Pearls & Perspectives: Promoting Trauma-Informed Sexual Medicine, With Lauren Walker, PhD

At the 2025 Sexual Medicine Society of North America (SMSNA) meeting in Grapevine, Texas, host Amy Pearlman, MD, and clinical psychologist and sex therapist Lauren Walker, PhD, discussed how language, adaptability, and trauma-informed practices are transforming the patient experience in sexual medicine.

Walker’s research explores the importance of terminology in shaping comfort and participation in care. Her study of men with erectile dysfunction after prostate cancer examined the use of a harnessed external penile prosthesis (EPP). When surveyed, patients strongly favored the term “external penile prosthesis” over “strap-on,” viewing it as more legitimate, respectful, and consistent with medical terminology already familiar within urology. The finding underscores how language can normalize treatment options and reduce stigma.

A central theme of the conversation was the idea of sexual flexibility, or the willingness to redefine sexual satisfaction and intimacy beyond traditional expectations. In rehabilitation after prostate cancer or antidepressant-related sexual dysfunction, flexibility allows patients and partners to prioritize pleasure and connection rather than a return to pre-diagnosis sexual function. Clinicians can support this by educating patients about anatomy and gradually introducing alternative methods of stimulation, such as prostate massage, in a manner that promotes comfort and trust.

Walker also presented her SMSNA award-winning work on implementing trauma-informed care across all areas of pelvic health. The project reframes trauma awareness as a structured, teachable set of behaviors applicable to every clinician performing pelvic or genital exams. Key principles include fostering patient autonomy, minimizing environmental triggers, and communicating clearly about procedures. Simple changes—such as covering instruments until needed, inviting patients to state their goals for the visit, and presenting exams as optional—can build a sense of safety without extending appointment times.

Pearlman emphasized the importance of creating physical spaces that accommodate patients with past trauma or heightened anxiety. In her practice, she established a secondary consultation room designed for a calmer, less clinical environment. Offering this choice has improved comfort and engagement across genders and backgrounds.

Walker’s team is now recruiting participants for a national study assessing practical trauma-informed strategies in pelvic healthcare. The study invites clinicians of any specialty to review proposed recommendations and provide feedback on feasibility and relevance. Details are available through the SMSNA website and on Instagram at @DrLaurenWalker.