Pelvic Health and a Gaggle of Therapists

 Posted by David Khalili, LMFT | Rouse Academy

There's something that happens when you put a room full of sex and relationship therapists together after a long day of conference sessions, give them appetizers and drinks, and invite a pelvic floor physical therapist to drop some knowledge. The guard comes down. The conversations get real. And suddenly you're talking about vaginismus, vibration therapy, and the future of sexual health care over a cocktail at Uptown Tavern in Hillcrest, San Diego — and it feels completely normal. Which, honestly, is exactly the point.

 Last Saturday, Rouse Academy co-hosted a post-CAMFT conference gathering with Jennifer Rehor, LMFT and the team at Affirming Therapy Center in San Diego. If you don't know Jennifer, she's been doing deeply affirming, kink-aware, and identity-inclusive work in San Diego for years, and getting to share space with her and her community was genuinely a gift. Our shared belief that clients deserve clinicians who are curious, non-judgmental, and actually educated about sex made this collaboration feel less like a networking event and more like finding your people. The Hillcrest neighborhood of San Diego — historically a queer hub — made for a fitting backdrop. There's something about being in a space that has long held community that makes conversation easier and more honest.

The real centerpiece of the evening was Dr. Rose Schlaff, pelvic floor physical therapist and sexologist, who brought her expertise directly to the room. Dr. Rose has a gift for taking subjects that tend to make people squirm — pelvic pain, penetration difficulties, muscle tension and its relationship to trauma and anxiety — and making them feel approachable, even fascinating. Providers who had never really understood what pelvic PT actually looks like in practice left with a much clearer picture of how to better serve and refer their clients. That kind of cross-disciplinary learning is exactly what Rouse Academy is here to support. Sexual health doesn't live inside one scope of practice, and the more fluently we can all speak across disciplines, the better the care we can offer our clients.

We also want to give a very warm and sincere thank you to our sponsor for the evening: Milli, the expanding vaginal dilator with vibration. Milli was not only a generous sponsor — they were a genuinely perfect fit for this event. Milli is the first and only FDA-cleared vaginal dilator that combines controlled, gradual expansion with vibration therapy, and it's available over the counter without a prescription. Designed for people experiencing discomfort during intimacy related to vaginal muscle tightness (vaginismus) or pelvic floor tension, Milli allows users to progress at their own pace, adjusting expansion with simple buttons and choosing from low or high vibration settings to support relaxation. For clinicians in the room, it was a meaningful reminder that our clients don't have to wait — Milli can bridge the gap between a referral and a first pelvic PT appointment, giving people agency over their own healing in the meantime. It's also FSA/HSA eligible, which matters when we're talking about access and equity in sexual healthcare.

The clinical evidence behind Milli is worth knowing. In a three-month study, 85% of participants were either back to having sex or actively making progress toward that goal. Over six months, 97% found Milli easy to use, and 87% said they would recommend it to a friend. What struck me most, though, was this: 57% of participants reported feeling less anxious about sex — which tells me Milli is doing something that goes well beyond the physical. Sexual anxiety and pelvic pain are so often intertwined; when the body begins to soften, so does the story someone has been carrying about themselves. That's the kind of outcome we care about in the therapy room, and it's exactly what makes Milli a product we can feel good about recommending. You can learn more at hellomilli.com.

Beyond the education and the sponsorship, what stayed with me most about Saturday night was the feeling of community. This field can be isolating — not everyone in your consultation group gets it, not every supervisor has the language, and not every colleague knows what to do with a client who presents with shame around kink or pain during sex. Finding a room full of people who do get it, who are reading the same research and asking the same questions and caring about the same clients, is genuinely sustaining. Jennifer Rehor and Affirming Therapy Center brought their community, Rouse Academy brought ours, and Dr. Rose brought the science. What we all brought together was something that felt important.

Rouse Academy exists because we believe that the quality of care our community receives depends on how well-prepared, well-connected, and well-supported the providers serving them are. Informal, educational, relationship-building events are as much a part of that mission as a formal CE training. 

If you're a provider in the Bay Area or beyond who wants to stay connected to what we're building, we'd love to have you in our world. 

You can check out our upcoming events and find more information about the evening here: https://www.rouseacademy.com/rouse-academy-events 

To Jennifer, Dr. Rose, Milli, and everyone who showed up on a Saturday night to talk about pelvic floors and drink something cold — thank you. This is what it looks like when providers advocate for their clients even when no one's watching.

Interested in learning more about and trying Milli?

They've extended a generous offer of $50 off their product when you use the code ROUSE50: hellomilli.com

Hearts and handbags, 

David F Khalili, LMFT 

Founder & Clinical Director

Rouse Relational Wellness | Rouse Academy