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Doctors urged to advise patients about risks of abstinence-centric sex education

American Academy of Pediatricians’ new report is the clearest denouncement of the failures of not talking about STIs and pregnancy prevention

Across the US only 50% of high school students receive sex education that meets the recommendations of the federal Centers for Disease Control and Prevention.

Across the US only 50% of high school students receive sex education that meets the recommendations of the federal Centers for Disease Control and Prevention.

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The country’s largest organization of pediatricians entered fraught political territory on Monday, with a call for doctors to use their time with patients to combat the potential health consequences of abstinence-centric sex education.

In a new report, the American Academy of Pediatricians (AAP) issued its clearest denunciation yet of sex education programs that fail to offer comprehensive information on topics such as sexually transmitted infections (STIs) and pregnancy prevention.

“This is the mothership telling pediatricians that talking about sex is part of your charge to keep children and adolescents safe,” said Dr Cora Breuner, a professor and pediatrician at Seattle Children’s research hospital and the report’s lead author.

“These guidelines give pediatricians in communities where people might say, ‘We don’t want you talking to our kids about this stuff,’ permission to say, ‘No, I can talk about this, I should talk about this, I need to talk about this.’”

The report is broadly a call for pediatricians to help fill in the gaps left by the country’s patchwork sex education programs. It urges pediatricians to teach not only contraception and the benefits of delaying sexual activity, but to cover topics such as sexual consent, sexual orientation and gender identity with school-aged children who may not receive any information in the classroom and involve their parents.

But the authors single out abstinence-heavy education, which sometimes excludes information about contraceptives, as a key concern for doctors looking to help adolescent patients avoid sexually transmitted infections and unintended pregnancy. As a result, it is likely to fuel an already contentious debate.

Groups that have advocated for sex education to emphasize abstinence instantly found fault with the new guidelines.

“A health organization like the AAP should not be affirming a behavior that can compromise the health of youth,” said Valerie Huber, the president of Ascend, a group that promotes abstinence-centric sex education and advocates for federal funding. The group was formerly known as the formerly the National Abstinence Education Association.

“They recommend ‘responsible sex’ for young adolescents. Exactly what is responsible sexual activity for adolescents? … The science is clear that teens are healthier when they avoid all sexual activity.”

Moreover, Huber said, programs that “normalize teen sex” are unpopular with many parents.

“Most communities do not support the type of sex education they recommend,” she said.

Still, others embraced the report as bringing the AAP’s recommendations more in line with the reality.

“This is a fantastic move,” said Chitra Panjabi, the president of the Sexuality Information and Education Council of the United States (SIECUS), a research group that supports comprehensive sex education. “It’s really important that our medical providers are standing up and saying, hey, the youth in our communities are coming to us because they’re not getting the information they need. And so we need to step in.”

The US does not enforce national standards for sex education and schools in many states are not required to teach it. Across the country, SIECUS estimates, only 50% of high school students receive sex education that meets the recommendations of the federal Centers for Disease Control and Prevention. The other half of students receive anything from an incomplete sex education, to education that emphasizes abstinence, to abstinence-only education, with a focus on delaying sex until heterosexual marriage.

In February, Barack Obama proposed a budget for 2017 that eliminated the $10m the department of health and human services spends on abstinence-only programs every year. But funding continues to flow to those programs from other sources. Title V, an abstinence-only program, allocates $75m a year to abstinence-only programs, money that states match by 75%.

In the last quarter-century, programs emphasizing abstinence as the optimal way to avoid pregnancy and STIs have received more than $2bn in funding from the federal government. Comprehensive sex education, by contrast, has no dedicated federal funding stream.

“It’s a political climate where people don’t want to talk about these issues,” said Breuner. “But it makes our job so much harder when we cannot coordinate our efforts with the schools. It takes time away from the other safety issues we need to be discussing. Don’t smoke weed. Don’t text and drive.”

Recently, two major surveys of existing research on sex education concluded that there was no evidence or inconclusive evidence to show that abstinence-centric programs succeeded in delaying sexual activity. One of the surveys found that comprehensive sex education was actually more effective than abstinence education at delaying sexual activity in teens. (Ascend points to select studies which show the opposite.)

A long-term study found that teens receiving abstinence-only programs were less likely to use contraceptives or be screened for STIs, although rates of infections were not elevated.

The studies helped compel the AAP to issue its first major guidance on sex education since 2001.

“It’s important for pediatricians to have the backing to say, ‘Look, I can’t support telling this stuff to children,’” Breuner said. “I have to deal with the aftermath, which is a 15-year-old who’s pregnant, or a 16-year-old who has a sexually transmitted infection he’s going to have for the rest of his life.”

Breuner said a number of her patients have suffered consequences from abstinence-only education. Many of them are pregnant teenagers and girls who, in the absence of accurate information, came to believe in common myths about pregnancy prevention.

“They’ll say, ‘I thought you couldn’t get pregnant when you were having your period,’ or, ‘I thought it took two or three years after you get your period to be able get pregnant.’ It’s heartbreaking, because I know with education, this could have been prevented.”

Complete Article HERE!

Gay Sex Questions, Answered by Davey Wavey’s Doctor: WATCH

sex_doctor

There is a lot of misinformation out there about gay sex. In an attempt to separate the myths from the facts, blogger Davey Wavey made an appointment with his physician, Dr. Jay Gladstein, to get to the bottom of things.

Among the things that you’ll find out in this check-up with Dr. Gladstein:

Does having anal sex stretch out your anus? … Can a dick ever be too big? … Is frequent douching bad for your body, and what should you douche with? … Why are some guys physically able to bottom and some aren’t? …. Is it important to tell your doctor you’re gay? … Why can’t gay men give blood? … Does bottoming cause hemorrhoids? … Does bottoming increase risk of prostate cancer? … Is the stigma of having many sexual partners justified? … Can you get STDs from swallowing semen? … If you are undetectable what are the chances of transmitting HIV? … Why is gay sex so fun?

Watch:

Is there a doctor in the house?

Hey sex fans,

I know I promised you a Q&A podcast for today, but I’m afraid I must disappoint. I’ve been experiencing technical difficulties all weekend long, so this charming exchange between me and a nervous mother will have to satisfy you till I can pull together the next podcast…this coming Wednesday, 12/05/12, I hope.

Name: Nora
Gender: female
Age: 26
Location: Mane
My husband and I are having a little problem with our 5-year-old son. He’s very bright and inquisitive and we encourage that in him. However, we’ve caught him playing doctor with playmates, twice in two months. Once with a 4 year old neighbor girl and most recently, a 6-year-old boy from his school. How do we handle this? We don’t want to stifle his inquisitive nature, nor do we want to send him the message that sex is bad or dirty. We weren’t raised like that and we don’t want to raise our son like that either. At the same time, he can’t continue to do this. If other parents discover this, there could be trouble. What do you think? Thanks.

Ya gotta love the curiosity and innocence of children, but I certainly understand your concern.

Reading your message took me back to one of my earliest memories. I must have been about the same age as your son at the time. A neighborhood boy, who was slightly younger than me, and I were playing in a vacant lot near our homes. We made a little fort in the tall grass. And there, out of the blue, I suggested that he, the neighbor boy, pull down his pants so that I could take his temperature with this little stick I was holding. He was perfectly compliant and, like it was an everyday thing, he bent over and I stuck the twig in his bum. I remember taking careful note of his little peepee in the process. He had one, just like me, which was a totally different configuration than my baby sisters. I had taken note of that when I watched my mother change their diapers. I remember thinking to myself, my god that is so weird. But I digress. The gist of the story is that I was a very inquisitive lad, just like your son. And the opportunity check out the neighbor kid was, just that…an opportunity to satisfy my curiosity.

A couple days later, pretty much out of the blue, my dad took me aside for a little chat. He asked me about my play with the neighbor kid. I wasn’t quite sure what he was referring to. Ya see the “doctor” incident didn’t register with me as particularly significant, or all the memorable. It just was what it was. But it sure did register with a nosy neighbor lady who witnessed the whole thing. Apparently she told my mother, my mother told my father and now he was telling me. You have to remember, this was the mid-1950s, so sexual experimentation at any age was a lot more taboo than it is today, or even when you and your hubby were kids.

To my father’s credit he wasn’t hysterical, but he was very firm. I got the unambiguous message that this sort of behavior was not OK. It’s funny, had no one seen me and the neighborhood kid in our innocent play, the incident wouldn’t have registered with me at all. I probably had the same level of interest in the kid as I would have seeing an interesting bug, or catching a glimpse of a rabbit or raccoon. It filled the moment, and then it was gone.

Like I said, despite my father’s mild manner, I did get the clear message that what I did crossed some line, a line that I didn’t even know existed beforehand. My father’s talk managed to instill a sense of shame where there was none before. And I remember realizing that my behavior wasn’t just wrong, like if I had hit someone, but it bad, like sinful. And even at that age, I understood to some degree what sin was. I had visions of Jesus and his blessed mother up in heaven crying their little hearts out over my indiscretion. So now, along with the shame I began to feel guilt.

Of course, even if my “doctor” play hadn’t been discovered at age 5 there certainly were dozens of subsequent opportunities for me to get the hardball message that sex was dirty and sinful — not just touching but even dwelling on the subject was enough to send one to hell. There simply was no escaping that fifty some years ago. Are things fundamentally different today? Probably not fundamentally! There are, no doubt, more parents these days who, like yourselves, are more enlightened than when I was a kid. But let’s face it; the predominant culture is still very sex-negative.

One of the biggest mistakes parents make when they are faced with the kind of situation you refer to, Nora, is they impose adult motivations onto their kid’s behavior. For the most part, young children don’t have a sense of shame about their bodies, nor do they have a highly developed sense of the personal space of another person. When their curiosity about their body and the bodies of others, both children and adults, turns to touching and exploration, it has no sexual connotation like we grown-ups understand.

Some years ago, I said much the same thing at a church sponsored workshop for parents. A mother in the audience stood up to tell me that I was all wet about this. She said she knew for sure that her pre-adolescent son had a sense of guilt about fondling himself, because when she caught him doing it one day he looked very guilty. Well, duh! But when we discussed the occurrence further, we were able to discover the truth. I asked her, to describe the situation. She said, “I happened to see my son, through the partially open door to his room. It was just after his bath. He was sitting on his bed touching himself impurely.” I had to chuckle at her vocabulary, but I asked her to proceed with her story. She said, “naturally, I threw open the door and said; ‘what in the world are you doing?’” I said, in a somewhat mocking tone; “Yes, naturally!”

I wasn’t hard to imagine the scene she was describing, because she was pretty agitated by just retelling the story. I could visualize the bedroom door flying open, her stomping into the room, hands on her hips, eyes glaring, nostrils flared, her voice pitched high. What she saw in her young son’s face was not shame; it was fright. I told her that she was the cause of the panic in his face. I explained that if she had barged in to his room that way, with her threatening body language and her “what in the world” screech while he was on his knees saying his bedtime prayers, the kid would have had the same look of alarm, which she interpreted as guilt. I also confronted the woman about the issue of privacy. Listen parents, even young children need and deserve their privacy. You don’t want to see embarrassing things? Avoid the temptation to walk in on your kids without knocking first.

The reason I tell you all of this, Nora, is I want you to realize that the way you address your son’s behavior is probably more important than what you actually tell him. If you approach the discussion all worried, or distressed, or alarmed, or agitated; you can be assured that your body language will tell him all he needs to know, even before you speak your first word.

If your son’s behavior doesn’t course correct all by itself, which it probably will, my advice is schedule a little family meeting. The key here is that you’ll want to talk about several things besides the bothersome behavior. You might bring up school, putting away his toys, playing doctor with the neighbors, and helping with some of the household chores. You’ll notice that the more difficult subject is couched between more mundane concerns. This will help keep the sexual issue properly situated…as part of everyday life.

When you ask him about his “doctor” play, and if you do it in a casual sort of way, he will probably tell you all about it as if he were telling you about his other play. My guess is he is not yet made the distinction between types of play. You might ask him why he’s playing this particular game. Maybe even ask him what he discovered, if anything. Once this part is over and you have some information about his motivation, you could add your perspective…the adult perspective. Here’s where you get to explain that some parts of our bodies are private. And now that he’s getting bigger he needs to understand the difference between public and private. You could make the distinction between bad and inappropriate — his play is not bad, just out of place. I’d be willing to guess that he already has a grasp on this concept.

You may not even have to tell him not to do it again. You could tell him that if he thinks he wants to play “doctor” again, he should ask for your permission. In the same way he would have to ask your permission to cross a busy street or stay at a friends house for lunch.

If after the family meeting you think you and your husband didn’t get it precisely right, just let it go. If the behavior continues you’ll have another opportunity to get it right. Here’s a tip, if you guys casually talk about body things, like personal hygiene…particularly if your son is uncut…on a regular basis you’ll have a foundation on which to build more complicated sex related discussions in the future.

Finally, keep all sex related talks firmly grounded in every day life. One good way of doing that is use examples from nature and apply it to human behavior.

Good luck

Hey dr dick! What’s that toll-free podcast voicemail telephone number? Why, it’s: (866) 422-5680. DON’T BE SHY, LET IT FLY!

The Doctor is IN!

Name: Paul
Gender: male
Age: 32
Location: Seattle
I hope this isn’t the first time you’ve gotten this kind of question but I’ve recently discovered that I have a urine fetish. And I guess what I want to know is if among gay men I am in a minority or what? Do you know of other guys out there who share my fetish? Also I’m in a relationship and I don’t think my boyfriend shares my interests so I was wondering if you might have some ideas on how to break the news to him. Thanks a lot.

A urine fetish, huh? Ok! Are you talking about what those in the know call watersports or golden showers, right? I think you’re telling me you like to play with your pee, or the pee of other folks, right?

40.jpgOh my god, this is like a totally popular fetish, and not just common among the gays, don’t cha know. I’m surprised that you haven’t encountered loads of other pee queens before now. Folks of every sexual stripe and persuasion are known to enjoy piss play. There’s even a scientific name for it: urophilia. Doesn’t that sound fun? Honey, guess what? I’m a urophiliac and you can be one too!

Hell, this is such a popular fetish that it has a full subset of associated fetishes. There are clothes wetting, bed-wetting and diaper fetishes, and urinal fetishes. For the BDSM crowd there are humiliation scenes and bladder control scenes just to name a few.

Historically speaking, people have been drinking their own urine as an alternative medicine for as long as…well, as long as there’s been pee to drink. Bathing in urine is also very common in some cultures.

Curiously enough, watersports is not necessarily always a sexual fetish, although it can be sexual in nature. Activities where piss is taken internally (swallowed or received anally or vaginally) can be risky. The pee-ee will no doubt ingest any and all un-metabolized drugs — pharmaceutical as well as recreational — which were consumed by the pee-er. In some societies and in some situations, this is the actual intent — for example intensifying and prolonging the effects of a hallucinogenic drug.

Prospective pee drinkers should be aware that there are a few drugs that pass through the body either partly unchanged or entirely unchanged, like those nasty amphetamines and their derivatives. So it’s all together possible to get really high from drinking a druggie’s piss.

Finally, how do you come out as a pee-queen to your boyfriend? I’m of the mind that the direct approach works best. There’s less room for misunderstandings. You could come right out and ask him for what you want. Darling, meet me in the bathroom. I want to show you something really festive and entertaining. I mean, what homo’s isn’t gonna fall for that?

A less assertive way would be to visit several golden shower oriented websites, they abound on them internets, ya know. Leave the page open for the BF to find. That will stir things up. And unless he’s as dense as a post, he’ll begin to get the message. You could also “accidentally” rent a watersports video. That would, no doubt, open the desired discussion. “Holy cow honey, look what I picked up by mistake. You wanna watch it? Isn’t this hot? Oh my god, I think I just wet my pants. Wanna see?”

Name: Maria
Gender: Female
Age: 24
Location: California
Hi Dr, My question is a little strange. My boyfriend has this weird fetish about cumming on me…not just on me but all over me. On my boobs, on my face, he likes to get it in my hair, on my feet. I’m practically swimming in the stuff. Most of the time I don’t mind it and sometimes it gets me off. But I’m just wondering what’s this all about. Why does he have this desire to cum all over me? Most of the time he wants me on my knees waiting for his gift, tongue sticking out like a dog. Any thoughts why?

Maria, darling, this is absolutely precious! I love it!

Did you ever see the brilliantly funny Mel Brooks movie, High Anxiety?

In the movie Mel Brooks plays Dr. Richard H. Thorndyke, the new administrator of the Psychoneurotic Institute for the Very, VERY Nervous. He goes to San Francisco for a conference where he is framed for a murder. Mid-way through the movie there’s a scene where Thorndyke is on the lam. He phones his new friend, Victoria Brisbane, (played by the amazing Madeline Kahn) from a phone booth to ask for her help. Victoria is in her hotel room when she answers the phone. Just at that moment, the real killer attacks Dr Thorndyke and has him by the throat. Because of all the heavy breathing and choking sounds on the Thorndyke end, Victoria thinks she getting a prank sex call. She protests but then is drawn into the call. It’s comic genius. Dr Thorndyke’s struggle comes to an end when his attacker is impaled on a shard of glass. His death gasp makes Victoria think her caller just shot his wad. She responds with disgust, “You animal!

That’s where my mind went, Maria when I got your call. The description of your boyfriend’s spooge fetish made me think of Victoria Brisbane and her exclamation, “You Animal.”

p10.jpgYa see, Maria, us boys think all the world is as enamored with our spunk as we are. And so we think we’re doing everyone a big favor by spreading our junk around. We’re particularly fond of getting as much of our joy-juice as possible on our partners and the messier the better. We’ll tell you that we do this because we love you and we just whipped up this tasty little batch of seed just for you. That’s bullshit of course.

What we’re really doing is marking our territory. Did you ever notice how pleased with himself a male dog is when he’s blissfully lifting his leg to pee on everything in site? I’d be willing to bet you’d see a similar shit-eatin’ grin on the BF as you’d see on that dog. Your BF is marking his territory, but he’s marking you with his jizz.

The upside of this is that our little nut concoction is heavily protein laden, so you’ll not find a better skin emolument. Just make sure he doesn’t get any in your eyes. That shit burns! Enjoy!

Name: Jim
Gender: male
Age: 23
Location: Sydney
I’m addicted to porn. I look at porn for hours and hours at a time at work at home on my cell phone whatever. I am noticing that the more porn I look at the more I want and now I’m searching out some real weird shit the weirder the better. I’m afraid this is taking over my life, but I can’t stop. What should I do?

Listen Jim, there’s no such thing as an addiction to porn! PERIOD!

Nowadays people bandy about the term addiction as if it could be applied to any and all obsessive behaviors. I have an addiction to chocolate, I’m addicted to shopping, or I’m a sex addict. NONSENSE!

Let’s be clear about this. An addiction is a very specific condition. It denotes a dual dependency, physical as well as a psychological. A physical dependency occurs when a substance is habitually used to a point where the body becomes reliant on its effects. The substance must be used constantly, because if it is withheld it will trigger symptoms of withdrawal. Psychological dependency occurs when the substance habitually used creates an emotional reliance on its effects. There is no functioning without it. Its absence produces intense cravings, which if not fed will trigger symptoms of withdrawal.

What you report about yourself, Jim, is not an addiction. Your behaviors, however, are a classic example of a severe fixation or obsession. Just because out of control behavior isn’t an addiction, doesn’t mean it’s not serious.

You may say to yourself, “What the fuck, doc, fixation, addiction it all sounds the same to me.” Well, sounding alike and being the same are two very different things. Besides, if one doesn’t properly identify the problem; how will one find the proper intervention? And you, my friend, need an intervention ASAP.

n.jpgYour relentless pursuit of pornography, your obsession with more and more graphic and extreme depictions of sex is clearly interfering with you living a normal life. And at such a tender age, what’s up with that? This has got to stop, pup. You can’t continue to take refuge in fantasy material in lieu of having healthy interpersonal relationships.

I’d also challenge your suggestion that you are enjoying the porn you consume. When consumption of anything — porn, food, whatever — is this unrelenting, there is no enjoyment factor anymore.

If you have the psychological capacity to limit your porn consumption on your own, great — Do it! Be strict with yourself. Deny yourself access to the materials that fuel your fixation. Channel that energy into connecting with other LIVE humans.

If you are unable to monitor your behavior on your own — seek professional help right away. Look to a sex-positive therapist who will assist you in creating boundaries for yourself. Your therapist will help you learn how to reward your successes and not reward your failures. You will, in time, be able to put this obsession behind you. But you must act now. Your humanity hangs in the balance.

Good luck, ya’ll!

The Vulnerable Group Sex Ed Completely Ignores & Why That’s So Dangerous

By Hallie Levine

When Katie, 36, was identified as having an intellectual disability as a young child after scoring below 70 on an IQ test, her parents were told that she would never learn to read and would spend her days in a sheltered workshop. Today she is a single mum to an 8-year-old son, drives a car, and works at a local restaurant as a waitress. She blasted through society’s expectations of her — including the expectation that she would never have sex.

sex-edKatie never had a formal sexual education: What she learned came straight from her legal guardian, Pam, who explained to her the importance of safe sex and waiting until she was ready. “I waited until I was 19, which is a lot later than some of my friends,” Katie says. Still, like many women with disabilities, she admits to being pressured into sex her first time, something she regrets. “I don’t think I was ready,” she says. “It actually was with someone who wasn’t my boyfriend. He was cute, and he wanted to have sex, so I said I wanted it, but at the last minute I changed my mind and it happened anyway. I just felt really stupid and uncomfortable afterwards.” She never told her boyfriend what happened.

Katie’s experience is certainly not unique: In the general population, one out of six women has survived a rape or attempted rape, according to statistics from RAINN. But for women with intellectual disabilities (ID), it’s even more sobering: About 25% of females with ID referred for birth control had a history of sexual violence, while other research suggests that almost half of people with ID will experience at least 10 sexually abusive incidents in their lifetime, according to The Arc, an advocacy organisation for people with intellectual disabilities.

When it comes to their sex lives, research shows many women with intellectual disability don’t associate sex with pleasure, and tend to play a passive role, more directed to “pleasuring the penis of their sex partner” than their own enjoyment, according to a 2015 study published in the Journal of Sex Research. They’re more likely to experience feelings of depression and guilt after sex. They’re at a greater risk for early sexual activity and early pregnancy. They’re also more likely to get an STD: 26% of cognitively impaired female high schoolers report having one, compared to 10% of their typical peers, according to a study published in the Journal of Adolescent Health.

Katie, for example, contracted herpes in her early 20s, from having sex with another man (she says none of her partners have had an intellectual disability). “I was hurt and itching down there, so I went to the doctor, who told me I had this bad disease,” she recalls. She was so upset she confronted her partner: “I went to his office crying, but he denied everything,” she remembers.

Given all of this, you’d think public schools — which are in charge of educating kids with intellectual disability — would be making sure it’s part of every child’s curriculum. But paradoxically, kids with ID are often excluded from sexual education classes, including STD and pregnancy prevention. “People with intellectual disabilities don’t get sexual education,” says Julie Ann Petty, a safety and sexual violence educator at the University of Arkansas. Petty, who has cerebral palsy herself, has worked extensively with adults who have intellectual disabilities (while not all people living with cerebral palsy have intellectual disabilities, they face many of the same barriers to sexual education). “This [lack of education] is due to the central norms we still have when thinking about people with ID: They need to be protected; they are not sexual beings; they don’t need any sex-related information. Disability rights advocates have worked hard over the last 20-some years to get rid of those stereotypes, but they are still out there.

“I work with adults with disabilities all the time, and the attitudes of the caretakers and staff around them are, ‘Oh, our people do not do that stuff. Our people do not think about sex,’” Petty says. “It’s tragic, and really sets this vulnerable population up for abuse: if they don’t have knowledge about their private body parts, for example, how are they going to know if someone is doing something inappropriate?”

sex-ed2

Historically, individuals with intellectual disabilities were marginalised, shunted off to institutions, and forcibly sterilised. That all began to change in the 1950s and 1960s, with the push by parents and civil rights advocates to keep kids with ID at home and mainstream them into regular education environments. But while significant progress has been made over the last half century in terms of increased educational and employment opportunities, when it comes to sex ed, disability rights advocates say we’re still far, far behind.

“What I find is shocking is I’ll go in to teach a workshop on human sexuality to a group of teenagers or young adults with cognitive disabilities, and I find that their knowledge is no different than what [young people with ID would have known] back in the 1970s,” says Katherine McLaughlin, who has worked as a sexuality educator and trainer for Planned Parenthood of Northern New England for over 20 years and is the co-author of the curriculum guide “Sexuality Education for Adults with Developmental Disabilities.” “They tell me they were taken out of their mainstream health classes in junior high and high school during the sexual education part, because their teachers don’t think they need it. I’ve worked with adults in their 50s who have no idea how babies are made. It’s mind blowing.”

“There’s this belief that they don’t need it, or that they won’t understand it, or it will actually make them more likely to be sexually active or act inappropriately,” adds Pam Malin, VAWA Project Coordinator, Disability Rights Wisconsin. “But research shows that actually the opposite is true.”

Indeed, as the mother of a young girl with Down syndrome, I’m personally struck by how asexualised people with intellectual disabilities still are. Case in point: When fashion model Madeline Stuart — who has Down syndrome — posted pictures of herself online in a bikini, the Internet exploded with commentary, some positive, some negative. “I think it is time people realised that people with Down syndrome can be sexy and beautiful and should be celebrated,” Madeline’s mother, Roseanne, told ABC News. Yet somehow, it’s still scandalous.

Ironically, sometimes the biggest barrier comes from parents of people with ID — which hits close to home for me. “A lot of parents still treat their kids’ sexuality as taboo,” says Malin. She recalls one situation where a mom in one of her parent support groups got attacked by other parents: “She was very open about masturbation with her adolescent son, and actually left a pail on his doorknob so he could masturbate in a sock and then put it in the pail — she’d wash it with no questions asked. I applauded it: I thought it was an excellent way to give her son some freedom and choice around his sexuality. But it made the other parents incredibly uncomfortable.”

Sometimes, parents are simply not comfortable talking about sexuality, because they don’t know how to start the conversation, adds Malin. Several studies have also found that both staff and family generally encourage friendship, not sexual relationships. “It’s a lot of denial: The parents don’t want to admit that their children are maturing emotionally and developing adult feelings,” says Malin. An Australian study published in the journal Sexuality & Disability found that couples with intellectual disability were simply never left alone, and thus never allowed to engage in sexual behaviour.

I’m doing my best — but despite all my good intentions, it’s certainly not been easy. This fall, I sat down to tell my three small children about the birds and the bees. My two boys — in second grade and kindergarten — got into the conversation right away, and as we began talking I realised it wasn’t a surprise to them; at a young age, they’d already picked up some of the basic facts from playmates. But my daughter, my eldest, was a whole different story. Jo Jo is in third grade and has Down syndrome, so she’s delayed, both with language and cognition. And because of her ID, and all the risk that goes along with it, she was the kid I was most worried about. So it was disheartening to see her complete lack of interest in the conversation, wandering off to her iPad or turning on the radio. Every time I would try to coax her back to our little group, she would shout, “No!”

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Lisa Shevin, whose 30-year-old daughter, Chani, has Down syndrome, says she’s never had a heart-to-heart with her daughter about sexuality. “The problem is, Chani’s not very verbal, so I’m never quite sure what she grasps,” says Shevin, who lives in Oak Park, a suburb of Detroit. While Chani has a “beau” at work, another young man who also has an intellectual disability, “They’re never, ever left alone, so they never have an opportunity to follow through on anything,” says Shevin. “I feel so frustrated as her mother, because I want to talk to her about sex ed, but I just don’t know how. I’ve never gotten any guidance from anyone. But just because my daughter is cognitively impaired, it doesn’t mean she doesn’t have the same hormones as any other woman her age. You can’t just sweep it under the rug and assume she doesn’t understand.”

In one interesting twist, sex educators say they tend to see more women with intellectual disability than men being sexually aggressive. “I worked with a young woman in her late 20s who would develop crushes on attractive male staff members at her group home,” recalls Malin. “She would try to flirt, and the guys would play it off as ‘hah hah funny,’ but eventually she called police and accused one of them of rape.” While the police investigated and eventually dropped charges, Malin was brought in to work with her: “We had a long conversation about where this had come from, and she kept talking about Beau and Hope from ‘Days of Our Lives’,” Malin recalls. “It turned out she had gotten so assertive with one of the male staff that he’d very adamantly said no to her, but her understanding of rape boiled down to gleaning bits from soap operas, and she thought that if a man in any situation acted forcefully with a woman then it was sexual assault.”

While most cases don’t escalate to this point, sometimes people with intellectual disability can exhibit behavior that causes problems: Chani, for example, was kicked out of sleep-away camp a few years ago after staff complained that she was hugging too many of her male counsellors. “She’d develop little crushes on them, and she never tried anything further than putting her arms around them and wanting to hang out with them all the time, but it made staff uncomfortable,” Shevin recalls. Chani’s since found a new camp where counsellors take her behaviour in stride: “They’ve found a way to work with it, so if she doesn’t want to do an activity, they’ll convince her by telling her afterwards she can spend time with Noah, one of the male counsellors she has a crush on,” says Shevin. (At the end of the summer, Noah gave Chani a tiara, which remains one of her prize possessions.)

So what can be done? Sadly, even if someone with ID is able to get into a sexual education program, the existing options tend to severely miss the mark: A 2015 study published in the Journal for Sex Research analysed 20 articles on sexual education programs aimed at this group and found most fell far short, mainly because people who unable to generalise what they learned in the program to an outside setting. “This is a major problem for individuals who are cognitively challenged: They have difficulty applying a skill or knowledge they get in one setting to somewhere else,” explains McLaughlin. “But just like everywhere else, most get it eventually — it just takes a lot of time, repetition, and patience.”

In the meantime, for parents like me, McLaughlin has a few tips. “Take advantage of teachable moments,” she says. “If a family member is pregnant, talk about it with them. If you’re watching a TV show together and there’s sexual content, don’t just sweep it under the rug — try to break down the issues with them.” It’s also important to be as concrete as possible: “Since people with ID have trouble generalising, use anatomically correct dolls or photographs whenever possible, especially when describing body parts,” she says.

Some local disability organisations also offer workshops for both teenagers and adults with intellectual disabilities. And the Special Olympics offers protective behaviours training for volunteers. But at this point there’s a dearth of legislation and organisations that are fighting for better sexual education, which means parents like myself have to take the initiative when it comes to educating our kids about their burgeoning sexuality.

It’s a responsibility I’m taking to heart in my own life. Now, every night when I bathe my daughter, we make a game of identifying body parts, some of which are private, and I explain to her that no one touches those areas except for mommy or a doctor. Recently, she’s started humping objects at home like the arm of the sofa, and I’ve begun explaining to her that if she wants to do something like that, it needs to be in the privacy of her own room. It’s taken a lot of repeating and reinforcing, but she seems to be getting the message. I have no doubt that — like every other skill she’s mastered, such as reading or writing her name or potty training — it will take time, but she’ll get there.

As for Katie, with age and experience, she’s become more comfortable with her sexuality. “It took me a while, but I’m confident in myself,” she says. “I am one hundred percent okay saying no to someone — if I’m pressured, there’s no way in the world now I’ll do anything with anybody. But that means when it does happen, it feels right.”

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