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Expert Shares Tips for Talking Sexual Health With Cancer Survivors

by KATIE KOSKO

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Sexual health can be an uncomfortable or embarrassing topic to discuss for many people, and for patients with cancer and survivors it can feel even more awkward. Nevertheless, sex ranks among the top 5 unmet needs of survivors, and the good news is, proactive oncology practitioners can help fill that void.

Sixty percent of cancer survivors—9.3 million individuals in the United States alone—end up with long-term sexual problems, but fewer than 20% get professional help, according to Leslie R. Schover, PhD, founder of the digital health startup, Will2Love. Among the barriers she cited are overburdened oncology clinics, poor insurance coverage for services related to sexual health, and an overall lack of expertise on the part of providers, many of whom don’t know how to talk to patients about these issues.

And, oncologists and oncology nurses are well-positioned to open up that line of communication.

“At least take one sentence to bring up the topic of sexuality with a new patient to find out if it is a concern for that person,” Schover explained in a recent interview with Oncology Nursing News. “Then have someone ready to do the follow-up that is needed,” and have other patient resources, such as handouts and useful websites, on hand.

Sexual issues can affect every stage of the cancer journey. Schover, who hosted a recent webinar for practitioners on the topic, has been a pioneer in developing treatment for cancer-related problems with sexuality or fertility. After decades of research and clinical practice, she has witnessed firsthand how little training is available in the area of sexual health for healthcare professionals.

“Sex remains a low priority, with very little time devoted to managing sexual problems even in specialty residencies,” said Schover. “I submitted a grant four times before I retired, to provide an online interprofessional training program to encourage oncology teams to do a far better job of assessing and managing sexual problems. I could not get it funded.”

In her webinar, she offered tips for healthcare practitioners who want to learn more about how to address sexual health concerns with their patients, like using simple words that patients will understand and asking open-ended questions in order to engage patients and give them room to expand on their sex life.

Schover suggests posing a question such as: “This treatment will affect your sex life. Tell me a little about your sex life now.”

Sexual side effects after cancer treatment vary from person to person, and also from treatment to treatment. Common side effects for men and women include difficulty reaching climax, pain during sexual intercourse, lower sexual desire and feelings of being less attractive. Men specifically can experience erectile dysfunction and dry orgasm, while women may have vaginal dryness and/or tightness, as well as loss of erotic sensation such as on their breasts following breast cancer treatment.

Sexual dysfunction after cancer can often lead to depression and poor quality of life for both patients and their partners.

According to Schover, oncologists and oncology nurses should provide realistic expectations to patients when they are in the treatment decision-making process.

“Men with prostate cancer are told they are likely to have an 80% chance of having erections good enough for sex after cancer treatment,” Schover says. “But the truth is it’s more like 20 to 25% of men who will have erections like they had at baseline.”

To get more comfortable talking about sex with patients, Schover advises role-playing exercises with colleagues, friends, and family—acting as the healthcare professional and then the patient. When the process is finished, ask for feedback.

Brochures, books, websites and handouts are also good to have on hand for immediate guidance when patient questions do arise. But Schover is hoping for a bigger change rooted in multidisciplinary care and better patient–provider communication to find personalized treatments tailored to each individual’s concerns and needs.

Cancer treatment can impact hormonal cycles, nerves directing blood flow to the genitals, and the pelvic circulatory system itself, she explained. In addition, side effects like prolonged nausea, fatigue, and chronic pain also can disrupt a patient’s sex life.

“Simply to give medical solutions rarely resolves the problems because a person or couple needs to make changes in the sexual relationship to accommodate changes in physical function,” Schover stressed. “That kind of treatment is usually best coming from a trained mental health professional, especially if the couple has issues with communication or conflict.”

Schover wants to make sure that those resources are easily accessible to patients and survivors. Thus, she has created the startup, Will2Love, which offers information on the latest research and treatment, hosts webinars, and provides access to personalized services.

“Sexual health is a right,” concluded Schover, and both oncology professionals and patients need to be assertive in getting the conversation started.

Complete Article HERE!

28 Realities of Long-Distance Dating

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long-distance-dating

In short, long distance sucks. It’s the suckiest of all possible sucks, and not always for the reasons you’d expect. You might think you’re going to miss your SO when you’re hanging out with your couple gang, or when you fancy a movie date, and you will, but it will be the moments of frustration — like when you’re trying to put the quilt cover back on — that you’ll find yourself in tears because you miss them so much.

My partner and I are on our second bout of LD. In a way it’s easier than the first time — I know the lonesome drill — and in other ways it’s harder — I thought I’d paid my dues! Here are 28 things you totally know to be true when your SO lives in another city.

  1. You know your best FaceTime angle and where in your house has the best lighting. Especially important if you’re going to be talking after you’ve washed your face.
  2. You spend even more time looking at your phone. Who even knew that was possible? You’ve also downloaded 15 new ways of communicating with each other: Words with Friends, WhatsApp, Viber, Facebook Messenger, Pair . . . and if you’re planning a wedding like us: Trello, Google Docs and Evernote.
  3. You feel like you’re in a relationship with your phone. It’s like he actually lives in your phone, because it’s the only place you see him. If you lose your phone, it’s like you’ve killed him.
  4. All your money goes to flights. And you’re booking the cheapest, nastiest airlines so you’re not even accumulating points.
  5. You have a similar dating life to that of the girls on The Bachelor. When the ladies were complaining that it was all or nothing with Richie you could totally relate. When you finally see your SO it’s all fancy dinners, romantic strolls and helicopter rides (OK, maybe not that bit) but then it’s back to the #nunlife.
  6. You can get a bit *cough* lazy with the personal grooming. Are legs really hairy if no one’s there to feel them?
  7. You have about five conversations that are just “checking in” and one during which you download all information and admin. Wake-up call, mid-morning coffee call, lunch call, 3 p.m. call, and the “I’m heading home” call put together don’t run longer than 2.5 minutes. 8 p.m. call goes for an hour.
  8. You enjoy the luxury of more space. In the wardrobe, in the bed, in the kitchen — who knew those stupid protein powders were preventing you from having a teacup collection?!
  9. You devour every girly series he vetoed. You’ve cried your way through the later seasons of Downton Abbey, got into Outlander, devoured every season of Ru Paul’s Drag Race, rewatched Sex and the City — your Netflix has never looked so pink.
  10. You jam-pack your social calendar just to stop yourself feeling lonely. Exhausted and broke is better than lonely, right?
  11. You’re really happy when he’s having a good time without you, but also a teeny bit jealous. Shake it off girl.
  12. Your single mates like you so much more. You can stay out all night because no one’s waiting for you to come home and you’re basically chaste — you’re the ultimate wing-woman.
  13. You go back to having hours-long convos with your girlfriends. You know the kind you had in high school when time seemed to drag on forever? The downside of this is that time seems to drag forever.
  14. You get really good at mingling. Flying solo at a party for the first time in forever will actually make you feel awesome. You’re still fun. People still like you, see? Something you’ll recount to your partner later with the phrase, “I was the life of the party.”
  15. You say “yes” to a lot more. See above. Why would you not go to that Aztec party of a Facebook you forgot you had? You’re the life of the party.
  16. You become more sure of yourself. Jokes aside, it’s a huge confidence boost knowing you don’t need your dude with you to have a good time. You’re together because you want to be, not because you need to be. *sings “Independent Woman”*
  17. Time differences become your enemy. People will think you’re being a pathetic but even half an hour is annoying.
  18. Podcasts are your friend. Because your transit time is at an all-time high.
  19. You count down days like a kid waiting for Christmas. You literally mark them off the calendar like you’re in a ’90s Disney movie. Where did you even find a calendar?
  20. You get butterflies in your stomach when you’re about to see him. You’d kind of forgotten what it was like to be so nervous and excited at the same time.
  21. You get to discover another city. You’re going there so much that you learn where all the good cafes and bars are, and become a bit of an expert.
  22. People totally get it when you say you can’t do something because your SO is in town. The most you’re going to hear out of anyone that weekend is a love-heart emoji on your Insta pic. They’re just happy you’re together!
  23. You experience the most severe Sunday blues known to man. Your time together is over and it’s as if a group of Dementors have arrived for a sleepover.
  24. You do a lot more communicating. It’s all you’ve got, babe!
  25. You become more thoughtful. Because you know that a little note in his suitcase will brighten his whole day.
  26. You begin to appreciate him a lot. When you’re in each other’s face it’s easy to start taking each other for granted, but with a little distance you see, he’s amazing.
  27. You learn a lot more about yourself. If for no other reason than you’re spending a lot more time solo, making all the decisions. And yes, you do think a bowl of steamed broccoli followed by a block of Lindt chocolate is an adequate dinner.
  28. Your relationship will be stronger than ever. This is how I see it: when you start doing LD your relationship is like Goku, going into the Gravity Chamber to begin his training. It’s tough and at times he wants to go back to how things were, but he carries on and eventually he becomes super saiyan (blonde) and basically invincible.
     
    If Dragon Ball Z references are wasted on you, I’m basically saying, if you can make it through long-distance, you can make it through anything.

Complete Article HERE!

Why Sex Is Better At 57 Than 27

Jordan E. Rosenfeld

Dame Helen Mirren approves of her wax replica.

Dame Helen Mirren approves of her wax replica.

Despite the fondness certain corners of the internet and cable television have for mocking sexually vital women of a certain age, new research suggests that those who embrace their sexuality may be laughing all the way to longer, healthier lives—though older men aren’t as lucky.

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A study out of Michigan State University (MSU) published this month in the Journal of Health and Social Behavior has found that frequent sex (defined as once or more per week) for women age 57 and older—especially if it’s “extremely pleasurable or satisfying”—resulted in a lower risk of hypertension and protected against cardiovascular disease.

Unfortunately for men, frequent sex in the 57 and older range is actually dangerous, increasing their risk of cardiovascular events such as heart attacks and stroke. The risk is compounded by the use of medications such as Cialis and Viagra.

The study—an analysis of survey data of 2,204 people collected by the National Social Life, Health and Aging Project in 2005-6 and again five years later—isn’t just good news for older women, and should offer hope for younger women as they look to the future of their own sexuality.

Dr. Nancy Sutton Pierce, a nurse and clinical sexologist, suggests the best thing a young woman can do for her continued sexual health is to cultivate an attitude of optimism about it as she ages. “Younger women think sexy has an expiration date. Older women know it doesn’t,” she says.

The study is a stride toward busting the cultural myths that older women are supposedly non-sexual beings, which Sutton Pierce says “absolutely does them a disservice.” Sutton Pierce, who is almost 60, happily defies sexual stereotypes of older women. Married for thirty years to the same man, she says, “My sex life is better than ever, much better than my twenties.” In her work she says she sees women after forty “blossoming,” adding, “As women mature, we mature on all levels, which means we start to own our sexuality and sexual power. We don’t need someone else to tell us we’re hot, we can feel it.”

Study author Hiu Liu, an associate professor of sociology at MSU, also finds that for women, quality of sexual experience is a key contributing factor to the health benefits, not just quantity. “As a sociologist, I don’t see sex as just a physical exercise, as medical doctors do. It’s a social behavior, and has emotional meaning,” she says.

001For older women experiencing other kinds of physical declines related to illness, staying sexually active may bring other benefits. Irwin H., who asked to remain anonymous, of San Francisco found that for his 70-year-old wife, who has multiple sclerosis, increasingly limited mobility, and walks with a cane, “Sex gives her back her former sense of her physical self.” He even waxes a little poetic: “Sexuality for her is like an unexpected warm day in the middle of winter. It doesn’t end winter, but it makes it bearable.”

Some older women may believe they’ve lost their sexual selves when they experience the often dramatic physical changes at and after menopause, such as vaginal dryness and reduced libido. They need not despair, says Celeste Holbrook, PhD, a sexual health consultant and sexologist. “Sex, and fulfilling sex doesn’t always have to be centered on the goal of an orgasm, or penetrative sex,” she adds.

004However, Liu points out that the female sexual hormone released during orgasm, oxytocin, “may also promote women’s health” by reducing cortisol and increasing estrogen.

Holbrook urges communication between partners rather than silent acceptance. “Redefining your sexuality as we age for anybody is really good. Talk to your partner about your body changes and how you can create a fulfilling sex life while embracing those changes.”

Men shouldn’t worry too much, however. Though the MSU study seems to be the research equivalent of a cold shower for older men, Liu reminds them, “Moderate sex is good for older men, too.”

Complete Article HERE!

What Does Transgender Mean? Your Guide to Understanding Trans Terminology.

By

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For this edition of Elle Oh Elle, I’ve enlisted the voice of Monika MHz, a Portland DJ and columnist. Monika is a trans woman, and she’s here to explain how you can make the world a better place by removing transphobia from your life.

Although ultimately impossible to measure precisely, a new study suggests that about 1.6 million Americans are transgender. Too often in the LGBT discussion, we focus on the LGB, and forget about the T.

Let’s broaden our discussion, to include all of our sex-positive brothers and sisters. It is perfectly OK to not yet be familiar with these terms — but as you seek to better understand the trans community, it helps to start by understanding some of the language. Here’s your starter guide.<

Transgender

Transgender is an umbrella term used to describe a person who does not identify specifically with their assigned gender from birth. There’s a big spectrum on this — not everyone falls into an entirely male or female category — meaning the term includes a lot of gray area.

Some people use the term “transgender” to include drag queens and all gender nonconforming folks; others don’t. Some trans folks hate the term; others don’t. “Trans” bridges some of that gap. “When in doubt,” Monika says, “just say ‘trans.’ It’s a baggage-free abbreviation, umbrella, and identity for a large percentage of the community — and won’t be read as offensive or rude. No one is gonna start a hashtag because you called me trans.”

Cisgender

Here’s a simple way to understand what it means to be cisgender:

ELLE: I’m a cisgender female; meaning I identify with the gender assigned to me at birth. I was raised as a female, and I identify as such.

MONIKA: I’m a trans woman. I was assigned male at birth, and I’m a woman. I’m also a DJ and a writer. I’m wicked hot — and you, dear reader, should treat me like people.

FTM, MTF

FTM is an acronym for “female-to-male” that refers to trans men who were assigned female at birth. Conversely, MTF is “male-to-female” and refers to trans women assigned male at birth. Some people find the term uncomfortable and don’t like to use it; others prefer it. You should always ask before these acronyms to describe an individual.

But how do you ask someone a question like this?

“It’s like asking any other personal question,” Monika says. “Don’t drop the bomb in the middle of discussing Stranger Things on Netflix. But if the topic comes up and you are struggling to find the right wording in your head, it’s OK to just ask: ‘I’m sorry, this might be wrong, but do you prefer FTM or is there a better term?’ Just use good judgment, be polite, and you’ll be fine. Always better to ask!”

LGBT, LGBQ, LGBTQA, TBLG

The above acronyms are used in reference to L) lesbian, G) gay, B) bisexual, T) transgender, Q) queer, and A) asexual or ally. But while we lump all these groups together into a single acronym (i.e., “the LGBT community”), it’s important to remember that each part of these acronyms represents a specific identity. Trans is overlooked too often, even as strides are made among the gay, bisexual, and lesbian communities. But some of that is (finally!) starting to shift, ever so slowly.

“Trans folks have been at the front of the LGBTQ equality movement from the start,” Monika says. “Trans women fought on the front lines of Stonewall and the Compton Cafeteria riots. As things got better for LGBQ folks, the T just seemed louder by comparison. Our stories, eventually, cut through the noise and it leads us to where we are now.

“An ‘ally’ is what you call yourself when you use the right pronoun for your trans friend, or when you retweet Laverne Cox. However, being an ally is more than just a few actions. Even if you don’t know a trans person, you can ally.” Write an email to your state and national government officials in support of employment protections for trans folks, or talk to your family about the humanity of trans folks. You can ally all over your family.

Pronouns

Pronouns are the parts of speech we use to describe the gender of people, pets, and sometimes boats and cars (if you’re into that sort of thing). She, he, and — if you’re non-binary, or genderqueer — they. If you don’t know someone’s gender, it’s really easy to just use “their/they.” Try it! People do it with babies all the time.

“Your cat is licking their paws.”

“That person with long hair is waiting for their cab.”

“People do it all the time in general,” Monika says. “Chicago style manual, Washington Post, and many other style guides recognize it as just plain useful. I have a friend who doesn’t like it for formal writing, but they’re wrong. See what I did there?”

Transition

It’s sort of just like it sounds. It’s usually referring to the medical and/or social puberty experienced by trans folks. It’s just like a young cis (non-trans) boy “transitions” from boyhood to manhood during puberty. You might hear someone tell you that they transitioned when they were 16, for example. That would give you some idea of their life experience.

Transphobia

“People often read this as ‘fear of trans people’ and sorta rightly so, given its etymological roots,” Monika says. “However, the way it’s used is more than just the fear or hate of trans people. It’s about the systemic and socially mediated ways in which society mistreats an entire class of people and how that impacts the way trans folks, and trans women in particular, are treated.”

Intersex

“This has nothing to do with being trans,” Monika says. “It’s a generalizing medical term to describe folks born with genetic, reproductive, and sexual anatomy differences that don’t fit the usual definitions of male and female. Some intersex people are trans, and others aren’t, but they are separate things.”

Genderqueer

Genderqueer is a sort of catchall umbrella term often used to describe gender non-conforming and trans folks who don’t feel like they fit into the male or female identity. Not everyone uses it, and some people identify as genderqueer and a woman or a man. It’s a messy world, and language is often inadequate to describe how folks feel.

In one stand-up routine, comedian Whitney Streed sums their experience as such: “I cut my hair [short], I dress and move about the earth in this particular fashion, because I need my gender to be baffling. Like I need it not to scan. I’ve thought about it, and I want all of my catcalls to end in question marks, that’s what I’m going for. I want my gender to be something like a crossword puzzle. Because you are gonna work on this the entire bus ride to work. Just taking in all the clues, thinking about it. You get there, you think to yourself, ‘Did I get all of that right?’ –That’s me! I am the New York Times Sunday crossword of gender.”

Queer

In the same way some sex-positive people like myself refer to themselves as a slut, most younger LGBTQ people are happy to call themselves “queer” in an effort to reclaim the connotations of the word.

“It’s a term some LGBT folks forged out of an anti-gay slur,” Monika says. “Usually only referring to sexuality, I like to use it to describe my sexuality and not my gender. Some people, though, identify as queer rather than trans. [But] it can be very offensive to some people, especially gay men of older generations.”

Cross-dresser

Everyone is a cross dresser and everyone isn’t. Basically it’s all about social context. Women wear suits all the time now, but at a different time we might have called that cross-dressing.

Nowadays, people seem to use it to exclusively refer to men who wear clothing and makeup deemed too feminine for a man. It’s a ridiculous term past its prime.<

Gender identity

Gender identity is defined as the personal experience of one’s own gender. Which seems vague, but that’s fine.

“Sometimes it [gender identity] can feel less solid,” Monika says. “I don’t just identify as Latina, I am Latina. I am a woman.”

To cut through the confusion, just go with the gender an individual identifies as. A person with a vagina who identifies as a man, is a man. A person with a penis identifying as a woman, is a woman.

Trans man

This is a catchall usually used for trans people assigned female at birth who are men. Sometimes they have gone through — or are planning to go through — some medical interventions to enhance their comfort with their bodies.

Sometimes, people use the term to refer to people who don’t identify with manhood. These are individual cases.

Trans woman

See above. This usually refers to people assigned male at birth who are women. “Trans women” is also sometimes used as a term for all trans people who were assigned male at birth.

Tranny

For both uses of trans, is it OK to use the term “tranny”?< "You’re allowed to say any word, sure," Monika says. "But it’s probably ill-advised to skip down the street dropping the 'T' all day. Not only are you likely to ruin someone’s day, but you’ll likely sound like a clueless relic. So, unless you want to be a wanker, hold off on the 'T-word'... unless you’re a trans woman. It’s sort of 'our word.'” Same goes for “transvestite.” It’s archaic, and should be left to the script of the Rocky Horror Picture Show.

“Back in the ’90s,” Monika says, “there were these insufferably fine distinctions drawn between different types of transgender and gender-nonconforming folks. ‘Transvestite’ was a diagnosis from the DSM IV codes for mental illness — that has since been removed — used to describe folks who fetishized cross-dressing. If you identify as a man, and wearing lingerie while jerking off sounds like an ideal Sunday activity, then at that time you would have been considered a transvestite. These distinctions have largely fallen out of use, or fashion, or whatever. No one is really using this term anymore.”

Sex, sexuality, and gender are a larger ingredient to the recipe of a society. And human rights are an integral part of an ethical nation — but it all starts with our ability to communicate with each other. Asking questions, showing compassion, and seeking understanding: this is how we elevate our culture to a better place.

Complete Article HERE!

How sex education videos have changed over the last 50 years

By Amelia Butterly

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Sex and relationship education (SRE) in schools isn’t good enough – at least, that’s what a lot of you often say.

From not being taught early enough, to lacking information about LGBT relationships and issues of consent – SRE gets a lot of criticism.

But, looking back at the archives, experts say there have been improvements when it comes to telling young people about relationships.

We’ve looked at posters and films once used to explain the birds and the bees.

And we asked sex and relationships teacher Caroline Stringer, a specialist from the charity Brook, to talk us through them.

1970s

This video – which was shown in schools – was also aired as part of a televised discussion about whether this kind of material was suitable for children to see.

Caroline says the way the penis is described as going “hard and straight” so that it can go into the woman’s vagina could be a problem.

“How confusing to young men having involuntary erections through puberty – they may have thought they need to go and find a vagina,” she explains.

Nowadays, says Caroline, good sex and relationship education will include topics such as consent and same-sex relationships.

Elsewhere in the videos, a man and woman are shown modelling nude in an art class.

“I thought it actually started off quite well, saying: ‘These people aren’t embarrassed’,” says Caroline.

“But for me, it was all about reproduction and a man and a woman. That’s the bit that is easy to talk about. It’s fact.”

In modern educational materials however, real people would not be shown posing nude, says Caroline.

“We would show diagrams, rather than the real thing.”

1980s

This film, which depicts a naked man on a beach, is the other one to feature full nudity.

It depends on the context, Caroline says, but seeing real-life naked bodies can serve a really useful educational function.

“If we’re showing people what STIs, for example, look like. How do they know what private parts look like without those STIs, if we only ever show them ones with?”

Like other films, it focuses on committed relationships.

“It’s all about making love. That’s what we would want to promote but that’s not always the case for people,” says Caroline.

Sex-Education

1990s

Caroline says in her classes she talks about all the different words which people use to describe sex and the body, including slang for the genitals.

“You can use those words,” she tells the students.

“But you need to know the proper words as well because if you’re going to talk to a doctor, you need to know what they’re saying back to you.”

Again, this video would not fit with “inclusive” modern sex education, Caroline explains.

“I did like that they talked about pleasure. It’s the first time in these videos they talked about it, for both a man and a woman.”

She adds: “It’s really important that it’s taught with a positive attitude. We don’t want scare messages.”

Nowadays

The sexual health charity Caroline works for, Brook, goes to in one in 10 UK schools to teach SRE.

“Brook believes SRE should start early in childhood so that children and young people learn to talk about feelings and relationships from a young age and are prepared for puberty before it happens,” they said in a statement.

“As children get older, we advocate SRE focusing on the positive qualities of relationships, such as trust, consent, body-positivity, commitment and pleasure.

“We also discuss the different forms relationships and sexuality can take.

“In addition to this, we also believe in ensuring that SRE is relevant and appropriate to the lives of young people so that it relates to other issues such as mental health, sexting, porn and staying safe online.”

Complete Article HERE!