Cassandra Kleefman is a Registered Psychologist, sex therapist, educator, and speaker whose work sits at the intersection of sexual health, intimacy, pelvic pain, and relationship wellbeing. Based in Edmonton, Alberta, she co-owns Transcend Psychological, where she is known for blending evidence-based practice with a refreshingly direct and compassionate approach to conversations about sex.

Drawing from extensive training in sex therapy, EMDR, Gottman Couples Therapy, Emotion-Focused Therapy, and pelvic health, Cassandra’s work challenges many of the assumptions people hold about desire, pleasure, and connection. Rather than viewing sexual concerns through a purely physical, psychological, or relational lens, she emphasises the complex relationship between the mind, body, and nervous system, arguing that meaningful change happens when all three are considered together.

In this conversation, Cassandra explores why great sex is cultivated rather than discovered, how the nervous system can shape experiences of both pain and pleasure, and why vulnerability remains one of the most overlooked ingredients of intimacy. She reflects on the impact of cultural narratives, sexual expectations, and performance pressures, while offering thoughtful insights into desire, body image, stress, burnout, and the pathways to a more fulfilling sex life.

That Changed How I See Sex Forever 

What’s the most liberating realisation you’ve had about human sexuality, either from your own life or through your clients, that completely shifted how you practise as a sex therapist?

Cassandra Kleefman: The most liberating realisation from my years of practice is that great sex does not exist in chemistry and sparks; it is cultivated through intentionality, communication, and deep friendship.

The Nervous System Is Part of Your Sex Life 

Pelvic floor pain and sexual discomfort are rarely talked about openly. What do you wish more women understood about the connection between pain, pleasure, and the nervous system?

Cassandra Kleefman: What many people don’t know is that pelvic pain is incredibly common (about 1 in 3 vulva owners will experience pelvic pain at some point in their lives), but it is not normal. If someone is experiencing pelvic pain, something is going on that needs to be investigated.

What’s also misunderstood is the role the nervous system plays in keeping that pain alive. Pain is not just a physical signal. It’s a message your nervous system sends when it perceives a threat. With chronic pelvic pain, the nervous system can get stuck in a protective loop, firing pain signals even when the original tissue injury has healed. The body learns pain the same way it learns anything else: through repetition. Over time, anticipating pain before sex, during a pelvic exam, or even just getting undressed can trigger a real pain response because the nervous system doesn’t always distinguish between a threat that’s happening and one it’s been conditioned to expect.

This is not “all in your head”. It is in your nervous system, which is very much in your body.

The good news is that what the nervous system has learned, it can unlearn. Neuroplasticity works in both directions. With the right support (i.e., pelvic floor physiotherapy, sex therapy, and sometimes trauma-informed care), the nervous system can be gradually reconditioned to associate those same cues with safety instead of threat. Pleasure isn’t the opposite of pain; for many people, it becomes part of the path out of it.

Are You Trying to Impress in Bed? 

In a culture obsessed with performance, how can people shift from “doing sex well” to actually feeling present, connected, and embodied during intimacy?

Cassandra Kleefman: First off, I think it is important for people to ask who they are performing for (e.g., partner, themself, a belief they have, etc.). Then, figure out why they feel the need to perform. In order to have present-minded, connected, and embodied sex, we have to let go of the many narratives given to us about who we are as sexual people and allow ourselves to be truly vulnerable with the other person (or people).

These narratives come from everywhere. Pornography sets a visual standard for sex that has almost nothing to do with genuine intimacy and everything to do with spectacle. Gender scripts tell women to be receptive and pleasing, while telling men to be tireless and technically skilled. Add a near-total absence of real sex education, and most people are left with a performance script assembled from the worst possible sources, internalised before they ever had a real experience to compare it to.

Vulnerability is what performance is designed to protect against. To perform is to manage how you are perceived. To be vulnerable is to stop managing and actually show up. This requires trust, safety, and the willingness to be seen as you actually are rather than as you think you should be. Many people have never experienced sex that felt genuinely safe, so the performance never had a reason to drop.

Sexual Problems Are Rarely Just One Thing 

How do you help clients distinguish between a sexual issue that is psychological, relational, physical, or a combination of all three?

Cassandra Kleefman: It is far too reductionist to assume any one sexual issue can be assigned psychological, relational, or physical responsibility alone. While we may be able to identify a specific contributing factor, how we respond and adapt to that issue shapes it just as much as what caused it. The mind and body exist in an intricate feedback loop, and I don’t believe they can be meaningfully separated.

Take pelvic pain caused by tight pelvic floor muscles as an example. If someone responds to that pain with anxiety, catastrophising, hypervigilance, increased muscle guarding, and avoidance of sex, all of those responses become part of the pain experience, regardless of what started it. The origin matters, but it doesn’t tell the whole story.

Desire Isn’t Gone; It’s Just Blocked

What advice would you give to someone who wants a more fulfilling sex life but feels blocked by stress, burnout, body image issues, or past experiences?

Cassandra Kleefman: More often than not, it is not the thing that is the issue, but rather our relationship to the thing. So, I would encourage people to examine their relationships with their stress, their burnout, their body image issues, and past experiences, and figure out how that relationship is helping/harming their relationship with sex. If we use stress as an example, how are we responding to our stress? What about that response is helpful? Harmful? How does that relationship to stress impact my relationship with sex? Etc.

For many people, sex fulfils deeper needs that we have. The need to feel wanted/desired, the need for connection, the need for pleasure and fun. When that fulfilment feels blocked, it is important to look outside of sex at the bigger context of our lives for clues that may point to how those needs are/aren’t being met elsewhere.

Editor Note 

Cassandra Kleefman challenges the idea that great sex is something we stumble upon through luck, chemistry, or perfect compatibility. Instead, she offers a perspective that is both liberating and deeply practical: connection is built through communication, safety, vulnerability, and intention.

The relationship between the mind, body, and nervous system. Whether discussing desire, pleasure, pain, or performance, the message remains consistent: our experiences are shaped not only by what happens to us but also by how we relate to those experiences.

Great sex isn’t found; it’s built. And like any meaningful relationship, it grows through curiosity, honesty, and the willingness to keep showing up for ourselves and each other.