, but it’s been a worthwhile one,” 31-year-old Erin shared. “Unlike with my previous therapists, I come out of Madelyn’s office feeling motivated and like, ‘OK, we’re going to work on this. We’re going to get better.’ It’s been a very empowering experience.” Madelyn helped Erin realize that she had been conditioned to please men instead of considering her own wants and needs. Erin had to rediscover pleasure on her own terms and learn to embrace her love of sex without shame.
Her journey of self-discovery and healing included homework, such as educational videos and books, that occasionally nudged her outside of her comfort zone and inspired her to think about sex in new ways. “I always like having homework when I see Madelyn because it helps me keep my mind on what we had been working on,” Erin said.
“Patients’ curiosity and willingness to explore new ideas is key,” Madelyn said. “Sexual health is incredibly stigmatized, to the point that we prefer our children to remain uneducated and then later pause when communicating concerns, even something as serious as pain, with our partners. When we don’t talk about sex, we create ideas of what it should include and how it should feel, when the measure should actually be pleasure, rather than a perceived outcome.”
After two years of therapy, Erin feels transformed. She is also in the best romantic relationship she has ever had — a connection that started as friendship before blooming into love. Through sex therapy, Erin learned how to communicate her own needs and desires, which has made her sex life even better. Her partner respects her and supports her therapy goals.
Erin doesn’t think she would have found this level of relationship satisfaction without Madelyn’s help. “I would still be hopping from bar to bar, looking for guys and finding all the wrong ones,” she said. “I would be incredibly not confident. I would be depressed because I would see my friends getting married, and I would be in this kind of repetitive circle of almost self-sabotage.”
Erin hadn’t realized how her sexual wellbeing was intertwined with her anxiety and depression. But as she began to focus on her sexual health, her overall mental health and self-esteem improved. Both patients and medical providers sometimes see sexual health as less important or optional in the hierarchy of health, Madelyn noted.
“However, sexual health intersects with physical health, relational health and mental health,” Madelyn said. “When something is ‘off,’ sexual health suffers. And that suffering is often in silence given the sensitivity of this topic.”
Erin’s renewed confidence has spilled over to other parts of life, too, changing the way she approaches work and friendships.
“There is something empowering about knowing that you’re slowly learning and getting to know yourself more, and you’re building this confidence,” she said. Not every day is great. Occasionally something will trigger Erin’s old feelings of insecurity, and she still works with Madelyn to address lingering issues. “And Madelyn is still there, and I’m just really thankful that she is,” Erin says.
Erin’s advice to others struggling with sexual issues: get educated, resist shame and seek help from a trusted therapist. “If you’re in the trenches,” she said, “know that there is a way to get out.”