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British Columbian study reveals unique sexual healthcare needs of transgender men

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by Craig Takeuchi

While HIV studies have extensively examined issues related to gay, bisexual, and queer men, one group missing from such research has been transgender men.

Consequently, Vancouver and Victoria researchers undertook one of the first such Western Canadian studies, with the findings published on April 3 in Culture, Health, and Sexuality. This study allowed researchers to take a look at HIV risk for this population, and within the Canadian context of publicly funded universal access to healthcare and gender-related public policies that differ from the U.S.

The study states that trans men have often been absent from HIV studies due to small sample sizes, eligibility criteria, limited research design, or the misconceptions that trans men are mostly heterosexual or are not at risk for HIV. What research that has been conducted in this area has been primarily U.S.–based.

The Ontario-based Trans PULSE Study found that up to two-thirds of trans men also identify as gay, bisexual, or queer.

The researchers conducted interviews with 11 gay, bisexual, and queer transgender men in Vancouver who were enrolled in B.C. Centre for Excellence in HIV/AIDS’ Momentum Health Study.

What they found were several aspects unique to gay, bisexual, and queer transgender men that differ from gay, bisexual, and queer cisgender men and illustrate the need for trans-specific healthcare.

None of the participants in the study were HIV–positive and only two of them knew of trans men who are HIV–positive.

Participants reported a variety of sexual behaviours, including inconsistent condom use, receptive and insertive anal and genital sex, trans and cisgender male partners, and regular, casual, and anonymous sex partners.

The gender identity of the participants’ partners did influence their decisions about sexual risk-reduction strategies, such as less barrier usage during genital or oral sex with trans partners.

While trans men shared concerns about HIV and sexually transmitted infections with gay cisgender men, bacterial vaginosis and unplanned pregnancy were additional concerns.

Almost all of the participants used online means to meet male partners. They explained that by doing so, they were able to control the disclosure of their trans status as well as experiences of rejection or misperception. Online interactions also gave them greater control over negotiating safer sex and physical safety (such as arranging to meet a person in public first or in a sex-positive space where others are around).

When it came to healthcare, participants reported that regular testosterone therapy monitoring and transition-related care provided opportunities to include regular HIV– and STI–testing.

Some participants, however, experienced challenges in finding LGBT–competent healthcare services, with issues arising such as clinic staff using birth names or incorrect pronouns, insistence on unwanted pap testing, and a lack of understanding of the sexual practices of trans men.

The researchers note that these findings indicate the need for trans-inclusive services and trans-specific education, particularly within services for gay men.

Complete Article HERE!

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Does Progesterone Influence Baby’s Later Sexuality?

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A new study addresses whether supplementing progesterone during pregnancy, a common practice to prevent miscarriage, could influence a baby’s sexual orientation in later life.

Dr. June Reinisch, director emerita of the Kinsey Institute in the U.S., led the study. She found that bisexuality is quite common among men and women whose mothers received additional doses of the sex hormone progesterone while pregnant.

As discussed in the journal Archives of Sexual Behavior, researchers tracked the sexual development of 34 Danes whose mothers were treated with the hormone to prevent miscarriage.

According to the investigators, progesterone appears to be an underappreciated factor influencing the normal development of variations in human sexuality and psychosexuality.

Researchers believe the findings warrant further investigation given that little is known about the effects on offspring of natural variations in levels of maternal progesterone and that progesterone is widely used to treat pregnancy complications.

Men and women all naturally produce the sex hormone progesterone. It is involved in women’s menstrual cycles, and helps to maintain pregnancies and development of the fetus.

Progesterone plays a role in neural development and the production of other sex hormones as well as steroid hormones that help to regulate stress responses, inflammation, and metabolism in the body.

Physicians often prescribe progesterone and its bio-versions to support the fertilization process, to prevent miscarriages or premature births, or to increase babies’ birth weights.

The 34 participants in the study were drawn from the Copenhagen Perinatal Cohort, which comprises information collected from virtually all children born between 1959 and 1961 at the university hospital in Copenhagen, Denmark.

The 17 men and 17 women were selected because their mothers exclusively received the progesterone lutocyclin to prevent a miscarriage.

These men and women were compared with a carefully selected control group who were not exposed prenatally to lutocyclin or any other hormone medication, but who otherwise matched the study participants based on 14 relevant physical, medical, and socioeconomic factors.

The participants were all in their mid-20s when asked about their sexual orientation, self-identification, attraction to each sex, and sexual history using questionnaires and a structured interview with a psychologist.

It was found that men and women whose mothers were treated with progesterone were significantly less likely to describe themselves as heterosexual. One in every five (20.6 percent) of the progesterone- exposed participants labeled themselves as other than heterosexual.

Compared to the untreated group, the chances were greater that by their mid-20s they had already engaged in some form of same-sex sexual behavior (in up to 24.2 percent of cases), and that they were attracted to the same (29.4 percent) or to both sexes (17.6 percent). Both exposed males and females also had higher scores related to attraction to men.

“Progesterone exposure was found to be related to increased non-heterosexual self-identification, attraction to the same or both sexes, and same-sex sexual behavior,” says Reinisch.

“The findings highlight the likelihood that prenatal exposure to progesterone may have a long-term influence on behavior related to sexuality in humans.”

The research team believes further studies on the offspring of women medically treated with progesterone and other progestogens during their pregnancies are necessary. Additionally, studies examining the effects of natural variation in prenatal progesterone levels are warranted to provide more insight into the role that this hormone plays in the development of human behavior.

Complete Article HERE!

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Why men and women lie about sex, and how this complicates STD control

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When it comes to reporting the number of sex partners or how often they have sexual intercourse, men and women both lie. While men tend to overreport it, women have a tendency to underreport it. Although the story is not that simple and clear-cut, I have discovered some interesting reasons why this is the case – and why it matters to doing research on sexual health.

Lying is an inherent aspect of reporting sexual behaviors. For instance, more females report being a virgin (i.e., had not had sexual intercourse) despite having had genital contact with a partner, compared to males.

I have studied sexual avoidance and also frequency of sex in patient populations. In this regard I have always been interested in gender differences in what they do and what they report. This is in line with my other research on gender and sex differences.

The low validity and usefulness of self-reported sexual behavior data is very bad news for public health officials. Sexual behavior data should be both accurate and reliable, as they are paramount for effective reproductive health interventions to prevent HIV and STD. When men and women misreport their sexual behaviors, it undermines program designers’ and health care providers’ ability to plan appropriately.

Pregnant virgins, and STDs among the abstinent

A very clear example is the proportion of self-reported virginal status among pregnant women. In a study of multi-ethnic National Longitudinal Study of Adolescent Health, also known as Add Health, a nationally representative study of American youth, 45 women of 7,870 women reported at least one virgin pregnancy.

Another example is the incidence of sexually transmitted diseases (STDs) which are not expected among young adults reporting sexual abstinence. Yet more than 10 percent of young adults who had a confirmed positive STD reported abstaining from any sexual intercourse in the last year before STD testing.

If we ask youth who have had sexual experience, only 22 percent of them report the same date of first sex the second time we ask about it. On average, people revise their (reported) age at first sex to older ages the second time. Boys have higher inconsistency reporting their first sex compared to females. Males are more likely than females to give inconsistent sexual information globally.

Why don’t people tell the truth about sex?

Why do people lie about their sexual behavior? There are many reasons. One is that people underreport stigmatized activities, such as having multiple sexual partners among women. They overreport the normative ones, such as higher frequency of sex for men. In both cases, people think their actual behavior would be considered socially unacceptable. This is also called social desirability or social approval bias.

Social desirability bias causes problems in health research. It reduces reliability and validity of self-reported sexual behavior data. Simply said, social desirability helps us look good.

As gender norms create different expectations about socially acceptable behavior of men and women, males and females face pressures in reporting certain (socially accepted) behaviors.

In particular, self-reports on premarital sexual experience is of poor quality. Also self-reports of infidelity are less valid.

Although most studies suggest these differences are due to the systematic tendency of men and women to exaggerate and hide their number of partners, there are studies that suggest much of this difference is driven by a handful of men and women who grossly inflate and underreport their sexual encounters.

Even married couples lie

Men and women also lie when we ask them who is making sexual decisions regarding who has more power when it comes to sexual decision-making.

We do not expect disagreement when we ask the same question from husbands and wives in the same couples. But, interestingly, there is a systematic disagreement. More interestingly, in most cases when spouses disagree, husbands are more likely to say “yes” and wives “no.” The findings are interpreted in terms of gendered strategies in the interview process.

Not all of the gender differences in reported sexual behaviors are due to men’s and women’s selective under- and over- reporting of sexual acts. And, some of the sexual behaviors do vary by gender. For instance, men have more sex than women, and men less commonly use condoms. Men have more casual partners, regardless of the validity of their report.

Secretive females, swaggering males

Studies have found that on average, women report fewer nonmarital sexual partners than men, as well as more stable longer relationships. This is in line with the idea that in general men “swagger” (i.e., exaggerate their sexual activity), while women are “secretive” (i.e., underreport sex).

Structural factors such as social norms shape men’s and women’s perceptions of appropriate sexual behaviors. Society expects men to have more sexual partners, and women to have fewer sexual partners.

According to the sexual double standard, the same sexual behavior is judged differently depending on the gender of the (sexual) actor (Milhausen and Herold 2001). Interestingly, men are more likely to endorse a double standard than women.

In the presence of sexual double standards, males are praised for their sexual contacts, whereas females are derogated and stigmatized for the same behaviors, “He’s a Stud, She’s a Slut.”

Research suggests that lifetime sexual partnerships affect peer status of genders differently. A greater number of sexual partners is positively correlated with boys’ peer acceptance, but negatively correlated with girls’ peer acceptance.

Self-serving bias is common

As humans, self-serving bias is a part of how we think and how we act. A common type of cognitive bias, self-serving bias can be defined as an individual’s tendency to attribute positive events and attributes to their own actions but negative events and attributes to others and external factors. We report on sexual behaviors which are normative and accepted to protect ourselves, and avoid stress and conflict. That will reduce our distinction from our surroundings, and will help us feel safe.

As a result, in our society, men are rewarded for having a high number of sexual partners, whereas women are penalized for the same behavior.

The only long-term solution is the ongoing decline in “double standard” about sexual morality. Until then, researchers should continue questioning the accuracy of their data. Computerized interviews may be only a partial solution. Increasing privacy and confidentiality is another partial solution.

Complete Article HERE!

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High-risk sex, girl-on-girl experimenting linked among NYC teens

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By Susan Edelman

Nearly half the Big Apple’s sexually active high-school girls have had female partners — and many engage in behavior that endangers their health, an alarming new study finds.

Researchers from New York University and the Albert Einstein College of Medicine based their findings on a 2013 survey of public high-school students citywide — but most heavily in “high-risk neighborhoods” in the Bronx, Brooklyn and Manhattan.

Of 4,600 girls surveyed, 1,101, or 27.5 percent, were sexually active. Of those, 513, or 46.6 percent, reported same-sex experiences, according to the study, published this month in the Journal of Pediatric and Adolescent Gynecology.

This “vulnerable population of girls” who engage in same-sex or bisexual activity are twice as likely as heterosexual teens to be sexually active. The researchers also found:

  • These girls start having sex sooner, have more sexual partners and suffer more “intimate partner violence.”
  • They are less likely to use contraceptive methods — putting them at higher risk of unplanned pregnancy if they also have sex with boys.
  • They use more alcohol, marijuana and other illicit drugs.
  • They report more suicidal thoughts or attempts. Girls “not sure” of their sexual orientation are at highest risk of trying to kill themselves.
  • Even though female-to female transmission of HIV is possible, many of these girls do not test for it or other sex-related diseases.

Dr. Chanelle Coble, an adolescent pediatrician and assistant professor at NYU Langone Medical Center, co-authored the study with Einstein assistant professors and psychologists Rosy Chhabra and Ellen Silver.

The researchers found the abundance of same-sex activity even though not all teens who indulged identified themselves as lesbian or bi-sexual.

“Just looking at how someone describes themselves doesn’t tell the whole story,” Coble said. “When they’re young, it’s harder for them to be specific about their identity — they’re still exploring and figuring it out.”

An advocate for lesbian and bisexual youth called the study’s results, “disheartening, but not surprising.”

Lesbian and bisexual girls are often stigmatized and treated with hostility, said Emily Greytak, research director for GLSEN, a Manhattan-based group that promotes safe schools for LGBT students.

“That can lead to more risky behavior, and takes a toll on their health,” she said.

The surveys were conducted by the city Department of Health for the US Centers for Disease Control and Prevention.

Complete Article HERE!

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SEXUAL HEALTH:

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A fake life is an unhappy life

If you want to be healthy in body, mind and soul, then do not lie about how little pleasure you receive in bed.

By JOACHIM OSUR

Up to 60 per cent of women have faked orgasm at one point or another. In fact, a quarter of married women fake orgasms all the time. That was my overarching message to Jane when she walked into the sexology clinic distressed. She had just been thrown out of her marital home for faking orgasm.

Trouble started when Jane revealed to her husband that she had faked it for two years of their marriage. “I meant well all these two years. I did not want to hurt him by revealing that I was not satisfied,” Jane explained, wiping her tears.

It was 8am and she was the first patient of the day. She had come in in her nightdress – her husband had pushed her out of the house and locked the door after they disagreed the night before. She spent the night on her verandah.

“He throws me out of the house because I tried to find a solution, but he never wants to talk about sex,” she lamented.

COMMON PROBLEM

Faking orgasm is not unique to Jane. Studies have shown that it is the best and most friendly way to end a boring sexual act, performed by women who want to reassure their man that he has not laboured in vain.

We now know that it is not just lack of sexual skills that leads to faking orgasm. The faker could also be having her own problems, either with the sexual function or with the relationship and intimacy. Take it this way: you are responsible for your own pleasure and your lack of it cannot be fully blamed on the man.

Some women dread sex, because of fear of disease or pregnancy, and values that teach them to look at sex negatively. The impact is that the person switches off sex, and orgasm is impossible under such circumstances. “Well, I am not such a big fan of sex anyway. I find it dirty,” Jane interrupted.

Whatever the reason is, it is important to note that faking is totally against the natural purpose of sex. Sex does not just give physical pleasure; there is something divine and supernatural about it. Good sex leads to enhanced self-esteem. The person’s feeling of well-being goes up and there is emotional healing. This improves a person’s happiness and gives them a positive outlook on life.

People who have healthy sex feel loved and radiate love and compassion to others. They have a sense of acceptance, beauty, reverence, grace and a feeling of rejuvenation. They feel powered to face life; in fact, they get a better sense of spiritual connection with their God. Healthy sex is therefore not just good for the body but also for the spirit and the soul.

Faking orgasm denies the faker all this. In itself, it is a symptom that the sex or the relationship is no longer healthy and needs attention. Unhealthy sex destroys emotions and the wellbeing of the people involved, and influences the way the affected people view life and other people. Unhealthy sex is not good for life.

I enrolled Jane and her husband in counselling and coaching on intimacy and sex. John, the husband, grudgingly came to the clinic after my pleas. He believed that it was Jane, not him, with a problem. It however turned out that they both lacked sex skills. Further, they had never freely discussed their sexual feelings and so were sexually illiterate about each other.

It took months of skills training and sexual values clarification before the couple could have healthy sex. Fortunately, they were both dedicated to having the relationship work out.

“This is what we needed to have gone through before our wedding,” Jane said on their last day of counselling. “I feel we have wasted two years of our marriage.”

“Yes, but better late than never. We are finally up to the task!” John replied. The couple burst out in laughter as they waved goodbye and walked out of the consultation room holding hands.

Complete Article HERE!

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