By Alexa Federico, as told to Lisa Mulcahy.

I’m 27, I live in Boston, and I’m a certified nutritional therapy practitioner, an AIP coach, an author, and the owner of my own business, Alexa Federico Wellness. And I have Crohn’s disease.

I was 12 when I was diagnosed. Many of my close friends have only known me since I’ve had Crohn’s. They’ve seen me sick, so I’ve been lucky in that I didn’t have to do much in terms of telling them about it. Those friends have always been so helpful and supportive.

Several years ago, I started to have complications — three fistulas and an abscess. I did 6 weeks of antibiotics and had a drain, but it turned out surgery was what I needed, so I had a bowel resection in 2019.

Dating experiences I felt were going to be hard. I went through great insecurities about my body. I started to feel damaged, which was not fun. The bowel resection left me with a scar on my abdomen. So I really worried about intimacy: What would happen when a guy saw it? But then I realized I have to change my attitude. I just decided that the way to handle the scar, and any other worries about relationships and Crohn’s that I had, was with total honesty.

When I started to meet new guys, I quickly realized it was better to tell them sooner rather than later about having Crohn’s. Holding in the information felt like a weight, so the sooner I let it out, the better I felt. My earlier experiences with friends who were supportive just made me think, OK, I’ll just say I got this scar after my surgery, here it is, you can see it. And no one has EVER batted an eye!

That gave me a lot more confidence. I decided that I’d tell guys I really liked within one to two dates. By the third date, I feel like you kind of know enough about the person you’re with to decide whether you want to take the relationship further. Crohn’s is part of me, so of course, I’m going to talk about it.

When one man I was seeing asked about the scar, I explained the bowel surgery, how I had an infection and the doctors needed to take some parts of my intestine out. I also went on to say how it was a great decision for my health. He was genuinely interested and understanding. I never tried to cover it up or showed my insecurity about it. I think not making it a big deal helped!

To women who are intimidated by dating and intimacy because of their Crohn’s, be sure you’re with someone you feel safe with and trust. That’s the most important thing. Then, be open. Intimacy isn’t scary when you don’t feel like you have to hide something. Let your partner know what your concerns are. If you do this ahead of time, if something you feel is embarrassing happens in the moment, you’ve already talked about it.

I’ve never had a man not accept me by talking about my diagnosis. If I ever did get a bad response, I just wouldn’t move forward with that person. I believe in romance AND respect — a guy should want to learn about how to support me as I want to learn how to support him. If that’s not there, I can’t be there. I’ve learned to be a clear communicator. With my relationships, I put it all on the table. I want a man who doesn’t run away from conflict. I’ve done a lot of work on myself, and I want someone strong.

I dated a guy who was not the person he presented himself to be. He was a lot older than I thought, and that didn’t bother me as much as the fact that he was not honest about it. He was trying to look younger. And my stomach dropped. I was just like, if you fudged this, what else are you fudging? This is not the kind of relationship I want.

You should be really diligent about stopping a date in under an hour if you feel this person is not going to be good for you. For myself? Ultimately, I want a positive relationship in which I get what I need, and I give that back. THAT is romantic. I deserve that kind of love — and whether you have Crohn’s or not, you do, too.

Alexa’s commitment to honesty is the foundation of the right approach to intimacy and Crohn’s. “In terms of romantic relationships, it all starts with good communication,” says Megan Elizabeth Riehl, PsyD, clinical assistant professor of psychology at the University of Michigan Medical School in Ann Arbor. “You want to go in with the goal of sharing what you are comfortable with sharing at first. See how this person responds to you. If you have Crohn’s, there may be times when you go on a date and find yourself stuck in the bathroom for a long time. How does your date act in that situation? Is this a kind human being? Does this person show you he or she deserves to be in your life?”

That’s key — never let Crohn’s make you feel like you have to settle. “Ask yourself, do you enjoy being with this person as you talk more in-depth?” Riehl says. “Your Crohn’s diagnosis is just one part of who you are as a person. You want to have fun with the person you’re with. You want to enjoy similar interests.”

You also shouldn’t worry about limitations in relationships. “Many patients of mine with IBS express long-term concerns — can they have a healthy child, for example. IBS patients can do this, and it’s important to talk about with your doctor and your partner.” Short-term work with a mental health professional can also be helpful when it comes to developing skills to discuss personal goals when you have Crohn’s.

In the end, talking openly about the condition can help you create a strong bond. “Truth in a relationship is like peeling an onion — you’re peeling the layers, revealing yourself, and relaxing into that,” Riehl sums up. “With Crohn’s, you can help your partner understand by being truthful about what you go through.”