Nisha McKenzie is on a mission to elevate the experience of female-bodied individuals when it comes to their sexual health.

“I want to help people understand that sexuality impacts so many other areas of our health,” she said. “It affects our mental health, our physical health, our relational health. I think it is wildly important and so misunderstood, and because sex is so interlaced with power, we shy away from it.”

Last month, McKenzie opened the Women's Health Collective. She has practiced medicine as a physician assistant for nearly 20 years, having spent the first part of her career in family medicine. During that time, she encountered countless women who were at a loss to clearly communicate their questions and concerns about sexual health issues they were experiencing. She realized that as a practitioner, she too was at a loss on how to help them.

“I had so many women in a joking tone cry for help,” she said. “And it was followed by a nervous chuckle and I would nervously chuckle along. I didn’t know what I was supposed to do. It was a brewing issue for years.”

Gender-bias continues to exist in patient care. A study published in 2018 found that women are less likely to survive a heart attack in men when treated by male physicians. In an article published in 2019 by medicaleconomics.com, Jane van Dis, MD, OB/GYN, suggest that this bias is the reason that the average woman with endometriosis — painful disorder in which tissue similar to the tissue that normally lines the inside of the uterus grows outside the uterus —goes nine years before she is diagnosed. In the same article, van Dis goes on to state that menstrual issues are lumped together and dismissed as par for the course for those with female anatomy. 

McKenzie’s experience reflects what van Dis believes is the issue: A lack of proper training during early medical education that results in general practitioners emerging from school with a general discomfort or aversion to performing pelvic exams and discussing sexual health with patients. 

“It is so commonly left out and described as its own little niche over in the corner that only certain people deal with,” she added. “That is what I am trying to change ... there shouldn’t be any shame. Every single being on the planet is affected by sexuality in some way, and we get really poor training as human beings on what that means for us. And as women, for sure, we get no talks about pleasure.”

McKenzie says that society has normalized unpleasurable or even painful sex for women. 

“Women really only get the fear tactics,” she said, “Like, ‘close your legs,’ ‘be careful,’ ‘be a nice girl,’ ‘if you do this or this, you will be viewed this way.’ Then, low and behold, on your wedding night, you are supposed to scream out in ecstasy. And that is scary.”

“Female-bodied people tend to experience sex as a weight,” she added. 

In 2018, The National Center for Biotechnology Information reported that between 10-20% of women experience painful intercourse. They also reported that, “Many women do not report genital pain, and most providers do not inquire about this type of pain.” 

McKenzie’s interest in medicine began at age 7 when her grandmother passed away from a heart condition.

“I remember thinking, ‘I am going to be a heart doctor and help hearts because people shouldn’t die of heart problems,’” McKenzie said. “Which is a little unrealistic but I just wanted to help people.”

McKenzie opted to pursue a career as a physician assistant (PA) as opposed to a medical doctor so that she could fulfill her dreams of practicing medicine but also be present while raising a family. According to the Michigan Academy of Physician’s Assistants, PAs maintain national certification and perform a wide range of medical procedures and duties, including diagnose and treat illness, order and interpret tests/studies, assist and surgical procedures, write perspectives, develop treatment plans and more. After practicing family medicine, McKenzie made the switch to women’s health in 2011 so she could focus on women’s sexuality.

“I learned that as I learned sexual medicine, I could ‘fix’ vaginas, painful sex, dryness, tears — all of the painful things people were having, but people kept coming back and saying, ‘But I still don’t have a libido,’ ‘my relationship is falling apart,’ or ‘what is wrong with me?’ I realized I was missing the human and the brain portion of sexuality. I was just treating the medicine part.” 

McKenzie goes on to talk about how often when a women’s sexual issue is physically cured but their issues persist, patients often receive the message that there is something innately wrong with them. 

“That began to infuriate me,” she expressed. “If people come to us for answers, we have to be able to help them better. That is how this collective was born. There are many people who have healing hands, not just medical doctors or PAs, but massage therapists, pelvic floor physical therapists, mental health therapists.”

At the Women’s Health Collective, McKenzie has aggregated a group of practitioners that allows the clinic to offer patients medical treatment and support for their overall wellness. Among the dozen conditions the clinic treats, as listed on its website, are overactive pelvic floor, arousal disorders and recurrent vaginitis. They also offer support, such as therapy and counseling, to alleviate the stress, anxiety and depression often experienced by gender non-conforming individuals. 

Along with offering a comprehensive team that can treat and support women through a variety of health challenges, McKenzie says that the center’s approach to bedside manner is focused on transparency and validation.

“The trait of saying, ‘I don’t know, but will find out,’ is not taught very well in medical school,” she said. “I think it is helpful to a patient to be able to hear their practitioner say, “That is so valid and so worth an answer, and I am going to find it for you.”

To learn more, please visit whcollective.com.