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

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

By

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

So, what’s your problem?

Dave,

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

Mark

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

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

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

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

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

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

I switched it to Parker Lewis and left the room.

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

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

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

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

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

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

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

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

Complete Article HERE!

How to Have a Sex Life on Antidepressants

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

By Shannon Holcroft

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

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

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

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

Why Antidepressants May Be a Downer for Your Sex Life

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

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

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

How to Work Around the Side Effects

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

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

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

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

1. Time It Right

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

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

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

2. Switch It Up

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

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

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

3. Augment

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

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

4. Exercise

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

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

Complete Article HERE!

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

By

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Complete Article HERE!

Reality Check: Anal Sex

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

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


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

Q

When did heterosexual anal start to become a thing?

A

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

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


Q

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

A

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

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


Q

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

A

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

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

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

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


Q

What are the health risks of anal?

A

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

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


Q

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

A

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

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

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


Q

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

A

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

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


Q

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

A

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


Q

What tests should people be getting if they practice anal?

A

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


Q

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

A

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


Q

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


A

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


Q

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

A

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


Q

What should we be telling our kids about anal?

A

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

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

Complete Article HERE!

Men who have sex with men account for over 80% of syphilis infection rates in the US

MSM are 106 times more likely to get syphilis than men who exclusively have sex with women

Doctors advise waiting for the skin to heal after shaving before having sex

by

A new study of syphilis transmission rates reveals men who have sex with men account for 81.7% of cases in the United States.

This study found gay, bisexual or men who have sex with men are 106 times more likely to get the sexually transmitted disease.

Researchers analyzed data collected in 2015 and compiled the first of its kind state-by-state report on syphilis rates.

The study found gay and bisexual men living in the South had the highest rates of the disease, such as North Carolina, Mississippi and Louisiana.

North Carolina, for example, had 748 cases per 100,000 gay and bisexual men.

Alaska had the fewest cases, with only 73 cases per 100,000 gay and bisexual men.

HIV infects healthy immune cells in the human body by inserting its DNA into the cell’s genome

Fred Wyand, spokesman for the American Sexual Health Association urged people to look at the broader picture.

Wyand said: ‘Better access to healthcare, more welcoming attitudes, better support systems are all important, of course,’ WebMD reports.

‘We need to understand there are challenges faced by many gay and bisexual men greater than what most folks endure,’ Wyand concluded.

For a full list of State-specific cases of syphilis, check out the Morbidity and Mortality Weekly Report.

Why do men who have sex with men report higher numbers of syphilis?

A further breakdown highlights men who have sex with men accounts for 309 cases per 100,000.

This is in contrast to men who only have sex with women accounting for 2.9 cases per 100,000.

And women with 1.8 cases per 100,000.

Dr Robert Grant, chief medical officer of the San Francisco AIDS Foundation explains why this might be the case.

Grant told CBS News: ‘Now that we have effective therapies for HIV, people who were previously untested and tested infrequently are now getting tested.

‘Sexually transmitted infections tend to go together.

If they come in and ask for HIV testing, we test for syphilis, chlamydia and gonorrhea as well.

‘People have everything to gain and nothing to lose by getting an HIV and syphilis test.

‘This report will help reinvigorate people’s awareness and hopefully send the message that by getting a test and following through with treatment, we can decrease or even eliminate syphilis as a problem,’ Grant said.

Complete Article HERE!