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Adolescents with autism need access to better sex education

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Intimacy is part of being human. There are well-documented benefits to positive relationships, from emotional security to good mental health1. Those who want relationships and can’t develop them face low self-esteem, depression, loneliness and isolation from the wider society2.

For adolescents, learning how to navigate sex and sexuality can be a minefield. How do you figure out the nuances of sexuality without experience? How do you approach a potential partner? And once you do, how do you communicate with him or her?

This path is especially fraught for adolescents with autism. For example, people with autism tend to report higher levels of sexual abuse and sexual exploitation than their neurotypical peers3. And yet there is a gap between what these young people need and what schools provide. According to a 2012 study, adolescents with autism know less about sex than do their peers and have less access to sex education4.

My team of researchers and I are documenting the experiences of adolescents with autism in relation to sex, sexuality and their schools’ sex education requirements. Our research suggests schools should provide sex education tailored to the needs of young people with autism.

These classes should include both the standard fare — from human development to safe sex — and additional instruction on topics such as how teens can express themselves to their potential partners and how to decode innuendos and other language used to describe sex. This education is vital to ensure that these adolescents can approach relationships in a way that is safe, confident and healthy.

Role play:

One common misconception about individuals with autism is that they prefer to be alone. My research suggests this simply isn’t true.

In an ongoing study, for example, my team conducted interviews related to sex and relationships with 40 adults with autism. Only three expressed ambivalence about relationships, mostly due to worries about coping with the needs of another person. Nearly half of the respondents had not yet had a relationship but expressed a strong desire for one.

Despite the desire to form relationships, this group expressed limited knowledge about how they would meet someone or show their interest. They found the idea of going out to a pub or club frightening, and socializing with groups of people provoked high anxiety. Some of them expressed a disdain for small talk, and others admitted they had little idea of how to engage in general conversation. They also found the use of dating apps unappealing and said they thought there was an inherent danger in meeting strangers.

Sex education could help these individuals feel confident in approaching others using role-play. For example, they could use techniques created by the late Augusto Boal, a Brazilian theater director who created plays in which audiences could participate.

In the context of sex education, an actor would play the part of the individual with autism and re-create one of that person’s real-life experiences, such as trying to talk to someone new in a bar. The individual with autism would then give the actor new directions — such as “What if I offer to buy her a drink?” — allowing the person with autism to try out many approaches, and witness potential consequences, in a safe environment.

Advice network:

Although instructors may help with some aspects of communication, it’s profoundly difficult to teach someone how to read the intentions and desires of others. Most teenagers rely on peers to work through some of these social complexities.

Teens get feedback from their peers on how to interact, meet new people and gauge the appropriateness of a relationship. Teens with autism struggle with close relationships, but sex education classes could facilitate that learning.

Our research suggests that they desire this guidance. For example, one individual in our study commented that schools should provide students with the “skills on how to find the right sort of partner.” To accomplish this goal, a school could provide an advice network, including regular group meetings in which young people with autism share and reflect upon their experiences. Social networking could extend this support.

For most adolescents, peers also fill in gaps such as helping to define sexual slang. In our study, another participant commented that hearing “dirty talk” from other students made her feel left behind. She was also unsure how to decode the words she heard, and said her school should explain what people might say in a sexual context and what these terms mean. With this context, she could decide to get involved or not.

Moderated discussions in a peer network could help address such slang and provide a safe space for students to ask questions about unfamiliar words.

Different sexualities:

To be effective, sex education in schools must take into consideration that some individuals with autism do not conform to traditional sex roles. When we interviewed 40 young adults with autism as part of an ongoing study, we found that 20 percent identified as gay or bisexual — more than is reported in national surveys of the general population. Gender fluidity may also be more common in individuals with autism: In a study we conducted this year (but is not yet published), we found an unusually high incidence of autism and autism traits in individuals who identify as transsexual or non-binary.

Despite these high numbers, some people with autism find it hard to accept different sexualities. As one male participant explained: “I have a rigid way of seeing the world, and this prevented me from accepting my sexuality. I sort of denied it to myself because I have very concrete black-and-white thinking and it didn’t quite fit in.” This early inability to accept his sexuality and identify as a gay man led to severe depression and admittance to a psychiatric ward.

In some ways, people with autism may even fall outside the ever-expanding range of sexual identities we see today, such as gay, straight, bisexual, pansexual and asexual. For example, one of our participants explained that her wonderful relationship with another girl with autism often involved sitting together for up to 10 hours reading in silence, or spending hours discussing Greek history.

Autism represents a profoundly different way of seeing and being in the world, and individuals with autism often expend great mental and physical effort just trying to appear ‘normal.’ Sex education in school needs to move away from suggesting that people with autism should fit in, and instead explore alternatives to traditional types of romantic relationships.

Awareness gaps:

Our work also suggests that individuals with autism aren’t always aware that they are sexual beings. This lack of self-awareness manifests both in the sexual cues they give off and how they may be perceived by others.

For example, two participants in our study reported behavior that could be perceived as stalking, such as continually following strangers, although they didn’t indicate that they understood how this could seem threatening. One described it this way: “I literally just saw him on the street. And then pretty much just stalked him.”

Not having a sense of one’s own sexuality can be harmful in other ways. For example, individuals with autism are three times as likely to experience sexual exploitation as their peers5. In our study, participants spoke of times when they had been extremely vulnerable and open to abuse. One woman reported that others had gotten her drunk and encouraged her to have sex with girls even though she doesn’t identify as gay. In the interview, she did not appear to be aware that these incidents could be perceived as someone taking advantage of her.

Sex educators need to understand these gaps in awareness to build confidence in young people with autism and to protect them from harm and from unintentionally harming others. For example, young people with autism need to be aware of the law on issues such as stalking, which they themselves may not see as a problem. Their education needs to include lessons on the language of sex and draw distinctions between playful and threatening behavior. It also needs to address issues of abuse and signs that a relationship or encounter is abusive.

Research such as ours can offer insight into this area and provide the tools for effective sex education for people with autism. With the right support, adolescents with autism can feel more comfortable building relationships and exploring their sexuality. This support will help them develop healthy relationships and experience their benefits to well-being, self-esteem and happiness.

Complete Article HERE!

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How to Talk to Your Younger Sibling About Sex

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Since older siblings can sometimes be the best sex-ed teachers, here are four important topics to cover and a few links about how to get the conversation started.

Positive sexuality is at the forefront of conversations being had by student activists on college campuses. Dismantling the societal constructs of traditional masculinity and femininity and redefining campus sexual scripts are priorities aiming to decrease sexual assault rates and increase discussion about what perpetuates them.

As a result, college students are in a prime position to be instigators of conversations amongst younger groups, because they are at the core of the rapidly changing dialogue prompting social changes that support young adults in expressing their sexuality and promoting safe sexual climates for everyone.

Being a mentor to the younger kiddos in your life, and more specifically the youngsters in your family, can be a tricky yet invaluable role to fill. If you decide to open up a conversation about sex with younger siblings, some awesome topics to include are consent, gender identities and expressions, contraceptives, birth control and the construct of virginity. There are certainly other categories to include, and questions will likely arise about the many nuances of sex, but starting with broad ideas essential to healthy sexuality will set up the conversation to be productive and meaningful.

1. Consent

It’s never too early to start introducing principles of consent into children’s lives, nor is it ever too late. If your siblings are elementary school-aged, having a conversation with them about consent does not have to centered around sex, because consent is applicable to any and all interactions, whether sexual intentions are present or not.

Teaching young kids to ask for permission to hug someone or to sit close to someone plants the seed for healthy habits of asking for and offering consent to grow. If younger individuals become accustomed to asking for consent in small, everyday ways, they will be more aware and respectful of others’ boundaries. As they grow into adolescents and college students, the concepts of consent will be second nature and clearly understood when they do enter into sexual contexts where consent is required.

Regardless of the age of your siblings, consent is applicable to everyone and should be a frequent, continuing conversation. For siblings that are old enough to dive deeper, unpacking the mechanics of genuine and enthusiastic consent can include information about how things such as power dynamics, substances, coercion and intimidation can all influence the improper acquisition of consent. This is also a great time to emphasize that despite the common tactics used to unfairly obtain someone’s consent, the right to enthusiastically consent to sexual activity without the influence of outside factors is omnipresent, powerful and absolute.

Consent is a quintessential component of healthy sexual encounters! For more info on consent, and the “Yes Means Yes” campaign advocating for enthusiastic consent, check out https://www.yesmeansyes.com and have your siblings take a look, too for the scoop on all things consent and respect. As quoted in an article on everydayfeminism.com “conversations about consent—especially if those conversations are with children—are not always easy to have. They are, however, necessary if we’re trying to create a society in which consent is understood and respected by adults and children alike.”

2. Gender Identities

Another frequently skipped-over chapter in the sparse book of sex education in America is the section on gender identity. Thanks to celebrity stories in recent years such as Caitlin Jenner, Jazz Jennings and many other Hollywood young adults openly identifying as gender fluid, bisexual and indicating other identities along the gender-nonconforming spectrum, gender identity and gender rights have become popular topics. While many school sex education programs are a bit behind the times and have yet to add conversations about various gender identities into their curriculum, older siblings can try to fill some of the gaps.

The biggest point to emphasize to a younger sibling is the difference between sex and gender, and that gender is a social construct that is governed by expectations and norms that align with the gender binary system. To expand on that, include notes about how gender is made up of multiple components that fall along a spectrum; there are new models, like the gender unicorn, being developed to illustrate this idea; the colorful and simple designs are engaging for young learners and a great visual representation of the spectrums in general.

Most of all, encourage youngsters to explore and contemplate their own gender identity by questioning the norms they’re conditioned to live in accordance with, and support them unconditionally in their discoveries. Your unwavering love may serve as an example for when they find themselves being a support for a friend or peer one day.

3. Contraceptives

For siblings that are approaching the age of dating and having sex, a little brush up on contraceptive options is a helpful addition to sibling sex-education sessions. This goes for all gender identities, not just the ladies! Everyone should be aware of how to protect themselves and their partner of choice, so that everyone can feel safe and focus on other matters at hand. A quick browse through the “Birth Control” tab on teenshealth.org gives an extensive explanation of the various methods of birth control and contraceptives, the intended uses of each, the effectiveness rates and some FAQs.

While talking with a healthcare provider is the best idea for beginning a birth control plan, providing kiddos with information about their options allows them to reflect on what they’re comfortable with and choose an option that suits them if and when they need it.

4. Virginity

When younger siblings are thinking about becoming sexually active, a chat about the virginity construct can help them reflect on what sex means to them. There is heavy emphasis placed on the “losing of” one’s “virginity” and how the experience is meant to be transformative, pivotal and special. For some, the giving of virginity to another person signifies an act of deep trust, intimacy and comfort. For others, the concept of virginity is merely an ancient phrase sometimes used to label the beginning of their sexual adventures.

There is no right or wrong way to think about a first sexual experience, nor is there a universal definition of what composes the official loss of virginity, which some sex beginners don’t get the chance to contemplate before diving in. The concept of virginity loss is associated with impurity and places the person taking someone’s virginity in a position of power, while the person who “lost” it is seen as sacrificing something valuable.

Contemplating the idea that virginity is not a physical state or thing, but instead a construct that can be accepted or disregarded, allows young people to decide for themselves how they want to think of sex and define it in their own terms. First times are a lot of things, ranging from spontaneous, meaningful, messy, calculated or a combination of everything. Restructuring the way young adults think about their first sexual experiences gives them the power to conceptualize their sexual debuts as they choose to.

Beyond everything, the most important thing about having a conversation with siblings about sex is just to have it (the conversation). In the era of change kids are growing up in, the taboo topic of sex is not yet a conversation of full disclosure, even as it gains traction. Being an advocate for positive sexuality development by starting dialogue can help change this, one awkward chat at a time.

The following websites are excellent resources with information on the topics above and many more! They’ve got tips for curious teens and lots of advice for how to start a conversation.

Complete Article HERE!

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LGBTQ kids are missing out on sex education—and it’s up to schools to change that

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Last year, California officially mandated LGBTQ history lessons in public schools, vowing to teach “the contributions of lesbian, gay, bisexual, and transgender Americans” and their impact on both the state’s and the country’s history.

This was a victory for LGBTQ rights, because it’s a rarity; in most states—in all but nine to be exact—schools don’t even cover LGBTQ sexuality, let alone queer history.

When surveyed by the Human Rights Campaign (HRC), only 12 percent of millennials said they received sexual education material that covered sex between gay partners—even though 20 percent of millennials consider themselves LGBTQ. American sex ed is “primarily or exclusively focused on heterosexual relationships between cisgender people,” according to a different study conducted by Planned Parenthood and the HRC.

This hetero-specific focus creates a multitude of problems for all young people sorting through their anxieties and questions about sex and sexuality. For one, straight students aren’t being forced to acknowledge other sexualities, which can foster bullying and promote a culture of intolerance. For another, a lack of school discussion means most LGBTQ students are being inadvertently told to stay in the closet. And with that messaging, there is the shame and hiding, and then there are the health risks.

Proper safe-sex education is important for all students, and LGBTQ people are no exception: 22 percent of all transgender women are HIV positive, and queer men face a higher risk of contact with HIV or a sexually transmitted disease, according to the Centers for Disease Control and Prevention.

While ignoring queer students may not be a new phenomenon, it doesn’t mean it doesn’t need to be remedied. And perhaps school districts can start by listening to the stories of queer people who have gone through the country’s lackluster sexual education systems. Through them, activists can learn how to fix such a massive gap in sex education.

This is what the queer sex ed gap looks like

Larissa Glasser, a librarian and writer living in Massachusetts, grew up in the 1980s, an era whose approach to sex ed was based in fear and simple authoritarian phrases like “Don’t do it.” Glasser, whose transgender, obviously couldn’t rely on schools to teach her about queer life.

“I was in public school until fifth grade and we had no sex education whatsoever,” she told the Daily Dot. “This was during the Reagan presidency, so all we ever heard about sex was AIDS as a scare tactic to be abstinent.”

Very little accurate information existed about transgender women outside of schools. Glasser was only exposed to trans people through filmmakers like John Waters and Ralph Bakshi.

“Finally, during the 1990s, trans issues were addressed somewhat respectfully in about 10 percent of the films I saw,” Glasser said. “Then I discovered writers like Jean Genet, Angela Carter, and Hubert Selby Jr., who were willing to portray queer femme sexuality in a somewhat positive light.”

Glasser’s experiences mirror many other LGBTQ students’ struggles. Sophie Searcy grew up miles away in Kentucky during the ’90s and 2000s, attending Catholic school all the way through high school, and she too had virtually no experience with LGBTQ education. Queer and trans sexuality just wasn’t discussed.

“The Catholic system I belonged to had a program called ‘family life,’ which was a religious health and sex education program,” Searcy told the Daily Dot. “Very basic facts about anatomy and puberty were explained in gender-separated rooms. There was no mention of safer sex methods, navigating consent, or any LGBTQ issues whatsoever.”

Searcy knew early on that her church wasn’t LGBTQ-inclusive. But looking back on those early years, she realized that queer people were treated as if they simply didn’t exist at all.

“The class explained sex as exclusively between a man and a woman, as if only heterosexual orientations existed,” Searcy said. “Similar to how the class erased all non-hetero orientations, the class explained gender, sexual development, and sexual intercourse in a way that didn’t even acknowledge the possibility of trans people. Boys had penises, girls have vaginas, boys develop into men, girls develop into women, etc., etc., etc.”

In particularly conservative areas, sexual education isn’t just biased—what it is lacking can induce violence. LGBTQ activist and writer Sarah Bess grew up in southeast Missouri in the 1990s, and she was repeatedly harassed, bullied, and physically assaulted across school districts.

“I was this awkward, autistic, queer kid from the middle of nowhere, so I got picked on a lot,” Bess explained. “I dropped out in the seventh grade because I was getting beat up so much and my home life sucked and I really didn’t care about school.”

Bess’s classes didn’t provide a respite from the attacks. “Being gay wasn’t really mentioned as a possibility in my sex ed classes. The existence of trans people definitely wasn’t acknowledged. There was a lot of fear-mongering about pregnancy and STIs, and that’s mostly what I remember,” Bess explained. “I don’t remember anyone at school even mentioning trans people. Beyond transphobic Jerry Springer and Maury Povich episodes, I don’t think we were on anyone’s radar.”

In one case, her sex education teacher enabled a physical assault.

“My seventh-grade sex ed class was taught by a gym coach who watched two boys beat the shit out of me after school one day,” Bess said. “He just laughed, got in his car and drove off.”

When anti-LGBTQ sentiments take hold in a school, then queer students live in an ongoing state of fear. This not just impedes their education, it can be debilitating for their growth and self-esteem—and it can separate queer people from one another by forcing them to stay hidden. For someone like Bess, this was extremely alienating.

“I was in my late teens the first time I knowingly talked to another trans woman online,” Bess explained. “I was in my twenties before I knowingly met anyone like me in person.”

For others, sex education classes could have possibly saved their lives. A 2014 report published by the American Foundation for Suicide Prevention and the UCLA Williams Institute reveals that suicide attempt rates are particularly high among transgender and gender non-conforming students who face harassment or bullying at school. Through sex education, though, students could have a better understanding of gender transitioning or normalizing queer sexuality. The more that classrooms validate LGBTQ experiences, the more likely students are to treat their fellow classmates with respect.

“Gender was always conflated with assigned sex and body parts,” Searcy said. “It wasn’t that trans people were portrayed as evil or misguided, but that the possibility of being trans was never even acknowledged.”

Then came the internet

So if LGBTQ students aren’t able to learn about their bodies from primary and secondary schools, where do they go for information about queer sexuality? Many turn to the internet.

But the internet is a luxury, one that not everyone is able to access—especially those in previous generations. In Bess’s case, this directly impacted her exposure to trans material.

“I didn’t have consistent internet access for most of my life, so I picked up bits and pieces where and when I could,” she said. “I watched a lot of porn with trans women in it and read a lot of gross forced fem erotica, none of which was very helpful for learning about sex.”

Even when internet access is available, its resources aren’t always helpful. Sometimes they can be damaging.

Shortly after Glasser graduated from library school, she stumbled across a gender transitioning guideline called tsroadmap, also known as “Transsexual & Transgender Road Map.” Glasser felt even worse about herself while using the website, in part because the guide relied on rigid stereotypes and generalizations for trans women. In one case, the site demanded that trans women undergo surgeries in order to properly transition, when many trans people prefer not to undergo permanent surgery.

“It was useful at the time,” she said, “but in hindsight, I think its normativity had a fairly toxic effect on my self-esteem when I was at my most vulnerable point.”

Searcy, on the other hand, saw internet access as a major source for learning more about non-hetero sexuality. Some of her biggest resources for her transitioning were writers who have gained significant prominence thanks to the internet’s impact on the trans community.

“Ultimately, a close friend came out as trans which led me to question my own gender and explore resources on my own,” Searcy said. “Julia Serano and Morgan M Page were particularly helpful, as were Imogen Binnie and Casey Plett.”

So while online resources aren’t exactly perfect, the internet has advanced far enough that it can connect trans and queer people with the online communities they need to learn more about themselves. On Reddit, there are subreddits like /r/asktransgender that let trans people learn about undergoing gender transitioning. Sites like Sites like Keshet and Queer Theology provide resources for religious queer and transgender people. Resources like TJOBBANK host employment listings for LGBTQ folks searching for inclusive workplaces. And services like Discord and Slack allow queer and trans users to create their own closed groups where LGBTQ members can hang out, talk about queer life, or get together and play video games. The internet has changed over time, and that means there are more ways for queer and trans people to meet each other than before.

But it’s unfair to relegate LGBTQ students to the internet for advice, often in secret. It can stall LGBTQ kids from coming out, make trans and queer sexuality feel like a taboo, or send the message that queer and trans life isn’t important enough to understand.

Schools are supposed to provide students with learning opportunities that help young kids grow into productive adults. That’s why third graders learn basic reading comprehension skills, and high schools teach American history (albeit often from a very straight, white, male perspective), and middle schoolers get a whole class dedicated to sex and their bodies—so they can go out into the world informed and prepared.

But if schools leave out LGBTQ sexuality and force queer students to learn on their own time, then those schools are failing at their jobs. Why must the burden be on LGBTQ youth to educate themselves?

The solutions that exist

Casey Plett, author of A Safe Girl to Love, lived in an upper-middle class suburb in Oregon during her high school years. At the time, she enrolled in an “internationally-focused hippie-ish sub-program” that seemed more like “actual sex ed taught by Planned Parenthood.” And yet like Glasser and Searcy, she says, “I cannot recall LGBTQ issues ever coming up. Negatively or positively.”

And as for trans issues? “Ha,” she told the Daily Dot. “No. Zero.”

This was in 2001. But she recognizes things have changed since then. LGBTQ equality has become more mainstream, trans rights have entered the news cycle, and queer sex ed has turned into a serious activist rallying point. Today, she thinks there’s solutions that school districts can take to bring LGBTQ education to kids, instead of forcing them to turn to the internet. That is, if they’re willing to put in the effort.

“There are plenty of gay sexual health resources out there,” Plett said. “I’d get a hold of them, pay them to come, and let them take the wheel. And be open and loving and willing to learn.”

Plett is right. Today, many local LGBTQ organizations host workshops for queer youth, providing the resources students need to learn more about their sexuality. Long Island’s Pride for Youth, for example, facilitates workshops on fighting transphobia and working with LGBTQ youth. Other community centers, such as New York City’s Apicha Community Health Center and the Los Angeles LGBT Center, provide training segments for educators, giving them the skills they need to teach LGBTQ-inclusive material in classrooms. And in recent years, Planned Parenthood has both criticized the lack of LGBTQ sex education in public schools, and begun taking a more LGBTQ-inclusive approach to sex education.

Gender therapists and counselors traditionally host workshops for teens as well, allowing them to explore LGBTQ topics in an affirming environment. And programs like the GSA Network even give students the training they need to host workshops and class sessions that can debunk damaging myths about the queer community.

For those who don’t live in “gay-friendly” metropolitan areas, there are also online resources available for classrooms. TED hosts a variety of TED Talks covering LGBTQ issues, from coming out to helping transgender teens. And many educators host lesson plans and teach-ins that are available for free online, allowing students to engage in queer sex education topics through a vetted workshop environment.

These programs and groups normalize LGBTQ sexuality. Workshops talk frankly and openly about what it means to have sex as a gay or transgender person and provide safe sex education to prevent STIs. They also give educators the training they need not just to respect queer students, but to include LGBTQ topics in future lesson plans. If school districts aren’t sure how to approach queer sexuality, here is where they can start.

“It would have been incredible for me to hear the simple facts that sex is complicated and messy but that there are a few universals that we should consider (consent, safer methods, exploration),” Searcy explained, “or that gender is independent of assigned sex and that it might be helpful to consider if my assigned sex did not fit.”

That’s something echoed by Bess, who knows all too well that many school districts are still avoiding LGBTQ topics in their entirety. She insists that the federal government should take a more active role in protecting LGBTQ youth, especially in areas where people are particularly bigoted toward queer students. Many school districts simply aren’t evolving anywhere near the rate of young people’s attitudes toward sexuality.

“It’s been awhile since I was in school, but it doesn’t seem like things are much better now in the places I grew up,” she explained. “Federal intervention is absolutely necessary to protect queer and trans students and educators, especially in rural school districts.”

Safety is where educators need to start if they want to facilitate an open, tolerant conversation about sex and sexuality. With transgender students under attack through outrageous “bathroom bills” across the U.S. and the Trump administration officially rescinding any federal guidelines for protecting trans youth, state and federal intervention is more important than ever.

For example, in New York, Gov. Andrew Cuomo officially outlawed all forms of discrimination against transgender people in 2015. Discriminatory fines for “willful, wanton or malicious” discrimination is up to $100,000. Massachusetts offers the Safe Schools Program for LGBTQ Students, a joint initiative that provides training for school administrators on queer topics and gives students the tools they need to become activists in their school settings.

Fostering change and giving schools a legal incentive to end discrimination is important. Seeing how 42 percent of all queer youth feel their community is not accepting of LGBTQ people, promoting tolerance and opening constructive discussion are the keys to getting there.

Schools teach basic sex education for a reason: Most adults will have sex, and the repercussions of sex are often far-reaching and far-ranging and can be life-changing. But if sex education doesn’t address the current population and the culture, then it’s time for administrators to recognize they’re doing youth a disservice. Making things right could actually save lives.

Complete Article HERE!

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The New Gay Sexual Revolution

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PrEP, TasP, and fearless sex remind us we can’t advance social justice without including sex in the equation.

By Jacob Anderson-Minshall

The sexual revolution of the 1960s and ’70s came to an abrupt and brutal end for many gay and bi men the moment AIDS was traced to sexual contact. In the early days of the epidemic, sex between men was equated with AIDS, not just in the mainstream media, but also in prevention efforts by other gay men. Since AIDS in those days was seen as a death sentence, for men who had sex with men, every sexual interaction carried the risk of death. Indeed, tens of thousands died of AIDS-related conditions.

“I was alive when homosexuality was [still] considered to be a psychological illness,” David Russell, pop star Sia’s manager, recently told Plus magazine. “The two generations ahead of mine, and a good portion of my generation, were completely decimated by AIDS. They’re gone.”

While some men with HIV outlasted all predictions and became long-term survivors, the widespread adoption of condoms is credited with dramatically reducing HIV transmissions among gay and bi men in subsequent years. Yet reliance on nothing but that layer of silicone — a barrier some complain prevents true intimacy and pleasure — couldn’t erase the gnawing dread gay men felt that every sexual encounter could be the one where HIV caught up to them.

There have been, of course, moments when nearly every gay or bi man has allowed their passions to override their fears and enjoyed the skin-on-skin contact that opposite-sex couples often take for granted. Thinking back on those unbridled and unprotected moments of passion filled many of these men with terror, regret, and guilt.

“Shame and gay sex have a very long history,” acknowledges Alex Garner, senior health and innovation strategist with the gay dating app Hornet. “And it takes much self-reflection — and often therapy — to feel proud and unashamed of our sex when everything around us tells us that it’s dirty, immoral, or illegitimate.”

Since the late 1990s and the advent of lifesaving antiretroviral drugs, some of the angst around sex between men faded — and with that came changes in behavior. Condom use, once reliably high among gay and bisexual men, has dropped off in the past two decades. According to a recent study published in the journal AIDS, over 40 percent of HIV-negative and 45 percent of HIV-positive gay and bi men admitted to having condomless sex in 2014. Researchers found the decrease in condom use wasn’t explained by serosorting (choosing only partners believed to have the same HIV status) or antiretroviral drug use. And despite what alarmists say, condom use had been declining long before the introduction of PrEP.

Garner, who has been HIV-positive for over two decades, says he’s almost relieved he acquired the virus at 23, because “My entire adult life I have never had to worry about getting HIV.”

The Rise of PrEP

Now there’s hope the younger generation may also experience worry-free sex lives — without the side effects of living with HIV.

The use of the antiretroviral drug Truvada as pre-exposure prophylaxis, or PrEP (it’s the only medication approved for HIV prevention), has been shown to reduce the chance of HIV transmission to near zero. Since the medication was first approved as PrEP in 2012, only two verified cases of transmission have been documented among those who adhere to the daily schedule (a third, according to HIV expert Howard Grossman, could not be confirmed). New, longer-lasting PrEP injectables should reach market in the next few years. Studies suggest that on-demand PrEP (such as taking it before and after sexual activity) may also be effective.

“This is a revolution!” Gary Cohan, MD, who prescribes PrEP, told us in 2016. “This should be above the fold in The New York Times and on the cover of Time magazine. A pill to prevent HIV?”

Undetectable Equals Untransmittable

Those who are already HIV-positive also have a sure-fire option for preventing the transmission of HIV that doesn’t rely on condoms. It’s called treatment as prevention, or TasP. Those who are poz, take antiretroviral medication, and get their viral load down to an undetectable level, can’t transmit HIV to sexual partners. Last year, The New England Journal of Medicine published the final results of HPTN 052, a study that proved antiretroviral medication alone is enough to prevent HIV transmission among serodiscordant couples. In a Facebook Live interview for AIDS.gov, Dr. Carl Dieffenbach, director of the Division of AIDS at the National Institute of Allergy and Infectious Diseases, noted, “The chance of transmitting [HIV] if you are virally durably suppressed is zero.

Since Dieffenbach’s statement, a number of HIV organizations and medical groups have joined the “Undetectable Equals Untransmittable” bandwagon, including GMHC, APLA Health, and the Latino Commission on AIDS.

The Centers for Disease Control and Prevention recommends the use of condoms in addition to PrEP or TasP, primarily because neither biomedical approach prevents other sexually transmitted infections like gonorrhea or syphilis. Still, PrEP and TasP make it safer to have condomless sex — and that could jump-start the new sexual revolution. “When the threat of HIV is removed from sex there is a profound sense of liberation,” Garner says. “Sex can just be about sex.”

One hurdle is PrEP stigma, furthered by the myth of “Truvada whores,” and AIDS Healthcare Foundation’s Michael Weinstein’s deliberate efforts to portray the HIV prevention pill as “a party drug.”

“Fear and shame have been ingrained in gay sex for decades,” Garner admits. “And it will take time and a great deal of work to extricate those elements.” But he remains optimistic that “together negative and poz men can shift the culture away from fear and toward liberation.”

He argues that what’s at stake is far more than just a better orgasm.

“Our sexuality is at the core of our humanity,” Garner says. “Our sexuality is as integral to us as our appetite. We can’t advance social justice without including sex. As queer people and as people of color, our bodies have been criminalized, our sexuality has been pathologized, and structures continue to dehumanize us. It’s a radical act of resistance when, as gay men, we choose to find pleasure and intimacy in our sex. Our sex has been, and will continue to be, intensely political. It can change our culture and our politics if we embrace it and run to it instead of away from it.”

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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