The legacy of sex-pert Dr. Ruth Westheimer, dead at 96

Trailblazing sex educator Dr. Ruth Westheimer died last month (July 12, 2024) at the age of 96, leaving behind a legacy of breaking down taboos related to sex and sexuality on public television and authoring multiple books on the subject.

“She made people comfortable talking about sex, and talking about it in a way that was a positive thing,” Tami Rowen, MD, an OB/GYN and sexual health expert at UCSF Health, tells MDLinx. “Everybody knew her name, everybody knew who she was, and [she] made people feel comfortable and safe talking about sex.”

Celebrating the importance of good sex

“As a medical provider, we oftentimes think about sex as something that is associated with risk and illness, and one of the things I feel is really important about sexual medicine is making sex not be about risk assessment [but] more about pleasure,” Dr. Rowen says. “And she did that. She gave permission for that.”

In the 1980s, Dr. Ruth quickly became a household name thanks to her weekly radio show Sexually Speaking that aired after midnight on Sundays.^[] By 1985, her television show—The Dr. Ruth Show—drew an audience of 2 million every week. She also published more than 40 books on the topic of sex, sexuality, and relationships, and regularly lectured at Yale, Princeton, and Columbia, among other universities.^[][]

“Dr. Ruth got talking about sexuality from a medically accurate and clinical perspective right,” Dr. Lexx Brown-James, a certified sexuality educator and director of the sexual health certificate program at the University of Michigan, tells MDLinx. “She talked about more than the S-E-X within sexuality, which people tend to lose in conversations. Sexuality encompasses faith, power, body image, medical need, relationships, self-esteem and so much more, [but it's] a taboo topic that is mostly whispered about."

The most important sexual organ

Dr. Ruth once famously said, “When it comes to sex, the most important six inches are the ones between the ears.”^[] It’s a theory endorsed by both Dr. Brown-James and Dr. Rowen. “The brain is the most powerful sexual organ of the body. The skin is the largest. Pleasure, desire, arousal, are all beholden in the brain,” Dr. Brown-James says.

Whether it be pleasure or pain, Dr. Rowen also says when it comes to sex, it all starts with the brain. “[It’s] the locus of sexuality [and] where sexual desire comes from,” she says. “It's where arousal comes from. It's where orgasm comes from, [and] sexual pain is experienced in the brain. Again, you get a peripheral trigger, but it's the brain that tells you something hurts. Basically our entire sexuality is based on brain responses.”

Good sex is safe sex

Dr. Ruth was also an outspoken advocate for the importance of safe sex. In one of her books, she writes, “Safer sex isn’t only less dangerous, it’s also more enjoyable. So if you want to be the best lover you can be, always practice safer sex.”^[]

Dr. Brown-James agrees. “With the most powerful sex organ being the six inches between the ears, there is something to be said about feeling safe in a sexual encounter. Reducing worry is a clear path to increased pleasure,” she says.

“I think the younger generation didn't have the fear of God put into them the way most of us who grew up in the '80s did,” Dr. Rowen says. “I think safer sex is actually incredibly important, and it’s very hard for me to hear how many young people I know who aren't actually practicing safer sex.”

Outdated ideas about casual sex

But not all of Dr. Ruth’s ideas about sex have aged well. In one of her books she advocates against casual sex or one-night stands, writing, “Sex feels great, doesn’t it? But sex isn’t a toy. Sex is a serious act to be shared by responsible adults. A great lover integrates sex into an overall relationship and never has sex with someone he or she barely knows.”^[]

Both experts who spoke with MDLinx say the advice is less applicable in today’s world.

“I think this is an antiquated ideology that has since evolved. Hook-up culture was more covert then and less overt than now,” Dr. Brown-James says. “Barrier methods, testing, and pregnancy prevention were also less sophisticated, so a one-night stand might have different outcomes, some lifelong. Nowadays, in most places, a one-night stand can be just that, a one-night stand.”

Dr. Rowen argues people can have numerous motivations to have sex, and it does not necessarily need to be only in a relationship.

“People have sex for many different reasons, and I support all the different reasons if they want to have sex. Sex can be fun, sex can be anonymous, sex can be for multiple different reasons,” she says.

An enduring legacy

Both Drs. Rowen and Brown-James agree that Dr. Ruth’s career demonstrates that the public has an interest in—and a need for—conversations about sex.

“It's clear that the public thirsts for sexual knowledge, even if they don't ask out loud or directly. It is also clear that the world wants to know more about sexuality, the ins and outs, as well as to assess their own feelings. What I find in my professional work is that most people are wondering if they are normal,” Dr. Brown-James concludes.