To her surprise, everyone was having challenges and all were excited to talk about it. She started with Little People of America, an umbrella organization that provides support to people of short stature, from information on scholarships and medical procedures to artist’s funds and specially designed kitchen appliances.

LPA gave her permission to develop a workshop at the conference in 2004 in San Francisco.

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“This is so critical,” Naccarato explains, “because it tells me that Little People do want more satisfaction in their sex life even if they are physically limited, and are receptive to change and education.”According to the Little People of America website, there are roughly 200 types of medical dwarfism.

A Little Person is usually 2’8” to 4’8” in height, but it varies.

She is a board certified clinical sexologist, has a doctorate from the Institute for Advanced Study of Human Sexuality, and certification as a sexuality educator from the American Association of Sexuality Educators, Counselors, & Therapists, where she was a speaker last month.

She also serves on the board of the American College of Sexologists, was recently featured on Playboy Radio, and is a sex and disability blogger for sex-positive pioneer Betty Dodson’s website.

Although she was working for the IRS, she had always wanted to be a social worker, until one night when she watched a program on sexual health on a cable network.

“They were talking about the Kama Sutra," she recalls.Patti Britton, a mentor to Naccarato and the co-founder of Sex Coach U.“She is the first person I know of in the Little People community who has had the courage and the wherewithal to design and implement programs and materials designed specifically for the Little People community around their specific sexual needs.”Naccarato’s doctoral studies showed that among other issues, 20 percent of Little People have trouble reaching their genitals with their own hands without using assistive devices. “Dressing sticks, bottom wipers—there are tools to help in their everyday routine to help manage all of this."The narrator was explaining that in this particular male-female intercourse position, if the man was standing and the woman was on her back on the edge of the bed, it would be less pressure on his lower back."“When I saw the program it [piqued] my curiosity,” she says.Married to an average-sized man at the time, Naccarato and her husband adapted their sex lives because she had issues with her hip—like most Little People do—leading to issues with straddling.” Most of us will have hip implants and knee implants for mobility due to bone degeneration,” she explains.“And it included terminology, words people weren’t using in their language.