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Sex Therapy—What Is It and Who Needs It? – Part 2

(Look for Part 1 of this series HERE!)

Of course, there are plenty of individuals—and couples—who haven’t waited until the last minute to seek help. These people want to be proactive about their concerns. Some people simply need some clear, unambiguous information about human sexuality. A surprising number of people are trying to piece together their sexual lives, but are hampered by misconceptions and misinformation.

Sometimes a momentous event motivates a person to address arising sexual or intimacy issues. The birth of a child, a disease process, a death in the family, or an accident can fundamentally alter the power dynamic of a relationship, which will require a rethinking of the entire relationship.

Or perhaps someone comes to a new realization about him or herself: Perhaps they are finally able to acknowledge their bisexuality, or that he’s gay, or she’s a lesbian. Maybe they are finally able to acknowledge a fetish—he’s a crossdresser, or she’s into another kink. Things like this obviously impact the individual, but if that person is in a relationship, the relationship is also affected. People in these self-revelatory situations are often unsure how to talk about their discoveries with a partner, which is another reason they seek counseling.

Some couples don’t fret when the sex vanishes from the relationship; other couples are devastated. What does one do when one partner still has sexual needs, but the other doesn’t? Often, there are unexplored options that can hold the relationship together, but will address the disparity in sexual interest and desire.

In this case, I can help the couple make compromises without losing their moral compass. Some couples navigate this with ease; others not so much. It can be extremely challenging, but there are ways to preserve what’s sacred about a primary relationship, while contemplating opening the relationship to include others. I can help a couple establish guidelines and ground rules for making the necessary adjustments.

Sometimes the relationship is really wonderful and fun. The couple really loves each other, but they’ve noticed their sex life together is pretty boring and stale. I’m often approached to simply help a couple spice things up. In this instance, my work is sheer joy. Mostly, I just give them permission to experiment and have fun.

You’ve probably noticed that a good portion of the work that I do as a sex therapist is merely giving permission. That may not sound like therapy at all, but when you consider that our sex-negative culture is so full of prohibitions; permission giving is often the front line of sexual rehabilitation. Most of the permissions I give are for an individual to educate him or herself about his or her body and his or her sexual response cycle. Personal exploration, such as masturbation, is the very best means to that education. I’m a huge proponent of partners masturbating together.

Happily, our need to reacquaint and reeducate ourselves about our bodies and our sexual response cycle is a life-long process. There is always something new to explore. As we age, our bodies change, and if we don’t keep up with those changes, we can become frustrated and disoriented. Older people, menopausal women and andropausal men, take longer to build up “a head of sexual steam,” so to speak. If they’re not attuned to the changes they’re going through, they can easily miss the important cues their body is sending to slow down and enjoy the sensuality.

Of course, I could go on and on, but now I want to leave you with what is the distillation of years my thinking about the role sexuality plays in our life:

I believe that sex is like food. We can enjoy it alone, or with others. We can be abstemious, or gluttonous. We can nosh or nibble; dine or devour. And we can be certain there will be both times of feast and famine.

Sex is like food. It can nourish and sustain us, or it can make us sick. We can consume all the available bounty, or restrict our diet. It can completely satisfy, or leave us devastatingly empty. We can employ it to express our highest aspirations, or allow it to rob us of our soul. We can give it as a gift, or use it as a weapon. It can be both bacchanal and sacrament.

One thing is for sure, whether purely physical or transcendentally spiritual, no one can live without food…or sex.

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Yikes! WTF is wrong with me?

Name: Tony
Gender:
Age: 40
Location: Houston
I’ve loved several women and even married and divorced one. Over the last few years, I notice having similar feelings for men around me…longing, sweaty palms, difficulty thinking and wanting to be with them alone. Is this love? Am I bisexual? Am I a sick man better off dead? I have not crossed the line and I still have great sex with women. But there’s now a guy that I think about when I’m with her! Am I gay? Bisexual? Sick in the head?

Hey, chill out, my friend, this is not all that uncommon a phenomenon. Many people, just like you, inexplicably find themselves behaving in a completely unexpected sexual manner. I would, however, love to know what triggered you to veer off your comfortable and predictable sexual path?

While you enjoy these new found feelings, beware that there’s never a scarcity of sexual fascists out there. People who believe that sexual tastes and preferences are carved in stone, or that there’s only one “right” way to be sexual. They’ll persecute anyone who doesn’t conform to their strict immutable notions of sexuality and eroticism. Despite the proliferation of these hetero-fascists and homo-fascists; they are all very wrong about the indomitable human spirit and the flexibility of human sexuality.

Humans are not sexual automatons. Given a more permissive and sex-positive culture then our own, we’d all be more fluid in our eroticism and sexual expression. Are you one of the lucky few who has discovered the joy of this fluidity? Doesn’t quite sound like it to me, at least not yet. I think you’re still in the “scared shitless” stage.

For a guy who has yet to “cross the line” and actually act on your fantasy, you sure are preoccupied with your identity. Are you afraid that someone will take away your breeder card if you actually touch a dude in a sexual way? Does having same-sex feelings…sweaty palms and all…make you a gay? I certainly doubt it! Being gay entails a lot more than a sense of longing for something you’re not supposed to have. Are you bisexual? I can’t say for sure, but you’re certainly not exclusively straight either. I suppose you have to come to grips with the self-identify thing when you have a bit more information about your burgeoning eroticism. What I know for sure is that you are not sick.

Who knows, your homoeroticism might very well be situational. It might not extend any farther than the guy you think about when you’re fucking chicks. I know all of this is can be pretty disconcerting and it can really mess with your head. But at least you know you are still alive sexually. So many people are sleepwalking through their erotic lives.

Will you act on your inclinations? Will you test the waters, so to speak? What harm could it do? Might just open up a whole new sexual world for you. On the other hand, if you do nothing, or try and repress these natural feelings, you’ll always know in your heart of hearts that you have the desire, if not the capacity, to express yourself sexually with a much wider range of humans than what you are currently used to. And something tells me that if you choose the path of self-denial, it will eat away at you until you satisfy your curiosity.

Good luck

Name: William
Gender:
Age: 67
Location: Connecticut
Is there such a thing as a being a homosexual watcher only? Ya know, getting an erection, but not wanting to perform?

All of human sexuality is on a continuum. Are you familiar with the Kinsey Scale? The dean of American sex research, Alfred Kinsey, his associate, Wardell Pomeroy, and their colleagues developed this scale as a way of classifying a person’s sexuality in terms of both behavior and fantasy.

This is what they developed.

0- Exclusively heterosexual with no homosexual behavior or fantasy.
1- Predominantly heterosexual, only incidentally homosexual — most likely in fantasy only.
2- Predominantly heterosexual, but more than incidentally homosexual — fantasy for sure and possibly behavior too.
3- Equally heterosexual and homosexual in both behavior and fantasy.
4- Predominantly homosexual, but more than incidentally heterosexual — fantasy for sure and possibly behavior too.
5- Predominantly homosexual, only incidentally heterosexual — most likely in fantasy only.
6- Exclusively homosexual with no heterosexual behavior or fantasy.

These pioneering sexologists also discovered that an individual may be reassigned a different position on this scale, at different periods in his/her life. It’s conceivable that one could go from Kinsey 0 to 6 in a lifetime, or just a summer in San Francisco. This seven-point scale comes close to showing the many gradations that actually exist in human sexual expression.

Back to your specific question, William, yes, someone could be a Kinsey “6” in terms of his fantasy and desire, but be a Kinsey “0” in terms of behaviors.

We’re amazing creatures, huh?

Good Luck

Trouble in Paradise

Name: Carey
Gender:
Age: 33
Location: Kansas
My fiancée is 27 and in the past 3 to 4 years her libido has become virtually extinct I have tried everything and she just blames her birth control what do I do

You’ve been engaged to a woman for more than 4 years? Oh wait, maybe you’re trying to tell me that you proposed to this woman in spite of knowing she has an extinct libido? Either way, darling, that’s messed up, huh? Are you hoping this is “dry spell” is gonna somehow magically resolve itself once you’re married? I wouldn’t hold my breath for that, if I were you.

It’s true of course, birth control pills can seriously impact on a woman’s desire for sex. Your fiancée is probably one of these women. Maybe she ought to consult her physician about finding another type of pill that may have a less severe impact on her libido.

Many women find that triphasic birth control pills (which deliver differing amounts of hormones every week) interfere much less with their sex drive than monophasic pills (which deliver the same amount of hormones each dose).

She could also decide to discontinue the pill altogether, and choose another form of contraception, such as a condom or diaphragm. Just realize that once off the pill, her sex drive may only return very slowly.

You see how this predicament is a double bind for your fiancée. If she is more lax with her contraceptive efforts, just to please you and your sex drive; then she opens herself up for an unplanned pregnancy. And that’s not good for her, or you. Is there anything YOU can do to free her up from shouldering the full burden of contraception? Have you’ve considered a vasectomy? Probably not, huh? What man ever imagines he ought assume the responsibility for controlling reproduction?

While I wholeheartedly support the notion that married people deserve a rich and fulfilling sex life, unless there’s mutual agreement for another arrangement; that can’t happen if one of the partners is inequitably burdened by one thing or another. Perhaps, it’s time you and the little woman to have a frank talk about sharing the responsibility for contraception. And if this little talk is successful, maybe, just maybe, you’ll get laid again.

Good luck

Name: Tony
Gender:
Age: 40
Location: Houston
I’ve loved several women and even married and divorced one. Over the last few years, I notice having similar feelings for men around me…longing, sweaty palms, difficulty thinking and wanting to be with them alone. Is this love? Am I bisexual? Am I a sick man better of dead? I have not crossed the line and I still having great sex with women. But there’s now a guy that I think about when I’m with her! Am I gay? Bisexual? Sick in the head?

My first reaction is that what you present is not particularly uncommon. Many people, just like you, inexplicably find themselves behaving in a completely unexpected sexual manner. I’d love to know what triggered you to veer off your comfortable and predictable sexual path?

There’s never a scarcity of sexual fascists out there, people who believe that sexual tastes and preferences are carved in stone, or there’s only one “right” way to be sexual. They’ll persecute anyone who doesn’t conform to their strict immutable notions of sexuality and eroticism. Despite the proliferation of these hetero-fascists, homo-fascists, what have you; they are all very wrong about the indomitable human spirit.

For the most part, humans are not sexual automatons. Given a more permissive and sex-positive culture then our own, we’d all be more fluid in our eroticism and sexual expression. Are you one of the lucky few who has discovered the joy of this fluidity? Doesn’t quite sound like it to me, at least not yet. I think you’re still in the “scared shitless” stage.

For a guy who has yet to “cross the line” and actually act on your fantasy, you sure are preoccupied with your identity. Are you afraid that someone will take away your breeder card if you actually touch a dude in a sexual way? Does having same-sex feelings…sweaty palms and all…make you a gay? Doubt it! Being gay entails a lot more than a sense of longing for something you’re not supposed to have. Are you bisexual? I can’t say for sure, but you’re certainly not exclusively straight either. I suppose you have to come to grips with the self-identify thing when you have a bit more information about your burgeoning eroticism. What I know for sure is that you are not sick.

Who knows, your homoeroticism might very well be situational. It might not extend any farther than the guy you think about when you’re fucking chicks. I know all of this is can be pretty disconcerting and it can really mess with your head. But at least you know you are still alive sexually. So many people are sleepwalking through their erotic lives.

Will you act on your inclinations? Will you test the waters, so to speak? What harm could it do? Might just open up a whole new sexual world for you. On the other hand, if you do nothing, or try and repress these natural feelings, you’ll always know in your heart of hearts that you have the desire, if not the capacity, to express yourself sexually with a much wider range of humans than what you are currently used to. And something tells me that if you choose the path of self-denial, it will eat away at you until you satisfy your curiosity.

Good luck

Panic in Straightville

Name: Tony
Gender:
Age: 40
Location: Houston
I’ve loved several women and even married and divorced one. Over the last few years, I notice having similar feelings for men around me…longing, sweaty palms, difficulty thinking and wanting to be with them alone. Is this love? Am I bisexual? Am I a sick man better off dead? I have not crossed the line and I still have great sex with women. But there’s now a guy that I think about when I’m with her! Am I gay? Bisexual? Sick in the head?

Hey, chill out, my friend, this is not all that uncommon a phenomenon. Many people, just like you, inexplicably find themselves fantasying and even behaving in a completely unexpected sexual manner. I would, however, love to know what triggered you to veer off your comfortable and predictable sexual path?

While you learn to enjoy these new-found feelings, beware that there’s never a scarcity of sexual fascists out there. People who believe that sexual tastes and preferences are carved in stone, or that there’s only one “right” way to be sexual. They’ll persecute anyone who doesn’t conform to their strict immutable notions of sexuality and eroticism. Despite the proliferation of these hetero-fascists and homo-fascists, they are all very wrong about the indomitable human spirit and the flexibility of human sexuality.

Humans are not sexual automatons. Given a more permissive and sex-positive culture then our own, we’d all be more fluid in our eroticism and sexual expression. Are you one of the lucky few who has discovered the joy of this fluidity? Doesn’t quite sound like it to me, at least not yet. I think you’re still in the “scared shitless” stage.

For a guy who has yet to “cross the line” and actually act on your fantasy, you sure are preoccupied with your identity. Are you afraid that someone will take away your breeder card if you actually touch a dude in a sexual way? Does having same-sex feelings…sweaty palms and all…make you a gay? I certainly doubt it! Being gay entails a lot more than a sense of longing for something you’re not supposed to have. Are you bisexual? I can’t say for sure, but you’re certainly not exclusively straight either. I suppose you’ll have to come to grips with the self-identify thing when you have a bit more information about your burgeoning eroticism. What I know for sure is that you are not sick.

Who knows, your homoeroticism might very well be situational. It might not extend any farther than the guy you think about when you’re fucking chicks. I know all of this is can be pretty disconcerting and it can really mess with your head. But at least you know you are still alive sexually. So many people are sleepwalking through their erotic lives.

Will you act on your inclinations? Will you test the waters, so to speak? What harm could it do? Might just open up a whole new sexual world for you. On the other hand, if you do nothing, or try and repress these natural feelings, you’ll always know in your heart of hearts that you have the desire, if not the capacity, to express yourself sexually with a much wider range of humans than what you are currently used to. And something tells me that if you choose the path of self-denial, it will eat away at you until you satisfy your curiosity.

Good luck

A Spot of Heavy Breathing

Name: Bob
Gender: male
Age: 40
Location:
I’m a bisexual male. Recently I’ve been seeing this black guy, 25 years old, with a very big 9” very thick cock. We’ve been suckin’ and he’s been fuckin me. But most recently he’s been wanting me to get together with two or three of his friends and have a party. I mostly want to do it, but I’m a little scared. Would I be able to handle 2 or 3 guys? Would I be able to take all their cocks up my ass? I need some advice.

Bob, you are a little breathless, huh? I’m so delighted you stopped by with this tantalizing tidbit. So let’s get this straight, so to speak. You’ve got this heavy hung black dude, 15 years your junior, rockin’ your world with his thick 9”. Oh sure, count your money in front of the poor, why don’t cha? Say, all of us here at Dr Dick’s Sex Advice are wondering; how in the world did you get this dazzling urban specimen to tap your honky ass in the first place?

But there’s more…besides your amazing good fortune with this one fella, your young playmate wants to introduce you to a few of his big boned bruthas for some hot group action. Mmmm, how you do go on, sir! I suppose it’s only natural to be a bit intimidated, what with all that weighty pipe that will be swinging around. All I can say is I hope you film the event for posterity, darling. Because if you don’t no one, not even me, will ever believe you.

You want some advice? How could I possibly advise someone who can handle…and I quote “a very big 9” very thick cock.” If that’s truly the case, you don’t need nothin’ from me. Let’s just hope your hole will be able to withstand the massive gang fuck. And that’ll depend on one thing — you being as big of an insatiable bottom as you are a braggart. If you are, you’ll have no trouble at all.

Good luck…you’re gonna need it.

Name: Ben
Gender: Male
Age: 17
Location: New York, New York
Dr- I have read up on some of the questions you have answered and realized why my penis is curved. Because I began to masturbate in sixth grade! (The older boys on the bus encouraged me too) Now I know that this may sound dumb. But is there any way to fix this? I haven’t ever even had a blowjob, or hand job because I’m so timid about a girl seeing my penis. I’m also scared to call anywhere, and when the doctor asks me if I have any questions about my body I’m even to scared to say yes to that. Should I ask the doctor about it just too see if there is a way to fix my penis, or is there a natural way to fix it with a special kind of vitamin that I can take? Thanks a ton! -Ben

Hey Ben, why are you being such are a scaredy cat? I mean how bad a curve does your dick have that you would avoid a blowjob or even a hand job when offered? Is it really that misshapen? I mean, how many erect cocks have you seen in your short life span that you can say for sure that your unit is so fatally flawed? Can you be absolutely certain that the curve of your johnson isn’t just a normal variation on an otherwise handsome and hearty tool?

Listen pup, even a precocious masturbator like you is unlikely to change the shape of his willie simply by jerking off. That’s not to say that one’s dick can’t run into trouble from injury or abuse. For as hearty a plaything as it is, our cock, it is a relatively delicate instrument. When you get a woody, your cock is engorged with oxygen-rich blood, which is essential for the upkeep of the smooth muscle tissue. This kind of tissue makes up about 90% of your cock. So you can see how a healthy circulatory system is to a vibrant sex life.

If you dissected your woody and looked at a cross-section you’d see three distinct spongy tubular structures, each are made up of smooth muscle tissue. Two of these tubular structures — one on either side of your cock, both of which run the length of your cock — are called the corpora cavernosa. These marvelous structures become engorged with blood lifting and thickening your cock to erection. The corpus spongiosum, the third tubular structure is located just below the corpora cavernosa. This baby houses your urethra, through which urine and semen pass during urination and ejaculation, respectively. This may also become slightly engorged with blood, but less so than the corpora cavernosa.

An oxygen-deprived cock will build up a kind of plaque, which resembles scar tissue. This will cripple a dude’s rod (Peyronie’s disease) or rob him of his wood altogether. However, I don’t think this is the case for you.

So before you start tryin to “heal” or “fix” yourself with some contraption or herbal supplement visit a doctor first. If you’re too timid to make an appointment with your family physician, go to a free clinic, or neighborhood clinic near you. You’re living in the big apple for crying out loud; you have all these great resources available to you.

Good luck