NEW YORK — There’s no mistaking the elfin figure in the size-4, blue suede mocs who answers the door to apartment 10-O. This despite the fact that her hair, only recently lifted from the pillow, is uncharacteristically swept up like a kewpie doll’s caught in a tornado. Or that, standing 4 foot 7, she might easily be overlooked by a visitor drawn to the panoramic view of the Hudson River that fills the living-room window.

But there will never be any confusing — and most definitely, no ignoring — that voice.

“Good!” Ruth Westheimer declares by way of a greeting in the singular guttural trill once described as equal parts Grandma and Freud. “You don’t have a photographer, so I don’t comb my hair!”

As the celebrated sex therapist nears her 84th birthday this week, the voice has aged but certainly not mellowed, so that it now sounds even more the way you imagine the father of psychoanalysis would if he were alive, female and insisting you try a piece of chocolate rugelach in upper Manhattan’s Washington Heights.

When Westheimer — who fled Nazi Germany as a child — reached the U.S. in 1956, people told her she had to escape that accent. But with a job that paid $1 an hour and a baby daughter to care for, she had neither the money nor the time for speech lessons. Now, Westheimer’s delight of the moment (one she’ll point out repeatedly today to those she meets) is that an actress who will soon play her on stage is paying a dialect coach so that she can sound just like Dr. Ruth.

“It’s nice to be Dr. Ruth,” she says. “Put that down.”

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It’s been nearly 32 years since Westheimer broke into late-night New York radio with “Sexually Speaking,” launching a career as confider-in-chief to Americans who, it seemed, had been yearning to share their sexual doubts and fears. The voice that Westheimer found on radio, and in the books and television shows that followed, pushed the boundaries of popular culture, declaring it not just safe, but healthy, for people to speak explicitly about their sex lives.

The timing was opportune, coming just as fears began to explode about a new scourge called AIDS. But so much has changed since then; the country entered the age of Viagra and Internet porn, sexting and gay marriage. Can an octogenarian grandmother who has never learned to use a computer, adapt to the changing times?

A generation after the country embraced the Ruthian ethic of sexual honesty and moved on, what’s left for Dr. Ruth to talk about?

———

“Can you hear me in the back?”

It’s just after 1 p.m. and Dr. Ruth has again claimed a spot in front of a microphone. Years ago, when she taped her weekly radio show on Tuesday afternoons, employees at NBC studios broke away from their jobs to listen in. Today, though, it’s the mic, atop a small stage in a Manhattan town house that is home to the National Council of Jewish Women, that isn’t working.

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“We can’t even hear you in the front,” a woman calls from the second row.

Like today’s speaker, she and most others in the audience for this “lifelong learning” forum are female, Jewish and old enough to be well acquainted not just with grandmothering, but also widowhood. A couple arrive in wheelchairs and a few more lean in on walkers. Eventually the microphone cooperates, and Westheimer sets out ground rules.

“Here’s what we’re going to do. We’re going to talk about sex,” she announces. “I don’t think these walls have ever heard the words I’m going to use. Can you all say sex?”

“SEX,” the rows of grandmas respond, somewhat sheepishly.

“Can you all say ‘orgasm’?”

“ORGASM,” they reply, much louder now, the room filled with laughter.

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With the ice broken, though, Westheimer begins by talking not about lust, but about herself. It is an only-in-America-by-way-of-somewhere-else tale, one that draws nods of self-recognition from many in the room.

Westheimer fled Germany at 10, when her parents secured a spot for her on a train taking 100 Jewish children to refuge in Switzerland. Her last memory of home is seeing the faces of her mother and grandmother slip away as the train departed Frankfurt Hauptbahnhof. Both her parents were murdered in the Holocaust.

Raised in a Swiss orphanage, she left at 17 for what was then Palestine, joining the Jewish paramilitary Haganah and training as a sniper. Westheimer’s given first name is Karola, but Israelis deemed that too German. She became Ruth, but kept K as a middle initial in the hope that if anyone from her family had survived the Nazis, they might be able to find her.

A few years later, she moved to France to study at the Sorbonne and teach kindergarten. Reaching New York in the 1950s, she settled in the same upper Manhattan enclave of German Jews that had taken in future Secretary of State Henry Kissinger and his parents. She married, became the mother of two and earned a doctorate in the interdisciplinary study of the family. Her research tracked contraceptive usage among 2,000 women.

She might have stuck to academia and counseling if a New York radio executive, bound by law to broadcast public affairs programs, hadn’t gone looking for help addressing sex education on the air. On a Sunday in 1980, at quarter after midnight, the baroque notes of a piccolo — a tune chosen by the cantor at Westheimer’s synagogue — heralded the arrival of a voice synced with a sexual revolution come of age.

“No one captured the imagination of the country like she did,” says Pepper Schwartz, a professor of sociology at the University of Washington and the author of numerous books on sex and relationships. “That sort of mature, whimsical voice that she had, reassuring and knowledgeable, talking to you like your fantasy grandmother would … really gave the country permission to have this dialogue in a new way.”

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In the years since, “there’s been a generation of young people that have sort of taken the message and run with it,” Schwartz says. Americans began exploring the possibility that recreational sex could also be responsible sex. More people embraced oral sex, then debated whether it counted the same as intercourse. In her talk this afternoon, Westheimer confesses that when she read a section of her latest book contributed by a co-author gynecologist about the increasingly common practice among women of shaving pubic hair, she found herself blushing.

“Certain things have not only caught up, but they’ve passed her in some sense,” says Pierre Lehu, who has worked closely with Westheimer for 30 years, co-authoring many of her books and now tweeting on her behalf.

On those early broadcasts, Westheimer repeatedly counseled listeners to make sex part of a committed relationship, advocating monogamy and marriage. That message now sounds either timely or quaint, depending on your point of view, in a day when people have blind trysts via cell phones. But Dr. Ruth is not changing her pitch.

“I have been old-fashioned and a square and I’m still old-fashioned and a square,” she says during a conversation in her living room, leaning back on a pillow with “LOVE” stitched across the cover. “In our culture, most people want to have a significant other that means something to them in their lives.”

She deplores sexting as a “catastrophe,” and warns that men who rely on Viagra will find their advances rejected unless they also remember their partners’ birthdays and anniversaries.

At the end of her talk at the National Council, the questions are fairly tame. Asked for advice on how to find a man, Westheimer — whose husband, Fred, died in 1997 — says: “If I had an answer to that, at first I would take the guy for myself.”

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After posing for photos and signing copies of her newest book, Westheimer heads for a car waiting outside, leaving her fellow grandmothers to take stock of the message and its messenger.

“She’s still exciting because she’s touching a topic that is still taboo,” says Mildred Trencher, a retired school teacher and playwright who, asked about her age, says “I’ll never see 81 again.”

Others, though, say that, given how much has happened in the past 30 years, the therapist who showed Americans how to be honest about sex missed the chance to address this moment. To be a senior woman today means worrying about catching a sexually transmitted disease from widowed men who patronize prostitutes, notes one. It means not knowing what to say to adult grandchildren who have moved in with you after college and sometimes don’t come home until the wee hours, another says.

Westheimer’s talk “was interesting, but not where I’d say ‘Oh my God, it was a revelation,’” says Dolores Diller, a grandmother who lost a son to AIDS. “No, it wasn’t.”

———

In Dr. Ruth’s apartment, tucked between photos of her together with Paul McCartney and Bill Clinton, alongside shelves whose volumes include the “Kama Sutra” and her own work translated into Japanese, she keeps a pair of prized collections.

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One is a village of dollhouses, filled with tiny furniture, even candles. After the Nazis stole her family and her childhood, Westheimer says, she grew up wanting nothing so much as to control her own life. The tiny houses allow her to play out that wish, writ small.

The other collection consists of dozens of turtle figurines, fashioned from crystal and ceramic. Explaining why she likes them, Westheimer points out that in real life, turtles can always withdraw into their shells to avoid the world passing by outside.

But “if that turtle wants to move, it has to stick its neck out,” she says. “That’s certainly me.”

It’s been years since Dr. Ruth’s last television or radio series. She knows reality television is in vogue, but says she’d never agree to such a show because it would amount to playing with people’s minds without any chance of follow-up care. She sees just a few patients for private counseling now, keeping in-demand evening hours free for dinners with friends, charitable events, music and theater.

But she can’t stop sticking her neck out.

There’s the new book, her 36th, a women’s guide to sexual health. She has a syndicated column and serves as executive producer of a documentary series. She’s putting her name on a wine, Dr. Ruth’s Vin D’Amour. Next fall, she plans to teach a class on families and television at Columbia University. But before that, she’s heading to Israel to deliver a lecture on “The Future of Sex.” In late June, Westheimer plans to be in the audience when actress Debra Jo Rupp stars in a one-woman play about Dr. Ruth’s life, slated for the Barrington Stage Company in Pittsfield, Mass.

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At home, Westheimer is a blur of demands and doting, wisdom and wisecracks. It starts again when the phone rings. If it doesn’t, she dials.

“I go over there and spend a few hours and it’s like having a 4-year-old running around all over again,” says Mark St. Germain, the playwright of “Dr. Ruth: All the Way.” “She never stops.”

Westheimer says she wouldn’t have it any other way. She fondly repeats an aphorism she once heard: “Never retire, just rewire.”

“What am I going to do, sit with all the old people?” she asks, in a conversation about people who retire to Florida. “What, am I going to play mahjong or canasta or go for an early-bird dinner?”

After dinner at a French restaurant in midtown, Westheimer finds her seat for another of St. Germain’s plays, based on a scene he imagined from the last days of Sigmund Freud. Afterward, the playwright and his newest inspiration join the cast on stage, fielding questions from the audience. It’s been a full day, but Westheimer is clearly enjoying herself, debating the merits of Freud, chatting with admirers and posing for pictures.

A 20-something stage worker with spiky hair, too young to recall the days when the country had never heard a voice like Westheimer’s, asks if he can join her for a photo. She beckons him over to Dr. Freud’s couch, her mocs dangling several inches above the floor.

“Sit right here,” she instructs, patting the spot next to her on the couch. “Put your arm around me.”

The young man does just as the doctor ordered. Then he takes the lead, wrapping Westheimer in a hug and leaning over to plant a kiss atop her head. She breaks into a wide grin.

“It’s good to be Dr. Ruth,” she says.


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