When I turned 30, I had a preventative bilateral mastectomy. I have the BRCA2 gene, which carries an 86 percent (ish) lifetime risk of breast cancer, so I chose to have the mastectomy and reconstruction to minimize that risk. As my doctor said, “If there’s an 86 percent chance of rain, you’re taking an umbrella.” It wasn’t a case of if I got cancer, but when.
I had the surgery in London and spent a few months recovering. Physically, it went well. I was warned about the nerves reconnecting and the pain that comes with that, the lack of mobility, the general discomfort, and readjustment. But that’s all to be expected after any major intervention.
What I’ve struggled with in the years since, however, and what I’ve found to be a taboo topic, is sex after surgery. It’s something that has spiked my anxiety long after the scars have healed. Do I tell partners? Can people notice? Are my scars visible? Will the feeling ever fully come back, and if it does, will it feel the same? Will it come back too much? Is this even my body anymore? Am I an imposter having these thoughts when I didn’t actually have cancer?
I received a lot of support during the healing process, both medically and emotionally. But this is one area that wasn’t addressed, and it has had a lingering effect. Wellness culture talks endlessly about optimization: sleep, recovery, longevity. But sexuality after major surgery — something that can deeply affect identity, intimacy, confidence — rarely makes the menu. I’ve been to a number of excellent spas and wellness clinics since my mastectomy, and it's just not addressed like everything else. I can't be the only person struggling in the aftermath beyond physical recovery. I need something more profound than sound baths and massages.
I visited the Zem clinic in Spain when it opened in 2025, and was fascinated to see multiple divisions dedicated to sexual health. I was curious to know why this wasn’t the norm — after all, sex is just one facet of a good and happy life. So why isn’t it treated with the same diligence as our physical and mental health? While I was at Zem for other reasons, I regretted not pursuing its sexual wellness offerings. Embarrassment got the better of me. Which is ironic, really; I’d flown to Spain for health optimization but still couldn’t bring myself to ask about sex — the one area where I needed the most guidance.
When I first arrive at Miraval in Arizona, a sprawling wellness retreat set in the foothills of the Santa Catalina Mountains, I’m not entirely convinced it’s the place to confront any of this. The resort’s reputation is impeccable (Oprah is a fan), but the rituals on arrival don’t immediately reassure me. I’m asked to set an intention for my stay, and then strike a large golden gong to mark my arrival. So far, so… hmmm.
My first session, Optimize Your Sex Life, is led by Lyndi Rivers, a sexuality educator with more than 20 years’ experience in trauma, grief, and nervous-system regulation. It’s a group class, a mix of couples and singles, and we begin by introducing ourselves and sharing why we’ve come to Miraval — and to this session in particular.
When it’s my turn, I shock myself by bursting into tears almost as soon as I start speaking. It won’t be a one-off. As the session goes on, it becomes clear this kind of reaction is common — and that I’m far from the only one having it.
The session itself leans towards those in relationships, offering practical tools on communication, connection, and how dynamics outside the bedroom shape what happens within it. We talk about mismatched libidos, about how desire shifts over time, about the difficulty — and necessity — of communicating honestly. Rivers notes that it’s better to discuss an issue before it multiplies, and to do so in a neutral place. She recalls multiple studies on what makes a good sex life — one study in particular had most participants stating that their best sex was later in life, so ‘the best is yet to come!’ While insightful and informative, it feels more geared toward relationships and the issues within, which, although still important, is not what I came for.
The women-only session, Pleasure: Women, Sex, and Desire, is different. My group is more open, more candid about their reasons for attending. Among us, there’s a recent divorcee navigating her new status; someone trying to reconnect with her husband after 17 years and a few kids; a woman who has been dealing with a mountain of grief and, as a result, hasn’t had sex for seven years; another who found herself in a same-sex relationship after a long marriage to a man; and a 70-something-year-old with an 80-year-old husband who speaks about her colorful sex life with great vigor, noting a time period where she “slept with everyone” after the death of her first husband.
We’re all there for different reasons but tied by a communal thread. Everyone wants to talk about their experiences, about their worries, about their needs. When it’s my turn to speak, I say far more than I had expected to. Words come quickly — along with more tears — and they won’t stop. But it doesn’t feel embarrassing; it feels cathartic and necessary. I realize that the other women in the group are listening, nodding, leaning towards me; I feel all their eyes on me and instead of shying away, I’m encouraged to keep going. So I do. We talk about bodies changing through age, childbirth, and surgery. The conversation flows; the usual social barriers have already been stripped away by the introductions (or rather, the quiet acts of soul-baring) and there’s nothing left to hide behind.
We talk about making time for non-sexual pleasure; it should be woven into every day and become so much part of our routine that it doesn’t feel alien when we seek it during sex. Rivers talks about both the emotional side of intimacy and the biology, how there are two parts in our brain; one looks for reasons to be turned on, the other looks for reasons to be turned off. She refers to one as an accelerator and one as a brake, and outlines some of the things required to accelerate. What strikes me is how ordinary the 'accelerators' can be. It’s not always grand gestures; sometimes it’s as simple as having a clean kitchen, removing a distraction and creating calm. Small things, but not insignificant things.
See also: Arizona’s Healing Desert Is Drawing In Wellness Seekers
At the end of both sessions, we’re handed a printout. The first one is 15 pages long. The second one has multiple sections, including a ‘Sexual Temperament Questionnaire’ and recommended reading lists. It feels a little unsexy — paperwork is never much of a turn-on, is it? But approaching intimacy in this way makes it feel neutral, and takes away the emotional sting. It’s something to be worked on behind the scenes.
Despite the openness, I still feel uncomfortable at times. My instinct is to reach for my phone, both during the sessions and afterwards when I’m alone. It’s a reflex to distract myself and disengage from what I’m feeling. But Miraval is largely device-free, which means there’s no quick and easy escape. So I sit with it all instead. I try to understand why this still feels so hard. It’s been years. I should be able to cope. I should be over it. If anything, I’m lucky. The thoughts are unhelpful, but I let them run. Without the usual distraction, they gather momentum, then drift off — the way they rarely do when I can just scroll past them.
Miraval Resort
Miraval is a sprawling wellness retreat set in the foothills of Arizona's Santa Catalina Mountains
©Balf Walker
The vast desert landscape at Miraval Arizona offered space for reflection and introspection
©Balf Walker
While the resort offers a myraid of tradition and holistic treatments, from infared saunas to Reiki, many guests are not here to relax
©Balf Walker
While Miraval's desert setting creates space for those difficult and often avoided conversations
©Balf Walker
There are lighter moments, which are vital. I spend any free time I have in the spa’s infra-red sauna and cold plunge pool. I have the 80-minute Cara Dorada facial and fall asleep during the facial reflexology. I join morning hikes into the Catalina Mountains, led by Miraval’s guides, who tell me about the birds, jackrabbits, and enormous cacti we see. I attend a class on stress management in a yurt and visit the ranch for a session on barriers and communication with a horse named Ollie.
It becomes clear that most guests aren’t here to relax. They’re here to address something bigger. A New Yorker I speak to tells me she first visited in the New Year and it ‘changed her life,’ so she’s back, a mere two-and-a-half months later, for a ‘top-up.’
I find relief at unexpected times. During a surprisingly good Reiki treatment (ask for Amelia), I’m in fits of giggles and — you guessed it — more tears as she works along my stomach to help let go of the resentment I’ve been holding there. (The laughter and tears are signs it's working, she tells me.) I’m fairly skeptical about such treatments — I want facts and data, not crystals and talk of energy — but Amelia tells me things about myself that I haven’t disclosed to her or to anyone at Miraval. I feel exposed, but it’s a relief to stop holding onto something I’d been ashamed of, to be seen, to allow myself to admit it, and to realize that nothing terrible has followed — just a quiet sense of release.
Later, in a one-on-one with Rivers, she asks me what I want from the session. It’s something I’ve been asked constantly at Miraval. Nothing is passive. It feels unfamiliar to take control of the outcome. These treatments are not simply happening to me; I am contributing and deciding what they will be. This feels parallel to my experience — while I wasn’t passive in my decision to have a mastectomy, I’ve felt that way ever since. There’s a lightbulb-moment realization that I have more agency than I think.
We talk about grief, not just for what I lost physically but for the version of myself that existed before. I talk about intimacy, and my hesitation. How one important relationship slowly broke down in the aftermath. How others never really began, or were shaped by my anxiety. She notes that, over time, I’ve become more accepting of my body, less concerned with how it’s perceived by others. Since returning from Miraval — and, perhaps, in the process of writing this — a new relationship has formed. It’s with someone who has known me before, during, and after. There’s no fanfare, no sense of ‘I’m healed! It’s done!’ And there never will be. Instead, there’s been something quieter: a slow, steady integration. This is part of me now. It always will be. I used to think I’d be ‘over it’ by the time the scars faded. Now I understand it differently: the scars may soften with time, but so, too, will the weight I attach to them.
A few years after the surgery, I started CrossFit. I was completely in awe of (and intimidated by) the strength of the women there. I’m still hooked. I remember the months of recovery when I couldn’t use my upper body, when I couldn’t even lift myself out of bed. Now I can do muscle-ups. Lots of ’em.
Building strength in a body I once felt had betrayed me has reshaped how I see myself. It’s given me a sense of control, of resilience. After that brief period of helplessness, I’ve done everything I can to make sure I never feel that way again. But maybe that’s part of the problem. Strength, for me, has become a kind of protection. And sex — real intimacy — asks for the opposite. It requires vulnerability, a willingness to not be in control. I wasn’t sure if I could do that. Rivers is clear that nothing will be ‘fixed’ within a few days at Miraval. Rather, it’s a segment of a longer, more complex process.
Sexual confidence, body ownership, and intimacy after surgery aren’t considered part of recovery, even though they can shape how someone moves through the world long after the medical crisis — or in my case, the preventative intervention — has passed. Speaking to a trauma specialist here doesn’t feel like indulging in wellness trends. It feels more direct than that, more practical. It’s less about optimization, more about reckoning with the reality of a body that has changed, and a mind that is still grappling with it.
I’m still comforted by the stories of others that I heard at Miraval, and find peace in knowing that even though my problem/insecurity is my own, there are so many others who face difficulties in this area, from all walks of life. Even saying it out loud to a group of strangers made me feel lighter.
Miraval didn’t solve everything, nor was it meant to. I don’t have a neat conclusion but I realize I don’t need one. I said things out loud that I’ve spent years avoiding, and I stopped pretending that these things don’t matter to me. It’s not quite a resolution, but it’s a release.
Programs at Miraval Arizona from $799 per night.
