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It’s time to end the taboo of sex and intimacy in care homes

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Imagine living in an aged care home. Now imagine your needs for touch and intimacy being overlooked. More than 500,000 individuals aged 65+ (double the population of Cardiff) live in care homes in Britain. Many could be missing out on needs and rights concerning intimacy and sexual activity because they appear to be “designed out” of policy and practice. The situation can be doubly complicated for lesbian, gay, bisexual or trans individuals who can feel obliged to go “back into the closet” and hide their identity when they enter care.

Little is known about intimacy and sexuality in this sub-sector of care. Residents are often assumed to be prudish and “past it”. Yet neglecting such needs can affect self-esteem and mental health.

A study by a research team for Older People’s Understandings of Sexuality (OPUS), based in Northwest England, involved residents, non-resident female spouses of residents with a dementia and 16 care staff. The study found individuals’ accounts more diverse and complicated than stereotypes of older people as asexual. Some study participants denied their sexuality. Others expressed nostalgia for something they considered as belonging in the past. Yet others still expressed an openness to sex and intimacy given the right conditions.

Insights

The most common story among study participants reflected the idea that older residents have moved past a life that features or is deserving of sex and intimacy. One male resident, aged 79, declared: “Nobody talks about it”. However, an 80-year-old female resident considered that some women residents might wish to continue sexual activity with the right person.

For spouses, cuddling and affection figured as basic human needs and could eclipse needs for sex. One spouse spoke about the importance of touch and holding hands to remind her partner that he was still loved and valued. Such gestures were vital in sustaining a relationship with a partner who had changed because of a dementia.

Care staff underlined the need for training to help them to assist residents meet their sexual and intimacy needs. Staff highlighted grey areas of consent within long-term relationships where one or both partners showed declining capacity. They also spoke about how expressions of sexuality posed ethical and legal dilemmas. For example, individuals affected by a dementia can project feelings towards another or receive such attention inappropriately. The challenge was to balance safeguarding welfare with individual needs and desires.

Some problems were literally built into care home environments and delivery of care. Most care homes consist of single rooms and provide few opportunities for people to sit together. A “no locked door” policy in one home caused one spouse to describe the situation as, “like living in a goldfish bowl”.

But not all accounts were problematic. Care staff wished to support the expression of sex, sexuality and intimacy needs but felt constrained by the need to safeguard. One manager described how their home managed this issue by placing curtains behind the frosted glass window in one room. This enabled a couple to enjoy each other’s company with privacy. Such simple changes suggest a more measured approach to safeguarding (not driven by anxiety over residents’ sexuality), which could ensure the privacy needed for intimacy.

Conclusions

Our study revealed a lack of awareness by staff of the need to meet sexuality and intimacy needs. Service providers need guidance on such needs and should provide it to staff. The information is out there and they can get the advice they need from the Care Quality Commission, Independent Longevity Centre, Local Government Association and the Royal College of Nursing.

Policies and practices should recognise resident diversity and avoid treating everyone the same. This approach risks reinforcing inequality and doesn’t meet the range of needs of very different residents. The views of black, working-class and LGBT individuals are commonly absent from research on ageing sexuality and service provision. One care worker spoke of how her home’s sexuality policy (a rare occurrence anyway) was effectively a “heterosexuality policy”. It may be harder for an older, working-class, black, female or trans-identified individual to express their sexuality needs compared to an older white, middle-class, heterosexual male.

Care homes need to provide awareness-raising events for staff and service users on this topic. These events should address stereotyping and ways of achieving a balance between enabling choices, desires, rights and safeguarding. There is also a need for nationally recognised training resources on these issues.

Older people should not be denied basic human rights. This policy vacuum could be so easily addressed over time and with appropriate training. What we need now is a bigger conversation about sex and intimacy in later life and what we can do to help bring about some simple changes in the care home system.

Complete Article HERE!

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‘Stealthing’ – what you need to know

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By Jim Connolly

“Stealthing” is a term that describes when a man removes a condom during sex despite agreeing to wear one.

It may not be a word you’ve heard before but there’s a lot of discussion about it right now on social media.

It’s being talked about because of a US report which found cases are on the rise.

Victims’ charities say it must be treated as rape – and that it’s a hugely under-reported problem.

The study by Alexandra Brodsky in Columbia Journal of Gender and Law says it is a growing issue.

“Interviews with people who have experienced condom removal indicate that non-consensual condom removal is a common practice among young, sexually active people,” she explains.

And she says she’s been contacted by lots of victims.

We’ve been speaking to legal experts and people who support victims of rape for a better understanding “stealthing”.

What is it?

The report says it’s “non-consensual condom removal during sexual intercourse”.

Put simply that means taking it off or deliberately damaging it midway through sex without telling the other person.

The study warns it “exposes victims to physical risks of pregnancy and disease” and is “experienced by many as a grave violation of dignity”.

Is it rape?

“That person is potentially committing rape,” says Sandra Paul.

She’s a solicitor who works at Kingsley Napley and specialises in sexual crime.

She adds: “There has to be some agreement that a condom is going to be used or there is going to be withdrawal.

“If that person then doesn’t stick to those rules then the law says you don’t have consent.”

In non-legal language, it means that if you agree to having sex with a condom and remove it, without saying, then you no longer have consent.

Then it is rape.

What impact does this have on victims?

The report author speaks to a range of people who say they’ve been “stealthed”.

One student called Irin tells her: “The harm mostly had to do with trust.

“He saw the risk as zero for himself and took no interest in what it might be for me, and that hurt.”

The report said that “apart from the fear of specific bad outcomes like pregnancy and STIs, all of the survivors experienced the condom removal as a disempowering, demeaning violation of a sexual agreement”.

Legally, what is rape?

Sandra Paul tells Newsbeat that rape is when “you penetrate another person and the other person doesn’t consent”.

“Or the person doing the penetration doesn’t reasonably believe that they have consent.”

Is talking about ‘stealthing’ a good thing?

Sandra Paul deals with a lot of sexual assault cases and thinks “discussing it is a good thing”.

“Starting a conversation has got to be the right thing to do,” she explains.

However not everyone is sure that it is a good idea to call it “stealthing”.

“I always find it quite surprising when new phrases like this come up for things that are effectively just a form of sexual assault,” says Katie Russell from the charity Rape Crisis.

“If someone consents to a specific sexual act with you using contraception, and you change the terms of that agreement mid-act then that’s a sexual offence.”

“Giving it a term like ‘stealthing’ sounds relatively trivial,” she says.

“It’s a very acceptable term for something that’s extremely unacceptable and actually an act of sexual violence.”

What should you do if it happens to you?

“It can be really helpful to talk to someone in confidence like a trusted friend, or family member, or a specialist confidential independent service like a Rape Crisis centre,” Katie Russell says.

“They can just listen to you, support you and help you think through your options and what you might want to do in order to be able to cope with and recover from the traumatic experience.”

Complete Article HERE!

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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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Why Aftercare Is The BDSM Practice That Everyone Should Be Doing

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By Sophie Saint Thomas

If you’re unfamiliar with the BDSM scene, you might think it’s all whips, handcuffs, and pleasurable pain, but there’s one important element that BDSM practitioners have built into their sex lives to make sure that everyone involved feels safe and cared for after play time is over: a practice known as aftercare. And whether you’re into BDSM or have more vanilla tastes, aftercare is something everyone should be doing.

In the BDSM world, aftercare refers to the time and attention given to partners after an intense sexual experience. While these encounters (or “scenes,” as they’re called) are pre-negotiated and involve consent and safe words (in case anyone’s uncomfortable in the moment), that doesn’t mean that people can forget about being considerate and communicative after it’s all over. According to Galen Fous, a kink-positive sex therapist and fetish sex educator, aftercare looks different for everyone, since sexual preferences are so vast. But, in its most basic form, aftercare means communicating and taking care of one another after sex to ensure that all parties are 100% comfortable with what went down. That can include everything from tending to any wounds the submissive partner got during the scene, to taking a moment to be still and relish the experience, Fous says.

Specifically, with regards to BDSM, the ‘sub-drop’ is what we are hoping to cushion [during aftercare],” says Amanda Luterman, a kink-friendly psychotherapist. A “sub-drop” refers to the sadness a submissive partner may feel once endorphins crash and adrenaline floods their body after a powerful scene (though dominant partners can also experience drops, Fous says).

Of course, you don’t have to be hog-tied and whipped to feel sad after sex. One 2015 study found that nearly 46% of the 230 women surveyed felt feelings of tearfulness and anxiety after sex — which is known as “postcoital dysphoria” — at least once in their lives (and around 5% had experienced these feelings a few times in the four weeks leading up to the study). Experts have speculated that this may stem from the hormonal changes people (particularly those with vaginas) experience after orgasm, but many also say that it can come from feeling neglected. The so-called “orgasm gap” suggests that straight women, in particular, may feel that their needs in bed are ignored. And Luterman says that people in general can also feel lousy post-sex if they’re not communicating about what they liked and didn’t like about the experience.

Clearly, taking the time to be affectionate and talk more after sex — a.k.a. aftercare — can make sex better for everyone, not just those who own multiple pairs of handcuffs. So what does that mean for you? It depends on the kind of sex you’re having, and who you’re having it with.

Taking the time to be affectionate and talk more after sex — a.k.a. aftercare — can make sex better for everyone, not just those who own multiple pairs of handcuffs.

Like we said, there are lots of guidelines for BDSM aftercare, specifically. If you’re having casual sex, aftercare can mean simply letting your guard down and discussing the experience, something that can be scary to do during a one-night stand. It’s definitely dependent on the situation, but Luterman says that you can just express that you had a good time and see if they’re interested in seeing you again (if those are thoughts you’re actually having). “People want to be reminded that they still are worthwhile, even after they’ve been sexually gratifying to the person,” Luterman says. If your experience didn’t go well, it’s important to voice that, too.

And those in long-term relationships are certainly not exempt from aftercare, Luterman says. It’s something couples should continue to do, especially after trying something new (such as anal sex), she says. Did the sex hurt? Do they want to do it again? What did they like and not like about it? You can’t know what your partner is thinking unless you ask them. Plus, it can be easy for long-term partners to feel taken for granted, so making sure to cuddle, stroke each other’s hair, and savor the moment after sex can make even the most routine sex feel special.

One thing we should all keep in mind? It can also be helpful to continue these conversations when everyone’s vertical (and clothed) and any post-orgasm high has faded.

At the end of the day, aftercare is just a fancy term for making sure everyone’s happy once the sex is over. And while communication needs to be happening before and during sex as well, having these discussions afterwards comes with an added bonus: You can learn from the experience so that the sex is even hotter the next time.

Complete Article HERE!

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Is There A Vulva Version Of Morning Wood?

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By Cory Stieg

When your alarm clock rings, there’s a good chance that the only thing on your mind (besides your snooze button) is sex. People can feel very horny in the morning; John Legend even wrote a whole song about it. For people with penises, morning erections are an inevitable part of their sleep cycle, and even though a lot of people wake up with boners, it’s not always a sign that someone is aroused. But if someone with a vagina gets horny as hell in the morning, can they just blame it on biology? Maybe.

Turns out, people with vaginas also respond to their sleep cycle, and they can have increased clitoral and vaginal engorgement during the REM stage of sleep, says Aleece Fosnight, MSPAS, PA-C, a urology physician assistant and a sexual health counselor. “The clitoris has erectile tissue just like the penis, but instead of being out in the open for everyone to see, the clitoral engorgement happens internally and most women aren’t aware of the process,” Fosnight says.

Here’s how it works: During REM sleep, your body pumps oxygen-rich blood to your genital tissues to keep your genitals healthy, Fosnight says. This is also what happens when a person with a vagina gets aroused by something sexual: The erectile tissue in the clitoris becomes engorged and red because of the changes in circulation and heart rate, says Shannon Chavez, PsyD, a certified clinical sexologist. “The labia also has erectile tissue, and can become larger and more red in color as the arousal triggers a release of blood flow through the entire genital area,” she says. A person’s vagina could also get wetter or more lubricated during these bouts of arousal.

But, like penises, the changes your genitals experience at night don’t always occur because you’re exposed to something that arouses you — they just sort of happen. (Though if you woke up during one of these periods when your body thinks it’s aroused, you could subsequently feel more aroused and want to have sex, Fosnight says.)

That being said, some people do feel extra aroused in the morning, regardless of what their genitals are doing, because that’s when people’s testosterone levels peak, Dr. Chavez says. “This hormone is responsible for triggering feelings of sexual desire,” she says. You also might feel hornier in the morning because you’re more refreshed, relaxed, and comfortable than you are at night, according to Dr. Chavez. “This is the perfect formula for sexual arousal to take place,” she says, since sex at night can feel like work for some people, because you’re stressed and have used all your energy during the daytime. “There is lower tension in the morning when you are about to start the day ahead,” Dr. Chavez says.

So there you go: Women can have it all, even “morning wood.” There are tons of reasons why a person feels aroused when they do, but the time of day might have something to do with it after all. The next time you wake up with an urge to have sex, do it — morning sex is awesome, and your body knows it

Complete Article HERE!

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