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Why Sex Education for Disabled People Is So Important

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“Just because a person has a disability does not mean they don’t still have the same hormones and sexual desires as other individuals.”

 

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“Sex and disability, disability and sex; the two words may seem incompatible,” Michael A. Rembis wrote in his 2009 paper on the social model of disabled sexuality. Though roughly 15% of adults around the world (that’s nearly one billion people), and over 20 million adults in the U.S. between the ages of 18 and 64 have a disability, when it comes to disability and sex, there’s a disconnect. People with disabilities often have rich and satisfying sex lives. So why are they frequently treated as though they are incapable of having sexual needs and desires, and are excluded from sexual health education curriculum?

According to Kehau Gunderson, the lead trainer and senior health educator at Health Connected, a non-profit organization dedicated to providing comprehensive sexual health education programs throughout the state of California, the sexual health and safety of students with disabilities is often not prioritized because educators are more focused on other aspects of the students’ well-being. “Educators are thinking more about these students’ physical needs. They don’t see them as being sexual people with sexual needs and desires. They don’t see them as wanting relationships,” Gunderson told me when I met her and the rest of the Health Connected team at their office in Redwood City, California.

When I asked why students with disabilities have historically been excluded from sexual education, Jennifer Rogers, who also works as a health education specialist at Health Connected, chimed in. “In general, the topic of sex is something that is challenging for a lot of people to talk about. I think that aspect compounded with someone with specialized learning needs can be even more challenging if you’re not a teacher who’s really comfortable delivering this kind of material,” she said.

But it was the third health education specialist I spoke with, DeAnna Quan, who really hit the nail on the head: “I think sometimes it also has to do with not having the materials and having trouble adapting the materials as well. While people often just don’t see disabled people as being sexual beings, they are. And this is a population who really needs this information.”

The complete lack of sexual education in many schools for students with disabilities is particularly alarming given the fact that individuals with disabilities are at a much higher risk of sexual assault and abuse. In fact, children with disabilities are up to four times more likely to face abuse and women with disabilities are nearly 40% more likely to face abuse in adulthood. Yet students in special education classes are often denied the option to participate in sex education at all. When these students are included in mainstream health courses, the curriculum is often inaccessible.

Disability activist Anne Finger wrote, “Sexuality is often the source of our deepest pain. It’s easier for us to talk about and formulate strategies for changing discrimination in employment, education, and housing than to talk about our exclusion from sexuality and reproduction.” But as Robert McRuer wrote in Disabling Sex: Notes for a Crip Theory of Sexuality, “What if disability were sexy? And what if disabled people were understood to be both subjects and objects of a multiplicity of erotic desires and practices, both within and outside the parameters of heteronormative sexuality?”

When it comes to disability and sexuality, a large part of the issue lies in the fact that disabled people are so infrequently included in the decisions made about their bodies, their education, and their care. So what do people with disabilities wish they had learned in sex ed? This is what students and adults with disabilities said about their experience in sexual health courses and what they wish they had learned.

People with disabilities are not automatically asexual.

“The idea of people with disabilities as asexual beings who have no need for love, sex, or romantic relationships is ridiculous. However, it is one that has a stronghold in most people’s minds,” wrote disability activist Nidhi Goyal in her article, “Why Should Disability Spell the End of Romance?” That may be because disabled people are often seen as being innocent and childlike, one disabled activist said.

“As a society, we don’t talk about sex enough from a pleasure-based perspective. So much is focused on fertility and reproduction — and that’s not always something abled people think disabled people should or can do. We’re infantilized, stripped of our sexuality, and presumed to be non-sexual beings. Plenty of us are asexual, but plenty of us are very sexual as well, like me. Like anyone of any ability, we hit every spot on the spectrum from straight to gay, cis to trans, sexual to asexual, romantic to aromantic, and more.” Kirsten Schultz, a 29-year-old disabled, genderqueer, and pansexual health activist, sexuality educator, and writer, said via email.

Kirsten, who due to numerous chronic illnesses has lived with disability since she was five years old, was not exposed to information regarding her sexual health and bodily autonomy. “I dealt with sexual abuse from another child right after I fell ill, and this continued for years. I bring this up because my mother didn’t share a lot of sex ed stuff with me at home because of illness. This infantilization is not uncommon in the disability world, especially for kids,” she said.

Growing up in Oregon, Kirsten said she was homeschooled until the age of 13 and didn’t begin seeing medical professionals regularly until she turned 21. “This means all sexual education I learned until 13 was on my own, and from 13 to 21, it was all stuff I either sought out or was taught in school.” Schultz explained. But even what she learned about sex in school was limited. “School-based education, even in the liberal state of Oregon, where I grew up, was focused on sharing the potential negatives of sex — STIs, pregnancy, etc. Almost none of it was pleasure-based and it wasn’t accessible. Up until I was in college, the few positions I tried were all things I had seen in porn…AKA they weren’t comfortable or effective for me,” she added.

Internet safety matters, too.

While many disabled people are infantilized, others are often oversexualized. K Wheeler, a 21-year-old senior at the University of Washington, was only 12 the first time their photos were stolen off of the Internet and posted on websites fetishizing amputees. K, who was born with congenital amputation and identifies as demisexual, panromantic, and disabled, thinks this is something students with disabilities need to know about. “There’s a whole side of the Internet where people will seek out people with disabilities, friend them on Facebook, steal their photos, and use them on websites,” she said.

These groups of people who fetishize amputees are known as “amputee devotees.” K had heard of this fetish thanks to prior education from her mother, but not everyone knows how to keep themselves safe on the Internet. “This is something that people with disabilities need to know, that a person without a disability might not think of, ” K said.

K also believes more general Internet privacy information should also be discussed in sex ed courses. “In the technological age that we’re in, I feel like Internet privacy should be talked about,” they said. This includes things like consent and sending naked photos with a significant other if you’re under 18. “That is technically a crime. It’s not just parents saying ‘don’t do it because we don’t want you to.’ One or both of you could get in trouble legally,” K added.

Understanding what kinds of sexual protection to use.

Isaac Thomas, a 21-year-old student at Valencia College in Orlando, lives with a visual impairment and went to a high school that he said didn’t even offer sexual education courses. “I did go to a school for students with disabilities and, unfortunately, during my entire time there, there was never any type of sexual education class,” he said.

And Isaac noted that sexual awareness plays a large role in protection. “They should understand that just because a person has a disability, does not mean they don’t still have the same hormones and sexual desires as other individuals. It’s even more important that they teach sex education to people that have disabilities so they’re not taken advantage of in any kind of sexual way. If anything, it should be taught even more among the disabled community. Ignoring this problem will not make it go away. If this problem is not addressed, it will increase,” Isaac said.

Before entering college, Isaac said he wishes he had received more information about condoms. “I wish I had learned what types of condoms are best for protection. I should’ve also learned the best type of contraceptive pills to have in case unplanned sexual activity happens with friends or coworkers.”

Body image matters.

Nicole Tencic, a 23-year-old senior at Molloy College in New York, who is disabled, fine-motor challenged, and hearing impaired, believes in the importance of exploring and promoting positive body image for all bodies. Nicole, who became disabled at the age of six after undergoing high-dose chemotherapy, struggled to accept herself and her disability. “I became disabled when I was old enough to distinguish that something was wrong. I was very self-conscience. Accepting my disability was hard for me and emotionally disturbing,” she shared. “I was always concerned about what other people thought of me, and I was always very shy and quiet.”

It was when she entered college that Nicole really came to accept her body, embrace her sexuality, and develop an interest in dating. “I had my first boyfriend at 21. The reason I waited so long to date is because I needed to accept myself and my differences before I cared for anyone else. I couldn’t allow myself to bring someone into my life if I was unaccepting of myself, and if I did, I would be selfish because I would be more concerned about myself,” Nicole said. She also recognized the fact that while sexuality and disability are separate topics that need to be addressed differently, they can impact each other. “Disability may influence sexuality in terms of what you like and dislike, and can and cannot do,” but overall, “one’s sexuality does not have to do with one’s disability,” she clarified.

It’s important to make sex ed inclusive to multi-marginalized populations.

Dominick Evans, a queer and transgender man living with Spinal Muscular Atrophy, various chronic health disabilities, and OCD, believes in the importance of sexual education stretching beyond the cisgender, heteronormative perspective. He also understands the dangers associated with being a member of a marginalized group. “The more marginalized you are, the less safe you are when it comes to sex,” he said in an email.

Dominick, who works as a filmmaker, writer, and media and entertainment advocate for the Center for Disability Rights, has even developed policy ideas related to increased inclusion for students with disabilities — especially LGBTQ students with disabilities. “These students are at higher risk of sexual assault and rape, STIs like HIV, unplanned pregnancies, and manipulation in sexual situations,” Dominick said. “Since disabled LGBTQIA students do not have access to sexual education, sometimes at all, let alone education that makes sense for their bodies and sexual orientation, it makes sense the rates for disabled people when it comes to sexual assault and STIs are so much higher.”

According to Dominick, the fact that many disabled students are denied access to sexual health curriculum is at the root of the problem. “When it comes to disparities in the numbers of sexual assault, rape, STIs, etc. for all disabled students, not having access to sexual education is part of the problem. We know this is specifically linked to lack of sex ed, which is why sex ed must begin addressing these disparities.”

So what does Dominick have in mind in terms of educational policies to help improve this issue? “The curriculum would highlight teaching students how to protect themselves from sexual abuse, STI and pregnancy prevention campaigns geared specifically at all disabled and LGBTQIA youth, ensuring IEPs (individualized education programs) cover sex ed inclusion strategies, access to information about sexuality and gender identity, and additional education to address disparities that affect disabled LGBTQIA students who are people of color.”

Understanding power dynamics and consent.

It’s important to understand the power dynamic that often exists between people with disabilities and their caretakers. Many people with disabilities rely on their caretakers to perform basic tasks, like getting ready in the morning. Women with disabilities are 40% more likely to experience intimate partner violence compared to non-disabled women. This includes sexual, emotional, financial, and physical abuse, as well as neglect. For this reason, women with disabilities are less likely to report their abusers.

“Sometimes they’re more likely to think ‘this is the only relationship I can get,’ so they’re more likely to stay in these abusive relationships or have less access to even pursue courses of action to get out of the relationship. Especially if there is dependence on their partner in some way,” said K.

Dominick agreed. “Many of us often grow up believing we may not even be able to have sexual relationships. We often grow up believing our bodies are disgusting and there is something wrong with them,” he said. “So, when someone, especially someone with some type of power over us like a teacher or caregiver, shows us sexual attention and we believe we don’t deserve anything better or will never have the opportunity for sex again, it is easy to see why some disabled people are able to be manipulated or harmed in sexual situations.”

Dominick said this ideology led to his first sexual experience. “I probably should not have been having sex because I lost [my virginity] believing I had to take whatever opportunities I received,” he said, before going on to acknowledge the falsehood in these assumptions. “I’ve had many other relationships since then, and my last partner, I’ve been with for 15 years.”

But when it comes to disability, consent can be tricky. Some disabilities make communication a challenge. The lack of sexual education for many developmentally disabled students means they often don’t understand the concept of consent.

People with disabilities are more at risk for sexual exploitation and abuse.

According to the United States Department of Health and Human Services, children with disabilities also face a much higher risk of abuse. In 2009, 11% of all child abuse victims had a behavioral, cognitive, or physical disability. In fact, when compared to non-disabled children, children with disabilities are twice as likely to be physically or sexually abused. Those living with developmental disabilities are anywhere from 4 to 10 times more likely to face abuse.

Deni Fraser, the assistant principal at the Lavelle School for the Blind, a school in New York City dedicated to teaching students with visual impairment and developmental disabilities, believes it’s important for all students to understand the importance of boundaries, both other people’s and their own. Many students at the school, who range in age from 2 to 21, also have co-morbid diagnoses, making the students’ needs varied.

“It’s important for our students to know that we want them to be safe at all times,” Fraser said. “Letting them know what’s appropriate touch, not only them touching others, but other people touching them; saying things to them; for people not taking advantage of them; knowing who is safe to talk to and who is safe to be in your personal space; if there’s anything going on with your body, who would be the appropriate person to talk to; not sharing private information — so what is privacy; and the importance of understanding safe strangers, like doctors, versus non-safe strangers.”

The portrayal of disabled bodies matters.

The media also plays a part in perpetuating the idea that individuals with disabilities do not have sex. Sexuality is often viewed as unnatural for individuals with disabilities, and many disabled students internalize that. “Even Tyrion Lannister, one of the most sexual disabled characters on television, usually has to pay for sex, and even he was horribly deceived the first time he had a sexual experience,” Dominick noted. “If the media is not even saying sex is normal or natural for disabled people, and sex education is not inclusive, then often disabled people are having to learn about and understand sex on their own,” he added.

Many students with disabilities also want to see their bodies reflected in sexual education materials. “Part of the curriculum at a lot of different schools includes showing some level of video,” K said. But including a person with a visible physical disability in these videos would go a long way in helping to shatter the stigma surrounding sex and disability, she said. According to K, this would help people understand that sex isn’t only for able-bodied people.

People with disabilities make up a large part of the population. They’re the one minority group any person can become a part of at any time. Therefore, incorporating disability-related information into sexual education curriculum not only benefits students who are already disabled, but it can help students who, at some point in their lives, will experience disability. Embracing an inclusive approach and keeping bias out of the classroom would help raise awareness, create empathy, and celebrate diversity. By listening to disabled voices, we can work toward a society that values inclusivity.

Complete Article HERE!

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We must acknowledge adolescents as sexual beings

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As a teenager, Dr. Venkatraman Chandra-Mouli experienced shame and was often denied access when he tried to purchase condoms. Forty years later, adolescents around the world still face barriers to contraceptive access. In this blog, Dr. Chandra-Mouli discusses those barriers and how they can be overcome.

Dr. Venkatraman Chandra-Mouli recalls feeling shame and was often denied access when he tried to purchase condoms as a teenager.

By Dr. Venkatraman Chandra-Mouli

I grew up in India. While in my late teens and studying to be a doctor, I met the girl whom I married some years later. A year or so into our relationship we started to have sex. We decided to use condoms. Getting them at a government-run clinic was out of question. They were known to provide free condoms called Nirodh, which were said to be as smelly and thick as bicycle inner tubes. Asking our family doctor was also out of question. He knew my mother and I had no doubt that he would tell.

So, I used to walk to pharmacies, wait until other customers had left, and then muster up the courage to ask the person behind the counter for upmarket Durex condoms. Sometimes I was successful and walked out feeling like a king. Other times, I was scolded and sent away. I still recall my ears burning with shame. That was 40 years ago, but I know from adolescents around the world with whom I work that they continue to face many barriers to obtaining contraceptives.

Different adolescents, different barriers

In many societies, unmarried adolescents are not supposed to have sex. Laws and policies forbid providing them with contraception. Even when there are no legal or policy restrictions, health workers refuse to provide unmarried adolescents with contraception.

Married adolescents are under pressure to bear children. Many societies require girls to be nonsexual before marriage, fully sexual on their marriage night, and fertile within a year. In this context, there is no discussion of contraception until they have one or more children, especially male children.

Most societies do not acknowledge the sexuality of groups such as adolescents with disabilities or those living with HIV. Neither do they acknowledge the vulnerability of adolescent girls and boys in humanitarian crises situations.

Finally, no one wants to know or deal with non-consensual sex, resulting from either verbal coercion or physical force by adults or peers. Girls who are raped may need post-exposure prophylaxis for HIV, emergency contraception, or safe abortion—all of which are taboo subjects.

Overcoming these barriers

These powerful and widespread taboos have resulted in limited and inconsistent progress on improving adolescent contraception access. This has to change. We must acknowledge adolescents as the sexual beings they are. We must try to remember what a joy it was to discover sex when we were adolescents. We must give adolescents the information, skills, and tools they need to protect themselves from unwanted pregnancies and sexually transmitted infections.

With that in mind, I recommend the following:

  • We need to provide adolescents with sexuality education that meets their needs.
  • We need to change the way we provide adolescents with contraceptives by offering them a range of contraceptives and helping them choose what best meets their needs, and use a mix of communication channels—public, private, social marketing and social franchising to expand their availability. We must go beyond one-off training to use a package of evidence-based actions to ensure that health workers are competent and responsive to their adolescent clients.
  • We need to address the social and economic context of girls’ lives. In many places, adolescent girls do not have the power to make contraception decisions. Even when they are able to obtain and use contraception, an early pregnancy in or out of union may be the best of a limited set of bad options – when they are limited education and employment prospects.

To reach the 1.2 billion adolescents in the world, we must move from small-scale short-lived projects to large-scale and sustained programs. For this, we need national policies and strategies, and work plans and budgets that are evidence-based and tailored to the realities on the ground. Most importantly, we need robust implementation so that programs are high quality and reach a significant scale while paying attention to equity.

We need government led programs that engage and involve a range of players including adolescents. For this to happen, coordination systems must be in place to engage key sectors such as education, draw upon the energy and expertise of civil society, recognize the complementary role that the public, the private sector and social marketing programs can play, and to meaningfully engage young people.

Some countries have shown us that this can be done. Over a 15-year period, employing a multi-component program including active contraceptive promotion, England has reduced teenage pregnancy by over 50%. This decline has occurred in every single district of the country.

Ethiopia is another outstanding example. Civil war and famine in the mid-1980s had catastrophic effects on the country. However, over a 12 year-period, with an ambitious basic health worker program, Ethiopia has increased contraceptive use in married adolescents from 5% to nearly 30% . It has also halved the rate of child marriage and female genital mutilation, although this decline is more marked in some provinces than in others. These countries have shown that with good leadership and strong management progress is possible.

There will be logistic and social challenges in moving forward. Understanding and overcoming them will require leadership and good management, which is why a strong and sustained focus on implementation must be combined with monitoring and program reviews to generate data that could be used in quick learning cycles to shape and reshape policies and programs.

There is likely to be backlash from those that oppose our efforts to provide adolescents with contraceptive information and services, and to empower them to take charge of their lives. We must do our best to bring these individuals and organizations on board. But we must not be silenced or stopped. We must stand our ground and we must prevail. We owe that to the world’s adolescents.

Complete Article HERE!

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Threesome Tips: 6 Things You Should Know Before Having One

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By Sophie Saint Thomas

Yes, “unicorn” is a problematic term for a person who joins a couple for a threesome (they’re a person, not a sex toy or prop). But the title gets one thing right: Like unicorns, enthusiastic guest stars in couples’ sexual adventures are hard to find. (I refuse to accept that unicorns do not exist at all. They’re probably somewhere in Alaska or Iceland, and the narwhals just won’t tell us where.) The person who is eager to show up and fulfill both your and your partner’s sexual fantasies and then disappear without a trace is likely, well, a fantasy. Hot threesomes happen, but they take preparation and communication, and not everyone is ready to successfully venture into the mystical land of group sex. For all those in relationships considering having a threesome, here are six things to know before you dive in.

1. A threesome will not “fix” your relationship.

If your partnered sex life is suffering, you could have an adult conversation about how your needs aren’t being met. You could see a couples therapist. You could carve out a night for absolutely nothing except an oral-sex marathon. (Actually, maybe do that no matter how good your sex life is.) What you shouldn’t do is expect a new sexual experience to magically solve your problems. David Ortmann, a San-Francisco- and Manhattan-based psychotherapist and sex therapist, says couples who turn to threesomes often do so in an effort to put a Band-Aid on unresolved intimacy issues. “If you’re having a threesome because sex is boring, you need to address why the sex is boring before you bring in the third,” Ortmann says. When the third leaves, your intimacy issues will still be there.

2. Your pre-threesome communication with your partners should be exhaustive.

Before you and your partner have a threesome, you should have talked about it so much that you’re tired of talking about it. “The couple needs to be on solid ground sexually and communication-wise. They need to know what they want to happen and why,” Ortmann says.

Do you feel more comfortable sleeping with a mutual acquaintance or creating a couple’s Tinder account to find a third? If you’re an opposite-sex couple looking for a female-bodied third, can the male partner have all kinds of sex with them or, for example, only manual and oral? Does the third get to spend the night? Does the third want to spend the night? Have you discussed what you want out of the group sex, both sexually and emotionally? What’s your exit plan if someone gets uncomfortable and says the safe word? Do you have a safe word? (You should.) Are you tired of reading these questions? Conversations around sex and intimacy can feel tedious, but they’re the foundation of a positive experience.

Unless you, your partner, and your third are on the same page about everyone’s boundaries, expectations, and desires — and you understand things might not go to plan — you’re likely not ready for a threesome. Talk with your partner about what you don’t want to happen, what you’d like to happen, and what you’re expecting to get out of the threesome experience. Then, when you’ve identified a potential third, discuss all of the same with them, too. A threesome should be like a carefully planned trip to a foreign country you’ve never visited: Prepare with an itinerary, but also expect the unexpected.

3. Someone may feel left out at some point — and if you can’t bear the thought of it being you, you may not be ready for a threesome.

Ortmann puts it bluntly when he tells me, “Three people is actually the most problematic of all of the configurations.” Considering the emotional and physical needs of one person during sex (while also expressing your own) is hard enough. Adding an extra person compounds the complications, whereas in “moresomes,” or groups or partners larger than three, it’s often less likely an individual will feel left out at any given time.

Here’s a heads-up for those in \relationships: Be ready to awkwardly sit on the bed questioning what to do while your partner goes down on the third with a hunger you haven’t seen from them for months. Maybe you’ll end up realizing, “Oh! I get to touch some boobs,” but you might also find yourself wondering, “Wait, why is no one’s face in my delicious genitals?”

These moments happen, but one way to make it less likely anyone will feel extraneous is to meet a potential third in a non-sexual setting before inviting them into your bed. Once I convinced my ex-boyfriend to go on a date with me and another woman with the goal of facilitating a threesome. We matched with a woman on Tinder who accepted our invitation for drinks. My ex and this woman vibed, and while I liked her as a person, there was no chemistry between us. I felt like the third wheel on a date with my own partner — a great sign the dynamic in bed wouldn’t have been rewarding for me either.

4. Safer sex precautions are non-negotiable.

Safer sex devices, such as condoms and dental dams, are crucial in a threesome. Your souvenirs of the experience should be hot memories, not STIs or unintended pregnancy. And condoms aren’t just for penises: Any threesome that features sex toys should incorporate them too. Perhaps you and your partner are in a monogamous and fluid-bonded relationship, meaning you’ve decided to exchange bodily fluids and start having unprotected sex, but you’re bringing in a third who is likely sleeping with other people. It’s important to discuss everyone’s safer sex rules before any action takes place.

Your souvenirs of the experience should be hot memories, not STIs or unintended pregnancy

In terms of etiquette, when it comes to threesomes, I feel about condoms the way I feel about appetizers: If you’re hosting the party, you should be the one providing them. Talk as a group about what other items you’d like to have at the ready: Will lube enhance the experience? How about toys? And P.S.: Even if you’re not having penetrative sex, or even oral sex, keep in mind that STIs such as HPV and herpes can be spread by skin-to-skin contact.

5. You could catch feelings.

Once my traveling ex-boyfriend said it was cool if I dated other people while he was out of town with the sneaky hope I would find a third for when he got home. He and I broke up, and the woman I met on Tinder while he was away had hot sex on our own and eventually became best friends. (Hey, he said I could date and I took him at his word.) Going back to communication, it’s important to be crystal clear with your partner about what you’re looking for. If you are both in pursuit of hot sex via a threesome, great. But if one of you is secretly looking for an extra-relationship emotional connection and the other isn’t, things could get messy.

And even if you and your partner are both just looking for hot sex, it’s important to understand all three people in a threesome have emotions that can’t be completely predicted. The third could leave with a desire to see one or both of you again, or your partner could want more and end up hitting up the third on the DL — when you open a sexual door, emotions may creep in too. It might feel awkward to bring this possibility up with your partner in advance, but you’ll be that much more equipped to deal with the eventuality if you do.

6. A threesome will likely change your dynamic with your partner.

Now, this isn’t always a bad thing. If you’ve communicated well and put due diligence into finding a third you’re both comfortable with, you could have a satisfying threesome that inspires more wild sex between the two of you long after you’ve kissed your third goodbye. In my experience, locking eyes with your partner as they penetrate your new friend from behind while said friend goes down on you is about as sexy as Earthling existence gets.

Threesomes can be enticing and exciting, and you and your partner could both really like the experience: You may want to integrate it into your regular sex life or consider even dating a third person. Then again, the sex could suck, you could feel left out, or your partner could develop feelings for the guest star — it’s all possible. If you’re in a healthy relationship based on strong communication and shared desires, you should be able to weather these risks. And if not, you probably have a few things to work on before you’re ready to welcome a guest star to your bed.

Complete Article HERE!

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Sex Education Based on Abstinence? There’s a Real Absence of Evidence

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Sex education has long occupied an ideological fault line in American life. Religious conservatives worry that teaching teenagers about birth control will encourage premarital sex. Liberals argue that failing to teach about it ensures more unwanted pregnancies and sexually transmitted diseases. So it was a welcome development when, a few years ago, Congress began to shift funding for sex education to focus on evidence-based outcomes, letting effectiveness determine which programs would get money.

But a recent move by the Trump administration seems set to undo this progress.

Federal support for abstinence-until-marriage programs had increased sharply under the administration of George W. Bush, and focus on it continued at a state and local level after he left office. From 2000 until 2014, the percentage of schools that required education in human sexuality fell to 48 percent from 67 percent. By 2014, half of middle schools and more than three-quarters of high schools were focusing on abstinence. Only a quarter of middle schools and three-fifths of high schools taught about birth control. In 1995, 81 percent of boys and 87 percent of girls reported learning of birth control in school.

Sex education focused on an abstinence-only approach fails in a number of ways.

First, it’s increasingly impractical. Trying to persuade people to remain abstinent until they are married is only getting harder because of social trends. The median age of Americans when they first have sex in the United States is now just under 18 years for women and just over 18 years for men. The median age of first marriage is much higher, at 26.5 years for women and 29.8 for men. This gap has increased significantly over time, and with it the prevalence of premarital sex.

Second, the evidence isn’t there that abstinence-only education affects outcomes. In 2007, a number of studies reviewed the efficacy of sexual education. The first was a systematic review conducted by the National Campaign to Prevent Teen and Unplanned Pregnancy. It found no good evidence to support the idea that such programs delayed the age of first sexual intercourse or reduced the number of partners an adolescent might have.

The second was a Cochrane meta-analysis that looked at studies of 13 abstinence-only programs together and found that they showed no effect on these factors, or on the use of protection like condoms. A third was published by Mathematica, a nonpartisan research organization, and it, too, found that abstinence programs had no effect on sexual abstinence for youth.

In 2010, Congress created the Teen Pregnancy Prevention Program, with a mandate to fund age-appropriate and evidence-based programs. Communities could apply for funding to put in only approved evidence-based teen pregnancy prevention programs, or evaluate promising and innovative new approaches. The government chose Mathematica to determine independently which programs were evidence-based, and the list is updated with new and evolving data.

Of the many programs some groups promote as being abstinence-based, Mathematica has confirmed four as having evidence of being successful. Healthy Futures and Positive Potential had one study each showing mixed results in reducing sexual activity. Heritage Keepers and Promoting Health Among Teens (PHAT) had one study each showing positive results in reducing sexual activity.

But it’s important to note that there’s no evidence to support that these abstinence-based programs influence other important metrics: the number of sexual partners an adolescent might have, the use of contraceptives, the chance of contracting a sexually transmitted infection or even becoming pregnant. There are many more comprehensive programs (beyond the abstinence-only approach) on the Teen Pregnancy Prevention Program’s list that have been shown to affect these other aspects of sexual health.

Since the program began, the teenage birthrate has dropped more than 40 percent. It’s at a record low in the United States, and it has declined faster since then than in any other comparable period. Many believe that increased use of effective contraception is the primary reason for this decline; contraception, of course, is not part of abstinence-only education.

There have been further reviews since 2007. In 2012, the Centers for Disease Control and Prevention conducted two meta-analyses: one on 23 abstinence programs and the other on 66 comprehensive sexual education programs. The comprehensive programs reduced sexual activity, the number of sex partners, the frequency of unprotected sexual activity, and sexually transmitted infections. They also increased the use of protection (condoms and/or hormonal contraception). The review of abstinence programs showed a reduction only in sexual activity, but the findings were inconsistent and that significance disappeared when you looked at the stronger study designs (randomized controlled trials).

This year, researchers published a systematic review of systematic reviews (there have been so many), summarizing 224 randomized controlled trials. They found that comprehensive sex education improved knowledge, attitudes, behaviors and outcomes. Abstinence-only programs did not.

Considering all this accumulating evidence, it was an unexpected setback when the Trump administration recently canceled funding for 81 projects that are part of the Teen Pregnancy Prevention Program, saying grants would end in June 2018, two years early — a decision made without consulting Congress.

Those 81 projects showed promise and could provide us with more data. It’s likely that all the work spent investigating what is effective and what isn’t will be lost. The money already invested would be wasted as well.

The move is bad news in other ways, too. The program represented a shift in thinking by the federal government, away from an ideological approach and toward an evidence-based one but allowing for a variety of methods — even abstinence-only — to coexist.

The Society of Adolescent Health and Medicine has just released an updated evidence report and position paper on this topic. It argues that many universally accepted documents, as well as international human rights treaties, “provide that all people have the right to ‘seek, receive and impart information and ideas of all kinds,’ including information about their health.” The society argues that access to sexual health information “is a basic human right and is essential to realizing the human right to the highest attainable standard of health.” It says that abstinence-only-until-marriage education is unethical.

Instead of debating over the curriculum of sexual education, we should be looking at the outcomes. What’s important are further decreases in teenage pregnancy and in sexually transmitted infections. We’d also like to see adolescents making more responsible decisions about their sexual health and their sexual behavior.

Abstinence as a goal is more important than abstinence as a teaching point. By the metrics listed above, comprehensive sexual health programs are more effective.

Whether for ethical reasons, for evidence-based reasons or for practical ones, continuing to demand that adolescents be taught solely abstinence-until-marriage seems like an ideologically driven mission that will fail to accomplish its goals.

Complete Article HERE!

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Fun sex is healthy sex

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Why isn’t that on the curriculum?

by Lucia O’sullivan

Damn—we forgot to teach our kids how to have fun sex.

Most news covers the sex lives of young people in terms of hookups, raunch culture, booty calls and friends with benefits. You might think that young people have it all figured out, equating sex with full-on, self-indulgent party time.

Despite my decades as a researcher studying their intimate lives, I too assumed that the first years of consensual partnered sex were pleasurable for most, but got progressively worse over time. How else to explain the high rates of reported by adults? I was wrong.

Our research at the University of New Brunswick shows that young people (16 to 21 years) have rates of sexual problems comparable to those of adults. This is not just a matter of learning to control ejaculation timing or how best to have an orgasm. Their sex lives often start out poorly and show no improvement over time. Practice, experience and experimentation only help so much.

This project came to be after a former colleague at my university’s health centre told me that many complained of pain from vulvar fissures (essentially tearing) from intercourse. The standard of care is to offer lubricant, but she began to ask: Were you aroused? Was this sex you wanted? They would look at her blankly. They had been having sex without interest, arousal or desire. This type of tearing increases a young woman’s risk of STIs, but also alerted my colleague to a more deep-seated issue: Was sex wanted, fun and pleasurable?

What emerged from our first study was verified in our larger study: Low desire and satisfaction were the most common problems among followed by erectile problems. Trouble reaching orgasm, low satisfaction and pain were most common among young women.

Was this a select group? No. Overall, 79 per cent of young men and 84 per cent of young women (16-21 years old) reported one or more persistent and distressing problems in sexual functioning over a two-year period.

Parents focus on disaster

Despite what you might think from their over-exposed social media bodies, today’s youth start sex later and have fewer partners than their parents’ (and often their grandparents’) generation did. A recent U.S. national survey found that young people have sex less often than previous generations.

Did years of calamity programming in the form of “good touch/bad touch,” “no means no,” and “your condom or mine” take a toll? Perhaps that was intended as so much of our programming is designed to convince young people of the blame, pain and shame that awaits them in their sexual lives. If we really believe that young people are not supposed to be having sex (that it should just be reserved for adults in their reproductive years and no others, thank you), it might as well be unpleasant, dissatisfying or painful when young people have sex, right?

Young people are over-stressed, over-pampered and over-diagnosed. They are also under-resourced for dealing with challenges in their sexual lives. This is how a bad sex life evolves.

Parents make efforts to talk to their children about sex and believe they get their messages across. Yet, their children typically report that parents fail to communicate about topics important to them, such as jealousy, heartbreak, horniness and lack of horniness. Parents’ messages are usually unidirectional lectures that emphasize avoiding, delaying and preventing. Young people dismiss these talks, especially in light of media portrayals of sex as transformative and rapturous.

Sex in Canada’s schools

Canada’s schools deliver fairly progressive sex education across the provinces. But they do not resemble the comprehensive approaches offered in countries such as The Netherlands and Switzerland. Those countries have teen pregnancy rates as low as 0.29 per cent of girls aged 15 to 19. Canada’s rate is 1.41 per cent, far higher than many European countries (such as Italy, Greece, France and Germany) but consistently lower than the United States. Thankfully.

These rates are a general metric of youth sexual health and key differences in the socialization and education of young people. They reflect the extent to which we are willing to provide a range of sexual information and skills to young people. More progressive countries reinforce messages that sex can be a positive part of our intimate lives, our sense of self, our adventures and connection. Young people in those countries have healthier and happier sexual lives. They know how to enjoy sex while preventing infections and unwanted pregnancy.

Many countries, including Canada, are swayed by a vocal minority who strongly believe that teaching young people about the positive components of sexuality will prompt unhealthy outcomes, despite all evidence to the contrary. When parents and educators fail you, and peers lack credibility, where else are you to turn?

Porn – lessons in freak

Enter porn. Young people turn to porn to find out how things work, but what they learn is not especially helpful. Porn provides lessons in exaggerated performance, dominance and self-indulgence. The relationships are superficial and detached. Producers rely heavily on shock value and “freak” to maximize viewer arousal, distorting our understanding of what is typical or common among our peers.

Of course young people turn to porn to find out how sex happens. It’s free, easily accessible and, for the most part, private. One young man in our interviews said, “I learned a lot about what goes where, all the varieties from porn, but it’s pretty intimidating. And, I mean, they don’t look like they’re loving it, really loving it.”

Our research makes painfully clear how few messages young people have learned about how to have fun, pleasurable, satisfying sex. They may seem self-indulgent to you, but then nobody took on the task of saying, “Sex should be fun, enjoyable and a way to connect. Let’s talk about how it all works.”

Fun sex as safe sex

Did anyone teach you these lessons? A friend and esteemed fellow researcher told me that he learned how sex worked by viewing his dad’s porn magazines. The only problem was that in his first sexual encounter he did not realize that there was movement involved.

Without a platform of positive communication with our youth about sexuality, and specifically about how sex unfolds and can brighten life and improve health and well-being, there is no room for them to address new challenges in the sexual realm. The World Health Organization’s alarming report of the rise of antibiotic resistant gonorrhea, for instance, will sound like another dire warning from an endless stream. Nobody is consistently motivated by threats.

We must talk to young people about how to have fun sex. This will help to offset the chances that struggling with problems in their sexual lives now will develop sexual dysfunctions and relationship strain that distress so many adults. These lessons will arm them with the information and skills required to keep them safe and to seek effective solutions when problems emerge. Best of all, they will be healthier and happier now and as adults as a result.

Complete Article HERE!

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