By Justin Lehmiller

What is a day in the life of a sex researcher like? In this interview series, I talk to some of the world’s foremost authorities on sex in order to answer this question, but also to provide a glimpse into what they’re currently working on, what the media tends to get wrong about sex, and what they think about some of the most pressing issues facing the field of sex research today.

For this interview, I spoke with Dr. Kristen Mark, who holds a doctoral degree in health behavior from Indiana University and completed a concentration in human sexuality at The Kinsey Institute. She studies a range of topics, including women’s sexual health, sexual desire, sexual satisfaction, and sexuality education. Dr. Mark is currently an Associate Professor and Director of the Sexual Health Promotion Lab at the University of Kentucky. Below is the transcript of our email conversation.

Lehmiller: Please tell us the story behind how you became a sex researcher. What is it that initially inspired you or drew you to this field of study?

Mark: Looking back, I was always really comfortable talking about sex and quickly became a person friends tended to turn to for sex and relationship advice. My parents were always pretty open too, as I can clearly recall my brother receiving condoms in his Christmas stocking from a relatively young age (though I look back wondering why he was the only one gifted those!). I always felt like I could ask questions and talk about sex with my parents, despite the fact that I rarely did.

As a young and ambitious undergraduate psychology student at Queen’s University in Canada, I was determined to be like Clarice in Silence of the Lambs, one of my favourite movies: I wanted to be a forensic psychologist and I wanted to work with the most serious of sexual offenders. I thought that my openness to talking about sex and my very pragmatic and direct nature would serve me well in this career. I had no idea what research was; I was a first-generation college student and pretty naïve to the whole academic system. My determination to be like Clarice led me to a research assistantship at Kingston Penitentiary (the largest penitentiary in Canada at the time) and I was provided the opportunity to discuss this career path with forensic psychologists who worked with the solitary confinement and life-sentence populations. I will be forever thankful for their candor in how they felt about their work; they described it as difficult and not particularly rewarding. They discouraged me in the kindest and most informative way possible. I took their advice seriously and considered other prospects.

Anyone who knows me well knows that I always have a plan and the next goal post to reach isn’t far away, so it was uncomfortable for me to not know what I was going to do with my life. At that time, I was enrolled in an undergraduate human sexuality course and it fascinated me. I learned that there are people who dedicate their careers to studying human sexual behavior. Learning how young the field was and how ripe it was for new scientists appealed to me. I enrolled in a specialized certificate in LGBTQ* studies and an upper-level sexual function and dysfunction seminar course with Dr. Carolyn Pukall and I was hooked. I became fascinated not just with sexual function and dysfunction, but also with what happens in relationships when those issues arise. I did an undergraduate thesis on romantic rejection with Dr. Uzma Rehman and looked for graduate school opportunities at the intersection of human sexuality and healthy couple relationships. I initially thought I wanted to be a couple’s and sex therapist, but struggled to get into a clinical program and fell in love with sex research when I found Dr. Robin Milhausen at the University of Guelph. I was resolute to work with her for my master’s degree and that paid off. She is still one of my most valued mentors, has become a close friend, and is responsible for encouraging me to do my doctorate at her alma mater Indiana University, home of Kinsey!

At Indiana, I had the opportunity to work so many talented and smart sex researchers—Drs. Michael Reece and Debby Herbenick were my mentors—and I got to interact with and even work with some of the big names I had read about during my undergraduate courses, including Drs. Stephanie Sanders and Dennis Fortenberry. It was the dream!

Eventually, after embarking on an academic career and receiving promotion and tenure at the University of Kentucky, I circled back to the goal of becoming a couple’s and sex therapist. I actually just completed a clinical fellowship in couple’s therapy for licensure in couple’s and family therapy, and my experience as a sex researcher studying sex and relationships for more than a decade really prepared me to do that well. I love the way my research informs my clinical work and I’ve started to see how my clinical work informs my research. It is so rewarding to have my research put into practice and immediately make a difference in couples’ lives—and also for them to help me generate new research ideas.  

Lehmiller: I love this story so much. Thank you for sharing it! Now please tell us a little bit about  your primary area of research and the methods you typically use to answer your research questions.

Mark: My research exists at the intersection of sex and relationships, particularly as it relates to sexual well-being. More specifically, I have been interested in what makes relationships last and what keeps sex alive (and satisfying!) in relationships longer-term. My research has examined questions around sexual satisfaction, relationship satisfaction, sexual pleasure, quality of sexual experiences, sexual desire, desire discrepancy, infidelity, compatibility, and the impact of sex education (or lack thereof) on adult sexual lives, among other things. Typically, I rely on survey-based quantitative research methods including daily electronic report or semi-structured qualitative interviews; I often combine the two when mixed methodology is necessary for our research question of interest. When I am doing research on couple relationships, I try to collect data from both members of the couple as often as possible.

Lehmiller: You have published research on several topics. Can you please give us a sneak peek at one study you’re working on right now? For example, could you tell us a little about the study you’re most excited about at the moment?

Mark: Definitely! I have two studies that I’m super excited about, so if you don’t mind, I’ll discuss both.

We recently finished data collection from over 250 mixed-sex couples where at least one member of the couple identifies as bisexual. They may appear to the outside world as ‘heterosexual’ couples, but one or both members of the couple do not actually fit that description. This can result in a person feeling like their identity is erased (called bierasure) in the context of their relationship configuration and beyond, especially if there is not a lot of social support or if the person isn’t out to important others. We collected baseline data and daily electronic reports for 30 days from both members of the couple, plus a follow-up qualitative interview. There are a lot of interesting analyses we are conducting to examine the ways in which minority stress can impact satisfaction not just for the bi person, but for their partner too! We are also looking at how outness and support from the partner can impact the ability to experience sexual pleasure on an event level, or how sexual desire is impacted (and often heightened) by feeling like your partner really ‘gets’ you. This is a hard-to-reach population and I am really happy with our sample size and the high quality of the data. The couples who participated were really dedicated to the project and they became invested in it, so that makes for very little missing data and genuinely honest accounts of what’s happening in the relationship. Plus, we have data from both members of the couple, so we have data on the interaction between the couple, which is so informative and interesting.

The other study is at the intersection of sexual trauma and sexual pleasure. Many people who have experienced sexual trauma go on to have healthy, happy, pleasure-filled sexual lives. In fact, their experience of sexual trauma is often the impetus for looking very deeply and seriously at what a healthy sex life means to them. Consent is really what separates a sexually pleasurable experience from a sexually traumatizing one. Sexual trauma is void of both consent and pleasure but often involves arousal and sometimes orgasm, and the presence of these in the context of a healthy couple relationship may be troubling and/or triggering for those who have a history of sexual trauma where this occurred. Individuals and couples are tasked with working through reconciling the components of a healthy sexual life—consent and pleasure—with their prior experience of trauma. There is so little research on this topic, so I interviewed 41 women with a history of sexual trauma and talked with them in depth about their experience; how they worked through the trauma, how they navigate pleasure in their healthy relationships, how they define consent, how they define pleasure, strategies that worked and strategies that didn’t work in building a healthy relationship, and disclosure strategies to new partners. This has been one of the most rewarding and interesting studies I have ever conducted. The women I interviewed were all so thankful I was doing research on their resilience rather than their struggles (though we certainly discussed the struggle to get to resiliency), especially as it relates to sexual pleasure. I am really excited about the utility of this work for couple’s therapists and women with a history of sexual trauma, but also see it as having great utility in extending our understanding of constructs like consent and pleasure far beyond the trauma lens.

Lehmiller: You are active on social media and have written for several media outlets about the science of sex. Please tell us a little bit about why you think it’s important for sex researchers to be involved in disseminating their findings.

Mark: This is something I have been committed to since I first began my sex research career. Growing up, I cringed reading sex or relationship information in Cosmo or Seventeen (although I always read every issue!). The male-centric advice and seemingly unrealistic and unrelatable information misled me. I was left feeling like I could have benefitted from more accurate, less male-centric information. This realization was very formative in my becoming the passionate feminist that I am! I also never really understood science or how it could be translated for the public until I had to start explaining to my extended family why I was continuing school after I finished undergrad.

I am a first-generation college student from a very small Canadian town; my dad is an electrician, my mom stayed home with us (though is now a successful real estate agent). I didn’t quite get what it meant to publish a journal article and wondered what the relevance was when no one (other than scientists) could access it; and my family had the same questions. I really wondered–what’s the point?! I am glad that open-access journals are gaining traction and that we increasingly have ways to share our research articles with others, but the academic language is still a barrier. So, if I was going to be a scientist, I needed to make sure that accurate information based on data was also accessible to the general public.

There are a lot of people out there pretending to be sex experts. Everyone seems to think they are an expert. But we—me, you, other sex scientists—have the actual expertise! We study something that people are super interested in and that is widely relevant, whether you’re having sex or not. I needed to make sure Cosmo and Seventeen heard from informed people rather than people posing as experts without much training beyond a pretty website. Although I have come to learn and respect the value in publishing in peer-reviewed journals (I see value in the scientific method, tenure, and in the critical evaluation of my work)—and this is something I do prioritize in my career—I also see the value in disseminating science to the public in a responsible way that allows our work to reach the masses and make a difference. I think it is important to reply to journalists in a timely fashion so they can include expert voices. I think it is important to write articles that can be digested by the public so that we don’t keep what we learn as scientists locked up behind journal article paywalls. I’ve always categorized my media work as the public dissemination of science and consider it to be an integral and necessary part of my job as a scientist working at a public institution.

Lehmiller: In your experience as a sex researcher, educator, and therapist, what are some of the biggest misconceptions you’ve encountered about sex? In other words, what are some things that are widely believed about sex, but not supported by the science?

Mark: This is something that even within the field some people will dispute, but for me, the biggest misconception is that women have lower sexual desire than men. Our data simply don’t play out that way. Yes, across the board, if we look at averages, men tend to have a bit higher sexual desire than women. But it is only a bit! And although it is sometimes a statistically significant difference, I don’t think it has much clinical significance. Also, how do we know those measurement tools aren’t privileging the male respondent? We don’t! And that’s the case with all methods of data collection–self report survey, interview, psychophysiological, fMRI, etc. I think there is a lot more going on that has yet to be investigated. We are doing some work looking into that and so are others in the field. I simply can’t get on board with those who claim this huge gender difference in sexual desire when I haven’t seen the data to convince me of it.

Lehmiller: For the last several years, you have taught a study abroad course on human sexuality in the Netherlands. Why do you think it’s important for sex educators, researchers, and therapists in training to take courses like this? And why specifically is the Netherlands a good place for a study abroad course focused on sex?

Mark: I love that program! The Netherlands has the lowest unintended pregnancy rate in the world, some of the lowest STI and HIV rates, and comprehensive sexuality education from preschool onward that is federally mandated. They also see sex as a natural part of human development rather than something to be ashamed of. I think it is important generally to be open to the fact that the USA isn’t number one in everything, though we are number one in unintended pregnancy! Generally, we do not rank well when it comes to health outcomes, especially sexual health outcomes.

This is counterintuitive because we spend more on healthcare than anyone else in the developed world and have access to some of the newest and most innovative medical technologies. As a result, many Americans assume the USA is the best in the world. But it is crucial that we look to other cultures and healthcare systems to see the ways in which we can learn from those who are doing better. When it comes to sexual health, the Netherlands is a wonderful model for us to look toward! For those who know the USA can do better and are open to learning about how, this program can be even more enjoyable and informative.

The benefit of sex researchers, educators, and therapists immersing themselves in a culture where sexual pleasure is a human right, sex workers are (for the most part) respected as entrepreneurs and business owners, LGBTQ* rights are human rights, and sex is celebrated as an important part of human development is refreshing, affirming, informative, and for some, life-changing.  

Lehmiller: Last question—I have a lot of admiration and respect for you because you are doing EVERYTHING. In addition to teaching, research, therapy, and media work, you are also actively involved in shaping local policy on sex education. Please tell us a little bit about the policy work you’ve done and what that experience has been like.

Mark: It is so funny you say that because I often don’t feel like I’m doing enough, which is likely what drives me to do more. Similar to my reason for contributing to the media, I think we have so much power to be able to ignite change in our communities by working with them. I always thought I wanted a job back in Canada once I finished my doctorate so I could be closer to family and friends, but the job market just wasn’t going to happen for me that way. I got my current job in Kentucky and grew to absolutely love this special city of Lexington and the University of Kentucky community.

I attribute my increased engagement in my local community to a colleague I really respect, Dr. Alex McKay, the Executive Director of the Sex Information and Education Council of Canada. He provided great insight when I first started my job by telling me “you have my dream job.” I was flabbergasted and asked why. He explained it was because in a place like Kentucky, I really have the potential to make a difference. He was right! Once he said that to me and I shifted my perspective, I began to really invest in the community here to try and make a valuable difference. This led me to engage more than I had previously in activism, community work, and sex education policy change. There is a lot of resistance to what I do here; people are generally uncomfortable with sex, sexuality, and sexual health (and they certainly don’t want to talk about it!) and I have had to do a lot of educating, everywhere from IRB panels to the teachers I train to my fellow professors and administrators. But at the end of the day, I know that I am doing the right thing by fighting for comprehensive, medically accurate, LGBTQ*-inclusive sexuality education for everyone.

In Kentucky, the law does not require sex education to be medically accurate. It is inconsistently offered to the point where two kids who grow up on the same street could be receiving vastly different information about sex (or no information at all, aside from scare tactics and abstinence-only messaging). One recent successful initiative was the creation of LexEd, which is a coalition of researchers, educators, parents, and concerned citizens who advocate for comprehensive and inclusive sexuality education in our county. We were unsuccessful working from the top down. When we were kicked out of a school board meeting for using medically accurate terminology about sexual health and one of our advocates, a local high school student, left the board meeting in tears, we shifted our approach. We began working with the wellness coordinator and each individual school to get the curriculum approved – and we did it! Now that the curriculum is in place, we are struggling with teachers actually teaching the content (this has been due to fear of losing their job, lack of comfort with the material, and/or personal morals and values running counter to comprehensive content).

We are now at the next step of figuring out how to work with the teachers to equip them with the skills necessary or provide them with a sex educator to fill in the gaps. But there is so little funding available for this type of work and it takes so much time to implement—it is very slow moving. My lab, the Sexual Health Promotion Lab, has been trying to fill the gap through volunteering our time for a variety of local organizations such as a home for women who have been sex trafficked, a school for pregnant teens and teen moms, etc. This is hard to sustain without funding but is so impactful for those we serve, so it is not something we want to give up. Finding that balance has been part of the struggle with integrating the policy and community work into everything else I do. I have been so thankful to have a team of undergraduate and graduate students in the Sexual Health Promotion Lab who are motivated and eager to contribute to these efforts and I wouldn’t be able to engage in the community and policy work I do without them.

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Dr. Justin Lehmiller is an award winning educator and a prolific researcher and scholar. He has published articles in some of the leading journals on sex and relationships, written two textbooks, and produces the popular blog, Sex & Psychology. Dr. Lehmiller’s research topics include casual sex, sexual fantasy, sexual health, and friends with benefits. His latest book is Tell Me What You Want: The Science of Sexual Desire and How It Can Help You Improve Your Sex Life. Follow him on Twitter @JustinLehmiller.