“I assessed the toys/and took my pick/a brand new bike,” poet Grace Cavalieri writes in her poem “Language Lesson.” “My new playmate ran crying/…Me wants the bike.”
“I felt the sweet pleasure of/superiority, the first ache/of it, age three,” Cavalieri continues. “There would be no contest/I/could play as long as I liked./I had him by the pronoun.”
I’ve been thinking lately of Cavalieri’s lovely poem of childhood joy and empowerment. Why is “Language Lesson” on my radar screen? Because, even in this age of Instagram and selfies, few things are more powerful than language. No matter how we identify by gender or sexually, we desire the pronouns and terms used to describe us to reflect our true identifies. Even as toddlers, we know: there’s power in pronouns.
As a writer, like most wordsmiths, I want to use language that most accurately and clearly reflects the people who I write about – especially the LGBTQ community. This is an interesting challenge. Language evolves every nano-sec, and there’s often disagreement within a community about what language should be used. Recently, the Associated Press addressed the evolving language around LGBTQ people and gender. On May 31, AP released its 2017 Stylebook. The new Stylebook contains changes on the language used around gender, LGBTQ people and “they,” as a “singular, gender-neutral pronoun.”
Things are changing. Yet for far too long, much of the mainstream media, and even some of the gay press, have used misleading and demeaning terms to identify transgender and gender nonconforming people. Some of this is due to confusion. As a cisgender lesbian scribe, it took me eons to get that gender and sexuality aren’t the same: to understand that, as You Tuber Brendan Jordan, who identifies as gender fluid told CBS News, “Sexuality is who you go to bed with, and gender identity is who you go to bed as.”
The new AP Stylebook explains the meaning of cisgender, transgender and intersex, and clearly states that sex and gender are different. “Not all people fall under one of two categories for sex or gender, according to leading medical organizations,” the Stylebook says, “so avoid references to both, either or opposite sexes or genders as a way to encompass all people.”
For a while, folks in our community have referred to themselves as not only LGBT (lesbian, gay, bisexual and transgender), but LGBTQ (lesbian, gay, bisexual, transgender and questioning/and/or queer). AP’s new Stylebook says that LGBT and LGBTQ are acceptable. It adds that LGBTQIA “and other variations” are permitted if used in quotes or as names as organizations. “I generally stands for intersex,” the entry says. A can stand for ally, asexual or both, it says.
Adapting to evolving language is frequently difficult. The new AP Stylebook entry on “they” as a singular pronoun brings this home. “I learned in third grade that ‘they’ refers to more than one, not a single, person,” a 69-year-old friend told me, “I love what I learned! But I guess it’ll have to change.”
Many of us know people who don’t want to be referred to as he or she – him or her. They want to be identified by a gender-neutral pronoun. The AP Stylebook is catching up with this reality. It says using “they” as a “gender neutral, singular pronoun” is acceptable if it’s essential. It doesn’t permit the use of “ze” or other gender neutral pronouns.
“The singular ‘they’ [has] been in consistent use since the 1300s and the language hasn’t fallen apart yet,” Kory Stamper, an associate editor at Merriam-Webster and author of the fascinating book “Word by Word,” emailed the Blade.
Language is so personal to us, Stamper said, “it’s the primary way that we communicate who we are and what is important to us.”
Kudos to the AP for helping us communicate who we are and what’s important to us.
[H]ave you ever wondered why men often wake up with an erection?
The morning penile erection, or as it is medically known, “nocturnal penile tumescence”, is not only an interesting physiological phenomenon, it can also tell us a lot about a patient’s sexual function.
Morning penile erections affect all males, even males in the womb and male children. It also has a female counterpart in the less frequently discussed nocturnal clitoral erection.
What causes erections?
Penile erections occur in response to complex effects of the nervous system and endocrine system (the glands that secrete hormones into our system) on the blood vessels of the penis.
When sexually aroused, a message starts in the brain, sending chemical messages to the nerves that supply the blood vessels of the penis, allowing blood to flow into the penis. The blood is trapped in the muscles of the penis, which makes the penis expand, resulting in an erection.
Several hormones are involved in influencing the brain’s response, such as testosterone (the main male hormone).
This same mechanism can occur without the involvement of the brain, in an uncontrolled reflex action that is in the spinal cord. This explains why people with spinal cord damage can still get erections and why you can get erections when not sexually aroused.
What about erections while we sleep?
Nocturnal penile erections occur during Rapid Eye Movement (REM) sleep (the phase during which we dream). They occur when certain areas of the brain are activated. This includes areas in the brain responsible for stimulating the parasympathetic nerves (“rest and digest” nerves), suppressing the sympathetic nerves (“flight and fight” nerves) and dampening areas producing serotonin (the mood hormone).
Sleep is made up of several cycles of REM and non-REM (deep) sleep. During REM sleep, there is a shift in the dominant system that’s activated. We move from sympathetic (fight and flight) stimulation to parasympathetic (rest and digest) stimulation. This is not found during other parts of the sleep cycle.
This shift in balance drives the parasympathetic nerve response that results in the erection. This is spontaneous and does not require being awake. Some men may experience nocturnal penile tumescence during non-REM sleep as well, particularly older men. The reason for this is unclear.
The reason men wake up with an erection may be related to the fact we often wake up coming out of REM sleep.
Testosterone, which is at its highest level in the morning, has also been shown to enhance the frequency of nocturnal erections. Interestingly, testosterone has not been found to greatly impact visual erotic stimuli or fantasy-induced erections. These are predominantly driven by the “reward system” of the brain which secretes dopamine.
Men don’t wake up with erections because they’ve been having sexy dreams.
Since there are several sleep cycles per night, men can have as many as five erections per night and these can last up to 20 or 30 minutes. But this is very dependent on sleep quality and so they may not occur daily. The number and quality of erections declines gradually with age but they are often present well beyond “retirement age” – attesting to the sexual well-being of older men.
It’s also important to highlight the counterpart phenomenon in women, which is much less researched. Pulses of blood flow in the vagina during REM sleep. The clitoris engorges and vaginal sensitivity increases along with vaginal fluidity.
What’s its purpose?
It has been suggested “pitching a tent” may be a mechanism for alerting men of their full overnight bladder, as it often disappears after emptying the bladder in the morning.
It’s more likely the reason for the morning erection is that the unconscious sensation of the full bladder stimulates nerves that go to the spine and these respond directly by generating an erection (a spinal reflex). This may explain why the erection goes away after emptying one’s bladder.
Scientific studies are undecided as to whether morning erections contribute to penile health. Increased oxygen in the penis at night may be beneficial for the health of the muscle tissues that make up the penis.
What does it mean if you don’t get one?
Loss of nocturnal erection can be a useful marker of common diseases affecting erectile function. One example is in diabetics where the lack of morning erections may be associated with erectile dysfunction due to poor nerve or blood supply to the penis. In this case, there’s a poor response to the messages sent from the brain during sleep which generate nocturnal erections.
It is thought nocturnal erections can be used as a marker of an anatomical ability to get an erection (a sign that the essential body bits are working), as it was thought to be independent of psychological factors that affect erections while awake. Studies have suggested, however, that mental health disorders such as severe depression can affect nocturnal erections. Thus its absence is not necessarily a marker of disease or low testosterone levels.
The frequency of morning erections and erection quality has also been shown to increase slightly in men taking medications for erectile dysfunction such as Viagra.
So is all this morning action good news?
While some men will put their nocturnal erections to good use, many men are not aroused when they have them and tummy sleepers might find them a nuisance.
Since good heart health is associated with an ability to have erections, the presence of nocturnal erections is generally accepted to be good news. Maintaining a healthy lifestyle is important in avoiding and even reversing erectile dysfunction, so it’s important to remember to eat healthily, maintain a healthy weight, exercise and avoid smoking and alcohol.
[F]or many of us, taking responsibility for our pleasure begins with healing our relationship with our body. We may think that we can experience true pleasure only when we look a certain way. When I lose ten more pounds, I’ll deserve a little pleasure. If my tan gets a little deeper, then I’ll really be able to feel good. <
Actually, the reverse is true: Opening yourself up to more sexual pleasure will make you recognize the beauty in your body as it is, and inspire you to treat it better. And here’s the thing: If you sacrifice your access to pleasure to the false belief that sexual satisfaction will find you when you are fitter or more beautiful, you will miss out on your own life. Make a decision now to stop comparing yourself to the myriad Photoshopped images of models that even models don’t look like. Instead, dedicate yourself now to finding ways to live more deeply in your body.
Sex is something you do with your body, so how you feel about and treat your body is a direct reflection of the respect you hold for your sex life. Resolve to treat your body with a little more attention and loving kindness, and it will reward you by revealing its capacity for pleasure—sexual and otherwise.
If your body needs coaxing, there is something very simple you can do to deepen your relationship with it and explore your pleasure response: masturbate. Even with all the benefits masturbation can bring to a couple’s sex life, it is still a behavior that many people are not comfortable sharing with their partners or even talking about.
In addition to the religious condemnation that has long been associated with self-pleasure, the practice was not long ago considered an affliction that medical doctors used the cruelest of instruments and techniques to control. So it’s not surprising that self-reporting of this behavior still hovers at 30% to 70% depending on gender and age.
Yet there are many benefits to a healthy dose of solo sex. First and foremost, it teaches us about our own sexual response, and personal experience is an invaluable aid when communicating with our partner about what feels good and what doesn’t. The practice of solo sex is helpful for men who have issues with premature ejaculation, as it familiarizes them with the moment of inevitability so that they can better master their sense of control. Masturbation can also be a great balancer for couples with a disparity in their sex drive, and solo orgasm can serve as a stress reliever and sleep aid just as well as partnered pleasure can.
A 2007 study in Sexual and Relationship Therapy reported that male masturbation might also improve immune system functioning and the health of the prostate. For women, it builds pelvic floor muscles and sensitivity and has been associated with reduced back pain and cramping around menses, as it increases blood flow and stimulates relaxation of the area after orgasm.
The one caveat is that masturbation, like anything else, serves us well in moderation. Becoming too obsessed with solo sex play, often enhanced by visual or digital aids, has been known to backfire and lead to loss of interest in the complexity and intensity of partner sex. There are also some forms of masturbation that can make partner sex seem less appealing because the form of self-stimulation is so different from what happens in the paired experience. If you are experiencing less desire or ability to respond to your partner, ask yourself what you can do to make your solo experience more compatible with your partner’s ability to stimulate you.
[F]irst things first, let’s clear up exactly what BDSM means: bondage and discipline (B&D); dominance and submission (D&S); sadism and masochism (S&M).
It’s split up this way because BDSM means a lot of different things to the people who identify with it. And don’t believe the 50 Shades Of Grey hype – when performed consensually, those people aren’t mentally unstable or have a history of abusive behaviour, they just have a kinkier nighttime ritual.
Another 50 Shades misconception is that BDSM involves pain or sex at all. It doesn’t (unless you both want that). The only requirement involved with BDSM is trust and consent. There is always a dominant person (gives orders, is in complete control) and a submissive participant (receives orders and does as they’re told by the dominant). EL James obviously wasn’t a fan of fact-checking.
Yet the book, which is generally looked down on by BDSM fans, has helped it become more mainstream, High Street even – some Ann Summers stores now have their own BDSM sections selling all the impedimenta you need, which, plainly, is great if you always wanted to partake but were too afraid to ask. But there’s still a slight stigma attached to it, so you’ll need to plan this carefully.
First of all, research is key. Settle in for a long session on a BDSM tube, hit a BDSM chat room (yep, they still exist), read BDSM erotic fiction – expose yourself to as much of it as you can and work out exactly what it is you like. Once you’ve got your head around it, share it with your other half. This is not the time for shock and awe – start gently, maybe showing them a video you’ve seen. Say, “Looks kind of sexy, don’t you think?” and gauge their reaction. If they’re into it, great. If not, park it. It may plant a seed in their mind that does eventually flower, it may not. You can’t force them. That’s not what BDSM’s about.
Assuming they’re happy, it’s time to introduce it to the bedroom. BDSM isn’t an impulsive act; it takes planning, research and preparation, but a good transitional device is a mask. Buy one and ask if they want to wear it/mind you wearing it during sex. It might seem trivial, but whoever’s wearing the mask (the submissive) has to put all of their trust into the person who isn’t (the dominant) and that’s where things should get sexy. If it felt good, suggest a massage with a vibrator while their eye mask is on.
If that’s the extent of your fantasy, great. Mission accomplished. But if you want to edge towards the kinkier side of things, you need to keep establishing that trust by never exploiting it, obviously, but also by having plenty of post-coital discussions about what you both liked and what else you could try. Then you need to prepare yourself. When I said BDSM wasn’t impulsive, I meant it – you need an awful lot of gear if you want to explore BDSM more broadly.
Want to tie someone up? You’ll need a specialist product that reduces the risk of rope burn. Then you’ve got to think about adjustments. Things like spreader bars (Ann Summers sells out of these every Valentine’s Day) and nipple clamps aren’t necessarily designed for pain because you can change how tightly they fasten, and some days you or they may wish to be in more or less pain than the time before. Then there’s putting on the BDSM uniform. Whether that’s just lingerie or, well, a uniform – it all takes time and a very free schedule. But if procuring the products, setting them up and getting dressed up is worked into the ritual of kinkier sex, the prep can become its own pleasure.
By now, you should be in full swing, enjoying all the safe, sexy delights BDSM can offer, whatever that might mean to you. I bet they put Christian Grey‘s efforts to shame.
Awhile back you responded to an Iraq vet who was having trouble in his marriage because he couldn’t get it up due to his PTSD (Post Traumatic Stress Disorder). I want to thank you for discussing that. It was helpful to me too. I’m an Iraq vet. I lost my right leg, to just above the knee and three fingers on my left hand to an IED. I think I’m doing ok with the physical rehabilitation. My prosthesis is state of the art and I’m even learning to run again. I joke that I’m the bionic man. Here’s what’s freaking me out though. I’m getting hit on by some really hot chicks, the kind I never could score with before Iraq. I come to discover they are hot for my leg stump. And I’m gettin all skeezed out by it. I’m passing up getting laid because this is fucking with my head. What gives with this shit?
[D]ude, you’ve stumbled upon, no pun intended, a silver lining of sorts, of being an amputee. Honestly, I’m not pulling your leg here, your good leg that is. Ok, ok really this is for real, Cade. But I think you already know that, huh?
Let’s begin with a definition. There is a fetish, or a paraphilia, if you prefer, called Acrotomophilia, or amputee love. It’s relatively rare, but there is a sizable Internet presence. You need only do a search for “amputee love” to get you started. These folks, often called devotees, are turned on by the limbless among us.
Here’s an interesting phenomenon, with the spike in seriously maimed vets returning from our numerous war zones and the media attention they’re getting these days — thanks the inadequate care some are receiving at our nation’s veteran’s hospitals — this fetish is growing by leaps and bounds.
A couple of weeks ago, I was part of a conversation with a group of gay men. We were discussing the wars in Iraq and Afghanistan and the horrific images we were seeing on the tube. Without missing a beat, a couple of the men in the group started to talk about the number of totally hot young vets they were seeing on TV. Sure they had missing limbs, but for some in the group that made them even hotter. A couple other guys were goin on and on about how they wanted to service these returning service men. Instead of the conversation weirding out the whole group, as I thought it might, most of the guys were like getting all into it.
I was being quizzed about the sexual issues, of course. Does an amputation affect a guy’s ability to get it up? …and things like that. I was totally blown away. Not by their questions, but by the fact that these men, who would otherwise be put off by a guy with a bad haircut; were beginning to fetishize seriously maimed vets. Then I thought to myself, OMG, I am watching the birth of some brand new baby devotees. And that, my friend, is how all fetishes begin.
I realize that you must be facing enormous hurtles, again no pun intended, to regain your sense of self after the disfigurement and amputations. It hardly seems fair to throw yet another curve ball your way. But, as we all know, life is supremely unfair. I suspect that you’re already feeling enough like an oddity without some chick — even a sizzilin’ hot one — coming on to you because of what you’ve lost. And that’s why I suggest you withhold judgment about all of this until you have a bit more information about this particular fetish and it’s practitioners.
Many amputees go through life without ever meeting a devotee. Others have intimate experience with these fetishists. One thing for sure, even though a devotee’s interest in you may creep you out; you can be certain that their interest is sincere. They are not like most of the other well-meaning people you’ll meet in your new life as a bionic man. A devotee will not pity or patronize you. Devotees, curiously enough, see you as more whole and desirable than those who have no missing parts. In other words, devotees are hot for you for how you are. This is not a “let’s pity fuck the gimp” sorta thing. I know this can be mind-bending, but I hope you can see the fundamental difference between the two.
Some amputee/devotee relationships are long-term, marriage and children included. Others are more recreational in nature. I suppose if you have your head screwed on right, you’ll be able to discern what might be best for you, if any of this appeals to you. Actually, in this realm, you’re absolutely no different than all your non-maimed peers. They too are trying to make sense of how love, sex and intimacy fit together.
I know some amputees are put off by devotees. They’re indignant that someone would objectify them for their stumps and not accept them as a human being first. Well, ya can hardly argue with that, can ya? But in reality, all of us do our share of objectifying. What about all the guys who flock around the blond with the big rack? You know they only see her tits and not her brain. Is the amputee/devotee thing any different? I think not.
You know how you are doing all this physical therapy to regain your ability to walk and run with your new bionic leg and foot? Well, there’s probably as much emotional and psychological therapy you need to do to adapt yourself to your new maimed-self. Part of this psychological adjustment may be embracing and celebrating the fact that you are now an object of desire for a whole new group of folks. So ok, your hotness is not the same hotness you may have had pre-Iraq, but it’s hotness nonetheless. You may not yet appreciate how a person could be sexually attracted to another person simply because of an amputation. Hell, the devotee may not even know why he or she is wired this way, but that don’t make it any less a fact. The confusion that can result from these desires or being the object of these desires can often sabotage a perfectly viable amputee/devotee sexual relationship.
Acrotomophilia, like all fetishes and paraphilias is learned behavior. Some devotees recall early childhood erotically charged encounters with women or men who were amputees. But just as plausible is that the fetish could have begun like the story I recounted at the beginning of my response — a group of people fantasizing about sex with a hot vet, who happens to be an amputee. You can see how just a little of that highly charged erotic reinforcement could turn anyone into a devotee. So it’s not so mysterious after all, is it?
I realize you didn’t choose this for yourself. But, for the most part, none of us is really in charge of what we eroticize, or what others eroticize about us. I know I nearly went to pieces the first time someone referred to me as a daddy. It wasn’t till I came to grips with the fact that I was no longer a young man, and that younger men might find me desirable, that the whole daddy thing settled in with me.
What you do with all this information, Cade, if anything, is completely up to you. Will you embrace your new bionic gimp hotness and let it take you for a ride? Or will you resist? Either way, at least you’ll be a bit more informed about what gives with this shit.
[W]e’ve all been there, feeling shy, bashful or even self-conscious due to a sexual encounter. But for some men and women, the idea of sex can be so daunting they’ll avoid it altogether.
Tara*, a 42-year-old who married young and divorced in her 30s, found herself a ‘practical virgin’ on the dating scene after finding herself single. For years, she avoided dating out of fear that she would eventually have to have sex.
“I simply couldn’t imagine stripping naked in front of a total stranger. I’d be too embarrassed,” Tara says. “My body was okay the last time I was dating, but now I’m older and I’ve had two children.”
Lacking the confidence in bed
Tara isn’t alone in finding the thought of sex incredibly intimidating. Whether it’s due to a bad experience in the past, body confidence issues, sexual dysfunction or anticipation about future sexual encounters, this is a common issue that many of us face.
According to Krystal Woodbridge, a psychosexual therapist at the College of Sexual Relationship Therapists (COSRT), finding sex intimidating can be centred around body image issues, especially for women, and how they perceive their partner wants them to look.
“Many women also don’t have the confidence to initiate sex,” says Krystal. “It’s quite common, particularly for women who struggle in this area, that they haven’t actually explored their own body through things like masturbation or understood their own sexual fantasies, sexual desires or urges.”
Many men feel that they need to perform and this constant worry over their ability in bed can lead to performance anxiety. “Men often feel like they need to act in a certain way, maintain an erection and take charge of the situation – and for some men this can be really intimidating.”
Very often people who suffer with a sexual issue, such as erectile dysfunction, premature ejaculation, vaginismus or low sexual desire, will also have problems with sexual confidence.
“Often these issues can put people off getting into a new relationship because when it comes to initiating sex, which would be something they normally do, they hold back because they don’t want their partner to know that there’s some kind of sexual problem,” says Krystal.
6 ways to overcome your sexual fear
Feeling unconfident and daunted by sex can be overcome. We spoke to Tracey Cox, sex and relationships expert about what you can do to turn this around.
1. Only have sex when you’re ready
“Forget any preconceived notions you have about having to climb into bed on date three. Have sex when you feel ready – when you know, trust and feel comfortable enough to sleep with them. Also remember, unless you’re planning on dating an 18-year-old supermodel, your new lover’s body isn’t going to be perfect either. While you’re frantically sucking in your stomach or worrying about how big your bum is, he’s nervous about the light hitting that not-so-well-concealed bald spot or wondering if the arms you’re grabbing on to aren’t as muscular as your ex’s.”
2. Think back to when you were a teenager and take your cue from there
“Start off slowly with foreplay. When you both really like each other, and are both nervous, this is the sexual equivalent of getting into the freezing swimming pool slowly rather than diving in at the deep end. The thought of having full sex after a few foreplay sessions together will feel a lot less scary.”
3. Stick to the basics at first
“Another big concern for people who find sex intimidating is: what if I don’t know what to do? Aren’t people doing stuff in bed I don’t know about? Both sexes worry about this one – and unnecessarily. The way we meet people to have sex with might have completely changed but once you’re having it, it’s pretty much the same scenario. After all, there are only so many physical sex acts you can perform and most people stick to the basics first time around. Requests for ‘kinky stuff’, if it’s going to happen, tend to happen a few months in so you’re safe for now. If they do suggest something you’re not comfortable with, simply say ‘I don’t think I’m ready for that now. Can we stick to basics until we know each other better?’.”
4. Explore your body with some solo sex
“If you’re not already doing this, start having some solo sex sessions to get your body used to the feeling of orgasm – perhaps by experimenting with sex toys. There are some good beginners’ toys you can try here. The more you explore your body and know what feels good and what doesn’t, the more confident you’ll be in bed with someone else. Sex toys are a great way to discover how your body works and what it responds to, making you sexually happier and more confident.”
5. Get your attitude right
“Sex isn’t an exam. You’re not going to be graded pass or fail (and if it feels like you are, you’re with the wrong person). So, stop stressing and thinking: ‘this has got to be perfect’. Perfect sex happens to people in movies; normal people muddle through the first time.”
6. Don’t be scared to dim the lights
“Lighting is crucial – especially if you’re body conscious. Don’t be scared to say what you need. If you want it really dark for the first time, say so. You can start turning up the dimmer switch when your confidence increases.”
[S]peaking to gay and bisexual trans men, the word “invisibility” comes up a lot. Invisibility in the bathhouse and on dating apps, invisibility among cisgender people, straight people, trans people and gay people. And, too often, invisibility in the doctor’s office.
“I have tried just going to walk-in clinics and stuff like that to ask questions or request tests,” one trans man recently told researchers in Vancouver. “And I just found the doctors were generally confused about me and my body. And I had to go into great detail. That made me not so comfortable talking to them about it because they were just kind of sitting there confused.”
“People have tried to talk me out of testing . . . saying I was low-risk behaviour,” another man told the researchers. “They didn’t understand my behaviour really. . . I’ve had practitioners as well say they don’t know what to do; they don’t know what to look for.”
Both men were speaking to researchers for a new study on the sexual health of trans men who have sex with men — a group social scientists know remarkably little about. Many of the men spoke about being on the margins of mainstream culture, gay culture and of the healthcare system.
It should be no surprise, then, that the study happened almost by accident. When PhD student Ashleigh Rich started work with the Momentum Health Study — a five-year, in-depth research project on the sexual health of men who have sex with men (MSM) conducted out of the BC Centre for Excellence in HIV/AIDS — she never intended to write a paper about trans MSM.
But a small group of trans men volunteered for the study, some pointing out ways the Momentum researchers could change their surveys to be more inclusive.
There were too few for quantitative research — only 14 — but Rich asked if they would sit down for an hour and talk about their experiences. Eleven agreed.
The result is a slim, 11-page paper that hints at a world of things we don’t yet know about transgender gay and bisexual men. We do know they form a large part of the trans population; nearly two thirds of trans men say they are not straight. We also know trans MSM participate in the same rich world of sexuality as other men who have sex with men — from dating apps to anonymous sex to sex work and a broad range of sexual behaviour.
We don’t know much about trans MSM risk for HIV; estimates range from much less than cisgender gay and bi men to somewhat more. We also don’t know much about how a combination of stigma, invisibility and limited healthcare options may be affecting trans men’s health.
Rich is cautious about drawing any broad conclusions from her study. Not only is it a tiny sample, but the men she spoke to are also mostly urban, white and educated. This study was less about answering questions, and more about figuring out which questions to ask.
A few themes, though, emerge clearly. One is that trans MSM often find themselves falling through the cracks when it comes to sexual health. Doctors are increasingly aware of how to talk to gay men, but don’t always see trans gay men as “real” MSM. They assume trans men are heterosexual, or fail to bring up sexual health altogether.
Some doctors give trans men information on PrEP — a preventative anti-HIV medication that can drastically reduce the risk of contracting HIV if taken every day — based on studies on cisgender men, without checking to see if different anatomy requires different doses. When trans men come in for HIV tests, they are sometimes urged to get pap smears instead.
“We come in with specific issues we want to talk about in a health care consult, and sometimes once people discover we’re trans they’ll want to do a pregnancy test or something,” says Kai Scott, a trans inclusivity consultant who collaborated on the study with Rich. “And we’re not there for that. They’re giving us things we don’t want, and not telling us the things we do need to know.”
Sam Larkham, a trans man who organizes sexual health clinics across Metro Vancouver with the Health Initiative for Men (HIM), says he was once referred by his doctor to a trans health care clinic that had been closed for years. Experiences like that make him think the best path for trans MSM is to rely on queer-focused health care providers like HIM.
“It would be ideal if it were the whole medical system, but that’s impossible,” Larkham says. “I think we have to look at what we can do, and that’s have specific places where we have nurses who are well trained to handle trans MSM. I think that’s the more doable thing. I would love to have every clinic be culturally competent, but that’s not the reality and never will be.”
Scott is more sanguine. He points to Trans Care BC, a provincial health program that has pushed for more education for doctors. Education needs to happen on both fronts, Scott says, among MSM organizations and in the health care system at large.
Lauren Goldman is a nurse educator for Trans Care BC. Since she was hired last fall, she’s been giving workshops to healthcare providers on how to treat trans patients. For now, though, the workshops are aimed at small groups of sexual health professionals, such as at the BC Centre for Disease Control or HIM. Goldman wants the program to expand to include everyone.
“We know trans patients are accessing care through a number of places all across the province,” she says. “We want everyone to have access to this information as soon as possible.”
Goldman says Trans Care is designing an online course that could bring trans cultural competency to primary care doctors everywhere as part of mandatory continuing education. Trans Care has also designed a primary care “toolkit” for doctors, and is in talks with UBC’s medical school about including trans-focused sexual health education for doctors in training.
Without specialized knowledge, Goldman says, there’s a lot doctors can miss. Testosterone can make vaginal tissue more sensitive and inflexible, for example, meaning trans men might have special difficulties with genital sex. Bacterial vaginosis is more common, and the usual antibiotics given to cis women may not solve the problem. Vaginal and rectal tissue may need different doses of PrEP to be effective.
And, most importantly, doctors need trans patients to know they will be heard.
“We need to be providing really obvious cues that show people that our services are trans inclusive,” Goldman says. “Including how we design our services, how we market our services, how we educate our clinicians, what signs we hang up, letting people know that our clinicians have a greater understanding of gender diversity.”
While Goldman is educating doctors, the trans men Rich studied were already very well educated about their own sexual health. They told Rich about careful risk assessments they make around sex, sharing information with other men, and advocating for STI screening to their reluctant doctors.
One man described slipping in HIV tests while getting regular testosterone-level screening: “Yeah, oh, I’m already getting blood drawn. I probably need to get tested, let’s just draw two more vials for HIV and syphilis.”
It’s not surprising that many trans men are so health-conscious, Scott says. “We’ve had to be champions of our own bodies for a while, and so that ethos carries through when it comes to health information.”
But it would be a mistake to overstate how safe trans MSM are, he adds. For one, the urban, white and well-educated men in Rich’s study may be more likely to have access to resources and care than less wealthy or more rural trans people. Also, the very reason trans MSM seem so safe might be because they aren’t getting the opportunities for sex they want.
“To some extent, we’re still on the sidelines,” Scott says. “I don’t think that systemic rejection should be the means of HIV prevention for trans and nonbinary people. We’re dealing with a lot of rejection, and so I don’t think we’ve really had the opportunity to be exposed to that risk.”
The theme of rejection is echoed frequently by the study subjects.
“I remember meeting this one guy at a friend’s party and we were flirting the whole time,” one participant recounted. “He was like, ‘Oh we should totally go for a beer’ and so we connected and then I told him I was trans and he was like, ‘Oh I’m not looking for anything.’”
“Cis men often shut down immediately, out of a sort of fear of the unknown, and being unaware of what can and can’t happen,” Scott says. “They can assume all trans guys are bottoms, which isn’t true.”
Constant rejection can wear trans men down, Larkham says. Not only does it damage mental health, but constant rejection can weaken trans men’s resolve to negotiate sexual safety.
Many trans men, the study notes, rely on online hookup sites, where they can be upfront about being trans, and avoid rejection by anyone who isn’t interested.
The burden of rejection is one reason trans MSM need better mental health services too, Larkham says. Too many men show up to sexual health clinics after being exposed to sexual risks. Mental health support, he thinks, could reach people earlier.
But again, Scott strikes a positive note. “It’s a source of celebration to me that despite huge barriers we’re still having the sex that we want,” he says.
In the end, the clearest message to emerge from Rich’s study is that there’s a lot more to learn. She hopes to get more answers from the next stage of the Momentum study, which will recruit a larger sample of MSM from across Canada. That study, she hopes, will be large enough to deliver the kind of precise, quantitative answers that this one couldn’t.
Scott is also eager to move forward.
“There’s so much you want to pack in and so much you want to report on,” he says. “There’s such a dire need to research these issues. People are really hurting, and I really feel that. But you’ve got to take it one step at a time.”
[M]illions of Americans identify as LGBTQ, and like any group, they have their own language to talk about both who they are and the challenges they face in a society that doesn’t fully accept or protect them.
If you want to be an ally, these terms might help — but be aware that many have been used derogatorily by straight, white, cisgender (defined below!) people, and were reclaimed over time by the LGBTQ community.
This list is by no means exhaustive, and some of these terms — because they are so personal — likely mean slightly different things to different people. If you’re puzzled by a term and feel like you can ask someone you love in the LGBTQ community to help you make sense of it, do it. But also be careful not to put the burden of your education on other people when there’s a whole wide world of resources out there.
Let’s get started
LGBTQ: The acronym for “lesbian, gay, bisexual, transgender and queer.” Some people also use the Q to stand for “questioning,” meaning people who are figuring out their sexual orientation or gender identity. You may also see LGBT+, LGBT*, LGBTx, or LGBTQIA. I stands for intersex and A for asexual/aromantic/agender. The “A” has also been used by some to refer to “ally.”
Speaking of intersex: Born with sex characteristics such as genitals or chromosomes that do not fit the typical definitions of male or female. About 1.7% of the population is intersex, according to the United Nations.
Sex: The biological differences between male and female.
Gender: The societal constructions we assign to male and female. When you hear someone say “gender stereotypes,” they’re referring to the ways we expect men/boys and women/girls to act and behave.
Queer: Originally used as a pejorative slur, queer has now become an umbrella term to describe the myriad ways people reject binary categories of gender and sexual orientation to express who they are. People who identify as queer embrace identities and sexual orientations outside of mainstream heterosexual and gender norms.
Sexual orientation: How a person characterizes their sexuality. “There are three distinct components of sexual orientation,” said Ryan Watson, a professor of Human Development & Family Studies at the University of Connecticut. “It’s comprised of identity (I’m gay), behavior (I have sex with the same gender) and attraction (I’m sexually attracted to the same gender), and all three might not line up for all people.” (Don’t say “sexual preference,” which implies it’s a choice and easily changed.)
Gay: A sexual orientation that describes a person who is emotionally or sexually attracted to people of their own gender; commonly used to describe men.
Lesbian: A woman who is emotionally or sexually attracted to other women.
Bisexual: A person who is emotionally or sexually attracted to more than one sex or gender.
Pansexual: A person who can be attracted to all different kinds of people, regardless of their biological sex or gender identity. Miley Cyrus opened up last year about identifying as pansexual.
Asexual: A person who experiences no sexual attraction to other people.
Demisexual: Someone who doesn’t develop sexual attraction to anyone until they have a strong emotional connection.
Same-gender loving: A term some in the African-American community use instead of lesbian, gay or bisexual to express sexual attraction to people of the same gender.
Aromantic: A person who experiences little or no romantic attraction to others.
Gender identity and expression
Gender identity: One’s concept of self as male, female or neither (see “genderqueer”). A person’s gender identity may not align with their sex at birth; not the same as sexual orientation.
Gender role: The social behaviors that culture assigns to each sex. Examples: Girls play with dolls, boys play with trucks; women are nurturing, men are stoic.
Gender expression: How we express our gender identity. It can refer to our hair, the clothes we wear, the way we speak. It’s all the ways we do and don’t conform to the socially defined behaviors of masculine or feminine.
Transgender: A person whose gender identity differs from the sex they were assigned at birth.
Cisgender: A person whose gender identity aligns with the sex they were assigned at birth.
Binary: The concept of dividing sex or gender into two clear categories. Sex is male or female, gender is masculine or feminine.
Non-binary: Someone who doesn’t identify exclusively as female/male.
Genderqueer: People who reject static, conventional categories of gender and embrace fluid ideas of gender (and often sexual orientation). They are people whose gender identity can be both male and female, neither male nor female, or a combination of male and female.
Agender: Someone who doesn’t identify as any particular gender.
Gender-expansive: An umbrella term used to refer to people, often times youth, who don’t identify with traditional gender roles.
Gender fluid: Not identifying with a single, fixed gender. A person whose gender identity may shift.
*(Note: While the previous six terms may sound similar, subtle differences between them mean they can’t always be used interchangeably).*
Gender non-conforming: People who don’t conform to traditional expectations of their gender.
Transsexual: A person whose gender identity does not align with the sex they were assigned at birth, and who takes medical steps such as sex reassignment surgery or hormone therapy to change their body to match their gender.
Transvestite: A person who dresses in clothing generally identified with the opposite gender/sex.
Trans: The overarching umbrella term for various kinds of gender identifies in the trans community.
Drag kings & drag queens: People, some who are straight and cisgender, who perform either masculinity or femininity as a form of art. It’s not about gender identity.
Bottom surgery: A colloquial way of referring to gender affirming genital surgery.
Top surgery: Colloquial way of describing gender affirming surgery on the chest.
Binding: Flattening your breasts, sometimes to appear more masculine.
Androgynous: A person who has both masculine and feminine characteristics, which sometimes means you can’t easily distinguish that person’s gender. It can also refer to someone who appears female — like Orange is the New Black’s Ruby Rose, for example — but who adopts a style that is generally considered masculine.
‘Out’ vs. ‘closeted’
Coming out: The complicated, multi-layered, ongoing process by which one discovers and accepts one’s own sexuality and gender identity. One of the most famous coming outs was Ellen DeGeneres, with “Yep, I’m gay” on the cover of Time magazine 20 years ago. Former President Obama awarded DeGeneres a Presidential Medal of Freedom in 2016, saying that her coming out in 1997 was an important step for the country.
Outing: Publicly revealing a person’s sexual orientation or gender identity when they’ve personally chosen to keep it private.
Living openly: An LGBTQ people who is comfortable being out about their sexual orientation or gender identity.
Closeted: An LGBTQ person who will not or cannot disclose their sex, sexual orientation or gender identity to the wider world.
Passing: A person who is recognized as the gender they identify with.
Down low: A term often used by African American men to refer to men who identify as heterosexual but have sex with men.
Ally: A person who is not LGBTQ but uses their privilege to support LGBTQ people and promote equality. Allies “stand up and speak out even when the people they’re allying for aren’t there,” said Robin McHaelen, founder and executive director of True Colors, a non-profit that provides support for LGBTQ youth and their families. In other words, not just at pride parades.
Sex positive: An attitude that views sexual expression and sexual pleasure, if it’s healthy and consensual, as a good thing.
Heterosexual privilege: Refers to the societal advantages that heterosexuals get which LGBTQ people don’t. If you’re a straight family that moves to a new neighborhood, for example, you probably don’t have to worry about whether your neighbors will accept you.
Heteronormativity: A cultural bias that considers heterosexuality (being straight) the norm. When you first meet someone, do you automatically assume they’re straight? That’s heteronormativity.
Heterosexism: A system of oppression that considers heterosexuality the norm and discriminates against people who display non-heterosexual behaviors and identities.
Cissexism: A system of oppression that says there are only two genders, which are considered the norm, and that everyone’s gender aligns with their sex at birth.
Homophobia: Discrimination, prejudice, fear or hatred toward people who are attracted to members of the same sex.
Biphobia: Discrimination, prejudice, fear or hatred toward bisexual people.
Transphobia: Prejudice toward trans people.
Transmisogyny: A blend of transphobia and misogyny, which manifests as discrimination against “trans women and trans and gender non-conforming people on the feminine end of the gender spectrum.”
TERF: The acronym for “trans exclusionary radical feminists,” referring to feminists who are transphobic.
Transfeminism: Defined as “a movement by and for trans women who view their liberation to be intrinsically linked to the liberation of all women and beyond.” It’s a form of feminism that includes all self-identified women, regardless of assigned sex, and challenges cisgender privilege. A central tenet is that individuals have the right to define who they are.
Intersectionality: The understanding of how a person’s overlapping identities — including race, class, ethnicity, religion, sexual orientation and disability status — impact the way they experience oppression and discrimination.
[A] month or so ago, my family had the awesome opportunity to meet Youtube vlogger, Miles McKenna. It was during this meeting that we filmed a cool episode for Miles’ new show Hella Gay on Fullscreen.
However, before Miles showed up at our house for the taping of the show, we had to sit down our kids and have a conversation because Miles is transgender. We explained to our kids as best we could about what transgender means and how Miles is trans. We then showed them wonderful Youtube videos of Miles coming out as trans and explaining his feelings and experience with his identity. From there, we let our kids watch silly videos that Miles has done to allow them to get to know Miles.
The results were fantastic. Our kids loved Miles and there was no question about Miles’ gender after that. As kids, they accepted who Miles is.
We live in a very diverse world these days, and it’s becoming increasingly clear as parents that we have a duty to prepare our kids and educate them on different things such as what each letter in the LGBTQ+ umbrella stands for. You don’t have to do it all at once and it doesn’t have to be anything extremely serious. Just take a look at our video below to see how great and easy the conversation was about “transgender” and feel free to copy it with your own kids.
And don’t forget to check us out on the newest episode of Hella Gay, here.
[H]irschfeld’s reasoning was simple: In turn of the 20th century Germany, where he lived, a law called Paragraph 175 made so-called “unnatural fornication” between men punishable by prison time.
“Magnus was gay himself,” says Undiscovered podcast co-host Elah Feder. “He was both a scientist and an activist, and he was really hoping that his science would lead to greater acceptance of gay and lesbian people.”
Hirschfeld founded what’s considered to be the first gay rights organization and established the Institute for Sexual Science in Berlin. He also gained international renown for his radical research on the biology of sexual orientation. “He was, in the 1930s, touring the world lecturing about sexuality in China and India,” says co-host Annie Minoff. “The American press actually called him the ‘Einstein of sex.’”
But as Minoff and Feder explore in a recent episode of Undiscovered, Hirschfeld’s legacy didn’t turn out quite as he’d hoped.
“Magnus was using the science at his disposal, right?” Minoff says. “So now, we might talk about genetics or even epigenetics, but back in his day, scientists could see chromosomes under the microscope, but they still weren’t sure if they had anything to do with heredity.”
“So, Magnus was really all about documenting and recording things like physical traits or behavioral traits, trying to see what gays and lesbians might have in common or might be different than the rest of the population.”
Today, some of Hirschfeld’s research comes across as antiquated, even a bit zany. In one excerpt from his book, “The Homosexuality of Men and Women,” Hirschfeld debunks an apparently long-held stereotype that gay men can’t whistle.
“This does not agree with the results of our statistics,” he wrote, explaining that in a sample of 500 gay men, 77 percent could whistle, although “only a few could truly whistle well.”
“But he found that among lesbians, the whistling arts were very strong, which was nice to hear,” Feder adds.
Other aspects of Hirschfeld’s science have better weathered the tests of time. “So, for example, he was interested in whether homosexuality ran in families,” Feder says. “You know — was it a heritable trait?”
“Or, you might remember a few years ago, there were a bunch of studies looking at the correlation between finger length ratios and sexual orientation. They seemed to find a connection in women. And he did stuff like that. He was looking at hip-to-shoulder ratios — pretty pioneering sex research.”
In 1919, Hirschfeld opened his Institute for Sexual Science, a big villa in Berlin’s Tiergarten. “They had medical examination rooms, they had a library, they had a sex museum that was apparently a big tourist attraction,” Feder says.
And, as Yonsei University history professor Robert Beachy explains, the institute also offered sex education to Germans who were queasy about publicly seeking advice.
“They had a little box at the edge of the property, and people could anonymously insert slips of paper with questions about sex or any sort of sexual issue that they had,” he says. “And then people were invited in, and these different slips of paper would be read out loud and then responded to.”
“There were questions about things like, I don’t know, [about] premature ejaculation and how effective it was to use condoms for preventing pregnancy. You know, just lots of relatively mundane questions. But it was supposed to be a public service.”
But if Hirschfeld hoped that greater scientific understanding could change Germany’s discriminatory law, Feder says things didn’t quite turn out that way in his lifetime. (Paragraph 175 wasn’t struck down until 1994.)
“It’s a nice idea,” she says, “but as we end up seeing in Magnus’ story, you can do science, you can hope that it’s going to be used in one way, and it can work out very differently.”
“And his story ultimately is a pretty tragic one.”
[S]ex is everywhere these days. Unfortunately, we often let our relationships get clouded by sexual intimacy. Sometimes being physically intimate with another person blurs our vision of how we truly feel about that individual.
Believe it or not, but you can actually make your partner want you even more in a relationship by abstaining from sex. So what does a healthy, intimate relationship, without sex look like? I have just the recipe for you.
Being able to have honest, open conversations, while maintaining eye contact and enjoying what the other person has to say is essential in creating and maintaining relationship intimacy. Once the beginning stages of that overpowering attractiveness dies down, you want to be able to carry on a conversation with the person you are with. Being vulnerable in your conversations will create a deeper intimacy as you learn to trust one another. Opening up and sharing your hopes, fears, and dreams helps intimacy develop and grow as both parties learn to trust one another more and more.
Enjoying each other’s company
If you can be comfortable together in sweatpants watching TV, or going to a black tie work function, you’re on the right track to a healthy, intimate relationship. It doesn’t really matter what you are doing together if you just enjoy being with one another. Focused one-on-one attention is a key ingredient in an intimate relationship and it must be fostered. Intimate moments can occur as you spend time together, having fun, talking, and building your relationship, but they do require intentionality to happen.
Both parties are themselves
Truly knowing the person you are with is one of the pillars in building intimacy in a relationship. While being able to be yourself will also be an important factor in your experiencing intimacy in your relationship. When you like the other person for who they are, and you feel loved and accepted just as you are, you are on the path to true intimacy.
Being a safe space
Being a comfort for your partner, whether they need to vent from a bad day or just want someone to talk to, is a sign of intimacy. When you are the one they seek out to provide that comfort, they know you are a safe place for them. You can increase intimacy even more by learning how to best comfort your partner in these situations. Learn how they want you to respond when they are upset, frustrated, or sad–listen, advise, console, hold …
Share what you like about one another
Providing positive affirmation and telling your partner specific things you like or love about them builds intimacy. It’s easy to assume that your partner knows why you like or love them, but sharing these specifics helps build closeness. Tell them you love their sense of humor or how much they care about family values. Through these interactions, we can grow a more secure emotional connection.
Think about your expectations about what intimacy in a healthy relationship looks like. Intimacy in a relationship means a deep closeness, affection, and acceptance. It’s essentially feeling comfortable and safe being completely vulnerable and real.
Make sure you don’t have a twisted view of intimacy as just being constant deep talks or long walks on the beach–because a healthy intimate relationship is so much more. A true healthy relationship is being with someone you care greatly for and are able to have open, honest communication about anything.
[W]hile the fight for LGBTQ rights might make headline news, that doesn’t mean queer education is making it into schools. For most Americans, sex ed courses barely talk about the ins and outs of being gay, bisexual, queer, or transgender, making it hard for many students to learn about themselves, their bodies, and their sexual preferences.
Many videos also explore sex ed topics through a scientific lens, explaining everything from mood swings to male erections. Seeing how public school classrooms rarely talk about these issues, and some schools are still stuck in abstinence-only mindsets, AMAZE is serving as a true trailblazer for reforming American sex education.
Location: San Francisco
I have been clean from meth for just over 6 years but was a hard-core user (injecting) from 1995 until March of 2002. Since then I have no sex drive and low self-confidence since my usage brought me to having Tardive Dyskinesia. What can I do to bring back my sex drive?
[Y]ep, seven years of slammin’ crystal will seriously fuck ya up, no doubt about it. I heartily commend you on gettin’ and stayin’ clean. CONGRATULATIONS! I know for certain that ain’t easy.
You are right to say that the residual effects of years of meth use can devastate a person’s sexual response cycle. Perhaps that’s one of the reasons people take as long as they do to rid themselves of this poison. While they are using, they are oblivious to the effects meth is having on their sexual expression.
Before we go any further, we’d better define Tardive dyskinesia for our audience. It is a condition characterized by repetitive, involuntary, movements. It’s like having a tic, but much worse. It can include grimacing, rapid eye blinking, rapid arm and leg movements. In other words, people with this condition have difficulty staying still. These symptoms may also induce a pronounced psychological anxiety that can be worse than the uncontrollable jerky movements.
That being said, there is hope for you, Augustt. Regaining a sense of sexual-self post addiction is an arduous, but rewarding task. With your self-confidence in the toilet and zero libido, I suggest that you connect with others in recovery. They will probably be a whole lot more sympathetic to your travail than others.
Try connecting with people on a sensual level as opposed to a sexual level. I am a firm believer in massage and bodywork for this. If needs be, take a class or workshop in massage. Look for the Body Electric School Of Massage. They have load of options. He has created over 100 sex education films, most of which are available at his online schools: www.eroticmassage.com and www.orgasmicyoga.com.
You will be impressed with the good you’ll be able to do for others in recovery as well as yourself. Therapeutic touch — and in my book that also includes sensual touch — soothes so much more than the jangled nerves ravaged by drug and alcohol abuse. It gives the one doing the touch a renewed sense of him/herself a pleasure giver. The person receiving the touch will begin to reawaken sensory perceptions once thought lost.
I encourage you to push beyond the isolation I know you are feeling. Purposeful touching, like massage and bodywork will also, in time help take the edge off your Tardive dyskinesia. I know this can happen. I’ve seen it happen. Augustt, make it happen!
[C]ommunication is essential in almost every aspect of our lives. But these days it can seem as though we’re more interested in social media than connecting with those we’re most intimate with. The 2014 British Sex Survey showed a shocking 61% of respondents said that it’s possible to maintain a happy relationship or marriage without sex. Whether you believe this or not, new research has emerged that shows just how important sex is for a relationship. According to lead author, Lindsey L. Hicks, more sex is associated with a happier marriage, regardless of what people say:
“We found that the frequency with which couples have sex has no influence on whether or not they report being happy with their relationship, but their sexual frequency does influence their more spontaneous, automatic, gut-level feelings about their partners,”
We spoke to Stefan Walters, Psychological Therapist at Harley Therapy London, to find out the role sex can play within a relationship and the attitude we should all be taking towards it. Here’s what he wishes we all knew:
1. It’s good to talk about sex!
Lots of clients still feel like opening up about their sex lives is a real taboo, and that sexual thoughts should be kept private and hidden away. But the truth is that sex is a huge part of who we are – it plays a vital role in determining our identities, and in shaping the relationships we choose throughout our lives – so it’s good to talk about it, and there’s nothing shameful or degrading about doing so. You might not think that your sexual thoughts are relevant to certain other issues in your life, but sometimes sharing these inner desires can really shine a light on something else that’s seemingly unconnected.
2. …but don’t JUST talk about sex
Sex is often the symptom, not the cause. Lots of people come to therapy looking to resolve a sexual issue, and often there’s a temptation to focus on that issue and not talk about anything else. But as you explore around the problem, you tend to find that what’s being played out in the bedroom is often related to other thoughts and feelings. Even something as innocuous as moving house or changing job can have an unexpected impact on libido, as attention and energy levels are focused elsewhere. So it’s really important to get the full picture of what’s going on.
3. There’s nothing you could say that would surprise your therapist
People go to therapy for all kinds of sexual issues. This might be a question of their own orientation, making sense of a certain fetish, or exploring some kind of dysfunction which they feel is preventing them from having the sex life they truly desire. No matter how embarrassed you might feel about a certain sex-related issue, your therapist won’t judge you for it, and will remain calm and impartial as you explore the problem. Sexual issues are very common reasons for people to seek therapy, so your therapist has most likely heard it all before; and however filthy or unusual you might think your kink is, someone else has probably already shared it.
4. The biggest sexual organ is the brain
People spend so much time focusing on genitals, but often forget about the brain. Sex is a deeply psychological process, and one person’s turn ons can be another’s turn offs. This is because we all get aroused by different sensory stimuli, and have a different set of positive and negative associations for all kinds of situations and events; often relating back to previous experiences. You can have a lot of fun with your body, but truly great sex needs to involve the brain as well. After all, it’s the brain that gets flooded with a magical cocktail of chemicals – dopamine, serotonin, oxytocin and endorphins – at the point of orgasm, to produce an almost trance-like experience
There’s no single definition of a good sex life
5. Sex means different things to different people, at different times
There’s no single definition of a good sex life. Sexuality is fluid, and needs and desires can change drastically from person to person, and even day to day. For example, at the start of a relationship sex is usually about pleasure and passion, but over time it can become more about intimacy and connection, and then if a couple decide to have children it can suddenly become quite outcome-focused. Sometimes people struggle to cope with these transitions, or may find that their own needs don’t match with their partners’, and this is why talking about sex is so important in relationships.
6. Don’t put it off
If you do have a sex-related worry or concern, it’s best to talk about it as soon as possible. If you don’t feel comfortable discussing it with a family member or a friend or partner, then seek out a good therapist to explore the issue with you. The longer you wait, the more it becomes likely that you build the issue up in your head, or start to complicate it even further. It’s always best to tackle issues, rather than to let them fester or be ignored. More than ever, people are talking openly about their sexual orientations and desires, so there’s no need to deal with your worries alone. Everyone deserves to feel sexually fulfilled, and that includes you.
The basic human need of intimacy does not disappear as we age however in aged care planning it is mostly overlooked and often regarded as inappropriate.
by Annie Waddington-Feather
[C]ouples in aged care facilities are being given little to no privacy in their intimate and sexual relationships, and it’s often the staff who prevent couples from having this intimacy.
A UK study involving residents, non-resident female spouses of residents with a dementia and 16 care staff, carried out last year, found feedback very different from the stereotypical assumption of older people not been sexual.
Carried out by a research team for the Older People’s Understandings of Sexuality (OPUS), some participants denied their sexuality, others expressed nostalgia for something they considered as belonging in the past, and some still expressed an openness to sex and intimacy.
More recently a New Zealand pilot study carried out by Associate Professor Mark Henrickson, from the School of Social Work, and School of Nursing senior lecturer Dr Catherine Cook explored attitudes to sexuality in aged residential care facilities.
They found the need for better understanding of the intimacy needs of older people and a significant number of staff, families and residents are managing complex situations without clear processes to protect residents’ rights and safety.
Intimacy in a care home setting is complicated. Issues include querying consent for someone who is in cognitive decline, staff managing adult children who deem their parent’s behaviour as wrong, and a lack of privacy for couples. Plus, there is a stereotype to overcome – for many sex and intimacy is associated with youth, not older people.
“We are a microcosm of an ageist culture,” says Australian expert Dr Catherine Barrett, Director, Celebrate Ageing.
Dr Barrett’s views go beyond a person’s sexuality and importance of sex, believing there should also be a focus on non-sexual physical intimacy. She highlights a study by the University of Queensland where babies were found to recover quicker if they are touched.
“We need to focus more broadly,” she says. “Some people have sexual relationships because they’re lacking skin on skin touch. Known as ‘skin hunger’ (also known as touch hunger) it is a need for physical human contact, and this can be mistaken as a need for sex.”
She cites one example of a male resident who behaved very inappropriately to any females in the room. “A massage therapist came once a week and he stopped doing what he was doing,” she says. While some residential homes do access sex workers, Dr Barret says in some cases it’s simply for a person to come over and cuddle.
Aged care advocate Anne Fairhall, whose husband of over 50 years is living with dementia and is in a care home says they both missed skin contact. And it wasn’t just between the two of them. “In an aged care home, everyone puts on rubber gloves,” she points out.
Ms Fairhall believes people living with dementia respond very well to love, affection and intimacy. “We’d gone from sleeping in one bed to sleeping in two different locations, and he asked me ‘do you still love me?’; he couldn’t comprehend why I’d put him in a home.” she says. “But it’s not just about holding his hand; it’s about having some privacy.”
“It’s also about eye contact, an arm around the shoulder and stroking his skin. It’s giving him the body language message I’m connecting with him,” says Ms Fairhall. “I’d go in later in the day, sit close to him at dinner and after he’d eaten, get him into his pyjamas, kiss, cuddle and put cheek to cheek.”
Just lying beside her husband is comforting. “Staff are surprised if they walk in and they are a bit embarrassed at first– less so now as they get to know you,” she says.
Dr Barret is calling for more training and education to be given. “We can’t point the finger and say ‘not good enough’ to aged care homes – we need to be asking how we can help,” she says.
To this end, through the OPAL (Older People And SexuaLity) Institute, Dr Barret has developed a set of tools and resources for service providers and organisations. This includes holding workshops and helping develop policies and procedures around sexuality and intimacy.
After attending one of the workshops, Victorian provider Cooinda is in the process of implementing a sexuality policy template.
“This is an important step forward in what we do and the care we give,” says April Betheras, community support, Cooinda. “We talk a lot about person centred care and we have ideas about sexuality and intimacy, but the big thing is being able to think about the whole picture. It’s about identifying with the person and having the conversation.”
She says there is more communication with residents about the subject now, but acknowledges not all residents want to participate. “While some feel that [sexual] part of their life has gone, there are other ways of being close,” says Ms Betheras. “A partner can participate in aspects of care. This is what keeps them close and feeling connected still.”
Training in sexuality and intimacy is also now compulsory for staff. “Staff feel confident in speaking about and dealing with issues. For instance if someone wants access to a sex worker, what would you do that? Who would you go to?,” says Ms Betheras. “LGBTI is also incorporated so we can consider all particular needs.”