British Columbian study reveals unique sexual healthcare needs of transgender men

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by Craig Takeuchi

[W]hile HIV studies have extensively examined issues related to gay, bisexual, and queer men, one group missing from such research has been transgender men.

Consequently, Vancouver and Victoria researchers undertook one of the first such Western Canadian studies, with the findings published on April 3 in Culture, Health, and Sexuality. This study allowed researchers to take a look at HIV risk for this population, and within the Canadian context of publicly funded universal access to healthcare and gender-related public policies that differ from the U.S.

The study states that trans men have often been absent from HIV studies due to small sample sizes, eligibility criteria, limited research design, or the misconceptions that trans men are mostly heterosexual or are not at risk for HIV. What research that has been conducted in this area has been primarily U.S.–based.

The Ontario-based Trans PULSE Study found that up to two-thirds of trans men also identify as gay, bisexual, or queer.

The researchers conducted interviews with 11 gay, bisexual, and queer transgender men in Vancouver who were enrolled in B.C. Centre for Excellence in HIV/AIDS’ Momentum Health Study.

What they found were several aspects unique to gay, bisexual, and queer transgender men that differ from gay, bisexual, and queer cisgender men and illustrate the need for trans-specific healthcare.

None of the participants in the study were HIV–positive and only two of them knew of trans men who are HIV–positive.

Participants reported a variety of sexual behaviours, including inconsistent condom use, receptive and insertive anal and genital sex, trans and cisgender male partners, and regular, casual, and anonymous sex partners.

The gender identity of the participants’ partners did influence their decisions about sexual risk-reduction strategies, such as less barrier usage during genital or oral sex with trans partners.

While trans men shared concerns about HIV and sexually transmitted infections with gay cisgender men, bacterial vaginosis and unplanned pregnancy were additional concerns.

Almost all of the participants used online means to meet male partners. They explained that by doing so, they were able to control the disclosure of their trans status as well as experiences of rejection or misperception. Online interactions also gave them greater control over negotiating safer sex and physical safety (such as arranging to meet a person in public first or in a sex-positive space where others are around).

When it came to healthcare, participants reported that regular testosterone therapy monitoring and transition-related care provided opportunities to include regular HIV– and STI–testing.

Some participants, however, experienced challenges in finding LGBT–competent healthcare services, with issues arising such as clinic staff using birth names or incorrect pronouns, insistence on unwanted pap testing, and a lack of understanding of the sexual practices of trans men.

The researchers note that these findings indicate the need for trans-inclusive services and trans-specific education, particularly within services for gay men.

Complete Article HERE!

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Sexual assault awareness | Sex in the Suburbs

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April is Sexual Assault Awareness Month — and here’s what you can do.

By

1. Believe survivors:

If someone comes to you and discloses sexual assault, believe them. Don’t ask what they were wearing. Don’t ask what they were thinking. Tell them you are sorry that it happened. Tell them it’s not their fault. And most of all, believe them.

Why?

Sexual assaults are dramatically under-reported in our society, for a variety of reasons. According to RAINN, a national anti-sexual violence organization, less than a third of sexual assaults are reported to police. One of the most prominent reasons is the concern that the survivor will not be believed. Consider the recent expose by the Salt Lake Tribune about BYU’s Honor Code, used against sexual assault survivors. More than two dozen survivors told the paper that they did not report crimes committed against them because they, the survivors, would get in trouble. Believing survivors is important.

2. Engage your voice:

Teens — lift your voice to counter any messages that any sexual assault is the survivor’s fault. Talk about consent with your friends and peers. Have speakers in to your school and other organizations to teach about consent. Don’t be silent.

Parents — talk with your teens about consent. Let them know that they can come to you safely if they are uncomfortable in a situation, even if they have broken a house rule. Think about it: Would you rather have a child who has had a few drinks call you for help and a ride, or would you rather have a child who didn’t want to get in trouble end up sexually assaulted?

Coaches — use your authority to counter cultural messages that pressuring people into sexual activity is OK. It isn’t. Make that clear with your teams and students, no matter what gender they are. Athletes are often leaders in their schools and popular. Help create an atmosphere that makes clear consent popular, too.

Fraternities and sororities — get educated and keep getting educated. Traditions can be wonderful, and they can be harmful. Make a commitment to work together in your organizations to create a healthier culture around consent, including caring for each other when alcohol is involved. Be smart. Engage your voices together.

Religious leaders — make a difference by shattering the silence so prevalent in our religious communities about talking about sex. Create healthy faith communities by having clear boundaries, smart supervision policies for children and youth, and engaging your voices in conversations around healthy relationships, communication and consent.

3. Get involved:

• Learn more by going to www.nsvrc.org to find ways to engage on social media, download posters for coloring, download postcards with healthy messages and more.

• Consider hosting a viewing and discussion of the movie “Spotlight.”

• Learn more about sexual assault, types of sexual violence, laws in Washington and the effects of sexual violence at www.rainn.org/about-sexual-assault.

Now is not the time to be silent. Engage your voice. Take action to become more aware of and to prevent sexual assault.

Complete Article HERE!

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Why Aftercare Is The BDSM Practice That Everyone Should Be Doing

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By Sophie Saint Thomas

[I]f you’re unfamiliar with the BDSM scene, you might think it’s all whips, handcuffs, and pleasurable pain, but there’s one important element that BDSM practitioners have built into their sex lives to make sure that everyone involved feels safe and cared for after play time is over: a practice known as aftercare. And whether you’re into BDSM or have more vanilla tastes, aftercare is something everyone should be doing.

In the BDSM world, aftercare refers to the time and attention given to partners after an intense sexual experience. While these encounters (or “scenes,” as they’re called) are pre-negotiated and involve consent and safe words (in case anyone’s uncomfortable in the moment), that doesn’t mean that people can forget about being considerate and communicative after it’s all over. According to Galen Fous, a kink-positive sex therapist and fetish sex educator, aftercare looks different for everyone, since sexual preferences are so vast. But, in its most basic form, aftercare means communicating and taking care of one another after sex to ensure that all parties are 100% comfortable with what went down. That can include everything from tending to any wounds the submissive partner got during the scene, to taking a moment to be still and relish the experience, Fous says.

Specifically, with regards to BDSM, the ‘sub-drop’ is what we are hoping to cushion [during aftercare],” says Amanda Luterman, a kink-friendly psychotherapist. A “sub-drop” refers to the sadness a submissive partner may feel once endorphins crash and adrenaline floods their body after a powerful scene (though dominant partners can also experience drops, Fous says).

Of course, you don’t have to be hog-tied and whipped to feel sad after sex. One 2015 study found that nearly 46% of the 230 women surveyed felt feelings of tearfulness and anxiety after sex — which is known as “postcoital dysphoria” — at least once in their lives (and around 5% had experienced these feelings a few times in the four weeks leading up to the study). Experts have speculated that this may stem from the hormonal changes people (particularly those with vaginas) experience after orgasm, but many also say that it can come from feeling neglected. The so-called “orgasm gap” suggests that straight women, in particular, may feel that their needs in bed are ignored. And Luterman says that people in general can also feel lousy post-sex if they’re not communicating about what they liked and didn’t like about the experience.

Clearly, taking the time to be affectionate and talk more after sex — a.k.a. aftercare — can make sex better for everyone, not just those who own multiple pairs of handcuffs. So what does that mean for you? It depends on the kind of sex you’re having, and who you’re having it with.

Taking the time to be affectionate and talk more after sex — a.k.a. aftercare — can make sex better for everyone, not just those who own multiple pairs of handcuffs.

Like we said, there are lots of guidelines for BDSM aftercare, specifically. If you’re having casual sex, aftercare can mean simply letting your guard down and discussing the experience, something that can be scary to do during a one-night stand. It’s definitely dependent on the situation, but Luterman says that you can just express that you had a good time and see if they’re interested in seeing you again (if those are thoughts you’re actually having). “People want to be reminded that they still are worthwhile, even after they’ve been sexually gratifying to the person,” Luterman says. If your experience didn’t go well, it’s important to voice that, too.

And those in long-term relationships are certainly not exempt from aftercare, Luterman says. It’s something couples should continue to do, especially after trying something new (such as anal sex), she says. Did the sex hurt? Do they want to do it again? What did they like and not like about it? You can’t know what your partner is thinking unless you ask them. Plus, it can be easy for long-term partners to feel taken for granted, so making sure to cuddle, stroke each other’s hair, and savor the moment after sex can make even the most routine sex feel special.

One thing we should all keep in mind? It can also be helpful to continue these conversations when everyone’s vertical (and clothed) and any post-orgasm high has faded.

At the end of the day, aftercare is just a fancy term for making sure everyone’s happy once the sex is over. And while communication needs to be happening before and during sex as well, having these discussions afterwards comes with an added bonus: You can learn from the experience so that the sex is even hotter the next time.

Complete Article HERE!

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Is I is or is I ain’t

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Name: Kate
Gender: Female
Age: 20
Location: canada
Lately I’ve been noticing I am attracted to both males and females. So I don’t know if I am a lesbian or not? Is that normal?

[P]erhaps you are unclear on the concept. If you’re attracted to both women and men, you could hardly be a lesbian, right? I mean think it through, darlin’! A lesbian, by definition, is a woman who is ONLY sexually interested in other woman. Apparently, that rules you out…unless you are simply fooling yourself about being attracted to men.

You are more likely bisexual — a rather common phenomenon in the female of the species, don’t cha know!

But, truth be told, all human sexuality is on a continuum. Probably it’s time to haul out my Handy Dandy Kinsey Scale for a look-see.

Wait, are you familiar with the Kinsey Scale? The dean of American sex research, Alfred Kinsey, and his associates developed this 0 to 6 scale as a way of classifying a person’s sexuality in terms of both behavior and fantasy.

This is what they developed.

0- Exclusively heterosexual with no homosexual behavior or fantasy.
1- Predominantly heterosexual, only incidentally homosexual — most likely in fantasy only.
2- Predominantly heterosexual, but more than incidentally homosexual — fantasy for sure and possibly behavior too.
3- Equally heterosexual and homosexual in both behavior and fantasy.
4- Predominantly homosexual, but more than incidentally heterosexual — fantasy for sure and possibly behavior too.
5- Predominantly homosexual, only incidentally heterosexual — most likely in fantasy only.
6- Exclusively homosexual with no heterosexual behavior or fantasy.

These pioneering sexologists also discovered that an individual could occupy a different position on this scale, at different periods in his/her life. It’s conceivable that one could go from Kinsey 0 to 6 in a lifetime, or just a afternoon at the Lilith Fair, if ya know what I’m gettin at. This seven-point scale comes close to showing the many gradations that actually exist in human sexual expression. Amazing, huh?

Good luck

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Is There A Vulva Version Of Morning Wood?

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By Cory Stieg

[W]hen your alarm clock rings, there’s a good chance that the only thing on your mind (besides your snooze button) is sex. People can feel very horny in the morning; John Legend even wrote a whole song about it. For people with penises, morning erections are an inevitable part of their sleep cycle, and even though a lot of people wake up with boners, it’s not always a sign that someone is aroused. But if someone with a vagina gets horny as hell in the morning, can they just blame it on biology? Maybe.

Turns out, people with vaginas also respond to their sleep cycle, and they can have increased clitoral and vaginal engorgement during the REM stage of sleep, says Aleece Fosnight, MSPAS, PA-C, a urology physician assistant and a sexual health counselor. “The clitoris has erectile tissue just like the penis, but instead of being out in the open for everyone to see, the clitoral engorgement happens internally and most women aren’t aware of the process,” Fosnight says.

Here’s how it works: During REM sleep, your body pumps oxygen-rich blood to your genital tissues to keep your genitals healthy, Fosnight says. This is also what happens when a person with a vagina gets aroused by something sexual: The erectile tissue in the clitoris becomes engorged and red because of the changes in circulation and heart rate, says Shannon Chavez, PsyD, a certified clinical sexologist. “The labia also has erectile tissue, and can become larger and more red in color as the arousal triggers a release of blood flow through the entire genital area,” she says. A person’s vagina could also get wetter or more lubricated during these bouts of arousal.

But, like penises, the changes your genitals experience at night don’t always occur because you’re exposed to something that arouses you — they just sort of happen. (Though if you woke up during one of these periods when your body thinks it’s aroused, you could subsequently feel more aroused and want to have sex, Fosnight says.)

That being said, some people do feel extra aroused in the morning, regardless of what their genitals are doing, because that’s when people’s testosterone levels peak, Dr. Chavez says. “This hormone is responsible for triggering feelings of sexual desire,” she says. You also might feel hornier in the morning because you’re more refreshed, relaxed, and comfortable than you are at night, according to Dr. Chavez. “This is the perfect formula for sexual arousal to take place,” she says, since sex at night can feel like work for some people, because you’re stressed and have used all your energy during the daytime. “There is lower tension in the morning when you are about to start the day ahead,” Dr. Chavez says.

So there you go: Women can have it all, even “morning wood.” There are tons of reasons why a person feels aroused when they do, but the time of day might have something to do with it after all. The next time you wake up with an urge to have sex, do it — morning sex is awesome, and your body knows it

Complete Article HERE!

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What’s Up With My Nips?

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Name: Dave
Gender: male
Age:
Location:
Does male nipple play excite all guys? Is there something wrong if it doesn’t?
THANKS,
Dave

[N]ipples of either the male or female variety are potential erogenous zones. The operative word in that sentence is “potential”. Not everyone has awakened his/her nipples to the delicious positive sex charge they can (and do) have. Some folks don’t know about the connection between their nipples and their cock (or pussy for that matter). Some folks are clueless because they’ve not taken the time to put 2 and 2 together, don’t cha know.

What a person to do? Simple! Spend some time wakin’ up them babies. This is where full-body masturbation comes in handy. While you’re pullin your pud; move the building sexual energy from your groin to other parts of your body — nipples, feet, ass hole, you name it.

If your nipples are particularly sensitive to start with, you may need a bit more stimulation than merely lightly stroking ‘em. Some guys find that the more erect their nip become, the more sensitive they are. No great mystery there, is suppose. To this end, some men employ some means of nipple enlargement. This might be done through clamps or suction. See Bully Nipple Clamps (C739), or a simple Snake Bite Kit (A300).

Once you got a nice nipple erections goin’ try stroin’, squeezin’ lickin’, suckin’ or even nibblin’ and bitin’ ‘em. Be sure to pay attention to the whole chest area, not just the nips.

If you’re workin’ on yourself, you will be getting immediate feedback on how it’s goin’. If you’re workin’ on someone else, or someone else is workin’ your nips — start out nice and gentle. Either you or your partner can ramp things up depending on the feedback you’re givin’ or gettin’. I always think adding different sensations like heat (candle wax) or cold (ice cubes) is a way to make things interesting. In other words, use your imagination. That’s why you have that block perched up on your shoulders.

Good luck

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What to do when your teen tells you they have a sexually transmitted infection

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[B]y now, most parents likely know that not talking about sex with their teens will not stop them from doing it. And, as a parent, you might even have done some reading on how to have The Talk with your kids. Maybe you think you’ve done everything right when it comes to having important conversations with your teen. Or maybe you’ve been avoiding the discussion because you’re not sure where to start.

No matter which category you fit into, you may still find yourself as the parent whose kid comes home and tells them they think they might have a sexually transmitted infection (STI), or that they have contracted an STI. The way you respond to that bombshell can make all the difference for your child going forward — in their relationship with you, with future partners, and with themselves. “Often, the response of the people that you confide in when you first have a diagnosis shapes how you see your condition from then on out,” says Myisha Battle, a San Francisco-based sex coach. “It’s important that parents have a response that can potentially produce a positive outcome for kids when they’re disclosing.”

That, of course, is easier said than done. Heather Corinna, founder of Scarleteen, a sex ed web site for youth, and author of S.E.X.: The All-You-Need-To-Know Sexuality Guide to Get You Through Your Teens and Twenties, says that the groundwork for a positive response begins before your child ever receives a diagnosis. In fact, the way you talk about STIs from the beginning may determine whether your child even comes to you if they’re worried about their sexual health. And that, says Corinna, includes things like not talking about any infectious illness in a stigmatized way. “The closer we get to people, the more susceptible we are to infections,” Corinna explains. So if you wouldn’t talk about getting the chicken pox or a cold from someone as something gross, you shouldn’t talk about STIs that way, either. “When STIs come up in media or if people make a stigmatizing joke, correct it,” Corinna says. “Also important is not assigning value to people who do or don’t have an STI.”

And, no matter how many safer sex conversations you have (or haven’t) had with your kid, even people who do everything right can contract an STI. “STIs can happen even if you use protection and get tested,” says Ella Dawson, a writer who was diagnosed with herpes at 20. According to the CDC, nearly all sexually active people will contract HPV in their lifetime; two in three people worldwide have herpes simplex I and half of new infections are genital. The CDC considers both chlamydia and gonorrhea to be common infections. But, as Corinna points out, “The tricky thing is that when we talk about STIs, we’re talking about easily treatable illnesses like chlamydia versus [something like] HIV.”

Something else that might affect how involved a parent is or needs to be is how a young person contracted their STI in the first place. Often, STIs are contracted during consensual sexual interactions, but they can also be contracted during abuse or an assault. Corinna says that the biggest concern that they hear at Scarleteen from teens who have STIs is that their parents or caregivers will be disappointed in them. But, more serious than that, are fears that they may be kicked out of their house for having sex. Or, “if it happens in a wanted or ongoing relationship,” says Corinna, “there is the fear that their parents will punish them by refusing to let them see the person anymore.” All of these things may prevent a young person from disclosing their status to their parent or caregiver, or to avoid seeking medical attention all together.

“Teens with STIs need two things,” says Dawson. Those things are “access to medical care, and support. Make sure that your child has gotten a quality diagnosis from a medical professional, and also make sure that they are being treated with respect by their physician,” she says. Then, bombard them with unconditional love and support. It’s also important to do what you can to avoid adding to the shame and stigma your child might already be feeling. “Believe me, they don’t need you to confirm their own feelings of shame and regret,” Dawson warns.

Of course, it’s normal for parents to panic when their kid comes to them with an unexpected revelation like an STI diagnosis, but “it’s important to keep that freak out away from your kid,” says Battle. Corinna encourages parents to put aside their emotional reaction and get themselves educated so they can best help the young person in their lives. “If you’re in denial about [your] young person having sex, try to move past it and help them with what they need. If it’s about you controlling their health care and not giving them access, fix that,” Corinna says. “If you didn’t have conversations about what it means to be sexual with someone else, it’s time to have this conversation.”

Everyone agrees that the best way to be helpful as a parent is to take your lead from your child. “If they are upset, validate that. If they don’t feel bad about it, don’t make it a big deal,” suggests Corinna. Demonizing the transmitter, especially if that person is a partner, is not a helpful tactic and may alienate your child. Also not helpful? Trying to implement behavior modifications that same day, like taking them immediately to buy condoms, because it may feel like blaming. Also, going behind the young person’s back and calling their healthcare provider or their partner or telling a co-parent without getting explicit permission are surefire ways to lose a teen’s trust.

If your child isn’t sure what their diagnosis means, it can be a great time to get educated together. If they’re unsure if they might have an STI, “ask, ‘What are your symptoms? Let’s go to trusted website and find out what next steps should be.’ Or if it’s a diagnosis, it’s still an opportunity to sit down and ask what they learned at the doctor and what they know, so you can understand the next steps,” says Battle. Check out the resources on Scarleteen, the CDC’s website, or the American Social Health Association.

If you haven’t had great sex education yourself, learn along with your teen. After there is some distance, you can initiate another conversation about safer sex and make sure your teen has access to the appropriate supplies to help them avoid an STI in the future.

At the end of the day, what’s most important is letting your child know that an STI does not change the way you see them. This “does not mean your child has erred, ruined their future, or shown their true, negative character. Anyone can get an STI, even if you’re on the Dean’s list,” says Dawson. “What’s really important is that your kid is having a respectful, consensual and healthy sex life.”

Complete Article HERE!

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Bats and BALLS

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[T]oday, we have a follow-up question from a fellow with a ball problem.

Last week this guy writes me to tell me he thinks he might have an abnormality in his nut sack. I wrote back to him: “I applaud you taking note of your balls in an inquisitive sort of way. Good for you! But you should also have at least a rudimentary understanding of your testicular anatomy. So that when you do your self-exam, you can have some sense about what it is you are examining.” To that purpose, I offered a medical diagram for him to look at. Despite my promptings to take his huevos to a doctor for a look see, he decided to write to me once again. D’oh!

Name: anoras
Gender:
Age: 47
Location: Northridge CA
Hey doc,
Thank you so much for your previous reply and for the diagram. Yes, I’ve seen it before but really didn’t look at it precisely — Ooops. So let’s see, the thing that goes into the testicles and that gangs up to the top of the testicle, that must be what I am referring to. Feeling my balls now I realize that it is at the top and not the bottom. Can I conclude that maybe I did feel it at that time on the top and thought it at the bottom, and/or that at that time maybe I my testicle turned around for some reason? Next, at the area where it is globulous, if pressure is placed on it, would it have a pain feeling rather than applying pressure anywhere else on the testicle? That is the question I’m asking, whether there are any areas on the testicle that you would naturally feel lumps and/or pain with any pressure. The next question would be if there are ways that the testicles can be turned around and when they do can they be readjusted. Thanks in advance for your understanding and great responses.

Sheesh, darling, take your nuts to a freakin’ doctor already, why don’t cha? Since I’m not there, while you root around in your groin, to see what you’re referring to, I’m not sure what you’re referring to. And even if I were there watching you poke and prod and I could feel what you feel, I wouldn’t hazard a guess about what’s going on with you. Ya know why? Because I am not a physician, that’s why!

You ask again about lumps. Here’s a rule of thumb for us all: If you got lumps of any sort see a doctor. You ask again about pressure and pain. Since I have no way of knowing what kind of pressure you are applying, all I can say is, if you’re applying lots of pressure, it’s probably gonna hurt. If your applying only light pressure and it hurts, I’d guess there’s a problem — see your doctor.

And no, I’ve never heard of inverted testicles — see your doctor!

Ok, audience, what have we learned in today’s lesson? If any of us has a concern about what we think might be an abnormality in our naughty parts…or any other part for that matter, don’t write me…especially more than once…go see the doctor. Get it? Got it? GOOD.

Good luck

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Following in the footsteps of Viagra, female libido booster Addyi shows up in supplements

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By Megan Thielking

[F]ollowing in the footsteps of its predecessor Viagra, the female libido drug Addyi has snuck into over-the-counter supplements that tout their ability to “naturally” enhance sexual desire.

The Food and Drug Administration announced a recall Wednesday of two supplements marketed to boost women’s sex drive. The supplements Zrect and LabidaMAX — both manufactured by Organic Herbal Supply — actually contained flibanserin, a medication approved by the FDA in late 2015 to treat hypoactive sexual desire disorder in women. It’s the first time federal officials have recalled a product contaminated with the drug.

“It’s the latest example of brand-new drugs being found in supplements,” said Dr. Pieter Cohen, a physician at Harvard Medical School who studies dietary supplements.

The problem has long plagued the male sexual enhancement supplement market. Viagra has turned up in dozens of over-the-counter pills that never declared they contained the drug. The FDA regularly checks supplements shipments for the presence of Viagra, and has added flibanserin into their scans since the drug was approved.

“FDA lab tests have found that hundreds of these products contain undisclosed drug ingredients,” said Lyndsay Meyer, a spokesperson for the agency.

The massive dietary supplement industry is largely unregulated. The products can be sold without a prescription in supermarkets, supplement stores, and, increasingly, online. The products currently being recalled were sold on Amazon through February.

And while supplement makers are not allowed to claim that their products cure or treat a particular condition, they are allowed to make general claims that their products support health or, in this case, promote sexual desire.

“There’s nothing that you can actually put into the pill that lives up to advertised claims, so there is this temptation to introduce a pharmaceutical drug that attempts to meet those claims,” said Cohen. Organic Herbal Supply, which is recalling its products, did not respond to a request for comment.

The FDA said it has not received any reports of adverse events tied to either of the supplements. But Cohen said they are far from safe — and argued a lack of regulation will allow those risks to remain.

“We have no idea the harms being caused by these products. As long as these products can be sold as if they improve your sexual health, there’s going to be no stopping this,” he said.

The amount of undeclared flibanserin in a supplement could vary widely from one pill to the next, as has been the case with Viagra. It’s also possible the drug could be introduced into a supplement along with other potentially libido-boosting compounds, exacerbating those effects.

“We don’t know what danger this poses because these combinations have never been studied before they’re sold to unsuspecting consumers,” Meyer said. Consumers can report adverse events tied to these or other dietary supplements to the agency online.

Cohen said the message from the recall is clear: “Consumers should just completely avoid sexual enhancement supplements. They either might be safe and don’t work, or they might work but are likely to be dangerous.”

Complete Article HERE!

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Does Morning Wood Mean Someone Wants To Have Sex?

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By Cory Stieg

[I]f you sleep in the same bed as someone with a penis, your partner’s boner poking you in the back in the morning is like a natural alarm clock: inevitable, not always welcome, and hard to snooze. And it’s not just in the morning: Men get three to five erections during one night of sleep, and each one can last between 20 and 30 minutes. But does that mean that each of those times your partner gets hard they’re turned on and want to have sex? Not exactly, and most people can’t help that they randomly get boners in the middle of the night.

The proper term for “morning wood,” or night boners, is “nocturnal penile tumescence” (NPT). Nocturnal erections seem to follow a man’s sleep cycle, and usually happen during the REM phase of sleep, says Aleece Fosnight, MSPAS, PA-C, a urology physician assistant and a sexual health counselor. “It doesn’t mean that he is aroused or had a sexual dream or fantasy, but rather [it’s] the body’s way of ensuring the penile tissue remains healthy,” Fosnight says.

So, if they’re not aroused, why exactly do people get full-fledged boners? There’s a neurotransmitter called norepinephrine, and it’s responsible for stopping blood flow from the penis, among other things, Fosnight says. “When your body goes into REM sleep, norepinephrine actually drops, causing a rush of blood flow into the penis,” she says. “The way that ‘morning wood’ happens is when you wake up during one of those REM cycles when the penis is fuller.” This might not happen every morning, because, technically, people with penises have to be experiencing REM sleep to wake up with a boner, and you usually don’t wake up during REM, because it’s the deep sleep phase. But still, morning wood is incredibly common, Fosnight says.

Some experts also say that when people with penises have a full bladder, there’s a mechanical pressure that their brain interprets as pleasurable sexual arousal, and causes an erection, says Laurie Watson, LMFT, certified sex therapist. Either way, when a person wakes up with a boner, there’s a good chance they weren’t aroused before. (Of course, that doesn’t mean they can’t become aroused once they realize they have a boner.) And this isn’t just biology’s way of messing with us; it could be evolutionary, Fosnight says.

“Most speculate that [NPT] helps to keep the penis healthy by promoting oxygen-rich blood flowing into those tissues,” Fosnight says, adding that NPT could also possibly prevent erectile dysfunction, or it could just be a sign that the penis is working normally. “Erections that occur during sleep are completely normal and happen nightly throughout a man’s life and are not caused by sexual stimulation,” she says.

And even though these boners may wake up sleeping partners in the middle of the night, NPT is considered beneficial from a sexual health perspective, too. “NPT is a wonderful thing, because it shows that a man is capable of achieving an erection organically,” says Eric Garrison, a clinical sexologist. “If he is incapable of achieving an erection with a partner, though he experiences NPT, then we would assume that there is an emotional cause for his erectile concerns.”

So, the next time your partner bumps you with their hard penis, they’re not necessarily trying to have sex, but you can consider it an opportunity to ask, “You up?”

Complete Article HERE!

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My Son Might Be Gay. What Should I Say to Him?

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There’s a reason he hasn’t come out to you yet.

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[M]aking your way through this cruel, confounding, ever-changing world is difficult. Something make you anxious this week, or any week? Lay it on me at askdaveholmes@gmail.com. I’m here to help you minimize the damage you will necessarily inflict on the world just by being alive.

So, what’s your problem?

Dave,

I have a 17-year-old son, and I am fairly sure he is gay. He is not out, although I don’t know if he might be to any close friends. What’s hardest for me as his dad is that I know that this time of life can be confusing and frustrating to any kid, and I only know the experience of a straight guy. I can’t imagine how much harder or more complicated it must be for him. I would love to be able to be more supportive of him, but I certainly am not going to confront him.
Since your column a couple of weeks ago was advice for coming out to your family, my related question is: What advice do you have for the family of someone who hasn’t yet come out?
Many thanks,

Mark

Mark, you are one hell of a father, so first and foremost: thank you. You’re attuned to your kid’s developing identity, you’re not trying to change him, and you’re considering how your words and behavior will affect him down the road. I’m not a parent, but I know these are all difficult and necessary things. You are actively improving your son’s quality of life just by thinking about them. Well done.

Here’s a story to illustrate what you should definitely not do. Years ago, when I was not much older than your son, I was at home on a Sunday night flipping through the TV channels with my mother. Not much was on: a Murder She Wrote we’d already seen; a Parker Lewis Can’t Lose she wouldn’t have understood; probably an actual opera in Italian on A&E or Bravo, because that’s actually what those networks used to give you. I paused on our local PBS affiliate, where a huge choir was singing, and after a few seconds I realized it was the Gay Men’s Chorus of some city or another doing a fundraising concert.

I stopped there, just to see what would happen. At this time in my life, I was 99 percent certain I was gay, though nowhere near ready to spring it on my parents. We had no gay people in our lives back then, no way to gauge my family’s level of tolerance. And here it was: the most passive, least courageous way I could drag the topic into the family room, kicking and singing.

We had no gay people in our lives back then, no way to gauge my family’s level of tolerance.

We watched as they delivered a rendition of what I remember as “Somewhere Over the Rainbow,” because either they or my memory are unforgivably basic. But it was gorgeous. Stirring and brave and subversive, coming as it did in a time before marriage equality was on the map, a time when you only saw gay people on the news. I got chills.

Then they finished, and my mom turned to me and said, “I really pity them.”

I switched it to Parker Lewis and left the room.

Now, I am comfortable telling you this story now because it was ages ago, she has come a long way since then, and also there’s a zero percent chance she’s ever going to read this because it’s on the computer. But it stands as evidence that sometimes saying nothing is the stronger choice

Good on you for not point-blank asking your son whether he’s gay. You are probably going to be the last person he tells. That doesn’t mean that he doesn’t trust you or that you didn’t make it an easy enough process for him. It means one simple, inescapable thing: Once you have told your dad you’re gay, there is no going back. You have given your final answer, and you are locking it in. And what if it all just lifts one day, and you wake up straight, and then you get married and have to spend your whole wedding day wondering whether your dad is thinking about what you told him that one time?

Right now, if your instinct is correct, your son is sorting through all of his competing urges and trying to determine which are his and which belong to society. Right now, everything is possible. You are probably correct that the confusion and frustration he’s experiencing is different than what you and all teenagers have gone through. But as to whether it’s harder, it’s all relative. This is the only adolescence he’s ever going to have. And as you know from personal experience, it’s not like straight teenagers are dying for their parents’ involvement in their relationships and identity development. Right now, he has to be secretive, not because he’s gay, but because he’s 17. And if his personal experience is indeed tougher than his peers’, then he will end up tougher than his peers.

I’d love to say that you should do a big, showy “Hey, I sure do like those gay people” at the dinner table. I want to tell you to find out when Brokeback Mountain is on HBO and then accidentally turn it on right at the beginning when he’s in the room. I wish it were as simple and CBS-sitcommy as invite the gay guy from work to family bowling night. But it isn’t. Don’t do any of these things. At this age, kids are not only wildly self-conscious, they are also you-conscious. They know what you’re trying to do and what you’re asking without asking. Any well-meaning attempt to raise The Topic is only going to make him more nervous.

At this age, kids are not only wildly self-conscious, they are also you-conscious.

The one thing you can do, which I suspect you’re already doing, is to make him feel like a secure and separate person. To chisel away at the shame our culture hangs on all of us. To make him strong in his opinions and choices, even when they wouldn’t be yours. Discuss the news of the day with him, and when he makes a point that differs from yours, thank him for giving you a fresh perspective. Do what you can to make him feel like he can stand on his two feet, even when he’s standing apart from you. It’s a skill he’ll need, no matter which side of the fence he eventually lands on.

No matter what you do, know one important thing: He’s 17, and he’s probably going to react by rolling his eyes and going to his room. That’s what I did when my own father subtly tried to engage with me long ago. Teens can’t help it. It is their job. But trust me: Your son is listening, and he won’t forget it. (And Dad, wherever you are: I see now what you were doing playing so much Wham! in your car, and I appreciate it.)

But again, by simply being the kind of person who asks a question like this, you are doing more than most fathers. This kid is lucky to have you. We all are

Complete Article HERE!

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How to Have a Sex Life on Antidepressants

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When quitting isn’t an option, is it possible to overcome the sexual side effects that come with an SSRI?

By Shannon Holcroft

So, you’ve finally filled the antidepressant prescription that’s been acting as a bookmark for the most recent novel you’re feigning interest in. Somewhere between missing your own birthday party and watching everyone else have fun without you, you gave in. After a few medicated weeks, things are starting to look up. Except for your sex life, that is.

Just last week, you were tied to a kitchen chair enjoying an amazing (albeit rather mournful) few minutes of escape through sex. Today, getting naked seems less appealing than all the other pressing tasks you have new-found energy to complete.

“Is it the meds, or is it just me?” you wonder as you deep-clean the fridge with new vigour. After some soul-searching, it becomes clear that you’re still the same person—just with fewer festering foodstuffs and a lot less crying.

“It must be a side effect,” you decide. But months after filling your prescription, your genitals are still giving you the physiological equivalent of 8d2cc2c1a43108301b149f7f33e1664d.png

Why Antidepressants May Be a Downer for Your Sex Life

“[Sexual dysfunction] is a difficult, frustrating, and very common issue with this class of medications,” says Jean Kim, M.D., clinical assistant professor of psychiatry at George Washington University.

Twelve percent of American adults reported filling an antidepressant prescription in the most recent Medical Expenditure Panel Survey. Not just for clinical depression, but for all kinds of off-label conditions like chronic pain and insomnia.

Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressant class. And between 30 percent and 50 percent of individuals taking SSRIs experience sexual dysfunction. Desire, arousal and orgasm may be affected by changes in function of neurotransmitters like serotonin and dopamine; the very mechanisms through which SSRIs treat depression.

How to Work Around the Side Effects

When fighting to survive a potentially fatal mental illness, there are often more important concerns than getting it on. It’s frequently not an option to stop taking life-saving medication to avoid side effects. So what’s a sexual being to do?

Despite SSRIs being pretty pedestrian, there’s no concrete answer to addressing sexual side effects. “Unfortunately, not much is reliably effective to deal with this [sexual dysfunction],” Dr. Kim notes.

This may sound pretty gloomy, but there are plenty of things you can try to bring sexy times back around. “Don’t hesitate to bring up the issue with your prescribing clinician, as there might be some helpful interventions available,” says Dr. Kim.

Here are other ways to work around the sexual side effects of antidepressants:

1. Time It Right

“Some literature advises trying to have sexual activity when the serum level of a daily antidepressant might be lowest in the bloodstream,” says Dr. Kim. In other words, the ideal time to get it on is right before you take your next daily dose.

If your dosing schedule makes it tough to pencil in sexual activities, chat with your clinician about changing the time of day you take your meds. In many cases, there’s room for flexibility.

“This would not work much with some SSRIs that have a longer half-life like fluoxetine (Prozac),” Dr. Kim adds. Those taking antidepressants that exit the body quickly, like Paxil and Zoloft, could be in luck.

2. Switch It Up

Switching to a different medication, with the support of your prescribing clinician, may make all the difference. Certain antidepressants have a greater incidence of sexual side effects than others. Commonly prescribed SSRIs associated with a high frequency of sexual dysfunction include paroxetine (Paxil), sertraline (Zoloft) and fluoxetine (Prozac).

Besides exploring the SSRI class, venturing into atypical antidepressant territory is another option. Buproprion (Wellbutrin) is an atypical antidepressant observed to present the lowest sexual side-effect profile of all antidepressants.

It may take some trial and error, mixing and matching to identify what works best for you, but it will all be worth it when you can [insert favorite sex act here] to your heart’s content again.

3. Augment

Some treatment add-ons may act as antidotes to SSRI-induced sexual dysfunction. “Supplementing with other medications that have serotonin blocking effects (like cyproheptadine [Peritol] or buspirone [Buspar]) or enhance other neurotransmitters like dopamine (like Wellbutrin) might help,” says Dr. Kim. She is quick to note that these findings are yet be confirmed by “larger-scale randomized controlled clinical trials.”

“Another common strategy is to prescribe erectile dysfunction drugs like sildenafil (Viagra) and the like for as-needed use before activity,” says Dr. Kim. Viagra has been found to reduce sexual side effects, even if you’re not in possession of a penis. In Dr. Kim’s clinical experience, “[Viagra] seems to help in more than a few cases.” Discuss with your doctor before adding any more medications to the mix.

4. Exercise

Now’s the time to take up aquacycling, indoor surfing sans water or whatever fitness fad tickles your fancy. Keeping active could be the key to preventing sexual dysfunction caused by SSRIs.

“Sometimes sexual dysfunction is not just a primary SSRI drug side effect but part of underlying depression/anxiety as well,” Dr. Kim explains. “Anything that helps enhance overall blood circulation, mood and libido might be helpful, such as exercise.”

Complete Article HERE!

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Married LGBT older adults are healthier, happier than singles, study finds

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Same-sex marriage has been the law of the land for nearly two years — and in some states for even longer — but researchers can already detect positive health outcomes among couples who have tied the knot, a University of Washington study finds.

For years, studies have linked marriage with happiness among heterosexual couples. But a study from the UW School of Social Work is among the first to explore the potential benefits of marriage among LGBT couples. It is part of a national, groundbreaking longitudinal study with a representative sample of LGBT older adults, known as “Aging with Pride: National Health, Aging, Sexuality/Gender Study,” which focuses on how historical, environmental, psychological, behavioral, social and biological factors are associated with health, aging and quality of life.

UW researchers found that LGBT study participants who were married reported better physical and mental health, more social support and greater financial resources than those who were single. The findings were published in a February special supplement of The Gerontologist.

“In the nearly 50 years since Stonewall, same-sex marriage went from being a pipe dream to a legal quagmire to reality — and it may be one of the most profound changes to social policy in recent history,” said lead author Jayn Goldsen, research study supervisor in the UW School of Social Work.

Some 2.7 million adults ages 50 and older identify as lesbian, gay, bisexual or transgender — a number that is expected to nearly double by 2060.

Among LGBT people, marriage increased noticeably after a 2015 U.S. Supreme Court ruling legalized same-sex marriage nationwide. A 2016 Gallup Poll found that 49 percent of cohabiting gay couples were married, up from 38 percent before the ruling.

For the UW study, more than 1,800 LGBT people, ages 50 and older, were surveyed in 2014 in locations where gay marriage was already legal (32 states and Washington, D.C.). About one-fourth were married, another fourth were in a committed relationship, and half were single. Married respondents had spent an average of 23 years together, while those in a committed, unmarried relationship had spent an average of 16 years. Among the study participants, more women were married than men, and of the respondents who were married, most identified as non-Hispanic white.

Researchers found that, in general, participants in a relationship, whether married or in a long-term partnership, showed better health outcomes than those who were single. But those who were married fared even better, both socially and financially, than couples in unmarried, long-term partnerships. Single LGBT adults were more likely to have a disability; to report lower physical, psychological, social and environmental quality of life; and to have experienced the death of a partner, especially among men. The legalization of gay marriage at the federal level opens up access to many benefits, such as tax exemptions and Social Security survivor benefits that married, straight couples have long enjoyed. But that does not mean every LGBT couple was immediately ready to take that step.

According to Goldsen, marriage, for many older LGBT people, can be something of a conundrum — even a non-starter. LGBT seniors came of age at a time when laws and social exclusion kept many in the closet. Today’s unmarried couples may have made their own legal arrangements and feel that they don’t need the extra step of marriage — or they don’t want to participate in a traditionally heterosexual institution.

Goldsen also pointed to trends in heterosexual marriage: Fewer people are getting married, and those who do, do so later.

“More older people are living together and thinking outside the box. This was already happening within the LGBT community — couples were living together, but civil marriage wasn’t part of the story,” she said.

The different attitudes among older LGBT people toward marriage is something service providers, whether doctors, attorneys or tax professionals, should be aware of, Goldsen said. Telling a couple they should get married now simply because they can misses the individual nature of the choice.

“Service providers need to understand the historical context of this population,” she said. “Marriage isn’t for everyone. It is up to each person, and there are legal, financial and potentially societal ramifications.” For example, among the women in the study, those who were married were more likely to report experiencing bias in the larger community.

At the same time, Goldsen said, single LGBT older adults do not benefit from the marriage ruling, and other safeguards, such as anti-discrimination laws in employment, housing and public accommodations, are still lacking at the federal level.

Over time, Goldsen and colleagues will continue to examine the influence of same-sex marriage policy on partnership status and health.

The study was funded by the National Institutes of Health and the National Institute on Aging. Other researchers were Karen Fredriksen-Goldsen, Amanda Bryan, Hyun-Jun Kim and Sarah Jen in the UW School of Social Work; and Anna Muraco of Loyola Marymount University.

Complete Article HERE!

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Reality Check: Anal Sex

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[F]irst it was shocking, then it was having a cultural moment, now it’s practically standard in the modern bedroom repertoire—or so a quick scan of any media, from porn to HBO, will tell you. But the reality about anal is not, actually, that everyone’s doing it, says research psychoanalyst and author Paul Joannides, Psy.D., whose comprehensive book on sexuality, The Guide to Getting it On!, is used in college and medical school sex-ed courses across the US and Canada. The book is amazing not just for its straight-up factual information on practically any aspect of sex you can think of, but also for its easy, nonjudgmental, at-times humorous tone.

The CDC reports that the number of heterosexual men and women who’ve tried it vacillates between 30 and 40 percent (oddly, the CDC doesn’t report on how many homosexual men have tried it, except in a statistic that weirdly combines it with oral). If anal turns you on, you are definitely not alone, but its prevalence doesn’t change the fact that it’s the riskiest sexual behavior in terms of HIV and other STDs. Here, Joannides talks us through the realities of making anal both as safe and as pleasurable as possible.


A Q&A with Paul Joannides, Psy.D.

Q

When did heterosexual anal start to become a thing?

A

In the 80’s, I remember hearing from a friend that he had a videotape of anal porn. This seemed shocking at the time. (This was pre-Netflix: Everything was on videotape, from porn to Disney movies to highlights from the Olympics. Video rental stores were everywhere.) I’m not sure there are too many middle schoolers today who would be shocked or even surprised to watch anal sex on Pornhub or Xhamster.

Since porn became as easy to access as YouTube, porn producers have had to fight for clicks, and so porn has become more extreme. I’d say that by 2005, porn had totally blurred the distinction between a woman’s anus and vagina. This wasn’t because women were begging their lovers for anal, it’s because porn producers were afraid you’d click on someone else’s porn if they weren’t upping the ante in terms of shock value.


Q

Does the popularity of anal in porn reflect reality in both homosexual and heterosexual couples?

A

No. There are some couples who enjoy anal sex a lot, maybe 10 percent to 15 percent of all straight couples. But if you ask them how often they have anal vs. vaginal intercourse, they’ll say maybe they have anal one time for every five or ten times they have vaginal intercourse. We occasionally, as in once a year, hear from women who say they have anal as often as vaginal, but that’s unusual.

As for gay men, statistics vary widely, and studies aren’t always consistent in how they collect data—some might be looking at different levels of frequency, i.e. have you had anal once in the past year, or do you have it regularly? I’ve seen studies suggesting that 65 percent of men have anal sex, and others that suggest the figure is less than 50 percent. So, I don’t have exact figures for hetero or homosexual couples, but there is data suggesting that a good percentage of gay men would rather give and receive blowjobs than have anal sex.


Q

How should we modify the anal sex we see modeled in porn to best suit an in-real-life couple?

A

The way the rectum curves shortly after the opening tells us we need to make a lot of adjustments for anal to feel good. Also, the two sets of sphincter muscles that nature placed around the opening of the anus to help humans maintain their dignity when in crowded spaces (to keep poop from dropping out) mean there’s an automatic reflex if you push against them from the outside.

So one of the first things a woman or man needs to do if they want to be on the receiving end of anal sex is to teach their sphincter muscles to relax enough that a penis can get past their gates. This takes a lot of practice.

Also, unlike the vagina, the anus provides no lubrication. So in addition to teaching the sphincters to relax, and in addition to getting the angle right so you don’t poke the receiver in the wall of the rectum, you need to use lots of lube.

They show none of this in porn. Nor do they show communication, feedback, or trust. Couples who do not have excellent sexual communication, who don’t freely give and receive feedback about what feels good and what doesn’t, and who don’t have a high level of trust should not be having anal sex.


Q

What are the health risks of anal?

A

A woman has a 17-times-greater risk of getting HIV and AIDS from receiving anal intercourse than from having vaginal intercourse. So your partner needs to be wearing a condom and using lots of lube, unless both of you are true-blue monogamous, with no sexual diseases. Any sexually transmitted infection can be transmitted and received in the anus. Because of the amount of trauma the anus and rectum receive during anal intercourse, the likelihood of getting a sexually transmitted infection is higher than with vaginal intercourse.

Unprotected anal sex, regardless of whether it is practiced by straight or gay couples, is considered the riskiest activity for sexually transmitted diseases because of the physical design of the anus: It is narrow, it does not self-lubricate, and the skin is more fragile and likely to tear, allowing STDs such as HIV and hepatitis easy passage into the bloodstream.


Q

Are those risks all mitigated by the use of condoms and lube, or are there still issues, even beyond that?

A

The risks are substantially reduced by the use of condoms and lube as long as they are used correctly, but you won’t find too many condoms that say “safe for anal sex” because the FDA has not cleared condoms for use in anal sex. That said, research indicates that regular condoms hold up as well as thicker condoms for anal sex, so there’s nothing to be gained from getting heavy-duty condoms.

As for using the female condom for anal sex—studies report more slippage and more pain than with regular condoms.

Do not use numbing lube, and do not have anal sex while drunk or stoned. Pain is an important indicator that damage can occur if you don’t make the necessary adjustments, including stopping. If there is pain, perhaps try replacing a penis with a well lubed and gloved finger. The glove will help your finger glide more easily, and might be more pleasurable for the person on the receiving end. Also, this allows a woman to do anal play on a male partner. (When it comes to anal sex, what’s good for the goose should be good for the gander.)


Q

Are there known health consequences of anal practiced over the long-term? Can you do it too much?

A

One of the urology consultants for my book believes that unprotected anal sex can be a way for bacteria to get into the man’s prostate gland. He prefers the person with the penis that’s going into the other person’s butt use a condom.

Also, small chunks of fecal matter can lodge into the man’s urethra. So if the couple has vaginal intercourse following anal intercourse without a condom, the male partner should pee first in addition to washing his penis with soap and water.


Q

Do pre-anal enemas make a difference in terms of health safety? What about preventing accidents?

A

I know of no studies on the relationship between pre-anal enemas and health outcomes. As for its general wisdom, people seem as divided on that as on politics in Washington. So I would say, to each her own. Also, some people use a “short shot,” which is a quick enema with one of those bulb devices instead of using a bag and going the full nine yards. In any case, accidents are likely to happen at one time or another.


Q

What tests should people be getting if they practice anal?

A

There’s “should” and there’s reality. If I were on the receiving end of anal sex, I would want to be sure my partner did not have HIV before I’d even let him get close to my bum with his penis.


Q

Probably more people try anal today than in the past—are there ways to make a first experience a good one?

A

Both of you should read all you can about it first. Spend a few weeks helping the receiving partner train her/his anal sphincters to relax. Make sure you and your partner have great sexual communication, trust, and that you both want to do it, as opposed to one trying to pressure the other, or not wanting to do it but doing it because you are afraid your partner will find someone else who will. Do not do it drunk or stoned, and do not use lube that numbs your anus. If it doesn’t feel good when it’s happening, stop.


Q

Do people orgasm from anal stimulation? Is it common or uncommon?


A

Some women say they have amazing orgasms from anal, but usually they will be stimulating their clitoris at the same time.


Q

Does it usually take a few tries to enjoy anal? Are there positions that make it easiest?

A

It depends on how much you are willing to work on training the receptive partner’s anal sphincters to relax, how good your communication is, how much trust there is, and probably on the width or girth of the dude’s penis. Common sense would tell you it should go way better if a guy is normal-sized as opposed to porn-sized.


Q

What should we be telling our kids about anal?

A

We don’t tell them about the clitoris, about women’s orgasms, about masturbation, about the importance of exploring a partner’s body, and learning from each other. We don’t tell them that much of what they see in porn is unreal, and we don’t talk to them about the importance of mutual consent. So I don’t see anal being at the top of most parents’ “should talk to our kids about” lists. There are more important things we need to be talking about first.

Paul Joannides, Psy.D. is a psychoanalyst, researcher, and author of the acclaimed Guide to Getting it On!, which is now in its ninth edition and is used in college courses across the country. He’s also written for Psychology Today Magazine and authors his own sex-focused blog, Guide2Getting.com. Dr. Joannides has served on the editorial board of the Journal of Sexual Medicine and the American Journal of Sexuality Education, and was granted the Professional Standard of Excellence Award from The American Association of Sex Educators, Counselors and Therapists. Joannides also lectures widely about sex and sexuality on college campuses.

Complete Article HERE!

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