For novelist Lev Rosen, school sex ed involved putting condoms on fruit. We need to be much more creative – and fun, he argues
By Lev Rosen
When I was 13 years old, when I knew I was queer but wouldn’t be saying so for a year, I remember some boys at school during lunch talking about gay sex. They called it “gross”, they laughed about it. That’s what I heard from my peers about the topic. I heard nothing from my teachers; I wasn’t about to ask my parents; and the gay people on TV never did more than peck each other on the lips.
Sex education for teens is one of those topics we tend to dance around. No one wants to talk to them about sex. It sounds pervy to tell kids how to have sex – as if you’re ruining their innocence or, worse, grooming them. I don’t know what your sex education was like, but I remember mine: it was putting condoms on bananas.
Fun fact about bananas: they’re all genetically identical. Every banana you’ve eaten is the same as every other banana you’ve eaten. And many of the sex-education classes taught today are exactly the same as the one I attended more than a decade ago. Condoms on bananas, STDs, reproduction – no talk of pleasure or consent, much less gay sex.
So, I wrote a novel for teens that features guides to oral sex, anal sex, and basic BDSM. I didn’t do this just so people had someone new to send hate mail to; I did it because teens have heard all this already from TV, playground talk, and online porn. Even sheltered teens already have some idea about how sex works; pretending they don’t isn’t going to help anyone. And while not all of them want to try these things, those who do, need to know how to do it safely, and with consent. Instead, they learn all of that from the media.
In most media aimed at teens, queer men tend to be sweet and sexless. You’ve seen or read the gay best friend character who talks about how hot guys are but never touches one. Or you’ve experienced mainstream gay romance – with gentle kissing, hand-holding, maybe a hug (fully clothed). Even when they get to say what they want, these boys on TV or in film rarely long for more than a kiss and a cuddle. We never see the mimed, under-the-covers sexy-and-shirtless making-out that our straight peers are treated to. Straight teens get to have sex on TV. Gay ones, not so much.
There’s this thing I call the glass closet: the idea that liberal-minded, well-meaning folks who genuinely don’t think they have a problem with queer people tend to confine them to a rigid definition of “good” queerness. For women, this means not going too butch, usually. For men, it means not going too femme, and also, not being too slutty. “I love gay people, but do they have to be so in-your-face about it?”; “I love gay people – but not being ‘too gay’, OK guys?”
And gay sex? That’s way too gay.
Society likes to keep gay teens sexless. It likes to maintain that gay content (even something non-sexual, like the representation of gay parents) is inappropriate for children’s TV or books. Those who complain say it’s too adult – implying that queerness, essentially, is all about sex, while straightness is just what a normal relationship looks like. It’s a weird dichotomy: straight people holding hands are non-sexual, while queer people holding hands is somehow the same as broadcasting pornography. The message is clear across all media: gays have to be kept sexless because they’re already too much about sex.
And so, if all the gay teenagers on our screens are portrayed as “good” gays, kept safely in the confines of the glass closet, and sex-ed doesn’t discuss more than bananas and STDs, then real queer teens turn to the one place they can see their desires: porn.
If you haven’t seen any gay (male) porn, let me describe most of it: everything is clean and polished (yes, even most of the dirty stuff). Everyone has lots of vocal fun. No one ever flags until they finish.
Of course, porn is fantasy, and the men in these videos do massive prep for these scenes. It looks much easier than it is – that’s half the fantasy. And as fantasy, it’s fine. But as a primary source of education, gay porn leaves young queer men with an idealised, routine set of acts that suggest a (wrongly) regimented set of requirements for “real” queer sex. Standardised sexual imagery, it turns out, is just bananas with abs.
I’ve also spoken to queer women about their sexual education. They didn’t always go to porn for their sex-ed, but they didn’t find it at school or home either. Those who did look for it in porn had the additional problem that the fantasy being presented wasn’t even being presented for them.
“Many young women will encounter lesbian sex through mainstream porn,” says Allison Moon, sex educator and author of Girl Sex 101. “This means everyone, not only girls, can get some very wrong ideas about lesbian sex, because the lesbian sex in mainstream porn is designed for male visual pleasure. So queer women have to navigate male sexuality whether or not it interests them.”
And that leaves queer teens in sex-education classes in an awkward place. Straight teens can ask about things they’ve seen on TV, they can apply condoms-on-bananas to what they learn from the media, and come away with a basic framework of sex. Queer teens can only turn to porn.
The good news is that, in some places, things are changing. When I contacted my old high school to find out how the condom bananas were going, I spoke to the director of health and wellness about how the sex-education curriculum has changed, and how it’s about to change even further.
“We can do better, and we’re on the cusp,” she told me, before going into future plans: a curriculum that covers the usual safe-sex issues, but also talks about consent, healthy relationships, porn literacy and queer sex. I was thrilled to hear it. I may have even become a little teary, thinking about a class of young queer people who get a real sexual education that applies to them.
But not every school does this. And they need to, because queer people are everywhere. We’ve made strides in acceptance, but today I still see gay men in their 20s and 30s online saying they don’t know how things work. I get emails from men saying my book taught them things they wish they had learned as a teen. Teens today tell me that it’s so nice to hear someone talk about gay teens having sex, about how they feel, as though, even if they’re out, they’re still not allowed to act on their desires – or are unsure how.
Right now, teenagers’ choices for learning are two extremes (the “good gay” or the “bad gay”) – neither of which is helpful. Either way, these teens end up feeling as if they’ve done something wrong. And we can fix that so easily. Just start talking about it, teaching it. We do it with straight sex. We can fix this the way we can fix most things in life: just gay it up.
What gay teens should watch and read
Another Gay Movie (2006) A raunchy teen sex comedy about four gay guys trying to lose their virginity before graduating. There are gross sex gags, some nudity, and the pressure to lose one’s virginity is problematic, but if you wanted a queer male version of the American Pie movies (or the more recent Blockers), this is it.
I Killed My Mother (2009) A French-Canadian film that features young gay men having fun, sexy sex without being porn – like many of the straight teens you see on TV today.
Release, by Patrick Ness There are plenty of graphic, but beautifully wrought sex scenes in this book about a queer teen trying to find some freedom for himself in a small American town and with his deeply religious family.
Under The Lights, by Dahlia Adler This fun romp on the set of a Hollywood television show has explicit lesbian sex behind the scenes, as the character deals with who she’s playing on TV, and who she is when she’s with her publicist’s daughter.
Princess Cyd (2017) In this quiet and beautiful film about a teen girl (Cyd) spending the summer with her aunt, there’s one great scene between Cyd and Katie, who is a “little bit boy” (and played by a non-binary actor). It’s exactly the sort of sex we should be seeing everywhere.
• Jack of Hearts (and Other Parts) by LC Rosen is published in paperback by Penguin on 7 February at £7.99.
If you’ve not watched Sex Education yet, no doubt you’ll have heard about it. The teen-focused sitcom starring Gillian Anderson landed on Netflix in January and quickly captured the hearts and minds of its audience. We follow Otis (Asa Butterfield) as he attempts to navigate the usual pressures of sixth form – mates, dates, bullies and deadlines – with the added pressure, knowledge and delightful adolescent awkwardness that follows from having a sex therapist for a mother (that’s where Anderson comes in).
Besides being really funny and introducing us to an exciting lineup of rising stars, the series has been praised for tackling love, sex and romance in all their complicated glory. In tandem with the release, Netflix partnered with women artists whose work speaks to the themes explored in the show and asked them to create a new piece that specifically tackles the awkwardness surrounding sex. Multimedia artist Stephanie Sarley focused on genitalia; ceramicists, illustrators and identical twins Liv and Dominique Cave-Sutherland explored Sex Education‘s prevalent topic of virginity; and illustrator Alison Rachel (the talent behind the Recipes For Self Love Instagram account) focused on body acceptance. The pieces produced are great, obviously, and celebrate a lot of the intimate things we’ve all felt uncomfortable addressing before.
Sarley’s earlier piece is all about exploring your sexuality. Here we see how her fun and at times absurd work, which challenges how sexuality is defined and understood, fits so closely with the conversations Sex Education is encouraging. “Sex Education has a humorous way of talking about sex, which is something I do in my art,” Sarley says.
Inspired by Sex Education
Mirroring many of the key themes explored in the series, Sarley’s new piece “Fruit Salad” celebrates the fact that all our bodies are different. Both the show and Stephanie’s work aim to move us into a more sex and body positive society. Speaking about the work she created for the occasion, Sarley says: “Sex Education demonstrates the complexities of sexuality in all its awkwardness, but in the funniest way possible.”
This work by sisters Liv and Dom encourages us to embrace sexual expression. They explain that this piece “is depicting how fun and freeing it can be to explore your sexuality alone for the first time, to gain confidence and understanding in your own body as a young person.”
“The First Time”
Inspired by Sex Education
This newly commissioned piece is pretty self-explanatory. They use clay models to suggest the awkwardness and insecurity surrounding virginity – which we all know is reinforced by societal and peer pressure. “It’s something that so many people relate to when recalling their first time or thinking ahead to how it could be,” Liv and Dom explain. “We’re looking at the insecurity and timidity that come with losing your virginity.”
“It was interesting to take a step back from our usual work where figures are more comfortable with their nudity – and to recall what it was like to be a teenager. We’re excited to see how much the series pushes the envelope.”
Alison Rachel (@recipesforselflove)
“Be Sex Positive”
Quite plainly, we should all be more sex positive and Rachel’s illustration encourages us to do just that. Her outlook on sex has much in common with Sex Education’s honest and humorous love letter to human connection, closeness and vulnerability. “I believe that so many of the world’s problems can be addressed through sex positivity and sex education,” Rachel explains.
She adds: “The world is in desperate need of sex positivity that encourages people to embrace their own and others’ sexual expression while being conscious of consent and safety, that shows us how sex can be a tool used to explore intimacy.”
“Masculinity Is Multidimensional”
Inspired by Sex Education
This new illustration explores masculinity in the modern world. Fans will immediately recognise the theme in a number of Sex Education‘s storylines, and Rachel hopes to break down patriarchal views of masculinity and create a safe environment for exploration. “There are so many unconscious lies about sex and sexuality that we are led to believe over the course of our lives and it’s great that this is shedding some light on these very important topics.”
As a boy, Tom Yarwood was assaulted by his musical mentor. Decades on, telling the story has not become any easier
In telling of the sexual assaults I endured as a child, I have always had the sensation of speaking into the void. I usually offer only the bare bones of the story, because I want my listener to fill in the emotional content, to tell me what I felt, what they might have felt in my position. I want them to explain to me how I could have suffered, when I felt pleasure, and how I was not to blame, though I didn’t resist. But their response is always underwhelming: they seem to understand so little about this kind of thing, less even than me. And it’s all so exquisitely embarrassing that I soon move on, apologise for myself, repeat the usual reassurances. It was nothing, really, it didn’t matter, I coped.
Each telling is a new humiliation, a new disappointment. And yet, like an idiot, I always go on to attempt another. Six months or a year later, usually when I’m drunk, at four in the morning, suddenly I can imagine it again – the moment someone will explain me to myself at last. Because on the one hand, I really do tend to think it was nothing, what happened. But on the other, it never leaves my head, the image of it, the stink of it, and he never leaves me, he is always there, the loathsome, pathetic man. And there’s this enduring longing to relieve myself of the weight of my silence, my slow-burning despair.
Still, something in this picture has shifted lately, since my father’s death three years ago, and my 40th birthday not long after. In childhood and youth, I knew, with the heroism of the young, that I would vanquish the effects of the abuse, by 20, then by 30, or by 35. The idea it might stay with me, in me, was as inconceivable as my own death. But now I’m closer by far to 60, the age at which my father had his first heart attack, than to 12, my age when the other man first laid hands on me. It has dawned on me that the assaults are with me for good. And so in talking about them again, I’m less inclined to defer to others. This time I will stand, for once, at the centre of myself.
As a small child, I was obsessed with classical music. My parents bought a piano from a junk shop in Ludlow, read us stories about the great composers. We didn’t have a television at home on our Shropshire housing estate, and so I spent a lot of time sitting in a little green velvet chair by the record player with my eyes closed, elaborating wild fantasies about my musical heroes as I listened to their symphonies. I started piano lessons at the age of four, but rarely practised, preferring to delight the neighbours (I felt sure) with endless improvisations, generally fortissimo and con fuoco.
In the summer of 1987, when I was 11, my mother took me and my siblings on holiday to Europe. My father was working abroad at the time, as he often did. In Bruges, we came across a grand exhibition of musical instruments, where I was thrilled to have the chance to try out a harpsichord. While I played, a man approached my mother and told her I was gifted. He said he was a conductor – a specialist in baroque music – and would love to foster my talent. Phone numbers were exchanged, and a couple of cassette tapes offered to my brother and sister and me – his own commercially produced recordings of Handel and Purcell. He was evidently a prominent figure in his field.
That autumn, my father took me to London to visit this dazzling new mentor. We spent the afternoon at the conductor’s house, playing the harpsichord and talking about music. I was self-conscious, and desperate to impress. He was charm itself, but I found something faintly peculiar about him. He had a manic, childlike energy, a tendency to clowning in which I detected no genuine mirth, and beneath it I sensed he was very tense. Still, we got on well enough, and my father trusted him sufficiently that I went back to see him for another day of music-making a few weeks later.
Before long, I was spending whole weekends on my own with the conductor, sleeping in his spare bedroom in London and attending rehearsals and recording sessions with him and his orchestra. There was little formal teaching, but I got to listen to some good live music, and doubtless soaked up some other valuable lessons – not least how to make tea, and set up a music stand – and occasionally we looked at scores or listened to recordings together. He would sometimes drive me all the way back to my parents’ house in Shropshire himself, and stay for supper.
My anxiety around him never abated. It wasn’t only the unnerving air of inauthenticity about his manner. He also seemed very driven, and he could be vituperative towards timewasters. Then there was the social gulf between us. My parents were bohemian members of the new middle class, but the conductor was an upper-middle-class product of the public school system. All was well in his world when people cleaved, outwardly, to the “sensible” values expressed by the authority figures of his childhood – headmasters, barristers, clergy. Those who made a fuss of their differences were “mad”. More unsettling still was his disdain for children of a certain kind – the vast majority, I suspected – the rude ones, the dirty ones, the ones who were not good.
He introduced me to alcohol, mixing gin and tonics for me, and cocktails sweet and heavy with cassis or curacao. I was drunk when he assaulted me for the first time. It was early on a Sunday afternoon, and he was in the kitchen, making a bland English bachelor’s lunch of pork chops, potatoes and frozen peas. He seemed to find something about the peas amusing. With wildly contrived laughter, he tossed them about the kitchen, pretending he was dropping them. I was embarrassed for him. He tipped several peas down my T-shirt, and chased me into the living room and around the sofa with the rest. I’m not six years old, I wanted to say. I grew out of this sort of thing quite a while ago.
He dropped a frozen pea down my trousers and wrestled me on to the sofa, undoing my trouser button. I ceased to struggle when he grabbed my penis. “Ah, the pea!” he said, as he tugged at it. After a while, he pulled down my pants, and complimented me on my first pubic hair, which I had noticed only days before. Nothing more was said as he went about his business. I did not move a finger. Afterwards, he cleaned me up, pulled up my trousers and did up my fly, telling me meanwhile that this was what boys did, and wasn’t something to worry about. We returned to the kitchen and the pork chops.
Not a single day has passed in the three decades since this incident without some effort on my part to cut through the tangle of dark thoughts and feelings it induced, and to understand the insidious effects it has had on my life. The physical sensations were pleasurable. But I did not want any kind of sexual contact with the conductor. I found him repugnant, and had he asked me whether I wanted him to continue at any point, I would have said no, and meant it. I had experimented sexually with friends in childhood; I had turned down sexual overtures from other friends. In this respect, I knew my own mind. And this is why it always seemed so strange to me that I said nothing, and didn’t resist.
I still remember the all-consuming shame I felt on being manhandled by a bigger creature, at relinquishing control of my body to another person, against my will. And I remember too how destroyed I felt at the exposure of my sexuality to an adult. The secret, underdeveloped heart of my psychosomatic being – still fraught with danger, still hedged around in thorns – had been torn out and thrown quivering before me, in full public view.
But it is only in recent years that I have gained the distance from these horrors – the sense of security in myself – to acknowledge their intensity. As a child, it was impossible for me to face my victimhood, impossible to own and name what had come to light.
I withdrew into a kind of mental panic room. This is nothing, I told myself. This doesn’t matter. This is him. This is not me. I will remain aloof. I will rise above. I marshalled all my contempt for the conductor and all my knowledge of sex. He thinks I find him attractive, but in fact I find him repulsive. I saw him, the adult in control of me, as a child – a “silly” child, as my mother would say, still fixated on other children’s penises like this. It was an extension of his general puerility, his weird clowning, his fake laughter. How pathetic, how contemptible, how sad. I had reversed our roles in my imagination – a fatal self-deception.
The panic room became a prison, a lunatic’s cell. This, I hazard, is the snare in which many victims of childhood sexual abuse find themselves – they are traumatised, but unable to face the fact. For almost three decades, I could not look back (or look down) at what the conductor did to me, but had to keep moving on, moving up, clinging to a reassuring sensation of balance like one of those weighted toys that always rights itself, no matter how hard you hit it.
Now that I can gaze more steadily at the ancient scene, I am struck by how very strange it appears. How strange it sounds, to have sex, to feel your body consumed by that fire, and actively to deny to yourself that you are involved in it at all. And how strange it looks – the child’s mute stillness, and the adult’s complete camouflage of his own desire, his voice never wavering from an even, nannying tone, as if he were teaching chess or changing a nappy.
The memories of the abuse still return many times a day, stirred up by chance impressions – scents like the soap the conductor used, or of his sweat, music that reminds me of his – even, of course, my own sexual thoughts and erotic sensations. And with these impressions come the associated emotions – the shame, the fear, the grief. But I always recoil instinctively from naming them, from facing the half-known horror that paralysed me during the assault. Lots of boys go through this, I might tell myself. He didn’t mean any harm. I’ll survive. Anything but the truth, the big taboo, the real words of power: I didn’t want it, I couldn’t deal with it, it tore me apart.
The loneliness was terrible. The abuse came between me and my parents, my siblings, my peers, sapped art of meaning, experience of joy. I felt a constant, immense pressure to speak, but something always seemed to intervene at the last minute, catching my words in my throat, forcing them back down, sickeningly, into my belly. I was, I can see now, the dream victim for a predatory paedophile. My father was often absent, and my mother’s attention was taken up by my adopted younger sister, who had severe behavioural problems. Since toddlerhood, my older brother and I always felt that we were holding the fort: the idea of turning myself into a problem child was anathema.
After the first attack, I buried my head in the sand, imagining that perhaps it had been a one-off, like a trip to Alton Towers. But on the next visit, I woke up late at night to find the conductor sitting on the edge of the bed with one hand under my duvet, stroking my thigh. He assaulted me again, and another sleepless night ensued.
I started working on my mother, trying to communicate my distrust of him. For a while, after several more assaults, it worked: she stopped phoning him, and each time he called, she found an excuse for me not to see him. Then, to my horror, he appeared on our doorstep in Shropshire – like a sexual Terminator, quite unfazed by what I thought of as the vast gulf between my family and the city. Although it makes me feel unhinged to think of it now, I had an overwhelming fear of what might come out if he were crossed, and so I insisted repeatedly to my parents that everything was fine.
When he had me strapped into the passenger seat of his Volvo, he drove a little way, pulled into a layby, took off the Schwarzenegger shades he wore when motoring, looked at me with wide eyes (his face, as usual, too close to mine), and told me that he knew he had upset me by what he had done, and that he promised, absolutely promised, that should I please him by resuming my visits, he would never, ever touch me again.
After that – and after he had been redeemed entirely in our family conversation – the assaults started again, becoming steadily stranger. He would pick me up and carry me up the stairs like an infant, apparently expecting me to find this humiliating horseplay as amusing as he pretended it to be. He would insist on bathing me. And as the assaults escalated, he took to putting a pillow over my head so I didn’t have to involve myself in what was going on – but I found this the greatest mortification thus far. It suggested he imagined I had thoughts and feelings about what he was doing, whereas I needed him to understand that I was not there.
It didn’t matter to me what he did, so long as he would let me be alone, inviolate, in my head. As an adult, I notice people often want to know the mechanics of the abuse you went through, and especially whether it was painful. Did he beat you, cut you, tie you up? If not, you sense, perhaps you’re making a bit of a fuss over nothing. The law also seems to operate like this, with its intricate scale of sexual transgressions, escalating in perceived severity, above and beyond the mere fact of exploiting a child for your own erotic gratification.
Pain and physical injury are traumas in their own right, but I suspect that the insult specific to sexual abuse in childhood is simply to have another person take ownership of your body against your will – to destroy your sense of sexual self-possession – after which everything can feel, indifferently, like rape.
Perhaps that is hard to imagine if you haven’t been through it yourself – if you haven’t felt forced, for the sake of your psychic survival, to dissociate yourself entirely from your erotic response, and then struggled to put these two aspects of your being – you and your capacity to feel – back together, to get them to work again as one.
I went to Eton on a music scholarship at 14, entering the school in the second year. The conductor had suggested it to my parents, after I was offered similar bursaries by Shrewsbury and Westminster. I came top of the music exams during my first term there, competing against boys who had spent years at choir schools and had enjoyed Eton’s excellent music tuition for a year longer than me. And that term I also told a wonderful new friend about the abuse, bursting into tears as I reassured him it was nothing. He told a senior music teacher. The teacher did nothing.
The conductor assaulted me more than 20 times over the course of three interminable years. The last attack came after a gap of several months, when I was 15 – old enough to acknowledge what he was doing. I objected repeatedly, and he overruled me, repeatedly, returning to my bedroom three times through the course of a single night, and finally getting what he wanted when both of us were haggard with sleeplessness, well after dawn.
At 16, I finally plucked up the courage to tell another adult at Eton the story in person. I gave them no room for doubt that I had hated my encounters with the conductor, but they explained to me that such incidents often cropped up in boys’ lives, and generally originated in the younger man’s admiration for the older. If there was no force used, they said, there was no reason to suspect harm.
Though I had long feared it, the revelation that the grown-up world as a whole couldn’t understand what I had been through came as a shock. My anger, my shame, and the ceaseless war between them – all this was my fault, it seemed, a fault in me. I was, in short, crazy. My immediate response was to give up music. It was a cry for help, a deliberate act of self-harm – killing off the great love of my life – but no one took much notice.
(It amazes me that I had kept going with music for so long; it is so tightly bound up with sex in our brains and bodies. My skin used to crawl every time the conductor called a favourite piece “erotic”, but somehow I had succeeded in imagining that there was music like his and music not like his, sex like his and sex not like his. Those lines became hopelessly blurred after I told my story to an adult at Eton. Touchingly naive adults such as my parents aside, the world was teeming with paedophiles and their sympathisers, and I was damned if I was going to open my body and soul to share the food of love with them again.)
I spent puberty and adolescence trying to construct in fantasy a relationship with my sexuality that was pristine, personal, free of the stain of rape. But when at last I went to Oxford and plucked up the courage to pick up another man for the first time, a friendly PhD student in his mid-30s, I was shocked to find that this mental construct had not taken root in my body. Something within me just wouldn’t move, wouldn’t melt, wouldn’t let go. Anger followed, shame, despair – all muted by stoicism. This is just me, I said to myself, this is my fate, I’ll get by. As a young adult, I developed an anxiety disorder to set beside the depression and insomnia that had plagued me since the first assault, and became prone to panic attacks.
The voices of denial – denial not that children have sex with adults, but of the fear and shame that shackle them, and of the violence of the act – always leave me feeling faintly deranged.
First came the voice in my head during the assaults. Then came his voice, explaining that the abuse was just a fact of life, an inevitable expression of my nature as a boy. And later, there were the voices of those from whom I sought help during my 20s – the mentors and teachers and parents and police and therapists and boyfriends – in whose responses I always found some admixture of bewilderment, embarrassment, incomprehension or indifference.
But only recently did I notice how closely these voices echo one another. It strikes me that our resistance to confronting the horror of child sexual abuse has common roots in human nature. The silence of victims and the general silence must also have reinforced one another over the millennia. I imagine those to whom I looked for help were simply as fearful as me – as fearful and more ignorant. I should have been bolder all along.
In 2007, when I was 31 years old, I heard from a friend that the conductor had been arrested and charged with sexually abusing four other boys in the 1980s. I am sceptical about the value of retributive justice, but I decided to join the prosecution. I needed to tell the world the truth.
The conductor was sentenced to three years and nine months in prison. I had no desire to see him punished, but I took this jail term as an indication of how seriously our society regarded his crimes. It seemed rather light. In his ruling, the judge apparently drew attention to the fact that the conductor had recently married and had a child, arguing that in doing so he had entered a new phase of life.
Searching the internet for commentary on the case not long afterwards, I found the loudest voices were those raised in my attacker’s defence. In classical music discussion forums, his admirers persuaded others that his “alleged” victims could well be liars, and had most likely suffered no harm anyway. And in the Observer, the poet James Fenton used his opportunity to comment publicly on the conductor’s conviction – the most prominent proven case of child sexual abuse in the history of classical music – not to consider the hurt he might have caused to the talented young musicians he assaulted, to their hopes of fulfilling themselves through music, nor to ask how the music industry as a whole had so long allowed the conductor to get away with it – but to argue passionately that his mistakes in life should not be allowed to damage his career. Fenton was relieved that the judge had allowed the conductor to keep associating with children: “To be debarred for life from working with the male treble voice would have been a harsh fate.”
In all this, I saw further evidence of our culture of denial. And I see it too in the way the music industry has welcomed the conductor back since his release from jail. Singers and instrumentalists with MBEs and honorary positions at the Royal Academy of Music go on appearing with him in the world’s most famous concert venues – the Wigmore Hall in London, the Concertgebouw in Amsterdam, the Elbphilharmonie in Hamburg, the KKL in Lucerne, and so on – and fans go on funding his performances and recordings.
They have restored to him the power and status with which they had entrusted him before, in putting their talent, labour, property and good names at his disposal. And they have done so despite the fact he abused all this – abused them – to gain the confidence of families and attack their children, and even though he called his victims “liars” and “loonies” during the trial, and has not expressed remorse.
There’s nothing more we can ask of the conductor himself. He apologised to me when I was 13, and went on to assault me again: another apology would be meaningless. And he has served his time. I don’t want revenge. I don’t want to dwell on the past. And there are doubtless many other moderating thoughts to which I should also give voice – about the value of mercy, for instance, and about how blessed my life has been in other respects.
But it has fallen to me to say something simpler here. I did not ask to be one of the ones who had these words to speak. They were a burden given to me a long time ago. I might have felt less crazed by others’ silence, or by their denial, had I spoken them earlier – shouted them from the stage of a London concert hall 30 years ago, perhaps, into the darkness of the stalls.
They are the words for which I have reached so often, the words I needed to hear when I was a child. Make of them what you will.
For people who have depression, even the most basic activities can seem daunting—and that includes sex. But because both depression and sexual problems are things that are difficult to talk about, even with intimate partners, the issues surrounding having sex while dealing with depression often wind up being ignored. As mental health advocate and writer JoEllen Notte puts it: “It’s the intersection of two taboo topics.” And it can lead to even more problems relating to a person’s mental and physical well-being.
Notte breaks the negative sex experience that comes with depression into two categories: loss of interest and side effects of medication. Notte says about the former: “I tend to reinterpret [it] as ‘everything seems incredibly hard and not worth doing’… Not wanting to be touched, and not wanting to deal with people.” While that applies to people who have depression and both are and aren’t on medication, the side effects specific to medication are a significant problem, too, and include, Notte says, “erectile dysfunction, vaginal dryness, genital numbness, delayed orgasm, and what’s usually referred to as ‘lost libido.'”
This loss of libido is symptomatic of a larger problem of depression: anhedonia, which Dr. Sheila Addison, a licensed marital and family therapist, tells me is “a loss of pleasure in ordinary things.” One of the things people with depression do to combat anhedonia is try to self-medicate and force pleasure, including through sex. Addison explains, “People with depression sometimes wind up chasing ‘peak’ experiences, little bursts of endorphins that seem to cut through the depression for a moment, but it’s a short-term fix for a long-term problem. And if it turns into having sex that they don’t really want, hoping to feel better, it can contribute to feelings of emptiness and self-loathing.”
The best thing to do when dealing with depression is to seek out a doctor, but even if you are comfortable seeking out help for depression, it can be difficult to broach the topic of sexual health, without feeling anxious. As Notte points out, “So many people have had bad experiences with doctors not wanting to deal with [sex] or prioritizing it as a topic.” My own doctor’s flippancy toward the subject was enough to shut me down for months, and it seems like this is all too common, leading to further stigmatization of this sensitive topic. Notte says, “All of the data that says these [sexual] side effects don’t happen is skewed, because people aren’t reporting them.”
Nevertheless, each person I talked to stressed that even though it’s difficult, if you are having issues with sex and experience depression, talk to a doctor first. Addison says that online forums can be the source of “a lot of unsolicited advice, pseudoscientific ‘cures,’ and supposed remedies that will lighten your wallet more than your mood.” And if you find the first doctor to be unsympathetic to your problems, then look for another one.
But how to find the right doctor? Notte recommends looking for keywords like “sex-positive” and “trauma-informed,” as it often means they’ll be more willing to discuss sexual issues or at least be able to point you in the right direction to someone who could. Addison herself is a member of LGBTQ Psychotherapy organization GAYLESTA and listed amongst kink-friendly professionals. These keywords tend to suggest the doctor has a more nuanced, whole-body approach to understanding and treating mental illness, but, of course, it may take a bit of searching to find someone whose methods you are comfortable with.
Once you find a doctor with whom you’re comfortable talking, you can also utilize them when you want to talk with your partner about any problems you might be having with regards to sex. “People often don’t know that you can bring anyone with you to your doctor visit if you want,” Addison points out. “Sometimes it’s easier to have the doctor talk directly to your partner because it’s not so personal.” Addison advises that the partner who isn’t experiencing depression seek care as well, saying, “Get support for yourself, from a therapist or from a group for partners of people with mental illness. Take good care of yourself, physically and emotionally
The main theme here, as with any taboo topics, is that talking about them is key, and the only way to remove the stigma. It’s particularly apt in this situation, though, as conversation, and communication in general, are also at the core of maintaining healthy romantic and sexual relationships no matter what your mental state.
But even though we know we should communicate openly, it can be difficult to get started. That’s why Allison Moon, sex educator and author of Girl Sex 101, recommends beginning conversations with “I statements” when breaching the topic of sexual issues. “It’s easy for people to catastrophize when partners bring up sexual issues, and they may be tempted to take responsibility for the issues of their partners,” Moon says. “It’s a good idea to use extra care when explaining one’s own experience, and be clear that the partner isn’t at fault or causing anything.” When considering the problem as a whole, Notte advises a team mentality for couples. She says, “What happens a lot is it gets treated as an issue of the healthy partner versus the other partner and their depression, and if we can be couples who are working on one team while the depression is on the other team, it’s a much healthier dynamic.”
Moon also recommends “speaking in concretes” when describing the ways depression affects your life and sexual experience to your partner. “Because mental health is so individuated, saying something like, ‘I have depression’ doesn’t always convey what one intends. Instead, I suggest discussing how something like depression manifests in a way the partner can understand. For instance, rather than saying ‘Depression makes me insecure,’ you could say, ‘Sometimes I need extra verbal validation from you. Can you tell me you find me sexy and wonderful? Can you remind me that I’m a good person?'”
Describing symptoms associated with depression can be difficult, though, and Notte often advises individuals to use what she refers to as “accessible” resources (“things that are not scary, that are not medical journals”) to work on coming to a mutual understanding of what you are going through. “Find things that are the language you and your partner speak,” she says; she sends her own partner comic strips and had them play Depression Quest, a role-playing game in which you navigate tasks as a person with depression.
We treat mental health very different than physical health,” Notte points out, adding, “If I were dating somebody and I had diabetes and wanted them to know I’d have to inject myself with insulin at some point, I wouldn’t have to be embarrassed to tell them that.” As with any disease, depression shouldn’t be treated as a liability in dating, and people who would treat it as such are not worth your time. Addison tells me, “Anybody who’s going to make you feel bad or weird about how your body works, does not deserve access to it. Disability rights folks have taught me, don’t apologize for how your body works or feel like you need to make someone else feel okay with you. If they can’t handle you, they can’t get with you.”
But that doesn’t mean it will always be easy—for either of you. So being present with your feelings and communicating them to your partner is vital. Moon says, “When you notice something coming up for you, whether it’s an emotion, a sensation, or a memory, practice giving it attention and letting it give you information.” Perhaps there is a “need attached to the emotion that you can turn into a request,” like needing more lube, or a moment to process your feelings before hooking up, etc. “If you notice that you’re going to cry, for instance, you can mention that so it doesn’t scare your partner,” Moon suggests. “Saying something like, ‘I’m having a great time, but I’m noticing some sadness come up. So if I start to cry, that’s okay, you’re not doing anything wrong. I’ll let you know if I want to stop, but I don’t want to right now.'”
Likewise, Addison recommends acknowledging the experience in the moment in a way that reassures your sexual partner that you don’t blame them for what’s happening. You can do this, she suggests, by saying something like: “This is just a thing my body does sometimes, and I”m not worried about it, so you shouldn’t worry about it either. Thanks for understanding. And I’m really enjoying [kissing you] so let’s do more of that.”
While the physical manifestations of depression in sexual relationships cannot be solved by medication, Notte recommends “workarounds” to address your specific sexual issue. Notte recommends using lubricants and not shying away from toys if experiencing anorgasmia, genital numbness, or erectile dysfunction. Exploring these types of options are especially great for people whose depression-related sexual problems manifest as specifically physical.
While all of this information is important for people with depression, it’s also essential for the partners who don’t have depression to understand how to respond in these situations. Addison tells me the best way is the simplest—nothing more than a “thanks for letting me know.” She explains, “Viewing someone as broken, or suffering, or in need of special treatment, is actually a poor way to approach sexual intimacy. If someone trusts you enough to let you know what’s going on with them, appreciate the gift that has been given to you, and treat it accordingly, with respect. [If your partner says,] ‘I don’t come through intercourse, and I might or might not finish myself off afterward,’ it is not an invitation for you to try to complete the Labors of Hercules to prove what an awesome lover you are. It’s information for you to let you know how this person’s body works, so be grateful that they trusted you enough to share something private with you, and act accordingly.”
And, she points out, “There’s nothing wrong with enjoying your climax when you’re with someone who’s said, ‘I probably won’t get off, but it’s still fun for me.'” Above all, Addison states, “Treat them like the expert on their own body, and you’ll be on the right track.”
Of course, finding people who will do that, especially at the beginning of a relationship or when dating around, can be difficult, but Addison advises to “decide what you’re looking for and what you’re willing to do or not do in order to get it… then screen your dates accordingly.” Finding someone who is comfortable with and respectful of your depression and sexual issues is a trait that can be filtered right in with your usual set of dating criteria. Addison says, “If you say, ‘Hey, I have medication that means I probably won’t come, and I’m looking for a partner who won’t be hung up about it—are you cool with that?’ and they try to inform you about how they’re going to be the one who makes you scream down the rafters, that’s a good reason to swipe left.” After all, she explains, “You can’t fuck somebody out of depression with your Magic Penis or Magic Vagina.”
If you or a loved one are seeking out further information about experiencing the sexual side effects of depression, seek out a psychologist or psychotherapist near you, and remember, as Addison says, “The only people who deserve to get close to you are people who can understand your needs and treat you with appropriate respect and care.”
Talking about dating violence is complicated, particularly when it can take many different forms, some far more subtle than others. When we think about domestic or relationship abuse, we often think of physical violence. That’s certainly one component, but it’s not the only one. We tend not to think about other symptoms of abuse, like the debilitating impact of gaslighting, constant check-ups, and financial control. Misunderstandings surrounding abuse and the ways it can manifest means that it can be difficult for the person being abused to identify it when it’s happening, but it’s sometimes harder when these abusive behaviors are taking place within an LGBTQ person’s relationship.
In 2012, a Stonewall report found that one in four lesbian– and bisexual-identifying women experienced domestic abuse in a relationship, two thirds of which say the perpetrator was a woman. It also stated that nearly half of all gay and bisexual men have experienced “at least one incident of domestic abuse from a family member or partner since the age of 16.” Published research focused on the experiences of trans and non-binary people remains extremely limited, however, in 2010, findings from the Scottish Transgender Alliance indicated that 80% of trans people have experienced “emotionally, sexually, or physically abusive behavior by a partner or ex-partner.” Despite these staggering figures, misconceptions surrounding queer people in relationships persist, including the myth that abuse doesn’t exist in relationships in which both people identify as LGBTQ.
Galop, a leading LGBT+ anti-violence charity in the U.K., notes that stereotypes also include ideas that “abuse in same-sex relationships is not as serious as heterosexual abuse,” “women cannot perpetrate violence,” and “sexual abuse doesn’t happen in same-sex relationships; a woman cannot rape another woman and men cannot be raped.” With this kind of prevalent misinformation, it’s no wonder that someone in an abusive queer relationship may feel unable to talk about the harm they could be experiencing.
Michelle*, a black, lesbian, cisgender woman, was with her ex-partner for two years and says she experienced physical and emotional abuse. She felt unable to disclose the violence taking place with friends and family, particularly because of the way she presents and how it could be perceived by others.
“As a 5’6” masculine-presenting woman dating a 4’11” feminine-presenting woman, I was always very vague when explaining the issues that I had in my relationship,” Michelle tells Teen Vogue. “Being masculine-presenting, I sometimes felt that I was supposed to be her protector, despite the fact that she was physically stronger than me.”
Additionally, Michelle, like many other black women in abusive relationships, faced a host of unique problems. According to Domestic Shelters, “Black women experience domestic violence at rates 30-50% higher than white women,” yet are often deterred from reporting or speaking about the abuse due to fears of adhering to stereotypes, such as the “strong black woman” narrative and not wanting to engage with police.
Oftentimes abuse can be characterized as just another rough patch in a relationship, making it difficult to determine certain behaviors as harmful or violent. This is further heightened when much of the information and resources around abuse relates to the experiences of cisgender, heterosexual women. David*, a white, gay, cisgender man, says he experienced emotional and mental abuse from his former partner who would purposefully ignore him and isolate him from other people. It wasn’t long before his former partner kicked him out of his home after accusing David of making arrangements to sleep with other men. Maya*, a black, queer woman, says she was financially and emotionally abused by her ex-partner who would manipulate her into giving her money, but then would make Maya feel that it was her fault for being bad with her finances. Naomi*, a queer, cisgender, mixed-race woman, says she didn’t realize that she was in an abusive relationship until she started directly working in domestic violence services. She thought that her experiences didn’t count as abuse because, she says, she “was never physically hit or strangled,” despite being spat on, having her possessions taken away if she didn’t act in an amenable way, and being threatened with rape. All three interviewees expressed that they weren’t aware they were experiencing abuse or that they had never known that such abuse was possible.
The assumptions made about LGBTQ relationships might act as another barrier to reporting abuse. Sadie*, a queer, black, cisgender woman, found people she told of her abuse to be dismissive: “Other people didn’t view my abuse as authentic because it came from another woman. They thought I should be able to overpower her or fight back.” Galop notes that the idea that abuse is about strength is another common misconception; according to the report, the reality is that abuse is about gaining power and control over another person, regardless of age, size, appearance, or any other physical factor.
Another unique form of abuse used against people who identify as LGBTQ is using their sexuality or identity against them in order to isolate and deter them. Domestic Violence London notes that women who identify as lesbian, bisexual, and queer can be threatened with being “outed” and having their sexual orientation or gender identity disclosed without their consent, or criticized for not being a “real” lesbian or bisexual woman if they’ve have had a previous heterosexual relationship.
Ruby*, a bisexual, non-binary/questioning woman, says she was in an emotionally and sexually abusive relationship with a man for three years. She says she often felt isolated and without community in the straight world and in LGBTQ spaces. “I think my ex could sense my vulnerability and saw that as an opportunity to abuse. I actually started [identifying] as bisexual during the period of time I was with my abusive ex, and it was something he used against me to increase my isolation,” Ruby says. “I couldn’t be friends with anyone of any gender, as I might cheat. He also sexualized my identity which [was] very difficult [for me] when it was something I was really struggling to express and understand.” Even after the relationship ended and people found out Ruby was bisexual and an abuse survivor, they would assume that the trauma had led her to be attracted to women, again leading her to question her identity and feel invalidated.
Rachel*, a mixed-race, cisgender woman who also identifies as bisexual, was in a relationship in which her ex gaslighted her and used physical violence during the relationship. She says she knew that they were not sexually compatible but also believed that she owed him sex for being with her. “I put up with the abuse because he was willing to stay with me, and I needed that because I was insecure. I would cry after we had sex every time. Deep down I knew that I didn’t want to be with him in that way, but I could never put my finger on what made me cry when we were intimate. I later figured out I hated it. I hated sex with a man; I felt so used.”
These stories illustrate that there are so many barriers to seeking help as a queer person in an abusive relationship, many of which point to the fact that some people simply don’t acknowledge that abuse is real between LGBTQ people. All these stigmas can also contribute to LGBTQ people not knowing where to turn if they do want to report abuse, particularly if the victim doesn’t want to disclose their sexuality or gender identity to organizations and agencies like the police, according to Domestic Violence London. End The Fear also notes that such agencies may “misunderstand the situation as a fight between two men or [two] women, rather than a violent intimate relationship, and therefore LGBT people may be discouraged from disclosing if service providers use language which reflects heterosexual assumptions.” The truth is, there is help available if you’re an LGBTQ person in an abusive relationship. Organizations like LGBT Domestic Abuse Partnership, Love Is Respect, the Anti-Violence Project, and many more are here to help you, because as the numbers show, you’re definitely not alone.
Looking back, Ruby says she believes that if more support for bisexual survivors had existed at the time, it would’ve made a big difference. “More awareness of the statistics about intimate partner violence and sexual assault against bisexual people would’ve helped me feel validated in my experiences and confident taking up space as an LGBTQ survivor.”
*All names have been changed to protect the identities of the interviewees.
If you or someone you know is in an abusive relationship, you can call the Loveisrespect hotline at 1-866-331-9474, the National Domestic Violence hotline at 1-800-799-7233, or text ‘loveis’ to 22522. The One Love Foundation also provides more resources, information, and support.
But there’s one big problem: Not enough Americans are getting enough of either.
However, recent research suggests fixing one could fix the other.
A 2017 study published in the Archives of Sexual Behavior suggests people, whether single or married, were having sex less often during the early 2010s than they were in the late 1990s — at a rate of nine fewer times per year.
Millennials are having the least amount of sex, but the researchers say it’s not due to longer working hours or increased pornography use.
Overall, fewer people are in steady relationships and those who are, including married people, are having sex less often.
And research has shown that a lack of quality sleep for the right number of hours a night can lead to a decline in mood, libido, and romantic motivation.
That alone may keep you up at night.
Does having sex help you sleep better?
Experts say while there isn’t enough solid clinical proof to suggest that sex makes you sleepy, the basic underlying mechanics of the chemicals released during sex may help one sleep better.
Among other things, it has a lot to do with the hormone oxytocin, nicknamed “the love hormone.”
Dr. Amer Khan, a Sutter Health neurologist, sleep specialist, and founder of Sehatu Sleep in Northern California, says the release of oxytocin has been stated to occur in conjunction with feelings of affection and affectionate or sensual touch, leading to a feeling of pleasant well-being and relief from stress.
“Other hormones, such as dopamine, prolactin, and progesterone, have been implicated in affecting the mind with a sense of relief, relaxation, and sleepiness following the act of satisfactory sex,” Kahn told Healthline.
But everyone is different, so these chemicals shuffling through your brain right at bedtime may be stimulating and wake-promoting or sleep-inducing, Khan said.
“After all the considerations, it seems reasonable to say that a mutually satisfying physical and mental interaction before sleep enhances mood, feelings of well-being, releases stress, and makes it easier to switch off the busy mind to go to sleep and stay asleep,” he said. “If a satisfying sexual orgasm after an exciting foreplay is a part of that interaction, it is also likely to lead to better sleep.”
A 2016 review of research done at the University of Ottawa suggests engaging in sexual intercourse before sleep can decrease stress and possibly help insomniacs initiate and maintain their sleep, making it a “possible alternative or addition to other intervention strategies for insomnia.”
Still, Khan warns, more large-scale studies are needed to explore the subject in more detail. Either way, he says, there’s more than one way to connect with your partner that can put your mind at ease before bedtime.
“As a sleep physician, I would advise people to enjoy their time together,” Khan said. “Physical, emotional, and mental togetherness is more important than focusing on the need to have an orgasm before sleep.”
Then again, some research suggests a good orgasm doesn’t hurt when trying to get better sleep.
A 2017 study out of CQUniversity in Adelaide, Australia found that more than 60 percent of 282 adults studied reported having slept better after having sex that led to climax.
Chris Brantner, a certified sleep science coach at SleepZoo, said women also experience increased estrogen levels after sex, which can enhance REM sleep — the truly regenerative kind — while men get a surge of prolactin, which causes a feeling of fatigue.
“However, like most things involving sleep, there’s a deeper relationship here,” Brantner told Healthline. “Because not only does having sleep help you get to sleep, but getting good sleep helps you have more sex.”
To help increase your libido, Brantner recommends the full seven to eight hours of sleep a night.
“Lack of sleep throws your hormones out of whack and decreases testosterone, which is crucial for both male and female sex drive,” he said. “Sleep deprivation also has a negative impact on your energy levels and mood, which both will make you less likely to want to have sex.”
But what about those without a partner to help release those love hormones?
The power of self love
As earlier noted, people are having sex less often, partially due to having a steady relationship with a partner.
So, what’s to prevent masturbation from being the way to calm oneself to sleep? Nothing, actually.
Some of those experiments include whether masturbation leads to more quality sleep. Animal studies, she says, have shown males who ejaculated had better sleep latency and quality, but it hasn’t yet been shown in humans.
“In animals, the effect is thought to be due to vasopressin, which also increases with orgasm in humans, so it is likely to work the same in humans,” Prause told Healthline. “Our federal government, however, does not fund sex research, so it is unlikely we ever will receive funding at the level necessary to demonstrate this in a sleep laboratory with humans.”
Besides studying the effects that sexual gratification has on sleep, Prause is also a licensed psychologist who works in behavioral medicine, including sleep maintenance issues.
Masturbation is not currently mentioned in any standardized sleep assessments or treatments, but Prause thinks it should be.
“I think it is a terrible disservice to patients, especially those struggling on their medications, and can increase the stigma for those who successfully use masturbation to manage their sleep disturbances,” she said.
Any sex expert worth their salt will tell you it’s not just the completion of the act, but the act itself.
As Khan mentioned, hormones that may help you sleep are released just by being close and intimate with someone, even if it doesn’t involve sex.
But since the bedroom is made for either sleep or sex, there are a few small things you can do to keep that space sacred. That includes removing distractions like TVs, tablets, phones, and anything else with a screen that isn’t a window.
Brantner says staring at your phone right before bed can mess up your circadian rhythm, or the body’s natural sync with the sun. Also, he says, research suggests it also contributes to partner dissatisfaction.
“If you’re staring at your phone, you aren’t cuddling, you aren’t conversing, and you’re definitely not having sex,” he said. “In other words, you’re ignoring your partner.”
So, if you’re reading this in bed, put your phone away and talk with your partner about sharing a hormone-filled experience in the bedroom.
By Jen Anderson
The pillar of any good relationship is open communication — and that doesn’t stop at being honest about whose turn it is to do the dishes. Opening up about sex with your partner, whether it’s about your birth control options, the positions that make you feel best, or the need to take emergency contraception, is essential to truly enjoying your sex life.
That’s why, in partnership with Plan B One-Step, we created a handy guide to the most common sex conversations you might encounter, tapping Katharine O’Connell White, MD, MPH, and Rachel Needle, PsyD, for their best advice on how to navigate each. No matter if it’s a new Hinge fling, a veteran booty call, or a long-term relationship, you should feel empowered to have these conversations — especially when they help ensure safe sexual health practices and more enjoyment to help you reach that O. Read ahead to see how Dr. White and Dr. Needle break it all down. A better sex life awaits you
The Birth Control Conversation
Before you engage in sex at all, it’s crucial that you and your partner are transparent with each other about what contraception you plan to use to protect against sexually transmitted infections (STIs), sexually transmitted diseases (STDs), and unintended pregnancies. This means talking about the methods you might already be using, like the pill or the IUD, plus barrier methods like condoms or a diaphragm. Be open and honest about your prior experience so that you’re both on the same page.
“The condom discussion is paramount, for the safety of all involved,” Dr. White says, and she suggests always having a supply of condoms on hand. This way, both parties can feel more comfortable going into sex knowing that you’re taking precautions to reduce the risk of STIs and STDs.
The Frequency Conversation
While you may feel like you’re the only couple that struggles with differing opinions on how often you want to have sex, the truth is that it’s very common. The key here is to bring up your feelings about frequency when you’re not hot and heavy. “Start off with something positive about your relationship, including your sexual relationship,” Dr. Needle advises. Then, “use feeling words and ‘I’ statements, [so you don’t put] your partner on the defensive.” Use the conversation to establish the factors that are contributing to either party’s decrease in sexual desire, and make plans to work on them, either on your own, together, or with a professional. Just remember: “There is not really a ‘normal’ amount or an amount of sex that is good or correct to have. Each couple is different.”
The Emergency Contraception Conversation
So the condom broke during sex, or it never got used. There’s no need to skirt around the issue. Dr. White suggests bringing up the emergency contraception conversation by saying something like, “Whoops, I think we forgot something,” if you and your partner forgot to use your preferred birth control method. If it broke, just say so, point blank. It’s likely that your partner is thinking the exact same thing as you are — someone just needs to break the ice and bring it up.
Make arrangements to buy Plan B One-Step for emergency contraception together, or, in the case of a fleeting one-night stand or a FWB-gone-awry, the conversation might not be necessary, and you should still feel empowered to get your emergency contraceptive on your own. It’s easier than ever, with Plan B available on the shelf at all major retailers without a prescription, age restriction, or ID. Just keep in mind: You have 72 hours after unprotected sex to take it, and the sooner you take it, the more effective it will be at helping prevent pregnancy.
When it comes to asking your partner to get tested, Dr. White advises keeping the convo friendly and factual. Try telling them your plans to get tested, and suggest they do the same. “That way, getting tested is a joint venture and not a one-way request,” she explains. If you already have an STI or STD, it’s important to chat about this prior to any sexual encounters — your partner has a right to know about their own risks. “Pick the right time and place for a serious conversation, and try [saying something like], ‘I like you a lot, so there’s something you need to know.'”
The Period Sex Conversation
Period sex isn’t for everyone. But for some, it can be just as enjoyable as non-period sex and even bring couples together in a new way. According to Dr. White, the best way to approach this topic is with a casual conversation that signals you’re not embarrassed and allows your partner to follow your lead. “Mention [upfront] that you’re on your period, so [you can] throw down a towel on the bed to protect the sheets,” she says — especially those white cotton sheets. Not only is this conversation important to have for transparency, but it could introduce a favorite new time of the month to get intimate. “Sex during your period has a lot of advantages,” she adds. “The blood can act as a [secondary] lubricant, and the endorphins released with orgasm can help soothe period cramps.”
The Painful-Sex Conversation
Plain and simple, painful sex isn’t good sex for anyone. “Any decent human will not want to cause you pain and will work with you to make it more comfortable,” Dr. White says. So use your voice to tell your partner immediately if something isn’t feeling quite right — even if this means stopping sex early. If the pain persists, “Trust your body… You should not keep doing the same thing that hurts. This will only teach your body to associate pain with sex, which can be a brutal cycle to break,” she adds.
As they move into adulthood, nearly half of these children (or even more when the studies are closely interrogated), continue to feel strongly that they were born in the wrong body. Many seek treatment – hormones and surgery – to transition into the sex with which they identify.
Although male to female (MtF) and female to male (FtM) transitions are now much more available and accepted, the road to transition is still fraught with uncertainty and opprobrium.
In the 1980s I was swayed by the passionate advocacy of Herbert Bower, a psychiatrist who worked with transsexuals in Melbourne. He was revered in the transgender community for his willingness to authorise sex change operations, which were highly controversial at the time. Aged in his 90s, he came to my laboratory in 1988 to explore the possibility that variation in the genes that determine sex could underlie transgender.
Dr Bower wondered if the gene that controls male development might work differently in transgender boys. This gene (called SRY, and which is found on the Y chromosome) triggers the formation of a testis in the embryo; the testis makes hormones and the hormones make the baby male.
There are, indeed, variants of the SRY gene. Some don’t work at all, and babies who have a Y chromosome but a mutant SRY are born female. However, they are not disproportionately transgender. Nor are the many people born with variants of other genes in the sex determining pathway.
After many discussions, Dr Bower agreed that the sex determining gene was probably not directly involved – but the idea of genes affecting sexual identity took root. So are there separate genes that affect gender identity?
Evidence for gene variants in transgender
The search for gene variants that underlie any trait usually starts with twin studies.
There are reports that identical twins are much more likely to be concordant (that is both transgender, or both cisgender) than fraternal twins or siblings. This is probably an underestimation given that one twin may not wish to come out as trans, thus underestimating the concordance. This suggests a substantial genetic component.
More recently, particular genes have been studied in detail in transwomen and transmen. One study looked at associations between being trans and particular variants of some genes in the hormone pathway.
A recent and much larger study assembled samples from 380 transwomen who had, or planned, sex change operations. They looked in fine detail at 12 of the “usual suspects” – genes involved in hormone pathways. They found that transwomen had a high frequency of particular DNA variants of four genes that would alter sex hormone signalling while they had been developing in utero.
There may be many other genes that contribute to a feminine or a masculine sexual identity. They are not necessarily all concerned with sex hormone signalling – some may affect brain function and behaviour.
The next step in exploring this further would be to compare whole genome sequences of cis- and transsexual people. Whole genome epigenetic analyses, looking at the molecules that affect how genes function in the body, might also pick up differences in the action of genes.
It’s probable that many – maybe hundreds – of genes work together to produce a great range of sexual identities.
How would “sexual identity genes” work in transgender?
Sexual identity genes don’t have to be on sex chromosomes. So they will not necessarily be “in sync” with having a Y chromosome and an SRY gene. This is in line with observations that gender identity is separable from biological sex.
This means that among both sexes we would expect a spread of more feminine and more masculine identity. That is to say, in the general population of males you would expect to see a range of identities from strongly masculine to more feminine. And among females in the population you would see a range from strongly feminine to more masculine identities. This would be expected to produce transwomen at one end of the distribution, and transmen at the other.
This occurrence of a range of differing identities would be comparable with a trait such as height. Although men are about 14 cm taller than women on average, it’s perfectly normal to see short men and tall women. It’s just part of the normal distribution of a certain human characteristic expressed differently in men and women.
This argument is similar to that which I previously described for so-called “gay genes”. I suggested same–sex attraction can readily be explained by many “male-loving” and “female-loving” variants of mate choice genes that are inherited independently of sex.
Why is transgender so frequent then?
Transgender is not rare (MtF of 1/200, FtM of 1/400). If gender identity is strongly influenced by genes, this leads to questions about why it is maintained in the population if transmen and transwomen have fewer children.
I suggest genes that influence sexual identity are positively selected in the other sex. Feminine women and masculine men may partner earlier and have more kids, to whom they pass on their gender identity gene variants. Looking at whether the female relatives of transwomen, and the male relatives of transmen, have more children than average, would test this hypothesis.
I made much the same argument to explain why homosexuality is so common, although gay men have fewer children than average. I suggested gay men share their “male loving” gene variants with their female relatives, who mate earlier and pass this gene variant on to more children. And it turns out that the female relatives of gay men do have more children.
These variants of sexual identity and behaviour may therefore be considered examples of what we call “sexual antagonism”, in which a gene variant has different selective values in men and women. It makes for the amazing variety of human sexual behaviours that we are beginning to recognise.
If you feel as though you and your partner are sexually incompatible, there are some things you can do.
Consider seeing a therapist or, specifically, a sex therapist, to determine the underlying reasons you and your partner aren’t enjoying sex together.
The most important thing you can do is communicate your expectations and desires with your partner.
Having a satisfactory sex life is often assumed to be had by everyone in relationships. Unfortunately, though, this is not always the case
In fact, a New York Times article revealed that 15% of married couples are in a sexless relationship. And, if you’re not familiar, the term “sexless relationship” consists of couples who have not had sex more than 10 times in one year, no sex in the last six months, or no sex in the last year. Unrecognized or disregarded sexual incompatibility is often a cause for this
If you’re in a sexually incompatible relationship, there are things you can try to fix the issue.
See a mental health professional.
Not all issues with sex are caused by physical limits. For some, mental or emotional blocks can be the cause, too. Psychotherapist Dr. Kathryn Smerling told INSIDER that you should consider seeing a mental health professional if this happens to be an issue in your relationship.
“There are all kinds of reasons that people are sexually incompatible,” she said. “If that is consistent for you, I’d suggest finding a mental health professional because it’s most likely not a physical problem, but an emotional issue that needs to be addressed. Very often, sexual incompatibility is due to one person withholding from another person; so explore that dynamic as well.”
Try visiting a sex shop.
Sex toys aren’t just meant for nights when you’re alone. Though pretty taboo in the past, many couples are taking more trips to sex shops to help spice up their time in the bedroom.
“Visiting a sex shop can help you find new ways to make sex exciting,” Smerling confirmed. “This helps with opening up the possibilities and opening up a dialogue.”
Don’t think about sex.
Not thinking about sex can be difficult when that’s the issue between you and your loved one, but according to Smerling, this could be a way to truly help the problem.
“Do something counterintuitive,” she said. “Cuddle, hold hands, touch each other — but refrain from actual intercourse. See if that takes the pressure off.”
Doing this can also build up the anticipation of wanting to be with one another intimately.
See a sex therapist.
Although Smerling suggested seeing a mental health professional to discover the underlying emotional or psychological issues dealing with your sexual performance, Heather Ebert — dating and relationship expert at WhatsYourPrice.com— told INSIDER that you shouldn’t count out seeing a sex therapist, too.
“The idea that we should work out our problems without help is slowly being deconstructed in society,” said Ebert. “Seeing a marriage counselor is becoming more and more acceptable and so should seeing a sex therapist. They can help you talk about sex and get to the root of the problem
Shower sex is the stuff that Hollywood love-making magic is made of. In real life, though, it’s more complicated than you might think — meaning, no showing off your yoga moves to your partner in the shower because we don’t want you to end up in the ER. When it comes to sex acts and positions, shower sex proves that there’s more to sex than just penetration. For example, you’re unlikely to slip if you’re on your knees, and since you’re already in the shower it’s super easy to get clean when you’re done.
You’ll have to think about barriers and not just condoms and dental dams, but also things like nonslip shower mats that can help ensure you have a much safer time while getting it on. Additionally, there are lubes that can help to make penetrative shower sex more enjoyable. That’s just the beginning of what’s good about shower sex — when you know how to do it right, it can be really amazing. Allure spoke to sex experts about the safest and steamiest (horrible pun intended) ways to have shower sex.
Which sex positions work best in the shower?
Those with nicer showers simply have an unfair advantage in the shower sex game, at least when it comes to space and positions. (Sigh — the one percent wins yet again.) If your shower has room for a chair, a bench, or has railings to hold onto, you’re far more likely to enjoy shower sex, as you have an array of seated positions available, such as cowgirl, reverse cowgirl, and seated oral sex.
To prevent a potentially painful spill, somatic psychologist and certified sex therapist Holly Richmond encourages using a railing to hold onto if you’re going to be lifting legs up or trying any positions that require balance. “People get really injured from slipping and falling,” says Richmond. “A mat or some kind of rail to hold onto is always helpful.” While installing a rail is more time-consuming, you can grab a nonslip mat from Amazon for $10.
However, that doesn’t mean that those of us with small showers can’t have a great time, too. The safest standing position in the shower is from behind, as you can leave both legs planted. “Unless you have safety rails installed, keep both feet on the ground if you’re using a standing position,” says sexologist Timaree Schmit.
And who says there needs to be any penetration involved? Oral shower sex can be super hot, too, not to mention a little simpler for the accident-prone. (Just be careful that you don’t choke on shower water.) There’s also nipple pinching, neck kisses, shoulder massages, and any other fun you can imagine.
What precautions should I take with using condoms in the shower?
While shower sex using condoms isn’t impossible, it’s not always the easiest — or the most fool-proof. “Have condoms or other barriers readily accessible, but be mindful that oil-based products degrade latex so consider what other soaps and lotions are on your hands,” explains Schmit. If you’re in a fluid-bonded relationship (meaning you have both been tested and have agreed to have sex sans condoms), shower sex comes with less stress.
Someone once told me in high school that you could have sex in the water and not get pregnant because the water would wash all the sperm away. Seriously. If you have heard any such rumor, don’t believe it; it’s dangerous fake news. “Don’t think because you’re submerged in water and you’re getting washed off that you can’t get pregnant or get an STI; you absolutely can get those,” says Richmond. If you’re not in a fluid-bonded relationship and feel apprehensive about the reliability of condoms in the shower, you can always move things to the bedroom after enjoying some bath-centric foreplay.
First-time sex has a lot of logistics attached to it—like where it happened, when it happened, and who it happened with. For most of us, it’s the “when” that holds a ton of weight. As a society, we tend to place so much importance on how old we were when we first shared that intimate moment with someone else. We rarely even consider if we were mentally, emotionally, and physically ready to do it. Now, new research shows your age really isn’t the only thing that matters when it comes to sexual readiness; there’s much more in-depth criteria that includes physical, emotional, and psychosocial well-being.
A study published in the journal BMJ Sexual and Reproductive Health questioned 2,825 people between ages 17 and 24 about their first sexual experience, including the nature of their relationship with the person they had their first sex with, both of their ages, and how much sexual experience their partner had. The researchers also asked about their socioeconomic status, their education level, family structure, ethnicity, and how and when they’d been taught about sex.
What does it mean to be “ready” for sex?
Rather than focusing on age as a key factor, the researchers used four distinct points to gauge how ready each person was based on the World Health Organization’s standards for sexual health. WHO defines sexual health as “a state of physical, emotional, mental and social well-being in relation to sexuality,” which includes a “positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination, and violence.”
Only those who met all four criteria were considered “sexually competent”—that is, ready to have sex—at the time they first did it.
“The concept of ‘sexual competence’ represents an alternative approach to timing of first sexual intercourse, considering the contextual attributes of the event, rather than simply age at occurrence,” the researchers wrote in the paper. “This departs from the traditional framing of all sexual activity among teenagers as problematic, and recognises that young age alone does not threaten sexual health, any more than older age safeguards it.”
Here are the four main criteria:
1. Contraceptive use
Are you using birth control of some sort? A person who isn’t willing and prepared to use contraception during sex is not mature enough to be having sex. That’s why researchers included it as such a major point, especially for those doing it for the first time. Of those surveyed, most people did use reliable contraception, but around one in 10 did not.
Are you having sex because you truly want to do it, or does it have to do with peer pressure or drunkenness? Sex should always be on your own accord and not because it’s something everyone else around you is doing.
Here’s a crucial one: Did both parties verbally and physically agree to have sex? If not, neither party was ready to do the deed—one person was forced into it and experienced sexual assault, and the other person assaulted someone, which is the furthest thing from sexual competence. The researchers excluded instances of forced sex from their study, but they noted that almost one in five women had reported not being in charge of the decision to have sex for the first time.
4. The “right” timing
Do you feel like this is the “right time”? Participants reported whether they personally felt like they’d picked the appropriate time in their lives to start having sex. Though the study didn’t specify, there are many personal reasons why it is or isn’t a good time to start having sex; they weren’t ready to have sex—you might be struggling with stress or insecurity and don’t want to complicate it by introducing intimacy in your life, or you might be very erotically charged and have a lot of free time, so why not? Other factors like finding a partner they feel attracted to and comfortable with could factor into this question.
More women than men felt their first sexual experience did not happen at the right time—40 percent versus 27 percent, respectively. This was the most commonly reported negative feature of first-time sex.
It’s no secret that many parents struggle with talking to their kids about sex. But a new study from Britain suggests those awkward conversations may be key in helping kids navigate their first sexual experiences—and offers some useful guidance on how to do it.
The National Survey of Sexual Attitudes and Lifestyles poll delves into sexual behavior in Britain. It asks some obvious questions, such as “What age did you first have sex?” Others dig deeper: “Did you feel peer pressure to have sex when you did it for the first time?” “Were you drunk?” “Did you want it as much as your partner wanted it?”
Researchers at the London School of Hygiene and Tropical Medicine used the survey to do a more in-depth study on the circumstances surrounding young people’s first time and how they felt about it, interviewing 2,825 young people from the survey. (The broader national survey included 15,162 men and women, aged 17-24, between 2010-2012.) The study, recently published in BMJ Sexual & Reproductive Health, was retrospective, meaning that young adults were asked to reflect on their first experience, which could have been years earlier.
In an effort to get beyond the simplistic question of “When did you first have sex” to the more important ones around whether young adults felt ready, the authors sought to assess respondents’ “sexual competence” based on questions the young adults answered in the survey. The components of sexual competence include:
Did you use contraception?
Did you feel in charge of your decision (or was the decision influenced by things such as peer pressure and/or drunkenness)?
Were you and your partner equally willing to do it?
Did it happen at the right time?
Competence feels like a loaded word, especially in the context of sex. But if you lose the word and look at the questions embedded in the definition, you have an interesting road map to what readiness may look like, including consent, protection, safety, and interest.
Not surprisingly, many people found their first times to be not-so-great. A whopping 40% of women and 26% of men did not think that their first sexual experience occurred at the ‘right time,’ while 17.4% of women reported that they and their partner were not equally willing to have sex the first time it happened. A similar share of women reported a non-autonomous reason—such as peer pressure or drunkenness—for their first sexual encounter. Nine out of ten young adults used contraception.
According to the researchers’ definition of competence, 52% of women and 42% of men were not sexually competent for their first time.
The relationship between age and sexual competence was not straightforward, but it was clearly directional: 78% of 13-14-year-old girls were not competent, compared to 36% of 18-24-year-old girls. (For boys, 65% were not competent at 13-14, compared to 40% at 18-24.)
First times are often fraught for a variety of reasons: peer or partner pressure, expectations, mechanics. But being older clearly has advantages. The study suggested that there was also a connection—for girls at least—between having conversations with parents or learning about sex and relationships in school and feeling ready.
“That young women who had discussed sexual matters with their parents, and those who reported school to be their main source from which they learnt about sexual matters, were more likely to have been sexually competent at first sex resonates with previous research,” the study said. The authors suggest that may be because parental input and conversations, and school-based relationships and sex education, “may provide the knowledge and skills required to negotiate a positive and safe sexual experience.”
That association was not observed with men. The authors suggest one interpretation is that communication is less important for men as they reflect on their first encounter.
Self-reported retrospective interviews necessarily may be influenced by flaws of memory and bias. But if self-reporting shows this much uncertainty and openness about not being ready, it seems safe to assume the numbers are even greater.
Clearly, parents need to do more to help kids figure out the right time to become sexually active. Forty-seven percent of 14-year-old girls and 58% of 14-year-old boys said they had never discussed sex with either parent. And as awareness of sexual health and well-being develops, conversations between parents and kids must go beyond advice like “Use protection. Don’t get a disease” to what healthy relationships look and feel like, what consent is, how to say no, and how porn pollutes our idea about what sex should be like.
A starting point for those conversations is a vernacular that makes sense. The definition of competence laid out by the BMJ researchers is compatible with that of the World Health Organization, which also goes beyond physical health (contraception and sexually transmitted diseases) to include mental well-being and social aspects, referring to a “positive and respectful approach to… sexual relationships” and “safe sexual experiences, free of coercion.”
Based on the BMJ study, the BBC suggests that parents talk to teens about sex using this checklist:
When is the right time?
If you think you might have sex, ask yourself:
Does it feel right?
Do I love my partner?
Does he/she love me just as much?
Have we talked about using condoms to prevent STIs and HIV, and was the talk OK?
Have we got contraception organised to protect against pregnancy?
Do I feel able to say “no” at any point if I change my mind, and will we both be OK with that?
Do I feel under pressure from anyone, such as my partner or friends?
Could I have any regrets afterwards?
Am I thinking about having sex just to impress my friends or keep up with them?
Am I thinking about having sex just to keep my partner?
Researchsuggests that our early experiences with sex can have a long-term influence on sexual health. So it makes sense for parents to do what they can—from an ongoing conversation to an anonymous checklist left on the table—to increase the odds that teens’ first encounters are good ones.
There is no doubt that sex is great. However, it can use something to make it more passionate and wild from time to time. The best thing to achieve that is to find the right “hardware” for your games and let it all play out really really well.
Besides making sex better, sex toys can bring many different benefits to the table, or into the bed, however you like it (this is a judgment-free zone). But among all the physical benefits, there are some psychological ones, too.
Some people are shy about their sexual lives or talking about sex in general. What is more, at the very mention of sex toys even they can get all giggly and blood rushes to their cheeks like they are teens again. However, what not many of us know is that if you get over it and talk about sex toys, you can actually feel more confident to talk about sex.
Sex toys are not a taboo anymore and everyone uses them; either with their partners or by themselves. So, if you are able to talk about them in any way, be sure you will be more free to talk about sex with your partner, for example. You will eliminate that shyness, guilt or embarrassment you might be feeling, and your sex life will get better and more satisfactory in no time.
“Cure” for sexual dysfunction
There are both men and women who can have sexual dysfunction, and sex toys are something that can aid in that. For example, there are women who suffer from anorgasmia, which means they can hardly reach orgasms while having sex. That is why vibrators and relaxing sex toys, are recommended. As far as men are concerned, a helping hand of sex toys can make them climax without having to get an erection. There is no harm in trying kinky toys like Hustler Hollywood has, for example, and giving it a shot.
Plus, if you manage to finally get that orgasm, there is no doubt that your confidence will rise. Another positive thing is that they will take the pressure off of you because you won’t be overthinking what you’re doing in bed. You just need to relax and let the toys do their thing. And, at the end, you will feel confident about your relationship, things will get back on track sex-wise and you will relieve stress!
Great sex equals a great relationship
You might have that spark with your partner, but things are bound to get boring sometimes. That is why you need to communicate. Surprisingly or not, sex toys will lead to better communication with your partner. Even a simple visit to the sex shop with your partner will make you communicate better. You do need to be open about what you want, like and dislike, so it is a great way to get to know each other better.
Furthermore, you will learn how to “navigate” your partner better. Without the toys, you might feel shy about telling him “a bit to the left” or her “to use less teeth”, but with sex toys, things can change. If you’re using vibrators you will be more relaxed and open about where he or she needs to go in order to hit the spot. Plus, some toys can reach places no man or woman has ever touched.
According to Bustle, you can say that sex toys can improve your honesty and communication because they will spark the conversation and make your relationship even better.
They just make you feel good
The mental benefits of using sex toys are almost the same as the benefits of sex. But double the dosage! Sex boosts your confidence, but with the use of sex toys, you are even more confident because you managed to go pass that stigma and taboo.
Sex leads to increased intimacy, love and trust in a relationship, but with the toys, you two can get even closer. This is because your aforementioned communication is better, you made that special bond when buying sex toys and you learned new things about each other and your bodies. Plus, a lot of oxytocin is released after each passionate, sweaty and successful round in the bed, which only leads to stronger relationships and more respect towards each other.
After all this, we can say for sure that sex toys are beneficial. Forget about all that kink-shaming and go a little wild. Your relationship can use a little something new and fun, and your partner will be happy about it, too! Not to forget about that confidence boost and more happiness in your lives. So, take your partner’s hand, find the toys you both like and go on an adventure of kinky fantasies and plenty of fun.
Jill was just 39 in July 2010 when she was diagnosed with stage 2 breast cancer. Her longtime boyfriend had felt a lump in her right breast. Two weeks later, she had a mastectomy and began chemotherapy. The shock, stress, fatigue and treatment took its toll on the relationship, and her boyfriend left.
“That’s when I began to realize that breast cancer was not only threatening my life, but would affect me physically, emotionally and sexually going forward,” said Jill, a library specialist in Denver who asked that her last name not be used to protect her privacy.
When someone gets a breast cancer diagnosis, intimacy and sexuality usually take a back seat to treatment and survival and often are ignored entirely, said Catherine Alfano, vice president of survivorship at the American Cancer Society. Doctors often don’t talk with their patients about what to expect sexually during and after treatment, and patients can be hesitant to bring up these issues, she said.
Among the common problems that the cancer treatment can cause are decreased sex drive, arousal issues and pain when having sex, and body image issues (if there has been such surgery as a mastectomy), Alfano said. Many of these problems are treatable, but only if a patient speaks up. That way, the clinician can refer the person to specialists versed in physical or psychological therapy for cancer survivors or health specialists familiar with the useful medications and creams.
According to the National Cancer Institute, about 15.5 million cancer survivors live in the United States. Of those, 3.5 million had breast cancer.
Sharon Bober, a Dana-Farber Cancer Institute psychologist and sex therapist, said the biggest problems couples and single women face after breast cancer are the surprises that unfold sexually. She said chemotherapy and hormone suppression therapy can send women abruptly into menopause or exacerbate previous menopausal symptoms, such as vaginal dryness, pain with intercourse and stinging, burning and irritation. Many women are also surprised to discover that breasts reconstructed after a mastectomy have no sensation.
Couples, Bober said, often can benefit from working with a sex therapist trained in breast cancer issues. “It takes time and practice, especially in the face of permanent changes such as loss of sensation or body alterations,” she said. “Women need to become comfortable in their bodies again.”
Amber Lukaart, 35, was diagnosed in 2016 with invasive ductal carcinoma in her right breast. She had no family history of the disease and found the lump herself. She had been working at the Center for Women’s Sexual Health in Grand Rapids, Mich., helping survivors navigate their sexual issues — work that turned out to help her, too.
Her treatment was 16 rounds of chemotherapy, a partial mastectomy of her right breast, 20 rounds of radiation that left the skin on her chest raw and inflamed, and six months of a hormone blocker to protect her ovaries so she could have children in the future.
These treatments affected her sexuality and marriage. The first time she and her husband had sex after the treatments was horribly painful because of dryness. The pain, plus fear of cancer recurrence and death, put a halt to their attempt to reconnect emotionally. At the same time, the partial mastectomy and radiation left her breast looking malformed. She said she felt self-conscious and uncomfortable about it.
She turned to people she knew from her work and felt lucky to have the support.
“I understood immediately that I was in a unique position to help myself and my husband understand and communicate to each other the questions and concerns we both had about our sexual relationship,” Lukaart said.
Yet even with access to sex therapists, sex counselors and treatments, Lukaart said she still felt frustrated with the relative lack of data regarding hormone use for someone like her with estrogen-receptor-positive breast cancer — which about 80 percent of all breast cancer patients have, according to the National Cancer Institute. This type of the disease causes cancer cells to grow in response to the hormones estrogen and progesterone. Hormone treatments that are standard for dryness usually cannot be used after this time of cancer. And over-the-counter remedies didn’t seem to help Lukaart.
She and the co-founder of the women’s center, Nisha McKenzie, researched nonhormonal options. They came across a laser therapy that increases the thickness and elasticity of the vaginal walls. It took three sessions but eventually Lukaart said it gave her back the ability to have a sexual relationship with her husband. Three treatments cost about $3,000 and are not covered by insurance. (Lukaart’s work at the center, which now provides laser treatment, allowed her to get the therapy for free.).
McKenzie and Lukaart are focusing their efforts to help survivors recognize that they may need to do more than just ask their doctors for advice if they want to find ways to get their lives back on track sexually.
“Women need to know,” said Lukaart, “that they have to advocate for themselves and that it’s okay to want more than just to survive cancer — it’s ok to thrive, too.”
In Jill’s case, after exhausting the help of her oncologist and other physicians, she joined a clinical study run by Kristen Carpenter, director of Women’s Behavioral Health at Ohio State University, that looks at ways of improving sexual and emotional health after breast cancer.
The study of 30 women used mind-body techniques, such as progressive muscle relaxation to help with sexual intimacy, Kegel exercises to improve pelvic floor muscle tone and cognitive behavioral therapy to help them rethink negative, self-directed thoughts.
The group also had discussions about assertiveness training, communication techniques to use with partners, sexual positions, and aids that may improve comfort and pleasure.
“We laughed, cried and learned from each other’s struggles and stresses in a warm and understanding environment,” Jill said. “and it helped give me the tools for communicating my needs and challenges and to be aware that psychological and physiological interventions are available.”
A supportive partner can ease the problems of breast cancer survivors.
Betty Bezemer, 72, had been diagnosed with breast cancer at age 50. Throughout her treatment, her husband kept her spirits up. The couple maintained their intimacy by not only discussing what was happening but also continuing their habits together, such as dancing and soaking in bubble baths.
Bezemer said their relationship never suffered. And, with the help of lubricants and other remedies, they found ways to be closer sexually and otherwise.
“My husband always made me feel that he had fallen in love with my head and heart and not just my breasts,” said Bezemer, who now serves on the Houston board of the breast cancer organization Susan G. Komen.
“Obstacles may not be easy to overcome, but women need to understand and accept that problems of intimacy and sex will often follow breast cancer treatment,” said Julie Salinger, a clinical social worker at Dana Farber. “But there are solutions, and the sooner people start to ask about them, the better, as they will only get worse by waiting.”
Other than typing ‘porn’ into YouTube on my family computer at age 11, I always saw it as a dangerously seductive zone not meant for my eyes. A force field also encircled my pelvis, the nether realm where I ought never to go. Any moments of curiosity when I was sure my parents were asleep resulted in a deep embarrassment that made my cheeks flush and my palms sweat. This only solidified the idea that I was a sexual anomaly amidst all other girls my age. Once or twice someone at school would ask ‘do you…?’ but the question was always dismissed by the shaking of heads in unison, faces aghast.
In my experience, female masturbation became more heavily loaded with age. Around the time when exchanging numbers at the school disco had turned into nudes being sent and drinking straight Glens at the weekly rich kid’s house party, it was still very hush-hush. For boys, an interest in their penis seemed to be a kind of comical inevitability, and touching it was a necessity that need not be questioned.
Like a mutually loved hobby, it was a source of jokes, bonding and outwardly expressed desire that just didn’t appear relevant to me. It seemed my own sexuality was only legitimate if a boy was involved, or if it was as some kind of spectacle – and if I were ever to talk about it, it was seen either as an invitation or as a statement about how rebellious and free-spirited I was.
‘Before you realise how programmed are you to be woman hating, if any other girl says they finger themselves you automatically think they’re trying to get attention, whereas a boy is seen as just being honest’ Molly says, when asked the about pre-university attitudes to female masturbation.
Like a mutually loved hobby, it was a source of jokes, bonding and outwardly expressed desire that just didn’t appear relevant to me. It seemed my own sexuality was only legitimate if a boy was involved, or if it was as some kind of spectacle – and if I were ever to talk about it, it was seen either as an invitation or as a statement about how rebellious and free-spirited I was.
‘Before you realise how programmed are you to be woman hating, if any other girl says they finger themselves you automatically think they’re trying to get attention, whereas a boy is seen as just being honest’ Molly says, when asked the about pre-university attitudes to female masturbation.
For girls it was seen as self-indulgent rather than natural instinct, a view which lingers at the back of my mind even now, despite knowing it is completely unfounded. When asked about their early orgasms, the general consensus among my female friends at university was that they used to keep it to themselves, and that the whole thing was generally a source of guilt. This sense of shame all seems so distant from sleepover masturbation and the soggy biscuit challenges of puberty described to me by my male friends.
For me, coming to university was like having a long conversation with a reassuring experienced friend. But she brought with her a confusing message: a lot of girls own vibrators, and they use them often. This was such a sudden change from the messages I had been given through school and sixth form, and I was confused as to why. Even in first year, under the shroud of 2 am when the clinking from the kitchen and the sound of footsteps in the corridor had finally stopped, I would still feel odd about doing it. Like somehow my flatmates could sense it, and that for them to know would be a terrible humiliation.
‘There’s a stark change in attitude towards girls masturbating at university compared to school. Suddenly, it’s completely acceptable for girls to own sex toys, speak freely about using them and even give each other tips’ my friend Isabel says, who tells me she never spoke about masturbation with friends before coming to university.
Of course, for many girls this wasn’t the case, and if it was, these feelings likely faded.
‘When I got to year 10 I became close with a girl who was really open about that kind of thing and she would tell me funny stories that had happened to her. It made me more open’ says Anna. ‘It definitely became more obvious to me as I grew up that it’s nothing to be ashamed of and it’s perfectly normal’ she adds.
‘I know that a lot of girls feel uncomfortable talking about masturbation and usually deny that they even do it, but that hasn’t been my experience because I was close to my friends at school and they were open minded about it like myself. At university masturbation was just so normal that it wasn’t an exciting thing to talk about anymore’ says Maddie.
The abrupt break in the silence on female masturbation upon coming to university seems unnecessary, and although it isn’t an experience shared by the entire female student demographic, the internalisation of these ideas amongst a lot of us is undeniable.