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Dr. Ruth
Credit: Dr. Ruth at home in N.Y.C. Photographed by Jennifer Livingston.

If it turns you on, freaks you out, or seems remotely titillating, Dr. Ruth Westheimer, the world’s most famous sex therapist, has been asked about it. At 91 years old, she is impossible to stump. Just try it. Her still-girlish face has two go-to expressions: poker and delight. The former was honed after decades of fans’ asking this German grandma the dirtiest questions they could muster; the latter stems from an ever-present joie de vivre. (A typical tweet: “Today is Fat Tuesday. I prefer to call it Sexy Tuesday, what about you?”)

And while her audience has tended to overshare with the good doctor, she has carefully maintained the revelations as a one-way street. But now, for those curious about the creation of her cult of personality as well as her incredibly varied journey comes Ask Dr. Ruth, a documentary premiering on Hulu this month. Directed by Ryan White (Serena, The Case Against 8), the film follows the divergent periods of her life as a Holocaust survivor (she prefers the term “orphan of the Holocaust” because she was “never in the camps” but put on a train to Switzerland by her mother and grandmother at age 10); a teenage sniper in the Haganah (the precursor to the Israel Defense Forces); an academic; and, finally, the Dr. Ruth that America knows best. “The happy munchkin of sex” has a groundbreaking radio show (Sexually Speaking), at least five TV shows, a board game, multiple commercials and sitcom cameos, and 46 books under her belt. Her very tiny belt.

“I’ve always made the best out of being small,” she says, as we sit across from each other in her apartment in Manhattan’s Washington Heights with its expansive view of the Hudson River.

VIDEO: Dear Dr. Ruth

Dr. Ruth takes a lot of pride in her 4 feet and 7 inches, just as she does her apartment, where she’s lived for 54 years. She scoffs whenever someone suggests she move. She prefers this “neighborhood of immigrants.” Her accent remains as thick as strudel, complete with r’s that sound as if they’ve been rolled over a washboard. Her home is a time capsule that flaunts her appreciation of — and perhaps empathy for — all things tiny. Collections of miniature elephants and crystal-covered turtles (“I have a lot of turtles … maybe 50, I think more”), ivory figurines (“these are illegal now”), vintage dolls, and memorabilia of decades past cover every surface. Even the chairs we sit in, squat and adorned with needlepoint pillows, feel better suited to oversize dolls. Unlike Joan Didion, who has spoken about the element of surprise her slight stature gave her as a reporter, Dr. Ruth insists “nobody has ever underestimated me because I was short.

“When I was at Sorbonne University,” she goes on, “studying psychology, it was very crowded in the auditorium, and so I went right next to the professor and let a good-looking young guy put me up on the windowsill so I could hear and see everything. That’s how I did my studies.”

Dr. Ruth oozes so much authority and confidence, I wonder if she can ever remember a time when she was embarrassed, particularly given her profession. “No. Absolutely not,” she says. “After I was sent to Switzerland, I was the one teaching about sex in the orphanage because I had read a book about it in my parents’ house in Frankfurt before the war. It was called Ideal Marriage, and it was hidden in the bookshelves. So I already knew, and I was a little bit the sex educator in the orphanage.”

It can be tricky, both in the film and in person, to draw a smooth connection between the little girl who saw her father being taken away in the night (he died at Auschwitz; there is no record of how or where her mother died) and the woman who famously said, “When it comes to sex, the most important 6 inches are the ones between the ears.” Sure, there’s the fundamental tie between survival and sex, the affirmation of life, but even Dr. Ruth herself compartmentalizes her past.

“There are certain things you don’t talk about,” she says. “Some years ago I realized that people were going to continue asking about my childhood, so I did an autobiography called All in a Lifetime. I put it out there. I put it out there in the documentary. But I don’t like to dwell on it. I even went to a psychoanalyst with a similar background beforehand to figure out what I wanted to say and what I didn’t want to say.”

She points out a common thread in her life then and her life now: She understands what it feels like to be “treated as subhuman.” It’s what has led to her vocal advocacy for disenfranchised groups over the years, most notably the LGBTQIA+ community, particularly during the AIDS crisis, when it was not so popular to be outspoken.

“What the Nazis did at the time was not only being against the Jews — though that was their main focus — but also being against gays and people with disabilities. I don’t forget that.” Or, as she puts it in the documentary, “[Given] all the things that I’ve survived, I have an obligation to live large and make a dent in this world.”

This means she’s still very active in Planned Parenthood (“It has to survive, and it will; I’m a big optimist”) and sees abortion as an issue of logic, stressing that “there is contraceptive failure, so abortion must remain legal for everyone.” At the same time, the current political situation falls squarely under the category of Certain Things You Don’t Talk About. Though to be fair, sex has never been political for Dr. Ruth. In the documentary her daughter and granddaughter debate her, trying to convince her that she’s a feminist even though she doesn’t like “labels” — they risk alienating the people she’s trying to help, which would be antithetical to her entire ethos. But at long last she caves, admitting that she just isn’t a “radical feminist.”

Of course, her life’s work is not all so weighty. Included in Ask Dr. Ruth’s footage is a clip of her trying to get Conan O’Brien to say “blue balls.” She casually refers to her first two marriages from her younger years as “legalized love affairs.” (“The third time was the charm for me,” she has said about her third marriage, to Manfred Westheimer, who died in 1997.) And she’s still approached for sex advice on a daily basis, though she concedes that she doesn’t get as many technical questions as she once did, thanks in part to the advent of the Internet. “People are more sexually literate these days,” she says. “So the questions have certainly changed. They’re much more about how to form and cultivate relationships.”

She smiles at the pile of mail commandeering the kitchen table. In a way, Dr. Ruth is famous beyond comprehension. The documentary doesn’t have to try too hard to beat the drum for its subject’s relevance. In another way, her presence is so ubiquitous, she’s easy to take for granted. But huge portions of our entertainment diet — from Sex and the City to the entire Vice network — wouldn’t be the same without her. Every daytime talk-show doctor owes a debt to Dr. Ruth. The very concept of being frank and nonjudgmental about sex, of framing it as a health issue in a country with such puritanical roots, began with her. We are all the beneficiaries of her life’s work. Beyond the communal and the cultural, think of every time you’ve felt empowered to talk about what you need in bed. There’s a piece of Dr. Ruth in that conversation.

And she shows no signs of slowing down. She’s simultaneously working on a new edition of Sex for Dummies, aimed at millennials, “talking about loneliness and the art of conversation,” as well as Crocodile, You’re Beautiful, a children’s book that uses animals to educate young readers about diversity. When I ask her what kind of animal she would be, she responds in quick, classic Dr. Ruth fashion: “An ant because I’m so short.”

As she walks me out of her apartment, I can’t help but ask the ultimate sex guru of our times one last question: Is she dating anyone?

“Put it this way,” she says, straightening her posture, “If I find someone to dance with, I will dance with them. My feet are very good.”

Photographed by Jennifer Livingston.

For more stories like this, pick up the June issue of InStyle, available on newsstands, on Amazon, and for digital download May 17.