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Two sessions: 18 September 2018, 4 October 2018
Total approximate duration: 2 hours 45 minutes
Interviewer: Tacey A. Rosolowski, Ph.D.
For supplementary materials:
Please contact, the Historical Resources Center, Research Medical Library:
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About the Interview Subject:
Clinical psychologist Leslie Schover, PhD (b. 1952, Chicago, Illinois) came to MD Anderson in 1982 as an Assistant professor of psychology in the Department of Urology. She spent time away from the institution, serving as a staff psychologist at the Cleveland Clinic Foundation (1986-1999), then returned to MD Anderson in 1999 in the Department of Behavioral Science. She had a joint appt in Gynecologic Oncology and Reproductive Medicine, Division of Surgery.
Her research and work on interventions for cancer patients helped to launch the field of onco-fertility.
Dr. Schover retired as a full professor from MD Anderson in 2016 to focus on her startup company, Will2Love.
Major Topics Covered:
Personal background and education; gender politics and harassment in psychotherapy
Research: sex/gender in the therapeutic relationship; patient views of fertility/sexuality; interventions for onco-fertility and sexuality
Views on the evolving fields of sex therapy, onco-sexuality, and onco-fertility
Onco-sexuality and onco-fertility at MD Anderson: acceptance by patients and clinicians; strategies to build acceptance
Institutional challenges: setting up new programs, internal politics
Bringing business grants to the Department of Behavioral Science
Entrepreneurship and creating a start-up company
About transcription and the transcript
This interview had been transcribed according to oral history best practices to preserve the conversational quality of spoken language (rather than editing it to written standards).
The interview subject has been given the opportunity to review the transcript and make changes: any substantial departures from the audio file are indicated with brackets [ ].
In addition, the Archives may have redacted portions of the transcript and audio file in compliance with HIPAA and/or interview subject requests.
Interview Session One: 18 September 2018
Tracking Toward a Career in Therapy Approaches
A Focus on Sex Therapy
The Decision to Bring Sex Therapy to Oncology
Acceptance of Sex Therapy in Oncology and at MD Anderson
Issues with Multi-Disciplinary Care and Taking a Position at the Cleveland Clinic
Building a Program in Reproductive Health at MD Anderson
The Evolution of Onco-Fertility
Interview Session Two: 4 October 2018
A Landmark Conference on Cancer Survivorship and Parenthood
Three Small Business Grants to Advance Onco-Fertility
Will2Love: A Start-Up to Disseminate and Commercialize Work in Onco-Fertility
Additional Programs and Final Thoughts
Interview Session One: 18 September 2018 (listen/read)
Interview Identifier (listen/read)
Chapter 01 (Educational Path)
Tracking Toward a Career in Therapy Approaches (listen/read)
In this chapter, Dr. Schover sketches her family background and educational pathway up to her graduate education. She talks about her areas of skill, her early interest in archeology, and how her adolescent experience of being in therapy stimulated her interest in that field. She talks about influences from her father and mother, who taught her the value of being self-directed. Next, she talks about selecting her college and sketches the honor’s thesis topic she worked on at Brown University (BA in psychology, 1974): selective attention in autistic children.
Chapter 02 (Professional Path)
A Focus on Sex Therapy (listen/read)
In this chapter, Dr. Schover explains how she shifted her focus to sex therapy, an evolving field in the seventies when she entered graduate school at UCLA (MA in psychology in 1975; PhD in clinical psychology, 1979). She explains that part of her interest arose from the fact that she was sexually harassed by her honor’s thesis advisor at Brown University, an experience that raised her awareness of gender roles and created an interest in addressing them. She also notes that more and more researchers were focusing on issues of gender and sexuality. She describes her working relationship with Ken Pope, PhD. She also talks about her own research into the reaction of psychotherapists when patients would raise issues of sexuality during sessions. Next, Dr. Schover talks about her postdoctoral fellowship in the department of Psychology (Clinical) Sex Therapy and Research at the State University of New York, Stony Brook (7/1979-2/1981). She describes the atmosphere in this department, which she describes as the “Camelot of sex therapy,” and where she had real mentors for the first time.
Chapter 03 (Professional Path)
The Decision to Bring Sex Therapy to Oncology (listen/read)
Dr. Schover begins this chapter with stories about her first job, as an instructor in the Department of Psychiatry, Sleep Disorders and Research Center at the Baylor College of Medicine in Houston (3/1981-1/1982). She describes a study she conducted, looking at erections in aging men. She discusses an ethical issue that arose during a research study at Baylor and explains how her time there taught her about physiology and disillusionment. Next she explains how in 1982 she made the decision to take a position (Assistant Professor in Urology; Assistant Clinical Psychologist in Psychology, 2/1982-6/1986) at MD Anderson based on an interview with Andrew von Eschenbach, MD. She explains her strategies of transitioning to a focus on oncology, knowing little about the field. She also talks about how she presented herself and her clinical services to patients, as discussing sexuality was quite new in patients’ experience of treatment at the institution.
Chapter 04 (Overview)
Acceptance of Sex Therapy in Oncology and at MD Anderson (listen/read)
;In this chapter, Dr. Schover discusses the acceptance of sex therapy in oncology nationally and at MD Anderson. She begins by noting that in the 80s, sex therapy was seen as the latest thing, but it was not applied to chronic illnesses. In oncology at the time, only a few clinicians felt that addressing quality of life was a primary concern, although research showed that 60% of people with cancer end up with severe sexual problems that influence their quality of life. Dr. Schover sketches the types of problems that arise. Next she explains how faculty members helped her come up to speed on oncology treatments, providing her with insight into the patients’ experience of cancer. She also talks about working with patients, her passion for educating them about choices. Next, Dr. Schover discusses why clinicians do not address sexuality in their work with patients and, on the other side, why patients don’t raise the issue with their oncology team.
Chapter 05 (Professional Path)
Issues with Multi-Disciplinary Care and Taking a Position at the Cleveland Clinic (listen/read)
Dr. Schover begins this chapter by explaining why she chose to leave MD Anderson in 1986 for a position as staff psychologist at the Cleveland Clinic. She sketches the political environment in the Department of Urology that motivated her decision. Next, Dr. Schover describes her work at the Cleveland Clinic, where she began to focus on fertility issues and conducted a first, pioneering study of fertility in young cancer patients. She also co-authored a textbook on sexuality and chronic illness with Tony Thomas: this book is still in print. Dr. Schover then explains why she left the Cleveland Clinic. Ellen Gritz, PhD, the head of Behavioral Science at MD Anderson offered her a job. Dr. Schover talks about the decision she had to make between her marriage and her career and other work/life issues.
Chapter 06 (Building the Institution)
Building a Program in Reproductive Health at MD Anderson (listen/read)
In this chapter, Dr. Schover explains that Dr. Ellen Gritz hired her in the Department of Behavioral Science to bring in grants and create programs in reproductive health. She discusses projects she worked on: intervention studies for men undergoing prostate cancer treatment; effectiveness of online interventions for follow up; studies of women under 35 undergoing treatment who wanted to have children later. Dr. Schover explains the impact of her research in an evolving field and the fact that her work helped to launch the field of onco-fertility, predating even work done at the Onco-fertility Institute at Northwestern University
Chapter 07 (Overview)
The Evolution of Onco-Fertility (listen/read)
In this chapter, Dr. Schover provides an overview of the growth of the field of onco-fertility and acceptance of it within MD Anderson. She first talks about what spurred interest in the issue of fertility, citing the cancer survivorship movement as well as the adolescent/young adult movement. She sketches how the field has changed since the 1980s. She also explains how problems arose because institutions found it easy to cast onco-fertility as a “frill” rather than a service essential to cancer care; researchers were also finding it difficult to get grants to move the field ahead. Next, Dr. Schover talks about views of onco-fertility at MD Anderson. She explains that she made a proposal for a reproductive health center in 2010, gaining support from several departments and from then-president John Mendelsohn, MD. That plan never came to fruition, but funds were provided to hire faculty for a program.
Interview Identifier (listen/read)
Chapter 08 (Building the Institution)
A Landmark Conference on Cancer Survivorship and Parenthood (listen/read)
In this chapter, Dr. Schover explains that in 2004, she and others at MD Anderson wrote a conference grant to bring together basic scientists and individuals in psychological fields to discuss cancer and parenthood at a landmark conference that furthered the field of onco-fertility. She explains the issues involved in this topic and also explains that two conference participants has authored embargoed papers, attesting to the national significance of the topic. Dr. Schover explains that this conferenced spurred collaborations across disciplines and that the conference proceedings were published in 2005, the same year a follow-up conference was held. She also comments on the
Chapter 09 (Building the Institution)
Three Small Business Grants to Advance Onco-Fertility (listen/read)
In this chapter, Dr. Schover discusses three projects she developed with NCI small business grants when she returned to MD Anderson in 1999 from the Cleveland Clinic, all of which were geared to providing accurate, timely information about fertility preservation for different populations of cancer patients. The first study (1999) surveyed physicians for their attitudes and practices working with patients around the issue of sperm banking. A second part of that study involved creating interventions: guidance for both male patients and for oncology professionals to increase awareness and use of sperm banking. She talks about the challenges evaluating this study and the importance of having strong networks among clinicians to ensure a robust population for a study. Dr. Schover also discusses why MD Anderson had not invested in in-house sperm banking services. Next she talks about the second study (2004) and its focus on providing an educational and counseling tool for women with regards to sexuality and fertility. The interventions included a website and a randomized trial to determine the effectiveness of in-person counseling versus 24/7 online access to information and guides to self-help in decision making. She then explains that the third grant focused on creating a similar reproductive health resource for men. Next, Dr. Schover notes that she used an American Cancer Society grant to develop an online intervention for couples after prostate cancer treatment.
Chapter 10 (The Researcher)
Will2Love: A Start-Up to Disseminate and Commercialize Work in Onco-Fertility (listen/read)
In this chapter, Dr. Schover sketches her work with her start-up company, Will2Love. She explains that after the third business grant from the NCI came to a close, she began to explore how to create a digital health business. In 2015 the Texas medical Center was initiating the TMCx program to enhance innovation and she received special permission to take part. She talks about the process of shifting to an entrepreneurial mindset and explains why hospitals have been resistant to undertaking programs in onco-fertility and sexuality. Next, she sketches the services that Will2Love offers for both patients and providers. She also talks about work with a provider, Greenville Health System in South Carolina, a innovative, APN-directed fertility program. She talks about the lessons learned in developing both the patient and provider materials. She discusses a possible contract with MD Anderson. Next, Dr. Schover talks about what is next for Will2Love.
Chapter 11 (The Researcher)
Additional Programs and Final Thoughts (listen/read)
Dr. Schover begins this chapter by discussing two additional projects she has worked on to test online interventions for sexuality and fertility. Next she talks about “Bring It Up,” a marketing effort for Will2Love aimed at increasing the number of people who discuss sexuality with their oncology teams. She talks about the self-help tool provided on the site to give patients an action plan for discussing sexuality with their providers. Next, Dr. Schover reflects on her hopes that onco-fertility will evolve into a topic of easy discussion with patients that is fully integrated in daily care of the active cancer patient and the survivor. Finally, she reflects on her time at MD Anderson, noting that when she first came to the institution, the focus was on providing drugs and has shifted productively to greater focus on quality of life issues. She notes that she has contributed to strides made and is pleased to have been recognized as a pioneer in onco-fertility.