I live in Lake County, California–an impoverished rural county three hours north of San Francisco. It’s a place that’s been ravaged by catastrophic wildfires (including the Mendocino Complex Fires last year) as well as flooding. Right now, our beautiful lake is fully beyond its usual capacity and some lakeside homes, piers, and businesses are becoming partially submerged. Our county is one of several included in Governor Newsom’s most recent State of Emergency declaration, though most of are doing a lot better than poor Sonoma County to the south. We’ve had some highway closures though. A few days ago, we couldn’t access the northern part of Highway 20–so no trips to Ukiah, the closest thing we’ve got to a city, one county over and about 45 miles away.

In Lake County, there’s not enough good quality mental and physical health care to go around. A lot of people go out of county to see specialists, some even drive all the way to San Francisco! “Telehealth”–appointments by phone or online–is an important option here. Sometimes it’s the only way to get a prescription or consult with a doctor on short notice. Some mental health providers offer this as an option (and so do I). It’s also a challenge to set up a private practice here, even a modest one, particularly because this is a place where people don’t have much to spare. And it takes a certain mindset to adjust to living and working in a rural area, especially when you’re used to city living.

From Urban to Rural–A Difficult Transition

Since January 2016, I’ve been struggling to make the transition from San Francsico Bay Area urbanite to rural “alternative and complementary health provider.” I tried it first during a relocation to Hawai’i Island (which lasted 19 months). Since November 2017, I’ve been trying to make a similar adjustment here in Lake County.

In Hawai’i, I rented office space once a week from Hinano Healing Arts, a small community clinic in Hilo. It offered community accupuncture, chiropractic work, and massage. However my services (sex counseling and hypnosis) may have been too odd for most people to consider. Some folks are leery of hypnosis and others have trouble talking openly about sex, even with a professional counselor. Plus I underestimated the challenges of being a newcomer in a place where one’s high school alma mater is super important. It means you’re either local or not. A lot of the “or not” people who’ve moved to Hawai’i get by with creating their own social and economic bubbles, but frankly that’s less possible on the Hilo side of the island.

In Lake County, there’s a similar distance between old-timers and the newcomers. But I thought that I was close enough to Mendocino, Napa, and Sonoma Counties, that I could be moderately “in demand.” But no, it hasn’t turned out that way. I feel again that what I have to offer may be too unusual. I keep trying though. Last year I did rent a charming little Upper Lake cottage as an office space and I shared it with three other practitioners. We lasted about six months–it just wasn’t financially sustainable!

The Rural Sexologist Sheds a Tear or Two…

I confess to feeling sad. I’m not ready to be put out to pasture, to “retire.” I know that people here (like everywhere) are coping with various forms of sexual dysfunction, confusion, and unhappiness. I know there are people who could improve their relationships with a little education in couples communcation and conflict management skills. I also know that my general “hypnosis for wellness” abilities could also come in handy for a lot of folks who want to quit smoking or manage their weight or stress. I’ve got all kinds of “mad skills” to assist people with all kinds of problems but no one either knows or cares.

And there’s the lack of colleagues here…that saddens me too. But even in San Francisco the fabulous Center for Sex and Culture is now no more…

The gloomy thoughts above were prompted in part by sitting down today, organizing paperwork and bank statements in preparation for doing my taxes. 2018 smells of failure. It adds to my feeling of being challenged by my isolated, rural environment–especially today as the lake is high and more rain is on the way.

But the Irony Is…

2018 was also the year that my message service was actually inactive for several months last year! No wonder I wasn’t getting any calls! I just found this out yesterday, while going through invoices.

It was also the year that three out of the four online professional directories that I depend on to waft clients in my direction have not been functioning correctly. And I have no idea how long that has been going on. So my “failures” last year were not as personal as I’d thought. (And here the rural sexologist emits something like “argh.”)

Professional certificate from AASECT granted to Amy R. Marsh. Intricate border, organization logo and text.
Most recent AASECT Sexuality Counselor certification for Amy R. Marsh.

Here are the three directories where I am either missing or the information hasn’t been updated (even after I’ve submitted it):

• This is the most important omission. AASECT doesn’t include me in their “find a professional” listing or in the membership directory, though I am an AASECT-certified counselor (certified through July 2021) and current in my dues.

• Least important. I’m still apparently part of the American College of Sexologists Advisory Board but my international directory profile still has me in Hilo, HI, (with the wrong website URL) even though I’ve submitted corrections to my profile at least twice since moving back to California. However, I shouldn’t feel too badly as the founder and “executive director” has been dead for several months. He’s still listed on the advisory board too.

• Most regrettable. In late December I decided I would not renew my membership in the World Association of Sex Coaches (WASC), because I discovered that they didn’t have me listed as a “clinical sexologist.” Instead, I was listed as an “allied professional” even though the organization’s founder and I are graduates of the same sexology school! It’s not like they don’t know me! I even teach two elective courses through the WASC-affiliated sites: Sex Coach U and Sexology University.

I’m also on the National Coalition for Sexual Freedom’s Kink Aware Professional (KAP) list, but that’s become somewhat unwieldy too. I can’t even search for me properly!

So no wonder I had very little client work last year! The structures that I depend on all seem to have conspired against me, keeping me even more isolated as a professional than I feel already. And as I became more frustrated by my lack of work, I became less attentive to tracking what I use to bring it in.

There’s a moral to this story somewhere, doncha think? “Pay attention” might be a good place to start.

For the record–I am here in Lake County  CA but I can work with people all over the world. I offer HIPPA-compliant online sessions via thera-LINK. You can leave a message at (707)515-5025 (yes the number should be working now) but I prefer email contact (it’s more reliable) — dr.amymarshsexologist@gmail.com. So do reach out. I’m here and ready to do good work on your behalf. Thanks!