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Contact

Email: dr_dick@drdicksexadvice.com

Mailing address:

Richard Wagner, Ph.D.
1122 E. Pike Street   #1133
Seattle, WA  98122

HPV, WTF?

Here’s an exchange I had with a fellow named Angel. He writes:

I have a friend that has HPV. We spoke about being together but I’m nervous about this because I don’t know enough about HPV. Like how safe would I be if we were to mess around and or have sex? I wait to here back from you. Thank you for your time.

Here’s what I know, Angel…

  • HPV (human papillomavirus) is a common virus that infects the skin and mucous membranes.
  • There are about 100 types of HPV. Approximately 30 of those are spread through genital contact (typically fucking). Around 12 of these types are called “low-risk” types of HPV, which can cause genital warts.
  • In addition, there are approximately 15 “high-risk” types of HPV that can cause cervical cancer.
  • It is estimated that 80 percent of all women – and 50 percent of men and women combined – will get one or more types of “genital” HPV at some point in their lives.

As you can see, this is a very widespread virus. However, it’s relatively easy to protect yourself. Use a condom. You were gonna do that anyway, right?stis-1

And, as you probably know, there is a human papillomavirus vaccine is used to prevent infection by HPV strains 16 and 18, which causes most cancers of the cervix, as well as some cancers of the vulva, vagina and penis. Infection with HPV strain 16 also causes most anal cancers and some throat cancers.

This vaccine, given to young men and women ages 9 through 26, prevents pre-cancerous changes that may become cancer. HPV vaccination is currently recommended by the Centers for Disease Control and Prevention for all boys and girls ages 11 or 12, and for men and women ages 13 through 26 who have not already received the vaccine or have not completed booster shots.

Depending on the specific vaccine used, it may also prevent genital warts caused by other strains of HPV. This vaccine will not cure an HPV infection that is already present, and does not prevent other sexually transmitted diseases.

condom_STI_titlesThe HPV vaccine is given as a series of three injections into the muscle in the upper arm or thigh. The first shot may be given any time beginning at 9 years of age. The second dose is given 2 months after the first shot, and the third dose is given 6 months after the first shot. The protective effects of the vaccine last for approximately 5 years. Whether or not a booster is needed after five years is not yet known.

Angel writes back with:

Yes ok then sorry I just figured it’s easier to be safe and just not go there. We are really good friends and don’t want to wreck that by worrying about what I may, or may not catch. He doesn’t want me to use condoms for oral sex.

I don’t suppose you happen to know what kind of HPV this person has, do you? That makes a big difference, ya know.

Many people are unclear on the risks associated with oral sex and HPV. It can be passed during oral sex, but it is rare. To reduce the risk of infection during unprotected oral sex, limit exposure to sexual fluids and ensure that no cuts or lesions are present in your mouth or on your partner’s genitals. But, in the end, your safest bet is use a condom. If he doesn’t want you to use a condom, tell him to such his own dick.

Good luck

A Good Man Is Hard To Find

I got email from a friend of mine that I haven’t had contact with for ages. We worked together on a couple projects in the past so I was delighted to hear from him. What follows is the exchange we had concerning his love interest. (All names have been changed.) I share all of this with you because I know other people, gay and straight, who have found themselves involved with someone they probably shouldn’t be involved with. Perhaps my friend’s dilemma will strike a chord with others in my audience.

Hello Dr. Dick
I think it’s been about 13 years now since we worked together. Ahhh the good ol’ days, and oh how I miss them.

I came across a recent post of yours on Google + and it reminded me I could use some of your professional guidance.hug in the butt

I don’t want to bias my story any or waste your time with unimportant details as to the nature of events. I would like you to hear (read) my situation word for word, exactly as it has been playing out.

I have about 50 pages of text messages compiled in PDF format over the past year or so between me and a guy I really like. I don’t want to walk away from him too soon, also don’t want to wait around for something that may never materialize (It’s been 3 years since we first started having sex).

Could I ask you to review these texts and give me your thoughts about it all?

Thanks for your time
Jackson
(PS this 40y.o. guy I like identifies as being STR8, he is a total redneck, he is married to a younger 27-year-old female, he loves to fuck me and be fucked by me, he loves to suck cock and get his sucked too, he is hard from minute he walks in my door…it is the best sex of my life no question about it. And that’s sayin’ something.)

Hey YOU!
So nice to hear from you after such a long time. Yeah, I hear ya about the good old days. Unlike you, however, I don’t really miss them.

biker I would be happy to help you. Are you sure you just want me to read what you’ve compiled? Or do you want to talk about it?

Without prejudicing my appraisal of your document, what you tell me is very indicative of a problem that I have seen over and over throughout the years. And it sounds like you’ve got it bad.

Anyhow, how do you want to proceed? We can set up a Skype call, if you’d like. I do a lot of remote counseling these days, and Skype makes that possible.

I look forward to hearing back from you.

Great to hear back from you. A quick note on ‘the past’, I think what I miss the most is the social life I used to have. I had a lot of friends and always made time to see them.

The last 7 or so years have been very stressful but it’s paid off in the end. My home was foreclosed on; I fought hard, went to court many times and it took over two years but I did manage to save it. In 2010 (About a year after getting my home out of foreclosure) the state began a road construction project literally right outside my back door. It caused major damage to my 100-year-old home during the 3+ years the project went on. I am still fighting the state in an effort to resolve the issues that the construction caused.

Lol, I am not all negative like everything is all bad, or I never get a break from the weird stuff, it’s just been very unusual for me to have such a string of bad luck.hot

So back to Kevin & I. Would it be all right if you just read one short recent conversation, and then you tell me if you feel you could help? I imagine it will only take a couple minutes. Basically we are at a point where we get along amazing well in person, sex is incredible, & he loves everything the way it is. (We see each other for sex, nothing more). I, on the other hand, want to hang out sometime besides sex. This text exchange comes after not seeing or talking to him in about 10 days, which is pretty common.

Let me know Dr. :)

[Attached to the above email was a lengthy document that contained the contained the transcription of this latest text exchange between Jackson and Kevin. I’ll spare you the gory details.]

There’s a lot goin’ on here…beside the fact that the last part reads like a porn script. 😉

Here’s what I see. I see two men who have a “hook” in one another. One is happy on the hook the other is tortured on the hook.

Kevin, despite, or even because, of the hot sex you guys are having, is at a crossroads. If things continue as they are going, he will have to make adjustments to his life and have to make some very painful admissions about who he is at least to himself. He doesn’t sound even remotely ready for that. And even if he wanted to make this life-altering decision, he is probably ill equipped to do so. I’m guessing that he has been running from facing his true identity for decades.

Jean CocteauYou, on the other hand, know exactly what you want and how to get it. For you falling in love with this guy and living happily ever after would be as easy as falling off a log. You’re in love and you know how to handle yourself when love happens. We both know this is not your first time at the rodeo.

It’s like you’re dating a Martian. He only knows how to be a Martian. Despite, or even because, you appeal to him to stop being what he is (straight) and be this other thing with you (gay), he is petrified. And he may actually hate the very thing that you love about him.

Another thing that is really obvious is that Kevin’s sex with you is shame-based, not affection-based. He probably does get off on the hot monkey sex you guys have together, but he’s also probably crippled with guilt and shame afterward.

Stop and look over the document you sent me. Choose any one of those pages and count the words that you typed and then count the words that he typed. I’m sure that you will immediately see that you overwhelm him. You bare your soul; you write paragraphs of self-disclosure. He responds in monosyllables. I’m pretty sure he can barely stand the barrage. He’s trapped between what he wants and what he will allow himself to have and it is sheer torture.

Despite the fact that is wants, maybe even desperately wants, what you have to offer, and not just the sex, he can’t allow himself to have it. It would shake his world to its foundation. And since he can have the hot sex without the emotional attachment, he’s getting everything he (thinks) he wants. You, on the other hand, are living a life of non-to-quiet desperation. You’re at heaven’s door, but he won’t cross the threshold with you.

If I had to guess, I’d say there’s no future beyond the wham-bam-thank-you-sir part bumpin’ you’re already getting. And I also speculate that this arrangement has a half-life. I’d be willing to guess that ya’ll are already past the mid-point. Your dissatisfaction will grow and begin to manifest itself in the way you treat him. There will be an ultimatum. Then there will be an end. With a little luck it will end well, but there is also a big chance that it will end very poorly indeed. Violence is not unheard of in situations like this and I think you know this already.redneck

In his defense, I don’t think Kevin is holding out on you. He probably would if he could. But he simply can’t. And if I had to guess, he’s not ever gonna turn this around. You said he’s in his 40’s, right? That’s a lot of life lived falsely, no? I’d be willing to wager that you aren’t the first man he’s fooled around with over the years and I don’t think you’ll be the last. He’s gotta have his fix even if it compromises his perception of himself.

I don’t envy you this conundrum, my friend. You are in anguish; I hear that. This is not a happy place for you and all I can say is, I hope you don’t give up any more ground.

Let me know if you want to talk about this at some point. No need to walk through this on your own if you don’t want to.

Good luck.

That gave me chills… Its like you were here the whole time. You identified every detail exactly as I have been living it.

One part in particular, Kevin said pretty much word for word as you did. He said, “I’m not holding out on you. I would if I could, but I simply can’t.” I got to admit I don’t understand.

Tuesday I sent him this text:
“Why is this normal social shit so awkward in your mind? All I want to do is hang out sometime. Let me repeat, I want to do something other than hookup one time. That’s it, if you don’t like it I won’t ask again.

I know you like the other shit more, I likely do as well. But is it that big of a deal to just hang out like regular dudes as well?

I’m not asking for anything else whatsoever no emotional connection or expectations of any kind.”

redneck buttHis reply:
“I can’t. I’m sorry.”

His response blows my mind; it makes no sense. Sounds like an adult telling a child NO! I don’t have to explain, no means NO!

I think the truth is he just doesn’t WANT to do anything, even though he surely could. Ughhhh anyway.

I want to talk more with you about this Richard. I’ll hit you up later about the Skype thing. Thanks for being a sounding board for me.

Wow, that is interesting. Poor guy!

Again, in Kevin’s defense, he does have a wife. Maybe he thinks if he keeps his sex with you on the down low it’s not really infidelity. You know, guys doin’ guy things together. An emotional attachment to you would blow that delusion out of the water. It’s like being between a rock and a hard place. He can’t win for losing.

Anyhow, thanks for entrusting your woes with me. I look forward to connecting with you on Skype in the near future. All the best till then.

Review: An Intimate Life: Sex, Love and My Journey as a Surrogate Partner

Hey sex fans!

I have another swell sex-positive book to tell you about today. Anyone who frequents this site will already be familiar with my dear friend and esteemed colleague, Cheryl Cohen Greene. If ya don’t believe me type her name into the search function in the sidebar to your right and PRESTO!

Not only will you find the fabulous two-part SEX WISDOM podcast we did together, (Part 1 is HERE! And Part 1 is HERE!) you will find a posting about the movie The Sessions. You’ve seen it right? It’s the award-winning film staring John Hawkes, Helen Hunt, and William H. Macy. It’s the story of a man in an iron lung who wishes to lose his virginity.  He contacts a professional surrogate partner with the help of his therapist and priest. Ms. Hunt plays Cheryl, the surrogate partner in the movie

Cheryl also contributed a chapter on sex and intimacy concerns for sick, elder and dying people for my book, The Amateur’s Guide To Death And Dying.

With all that as a preface, I now offer you Cheryl’s own story: An Intimate Life: Sex, Love, and My Journey as a Surrogate Partner. The first thing I want to say is this book is it’s not a clinical or technical tome. It is an easily accessible memoir. And that, to my mind, is what makes it so fascinating.

She writes in the Introduction:An Intimate Life

I started this work in 1973, and my journey to it spans our society’s sexual revolution and my own. I grew up in the ‘40s and ‘50s, a time when sex education was—to put it mildly— lacking. As I educated myself, I found that most of what I had been taught about sex was distorted or wrong. The lessons came from the playground, the church, and the media. My parents could barely talk about sex, much less inform me about it.

What follows is a candid and often funny look into the personal and professional life of a woman on the cutting edge of our culture’s movement toward sexual wellbeing.

Cheryl comes out of her conservative Catholic upbringing and her often tortured family dynamics with what one would expect—her own sexual awakenings as well as the conspiracy of ignorance and repression that wanted to stifle it. This is a common story, the story of so many of us.

Starting when I was around ten, I masturbated and brought myself to orgasm nearly every night. … If my nights began with anxiety, my days began with guilt. I became convinced that every earache, every toothache, every injury was God punishing me. … I couldn’t escape his gaze or his wrath. Sometimes I imagined my guardian angel looked away in disgust as I touched myself and rocked back and forth in my bed.

The miracle here is that this troubled tween would blossom into the remarkable sexologist she is today.

rsz_1greenecherylSome of the chapters in her book describe one or another of her hands on therapeutic encounters as a surrogate partner, but equally important and compelling are the chapters that describe Cheryl’s own sexual struggles as she moved to adulthood and beyond. Cheryl’s acceptance of her own sexuality enables her to build a career out of helping others do the very same thing.

Everyone has a right to satisfying, loving sex, and, in my experience, that most often flows from strong communication, self-respect, and a willingness to explore.

Despite the frank discussion of sexual topics within the book, there is no prurience or sensationalism. For the most part, Cheryl’s clients are regular people, mostly men, who have pretty ordinary problems—erection and/or ejaculation concerns, dating difficulties, as well as self-esteem, guilt and shame issues. Cheryl helps each of her clients with the efficiency and confidence of the world-class sex educator she is. Most of her interaction involves her supplying her clients with some much-needed information, dispelling myths, and giving them permission to experiment. As she says;

I continue to be amazed at how solid education delivered without judgment can eradicate much of the guilt and shame that turns life in the bedroom into a struggle instead of a pleasure.

Her most famous client, Mark O’Brien, the 36-six-year-old man who had spent most of his life in an iron lung after contracting polio at age 6, was the author of How I Became a Human Being: A Disabled Man’s Quest for Independence, in which he writes about his experience with Cheryl. This, of course, was adapted into a film, The Sessions, which I mentioned above. For her part, Cheryl delivers a most poignant remembrance of Mark early in her book.

I explained Sensual Touch to Mark. Although he was paralyzed, he still had sensation all over his body, so he would feel my hands moving up and down. … I encouraged him to try and recognize four common reactions: feeling neutral, feeling nurtured, feeling sensual and feeling sexual.

An Intimate Life chronicles Cheryl’s life-long interest in human sexuality. Her life and sometimes-turbulent loves are on display, but in the most considerate fashion. She teaches by example. She’s even able to speak with great compassion of her time living with and through cancer.

As I inch toward seventy, I appreciate more and more how much I have to be grateful for and how fortunate I’ve been. I was lucky to find a wonderful career and to be surrounded by so many smart, adventurous, caring people. My personal sexual revolution auspiciously paralleled our culture’s, and in many ways was made possible by it. I am eternally grateful to the pioneers, rebels, and dreamers who made our society a little safer for women who embrace their sexuality.

There is so much I loved about this book, but mostly it’s the humanity I found in abundance. Cheryl’sdr.-cheryl-cohen-greene enlightened soul shines brightly from every page. Her no nonsense approach to all things sexual is an inspiration. And her perseverance to bring surrogate partner therapy into the mainstream is laudable.

…what separates surrogates from prostitutes is significant. When people have difficulties grasping [that], I turn to my beloved and late friend Steven Brown’s cooking analogy that I’ve so often relied on to help me through that question: Seeing a prostitute is like going to a restaurant. Seeing a surrogate is like going to culinary school.

Finally, An Intimate Life is the culmination of Cheryl’s life as a sex educator, her surrogate partner therapy practice being just part of that mission. I highly recommend you read this book. You will, I assure you, come away from it as I have, a better person—enriched, informed, as well as entertained.

Cheryl, thank you for being in my life and being such an abiding inspiration. Thank you too for this marvelous book; now you can be in the lives of so many others who need you so that you can inspire them along their way.

Be sure to visit Cheryl on her site HERE!

The Dark Side of Love

Just in time for Valentines Day, I feature an exchange I had with an earnest and, I might add, very nervous young man about a prevalent STI. Our friend is freaking out about genital warts.  I know, I’m such a buzz-kill.

 

Name: Ryan
Gender: Male
Age: 20 something
Location: Lowell MA
A few years back, a friend confided that he contracted genital warts from his ex-girl friend. He had the genital warts on his genitals, anus, hands, feet and in his mouth. His ex-girl friend had it on her hands, in her vagina, mouth, anus and cervix. I can understand having it on the genitals and hands and in the anus, mouth and cervix. I didn’t ask how he got it on his feet.
He went to work in another state, but came back here two years later. He told me he liked a girl he met and would like to bring the relationship into a more intimate level. I asked him about his genital warts. He said he was cured of it. I read that genital warts cannot be cured. That it can be treated, but will remain incurable and contagious although dormant for a while.
Will the girl get it after they had sex? My friend comes to my house very often, drinks beer with my girl friend and me. He uses the bathroom and the hand towel. Even after scrubbing the bathroom and washing the hand towel, can my girl friend and I get the genital warts? As for my friend, was he condemned not to have sex for life? Or, is it safe to have sex if there was no outbreak or external signs?

I’ve seen several bad cases of genital warts, but never a case that included hands feet and mouth. I know that’s possible, of course, but I’ve never seen it. And without a doctor’s diagnosis, a particular outbreak could be something else. That’s why, something like this, needs to be diagnosed and treated properly.

the dark side of love

You are right; technically genital warts remain incurable, though non-contagious, and dormant if treated correctly. And proper treatment is the key. For more information you might consult WebMD.

Casual contact, the kind you describe below — bathroom, towels, etc. — cannot pass on the virus. Transmission is dependent on intimate genital contact. Does your friend (or his GF) have an outbreak going on now? Can you see something on his (her) hands and face?

     I know my friend is a responsible person and he will not knowingly infect me with his genital warts. But, how can he be sure that the wart is dormant and non-contagious? I am now wary because he told me his genital warts were cured. This makes me wonder whether he was given the wrong medical advice or he was just trying to put my mind at ease. Aside from using the bathroom and towels, he also eats dinner at my home and could infect my dishes, utensils, cloth napkins, etc. and pass the virus to me and my girl friend.
This matter has the potential of becoming a dilemma for me and my friendship with him. I don’t want to ask him details such as who is his doctor, what kind of treatment he is getting (it seems the infected person must be tested periodically and the treatment ongoing) and how is he going to determine when he is not contagious. He is a sensitive person and I know that he will get angry if I asked him these questions. I can make excuses not to see him at my house (this only goes so far). If I ask or make excuses, I’d lose his friendship. I don’t want to lose him as a friend. But, I don’t want him to infect me and my girl friend with the virus either, knowingly or unknowingly.
I don’t see any warts on his hands and on his feet (he wears sandals sometimes). I don’t know if he plans to tell the girl he plans to get intimate with.
My girl friend doesn’t know about this. She will freak out if I tell her and that will cause more problems. Help!!!???!!!

If I were you I would ask him about the treatment he received for his warts. That would put your mind at ease. Besides, your friendship sounds like it’s on the brink anyway. And here’s a tip: you probably have lots of casual contact with many other people with genital warts without even knowing it — it’s a very common malady.

     Thank you very much. I think he should also tell the girl about his genital warts before having sex with her. She must be given the option to reject or accept it. I also read that the virus can be passed just with skin-to-skin contact when there is a flare up. Is this true?
I feel bad about this. Although my friend is a responsible person, there is still a chance he could get carried away in the heat of passion and throw precaution and caution to the wind.
I imagine it is difficult to enjoy sex when you have to do and think of many things that could go wrong.      Giving him my sympathy will not help. He alone has the burden of doing what has to be done before having sex to prevent contaminating his girl friend or spreading he genital warts around.
I will appreciate any additional information/clarification/advice you can give me about this.
Thank you again for your help.

Again, genital warts, like herpes, are contagious only when there’s a flair-up. Skin to skin contact can pass the virus at that point. Also, like herpes, if the genital wart virus has been treated, the likelihood of passing on the virus is negligible.

I am of the mind that we all ought to be responsible and up-front with our sex partners about any health related issues that may impact on the health of our partners.

Good luck

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