Category Archives: Sex Therapy

Fear of Sex, Lasting Longer, Performance Anxiety, Preorgasmic Women, Sensate Focus

The way we teach sex-ed is old and ineffective. Here’s how to fix it.

By Stephanie Auteri

In a predictable bit of news, the results of a study released this past September show that students consider most sex-education programs to be out-of-touch, outdated, and lacking in the information that might actually prove useful to them. Among the deficiencies reported by teenagers were a focus on fear-based lesson plans, curricula that alienate LGBTQ+ students, instructors untrained in actually providing useful sex-ed, and a failure to acknowledge that some young people are  —  spoiler alert  —  sexually active.

When it comes down to it, though, these inadequacies do not stem from lack of trying on the part of certified sexuality educators. There are disparities in curricula, and in resources: Federal funding for sex-education flows to both abstinence-only and evidence-based approaches, and decisions about curricula are made on a state-by-state  —  and district-by-district  —  basis. There are still only 13 states that require sex-education to be “medically accurate.”

In fact, in the past year, 23 bills were introduced with the intention of restricting the quality of sex-ed. Such restrictions included moves to limit access to information about reproductive health options, and to exclude qualified sexuality educators from schools based upon their affiliation with abortion providers.

While the majority of these bills failed to advance, in many cases, educators continue to be hamstrung by red tape. And they worry that  —  in the wake of the most recent presidential election  —  their jobs will only become more difficult. What is an enterprising, conscientious sex-educator to do?

Recently, I attended the National sex-ed Conference in Atlantic City, New Jersey, where I saw sexuality educator Francisco Ramirez present a keynote on “hacking” sexual health. During his talk, Ramirez spoke about how educators might possibly shake things up, in some cases taking sex-ed outside the classroom in order to reach those who need it most. Happily, many educators are already doing this, systematically toppling many of the barriers that have long stood in their way. Throughout the conference, I was reminded of the many forms such resourcefulness can take. Here are the six most important fixes currently happening in American sex-ed.

1. Where can students get the answers they crave without fear of embarrassment or other negative repercussions? These days: their phones.

Sex-educators often employ anonymous question boxes in their classrooms, but the new-media generation is taking this idea of anonymity to the place where it thrives best: social media. I recently wrote about a variety of new social-media applications, YouTube series, and other online resources that allow teens to seek out accurate sexuality information anonymously. Since then, it seems that not a day goes by where I don’t hear about a new sex-ed app.

What’s important to remember about any of these sex-ed hacks is that just because a program works in one place, that doesn’t mean it will work in every community.

One of the more recent ones to catch my eye is Capptivation’s Reach Out, an app that provides sexual assault survivor resources to college-age students. According to Capptivation, a similar app for high schoolers is on its way. And the Healthy Teen Network — a membership-based advocacy organization  —  is in the process of developing two phone apps, one for high school-aged teens, and one for people who are older. They were inspired to do so after receiving an RFP (a request for proposal — a document from an agency soliciting a proposal for a specific commodity or service) from the Centers for Disease Control and Prevention (CDC). Alongside the United States Department of Health and Human Services, the CDC has been looking to fund the development of a mobile app that would support teen pregnancy prevention.

This push for sex-ed apps is not without precedent. A 2016 study on mobile phone-based interventions for smoking cessation showed that mobile interventions can lead to positive behavioral changes. And additional research  —  including a 2016 paper published in BMC Public Health  —  has shown that sexual-health apps remove certain barriers youth often feel in seeking out sexual-health services: namely, embarrassment. HTN is in the midst of conducting its own randomized control trials in order to determine the efficacy of its apps.

2. How can students take a leadership role in their own sex-education? Through peer-led sex-ed.

A recent review of 15 peer-led sexual-health education programs shows that peer-to-peer sex-ed can be successful at improving teens’ knowledge and attitude about sexual health  —  which is good news, considering that many teens don’t think adults are doing the best job. And just as with social-media apps, new peer-to-peer training programs are popping up all around the country. Teen PEP, which operates in both New Jersey and North Carolina, is one such program that trains teens to provide sex-ed to their peers at school. Another example is the team out of Planned Parenthood of North, Central, and South New Jersey, which leads an annual Teen Conference that students travel to on a one-day field trip.

In Austin, Texas, the Peer 2 Peer Project trains teens to teach both on school grounds and at other locations within their communities, going so far as to pay them for their efforts. In Baltimore, Maryland, the Healthy Teen Network and its subsidiary, the Healthy Teen Leadership Alliance, also empower teens to influence the field of sexual health. These are just a handful of programs among many that are handing the reins over to teens. It can be difficult to keep track of all the peer-led programs popping up around the country, but Advocates for Youth  —  an advocacy organization with its focus on adolescent sexual health  —  has gathered the results of numerous studies on the impact of peer education. These studies show how peer education reduces risky sexual behaviors and empowers teens, who seem to find their peers to be more credible than adult educators.

Complete Article HERE!

Inadequate sex education creating ‘health time bomb’

‘Shockingly high’ numbers of STI diagnoses prompt councils to call for compulsory sex education in UK secondary schools

A school nurse giving sex education advice to year 10 students at a school in Devon.

By

Inadequate sex and relationships education (SRE) in schools is creating “a ticking sexual health time bomb”, councils are warning, amid concern over high numbers of sexually transmitted infections (STIs) among young people.

The Local Government Association (LGA), which represents 370 councils in England and Wales, has joined the growing clamour urging the government to make sex education compulsory in all secondary schools. Currently it is mandatory in local authority-maintained schools, but not in academies and free schools which make up 65% of secondaries.

Izzi Seccombe, chair of the LGA’s community wellbeing board, said it was a major health protection issue. “The lack of compulsory sex and relationship education in academies and free schools is storing up problems for later on in life, creating a ticking sexual health time bomb, as we are seeing in those who have recently left school.

“The shockingly high numbers of STI diagnoses in teenagers and young adults, particularly in the immediate post-school generation, is of huge concern to councils.

The LGA argues that it is a health protection issue, with 141,000 new STI diagnoses for 20- to 24-year-olds in England in 2015 and 78,000 for those aged 15-19. Sexual health is one of local government’s biggest areas of public health spending, with approximately £600m budgeted annually.

The LGA appeal came as the government was reported to be close to making an announcement regarding SRE and PSHE (personal, social, health and economic education), after the education secretary, Justine Greening, flagged up the issue as a priority for government.

Campaigners hope the announcement will be made during the next stage of the children and social work bill, which is passing through parliament. An amendment with cross-party support was tabled last week which, if carried, would would amount to the biggest overhaul in sex education in 17 years, but it is not yet clear what the government announcement will amount to, and crucially whether it will make SRE compulsory.

Seccombe said: “We believe that making sex and relationship education compulsory in all secondary schools, not just council-maintained ones, could make a real difference in reversing this trend, by preparing pupils for adulthood and enabling them to better take care of themselves and future partners.”

The LGA says while SRE should be made compulsory for secondary school children, with statutory guidance on key issues including sexual health, parents should still be given the option of taking their children from the lessons.

Tory MP Maria Miller was among those proposing the amendment to the bill last week. It followed an inquiry by the women and equalities committee, chaired by Miller, which heard that most children have seen online pornography by the time they leave primary school and two thirds will have been asked for a sexual digital image of themselves before they leave secondary school.

According to Miller, research has shown that just one in four children at secondary school receives any teaching on sex and relationship issues, and Ofsted has said that when it is taught the quality of teaching is often poor.

“Different interest groups cannot agree on a way forward that suits them and in the meantime we are letting down a generation of children who are not being taught how to keep themselves safe in an online, digital world,” said Miller.

“We are not teaching them that pornography isn’t representative of a typical relationship, that sexting images are illegal and could be distributed to child abuse websites and how to be aware of the signs of grooming for sexual exploitation.

“Overwhelmingly parents and children are fed up and want change. They want compulsory lessons in school to teach children and young people about consent and healthy relationships.”

Complete Article HERE!

Coming down from the high:

What I learned about mental health from BDSM

By Jen Chan

Not too long ago, I took my first step into the world of kink. I was a baby gay coming to terms with my borderline personality disorder (BDP) diagnosis, looking for any and every label that could help alleviate the lack of self-identity that comprises my BPD.

I knew I was queer. I knew I identified as femme. But I didn’t know if I was a dominant (top), a submissive (bottom), or a pillow princess; I didn’t even know if I was kinky.

So I tried to find out.

I began to notice a pattern. The sheer rush of euphoria and affection created a high I felt each time I “topped” my partner, and it would sharply drop the minute I got home. I was drained of energy and in a foul mood for days, often skipping work or class. I felt stuck on something because I wanted to feel that intensely blissful sex all over again, but I couldn’t figure out how to get it back.

If you’re familiar with the after-effects of taking MDMA—the crash, the lack of endorphins, the dip in mood for up to a week later—then you’ve got a pretty good idea of how a “drop” felt for me. Just add in an unhealthy serving of guilt and self-doubt, a pinch of worthlessness and a dash of contempt for both myself and my partner, and voila! Top drop: the less talked about counterpart to sub drop where the dominant feels a sense of hopelessness following BDSM—bondage and discipline, domination and submission, sadism and masochism—if after care is neglected.

In the BDSM community, it’s common to talk about the submissive (sub) experience: To communicate the expectations and needs of the submissive partner before engaging in consensual kinky play, to make sure the safety of the sub during intense physical and/or psychological activities is tantamount, to tend and care for the sub after the scene ends and they’re brought back down to earth.

Outside of this, the rush of sadness and anxiety that hits after sex is known as post-coital tristesse, or post-coital dysphoria (PCD). It is potentially linked to the fact that during sex, the amygdala—a part of the brain that processes fearful thoughts—decreases in activity. Researchers have theorized that the rebound of the amygdala after sex is what triggers fear and depression.

A 2015 study published in the Journal of Sexual Medicine found that 46 per cent of the 230 female participants reported experiencing PCD at least once after sex.

Aftercare is crucial and varies for subs, depending on their needs. Some subs appreciate being held or cuddled gently after a scene. Others need to hydrate, need their own space away from their partner or a detailed analysis of everything that happened for future knowledge. But no matter what the specific aftercare is, the goal is still the same: for a top to accommodate a sub and guide them out of “subspace”—a state of mind experienced by a submissive in a BDSM scenario—as directly as they were guided in.

I asked one of my exes, who’s identified as a straight-edge sub for several years, what subspace is like. As someone who doesn’t drink or do drugs, I was curious about what it was like for them to reach that same ephemeral zone of pleasure.

“It gets me to forget pain or worries, it gets me to focus only on what I’m feeling right then,” they told me. “It’s better than drugs.”

My ex gave up all substances in favour of getting fucked by kink, instead. I’m a little impressed by how powerful the bottom high must be for them.

“The high for bottoms is from letting go of all control,” they added. If we’re following that logic, then the top high is all about taking control.

We ended the call on a mildly uncomfortable note, both trying not to remember the dynamics of control that ended our relationship.  Those dynamics were created, in part, by my BPD, and, as I would later discover, top drop.

In the days to follow, I avoided thinking about what being a top had felt like for me and scheduled a lunch date with another friend to hear his perspective.

“Being a dom gives you the freedom to act on repressed desires,” he told me over a plate of chili cheese fries. This is what his ex said to cajole him into being a top—the implied “whatever you want” dangled in front of a young gay man still figuring himself out.

He was new to kink, new to identifying and acting on his desires, and most of all, new to the expectations that were placed on him by his partner. He was expected to be a tough, macho top to his ex’s tender, needy bottom. His after-care, however, didn’t fit into that fantasy. If that had been different, maybe he wouldn’t have spiraled into a place where his mental health was deteriorating, along with his relationship.

The doubt and guilt that he would often feel for days after a kinky session mirrored my own. We both struggled with the idea that the things our partners wanted us to do to them—the things that we enjoyed doing to them—were fucked up. It was hard to reconcile the good people that we thought we were, the ones who follow societal expectations and have a moral compass and know right from wrong, with the people who are capable of hurting other people, and enjoying it.

For my friend, there was always a creeping fear at the back of his mind that the violence or cruelty he was letting loose during sex could rear up in his normal life, outside of a scene.

For me, there was a deep instinct to disengage, to distance myself emotionally from my partner, because I thought that if I didn’t care about them as much, then maybe I wouldn’t hate them for egging me on to do things I was scared of.

My friend has since recognized how unhealthy his relationship with his ex was. These days, he identifies as a switch (someone who alternates between dominant and submissive roles). The deep-seated sense of feeling silenced that was so prevalent in his first kinky relationship, is nowhere to be seen. He communicates his sexual needs and desires and any accompanying emotional fragility with his current partner. He’s happy.

I’m a little envious of him. My second-favourite hobby is rambling about all of the things I’m feeling, and it’s a close second to my favourite, which is crying. I credit my Cancer sun sign for my ability to embrace my insecurities, but there’s still something that makes me feel like I’m not equipped to deal with top drop.

There’s an interesting contrast between how a top is expected to behave—strong, tough, in control—and the realities of the human experience. When a top revels in the high of taking control, but starts to feel some of that control fading afterwards, how do they pinpoint the cause? How do they talk about that insecurity? How do they develop aftercare for themselves?

One of the hallowed tenets of BDSM and kink is the necessity of good communication; to be able to recognize a desire, then comfortably communicate that to a partner. Healthy, consensual, safe kink is predicated on this.

Complete Article HERE!

Why are some women never able to orgasm? A gynaecologist explains

Dr Sherry Ross says there has long been a gender bias in the way women’s sexual dysfunction has been treated compared to men’s

 

By Olivia Blair

Despite modern society being able to openly discuss female sexuality, there remains a number of existing taboos.

One of the most glaring is female orgasms. Women are rarely taught about the intricate details of their anatomy and often work these things out through their own experimenting.

What is the best way to get an orgasm? How often should I have one? Should I be able to have one during penetrative intercourse? Why have I never had one? – questions not uncommon to hear among small friendship groups of women over a bottle of wine.

Dr Sherry A Ross, an LA-based gynaecologist with 25 years experience aims to educate with a complete guide to the vagina in her new book She-ology: The Definitive Guide to Women’s Intimate Health. Period.

In the foreword of her book, Dr Sherry notes that “talking about the mighty V outside of doctor’s offices and bedrooms has remained a major taboo” and devoted an entire chapter to the female orgasm. The Independent asked the gynaecologist and obstetrician all the questions about female orgasms that are rarely spoken about.

Why might some women never orgasm?

Attitudes regarding sex, sexuality and gender vary greatly between different cultures and religions. Certain sexual practices, traditions and taboos are passed down through generations, leaving little to the cause of female pleasure or imagination.

For some women, finding and/or enjoying sexual intimacy and sex is difficult, if not impossible. Research suggests that 43% of women report some degree of difficulty and 12% attribute their sexual difficulties to personal distress. Unfortunately, sexual problems worsen with age, peaking in women 45 to 64.  For many of these women the problems of sexual dysfunction are treatable, which is why it is so important for women to share their feelings and concerns with a health care provider.

Unfortunately, there has been a history of “gender injustice” in the bedroom. Women have long been ignored when it comes to finding solutions to sexual dysfunction. In short, there are twenty-six approved medications for male erectile dysfunction and zero for women. Clearly, little attention has been paid to the sexual concerns of women, other than those concerns that involve procreation.

How many women might never orgasm?

During my 25 years in private practice, I’ve met a number of women in their 30s, 40s and 50s who have never even had an orgasm. In fact, 10 to 20% of all women have never experienced one.

Issues related to sex are not talked about enough even with a health care provider. Let’s just start by saying, 65 per cent of women are embarrassed to say the word vagina and 45 per cent of women never talk about their vagina with anyone, not even with their doctor.

Some patients say they have pain with sex, have problems with lubrication, don’t have a sex drive or don’t enjoy sex.  My first question is “Are you having problems in your relationship?”, “Do you like you partner?” , “Are you able to have an orgasm?”, “ Do you masturbate?” These open-ended questions tend to bring out sexual dysfunction including the inability to have an orgasm.

There is a great deal of embarrassment and shame when a woman admits she has never experienced an orgasm.

Is the inability to not orgasm normal?

The inability not to have had an orgasm can reflect women’s inability to know they own anatomy and may not be a disorder at all. In a survey of women aged 16-25, half could not find the vagina on a medical diagram. A test group of university- aged women didn’t fare much better with one third being unable to find the clitoris on a diagram. Clearly, if you can’t find it, how are you going to seek enjoyment from it?

Women must first understand what brings them pleasure and in their pursuit of happiness they have to understand where their clitoris is and how to stimulate it. Masturbation is a skill.  It has to be learned, just as walking, running, singing and brushing your teeth.

What is an orgasm disorder and how would you categorise one? 

The inability to have an orgasm falls under the category of Female Sexual Dysfunction of which there are five main problems: low libido or hypoactive sexual desire disorder, painful sex, sexual arousal disorder, an aversion to sex and the inability to orgasm.

Hypoactive sexual disorder, the most common female sexual dysfunction, is characterised by a complete absence of sexual desire. For the 16 million women who suffer from this, the factors involved may vary since sexual desire in women is much more complicated than it is for men. Unlike men, women’s sexual desire, excitement and energy tend to begin in that great organ above the shoulders, rather than the one below the waist. The daily stresses of work, money, children, relationships and diminished energy are common issues contributing to low libido in women. Other causes may be depression, anxiety, lack of privacy, medication side effects, medical conditions such as endometriosis or arthritis, menopausal symptoms or a history of physical or sexual abuse.

You are the person in charge of your vagina and clitoris. First and foremost, get to know your female parts intimately. Understanding your sexual response is a necessary health and wellness skill. Make mastery of that skill a priority.

Complete Article HERE!

Childhood cancer treatment may hinder later-life sexual relationships

 

Neurotoxic treatment for cancer during childhood may influence sexual activity and relationships in adulthood, according to new research.

Study co-author Vicky Lehmann, Ph.D., of Nationwide Children’s Hospital and Ohio State University – both in Columbus, OH – and colleagues found that adults who received high-intensity neurotoxic treatment for cancer as a child were less likely to meet certain sexual and romantic milestones.

However, the team found that childhood cancer treatment did not affect overall satisfaction for sexual and romantic relationships in adulthood.

Lehmann and team recently reported their findings in the journal Cancer.

According to the American Cancer Society, it is estimated that around 10,380 children aged 15 and under were diagnosed with cancer in the United States last year.

Leukemia is the most common form of childhood cancer, accounting for around 30 percent of all cases, followed by brain and spinal cord tumors, which make up around 26 percent of all childhood cancer cases.

Childhood cancer treatment and psychosexual development

While cancer was responsible for more than 1,200 childhood deaths last year, over 80 percent of children diagnosed with the disease will survive for at least 5 years. This is due to significant advances in cancer treatment, which include surgery, chemotherapy, and radiation therapy.

However, such treatment is certainly not without risk. For example, studies have shown that cranial radiation – often used to treat brain tumors – may cause harm to the developing brain, leading to long-term neurocognitive impairment.

Previous research has shown that neurocognitive impairment as a result of childhood cancer treatment may impact social interaction in adulthood, but studies investigating the effects of such treatment on psychosexual development are few and far between.

“Psychosexual development entails reaching certain milestones, such as sexual debut, entering committed relationships, or having children.

It is a normative part of becoming an adolescent or young adult, but only comparing such milestones without taking satisfaction into account falls short. These issues are understudied among survivors of childhood cancer.”

Vicky Lehmann, Ph.D.

To address this gap in research, the team enrolled 144 survivors of childhood cancer aged between 20 and 40. A further 144 participants who were not treated for childhood cancer (the controls) were matched by age and sex.

All participants completed questionnaires on psychosexual development, sexual satisfaction, and relationship satisfaction.

To determine the brain toxicity of cancer treatments in childhood, the researchers used data from the participants’ medical charts.

Neurotoxic cancer treatment might predict later-life psychosexual issues

Overall, the team found that adults who were treated for cancer in childhood did not differ significantly from the controls in terms of psychosexual development, sexual satisfaction, and relationship satisfaction.

However, on analyzing subgroups of childhood cancer survivors, the researchers found that those who previously received treatments high in neurotoxicity were less likely to have had sexual intercourse, be in a relationship, or have had children, compared with controls.

The type of cancer treatment in childhood did not appear to affect sexual satisfaction, the team reports. “This highlights the subjective nature of psychosexual issues, and the importance of addressing any concerns in survivorship care,” notes Lehmann.

The researchers say that their findings indicate that the neurotoxicity of cancer treatment in childhood may predict the likelihood of psychosexual problems in adulthood. They add:

“Additional research is needed to delineate how neurocognitive impairment undermines social outcomes for survivors, as well as other related factors.

Given the findings of the current study, healthcare providers should assess romantic/sexual problems among survivors, especially those who received high-dose neurotoxic treatments. Referrals to psychosocial care could prevent or reduce potential difficulties.”

 
Complete Article HERE!