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Time to make room for sex in our care homes

We need to open up to the significance of love and sexuality in later life

The persistence of romantic love in long-term relationships is, unsurprisingly, associated with higher levels of relationship satisfaction.

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Although Valentine’s Day is often criticised as a cynical creation by florists and the greeting cards industry, it is a useful focal point for considering love and sexuality as elements of human wellbeing that often escape attention in healthcare.

This neglect is most marked in later life, when popular discourse on late life romance is dominated by simple notions of asexuality or by ribald jokes

There are many reasons why healthcare professionals need to learn more about human love and sexuality, not least of which is a fuller understanding of the nature and meaning of ageing.

exuality is a core element of human nature, encompassing a wide range of aspects over and above those related to genital functions, and the medical literature has rightly been criticised for taking too narrow a vision of sexuality.

We need to open up to the continuing significance of love and sexuality into later life

This narrow vision is paralleled by a steady trend in the neurosciences of “neuroreductionism”, an over-simplistic analysis of which parts of the brain light up in sophisticated scanners on viewing photos of a loved one.

We need to open up to the continuing significance of love and sexuality into later life, understanding that sexuality includes a broad range of attributes, including intimacy, appearance, desirability, physical contact and new possibilities.

Studies

Numerous studies affirm sexual engagement into the extremes of life, with emerging research on the continuing importance of romantic love into late life. There is also reassuring data on the persistence of romantic love in long-term relationships, unsurprisingly associated with higher levels of relationship satisfaction.

A growing literature sheds light on developing new relationships in later life, with a fascinating Australian study on online dating which subverts two clichés – that older people are asexual and computer illiterate.

The challenge in ageing is best reflected in the extent to which we enable and support intimacy and sexuality in nursing homes. Although for many this is their new home, the interaction of institutional life (medication rounds, meals), issues of staff training and lack of attention to design of spaces that foster intimacy can check the ability to foster relationships and express sexuality.

For example, is the resident’s room large enough for a sofa or domestic furnishings that reflects one’s style, personality and sense of the romantic? Are sitting spaces small and domestic rather than large day rooms? Do care routines allow for privacy and intimacy? Is there access to a selection of personal clothes, make-up and hairdressing?

Granted, there can also be complicated issues when residents with dementia enter new relationships and the need to ensure consent in a sensitive manner, but these should be manageable with due training and expertise in gerontological nursing and appropriate specialist advice.

Supports

A medical humanities approach can provide useful supports in education from many sources, ranging from literature ( Love in the Time of Cholera), film ( 45 Years or the remarkable and explicit Cloud 9 from 2009) or opera (Janácek’s Cunning Little Vixen, a musical reflection of the septuagenarian composer’s passion for the younger Kamila Stösslová).

We, as present and future older Irish people, also need to take a step back and consider if we are comfortable with a longer view on romance and sexuality.

The Abbey Theatre did us considerable service in 2015 with a wonderful version of A Midsummer Night’s Dream set in a nursing home. We were struck by a vivid sense of the inner vitality of these older people, suffused with desire, passion and romance.

This contemporary understanding of companionship and sexuality in later life was enhanced by casting Egeus as a son exercised about his mother’s romantic choices instead of a father at odds with his daughter.

We can also take heart from an early pioneer of ageing and sexuality, the late Alex Comfort. Best known for his ground-breaking The Joy of Sex, he was also a gerontologist of distinction, and wrote knowledgeably about the intersection of both subjects with characteristic humour.

He wrote that the things that stop you having sex with age are exactly the same as those that stop you riding a bicycle: bad health, thinking it looks silly or having no bicycle, with the difference being that they happen later for sex than for the bicycle.

His openness and encouragement for our future mirror Thomas Kinsella’s gritty poem on love in later life, Legendary Figures in Old Age, which ends with the line: ‘We cannot renew the Gift but we can drain it to the last drop.’

Complete Article HERE!

The Beginner’s Guide to BDSM

Why are some women never able to orgasm? A gynaecologist explains

Dr Sherry Ross says there has long been a gender bias in the way women’s sexual dysfunction has been treated compared to men’s

 

By Olivia Blair

Despite modern society being able to openly discuss female sexuality, there remains a number of existing taboos.

One of the most glaring is female orgasms. Women are rarely taught about the intricate details of their anatomy and often work these things out through their own experimenting.

What is the best way to get an orgasm? How often should I have one? Should I be able to have one during penetrative intercourse? Why have I never had one? – questions not uncommon to hear among small friendship groups of women over a bottle of wine.

Dr Sherry A Ross, an LA-based gynaecologist with 25 years experience aims to educate with a complete guide to the vagina in her new book She-ology: The Definitive Guide to Women’s Intimate Health. Period.

In the foreword of her book, Dr Sherry notes that “talking about the mighty V outside of doctor’s offices and bedrooms has remained a major taboo” and devoted an entire chapter to the female orgasm. The Independent asked the gynaecologist and obstetrician all the questions about female orgasms that are rarely spoken about.

Why might some women never orgasm?

Attitudes regarding sex, sexuality and gender vary greatly between different cultures and religions. Certain sexual practices, traditions and taboos are passed down through generations, leaving little to the cause of female pleasure or imagination.

For some women, finding and/or enjoying sexual intimacy and sex is difficult, if not impossible. Research suggests that 43% of women report some degree of difficulty and 12% attribute their sexual difficulties to personal distress. Unfortunately, sexual problems worsen with age, peaking in women 45 to 64.  For many of these women the problems of sexual dysfunction are treatable, which is why it is so important for women to share their feelings and concerns with a health care provider.

Unfortunately, there has been a history of “gender injustice” in the bedroom. Women have long been ignored when it comes to finding solutions to sexual dysfunction. In short, there are twenty-six approved medications for male erectile dysfunction and zero for women. Clearly, little attention has been paid to the sexual concerns of women, other than those concerns that involve procreation.

How many women might never orgasm?

During my 25 years in private practice, I’ve met a number of women in their 30s, 40s and 50s who have never even had an orgasm. In fact, 10 to 20% of all women have never experienced one.

Issues related to sex are not talked about enough even with a health care provider. Let’s just start by saying, 65 per cent of women are embarrassed to say the word vagina and 45 per cent of women never talk about their vagina with anyone, not even with their doctor.

Some patients say they have pain with sex, have problems with lubrication, don’t have a sex drive or don’t enjoy sex.  My first question is “Are you having problems in your relationship?”, “Do you like you partner?” , “Are you able to have an orgasm?”, “ Do you masturbate?” These open-ended questions tend to bring out sexual dysfunction including the inability to have an orgasm.

There is a great deal of embarrassment and shame when a woman admits she has never experienced an orgasm.

Is the inability to not orgasm normal?

The inability not to have had an orgasm can reflect women’s inability to know they own anatomy and may not be a disorder at all. In a survey of women aged 16-25, half could not find the vagina on a medical diagram. A test group of university- aged women didn’t fare much better with one third being unable to find the clitoris on a diagram. Clearly, if you can’t find it, how are you going to seek enjoyment from it?

Women must first understand what brings them pleasure and in their pursuit of happiness they have to understand where their clitoris is and how to stimulate it. Masturbation is a skill.  It has to be learned, just as walking, running, singing and brushing your teeth.

What is an orgasm disorder and how would you categorise one? 

The inability to have an orgasm falls under the category of Female Sexual Dysfunction of which there are five main problems: low libido or hypoactive sexual desire disorder, painful sex, sexual arousal disorder, an aversion to sex and the inability to orgasm.

Hypoactive sexual disorder, the most common female sexual dysfunction, is characterised by a complete absence of sexual desire. For the 16 million women who suffer from this, the factors involved may vary since sexual desire in women is much more complicated than it is for men. Unlike men, women’s sexual desire, excitement and energy tend to begin in that great organ above the shoulders, rather than the one below the waist. The daily stresses of work, money, children, relationships and diminished energy are common issues contributing to low libido in women. Other causes may be depression, anxiety, lack of privacy, medication side effects, medical conditions such as endometriosis or arthritis, menopausal symptoms or a history of physical or sexual abuse.

You are the person in charge of your vagina and clitoris. First and foremost, get to know your female parts intimately. Understanding your sexual response is a necessary health and wellness skill. Make mastery of that skill a priority.

Complete Article HERE!

Have you ever had ‘unjust sex’?

Unthinkable: Examples include ‘women being pressured – not quite to the point of outright coercion – to have sex, or to have sex without contraception’, says philosopher Ann Cahill

“We need to remember that sexual assault is not the only kind of sexual interaction that is ethically problematic,” says author Ann Cahill.

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Uncertainty surrounding the boundaries of ethical sexual activity is not confined to boozed-up young adults or American presidents. Among academics there is discussion about what distinguishes rape and sexual assault from another category of “ethically problematic” sex.

Examples of “unjust sex” include “women being pressured – not quite to the point of outright coercion, but pressured uncomfortably nonetheless – to have sex, or to have sex without contraception,” explains Ann Cahill, author of a number of books on gender issues including Rethinking Rape.

Cahill, professor of philosophy at Elon University in North Carolina who is visiting Dublin this week, says she has tried to “figure out in more detail” what distinguishes sexual assault from “unjust sex”, drawing on the work of New Zealand psychologist Nicola Gavey.

Her analysis has led her to challenge the traditional feminist concern with “objectification”: treating women’s bodies as objects. Instead, she uses “derivatisation” – treating women as “stunted persons, persons whose identity and behaviour is primarily or entirely limited by the desires of another person” – as a standard by which to measure actions.

Cahill says “we need to remember that sexual assault is not the only kind of sexual interaction that is ethically problematic. Too often our approach to sexual ethics is limited by relying solely on the presence of consent, a reliance that obscures other crucial elements in sexual interactions that are ethically relevant”.

How do you distinguish “unjust sex” from rape?

“Briefly, I argue that examples of unjust sex and incidents of sexual assault share an indifference to women’s sexual preferences, desires and wellbeing, and that’s what explains how unjust sex perpetuates and upholds rape culture. In both cases, the specific sexuality of the woman is not participating robustly in the creation of the sexual interaction.

“What distinguishes the two examples, I then argue, is the specific role that the woman’s sexual subjectivity plays. In the case of examples within the grey area of unjust sex, women’s agency plays an important role: if a man repeats a request for or invitation to sex multiple times, for example, that very repetition indicates that the woman’s consent is important.

“However, I also argue that the role that the woman’s agency plays is a problematically stunted one that limits the kind of influence she can have on the quality of the interaction that ensues, and does so to such an extent that it renders the interaction unethical.

“In the case of sexual assault, the woman’s agency is either overcome – by force, or coercion, or other methods – or undone entirely, by use of drugs or alcohol.”

Where does “objectification” come into this, and does sexual attraction always entail some element of it?

“Feminists have long used the notion of objectification as an ethical lens, and specifically, as an ethically pejorative term. And certainly I do think that many of the social and political phenomena that feminists have criticised by using the term ‘objectification’ – dominant forms of pornography, oppressive medical practices, common representations of women’s bodies – are worthy of ethical critique.

“However, I worry about what the term ‘objectification’ implies, and when I dug into the philosophical literature that sought to really unpack the term, my worries only intensified. If objectification means, roughly, to be treated as a thing – a material entity – and if it is virtually always ethically problematic, then it seems we are committed to a metaphysics that places our materiality in opposition to our humanity or moral worth.

“But what if our materiality, our embodiment, is not contrary to our humanity or moral worth, but an essential part of it? If we approach embodiment in this way, then to be treated like a thing is not necessarily degrading or dehumanising. In fact, having one’s body be the object of a sexualising gaze and/or touch could be deeply affirming.

“Getting back to your question: does sexual attraction require objectification? The short answer is yes: sexual attraction requires treating another body as a material entity. But that does not mean that sexual attraction is necessarily ethically problematic.”

You say women “are encouraged, and in some cases required, to take on identities that are reducible to male heterosexual desires”. How do women avoid being so “derivatised” while in a relationship?

“This is a tricky matter, because human beings are intersubjective.

“Equal and just relationships among individuals require the recognition that they have a substantial contribution to make to those relationships, and that no relationship should position one of the individuals involved in it as the raison d’être of the relationship itself.”

Is the power dynamic always working in one direction, however? Women are capable of objectifying men. Should that concern us too?

“As I state above, objectification is not necessarily ethically problematic. And so to the extent that women have the capacity to treat men’s bodies as material entities, yes, they can objectify them.

“However, in our current political and social situation, women’s objectification of men’s bodies is far less common than men’s objectification of women’s bodies; even more importantly, it rarely amounts to derivatisation and does not serve to undermine men’s political, social, and economic equality.

“When I say that it does not amount to derivatisation, I mean that heterosexual men are less likely to view their bodies solely or persistently through the lens of how they appear to heterosexual women, and they rarely see male bodies represented in dominant media as defined primarily or solely through how those bodies appear to heterosexual women.

“While it’s not impossible for women to derivatise men – one can imagine, for example, a woman evaluating a man as a sexual partner solely on the basis of whether he matches her sexual preferences – structurally, those examples of derivatisation don’t add up to the kind of persistent inequality that still tracks along gender lines.

“For example, as political candidates, men don’t suffer for failing to meet the aesthetic ideals of heterosexual women, while women do suffer for failing to meet the aesthetic ideals of heterosexual men. Of course, they also suffer for meeting those ideals too well, because feminine beauty, while allegedly admirable in women, is also associated with shallowness and lack of intellect.

“Although I haven’t written about this before, however, it seems to me that hegemonic masculinity does have a derivatising effect on heterosexual men, to the extent that it requires them to derivatise women. In this sense, the subjectivity of heterosexual men is stunted to the extent that it is required to engage in the kinds of behaviour that demonstrates disrespect of women as moral equals – behaviour that is necessary for other heterosexual male subjects to be confirmed or affirmed in their own forms of masculinity.

“To the extent that heterosexual men can find their standing within homosocial relations threatened or troubled if they refuse to derivatise women, or at least pretend to, then they are also subject to a failure to recognise their own ontological distinctness.”

Complete Article HEREvi!

Swinging offers sexual freedom, but you have to play by the rules

Don’t assume ‘the lifestyle’ does not come with a rulebook. Communication is important, and rules can make relationships better.

Fatima Mechtab, Marketing Supervisor and events coordinator at Oasis Aqualounge, poses at the Toronto adult playground.

Toronto’s Oasis Aqualounge, at Carleton and Church Sts., is a pretty open environment. The clothing-optional sex club hosts events each week for people to explore their sexual fantasies. But for such a sexually free venue, there are certainly a lot of rules.

No photos. Certain areas are off limits to men unless accompanied by a woman. No touching of any kind unless given permission. No means no, of course, but the club takes it a step further: only yes means yes. That means there are no sexy times until consent is verbalized, says Fatima Mechtab, the marketing and events co-ordinator at Oasis, which had approximately 16,000 members last year.

The clothing-optional space, where sex is allowed, is by its nature vulnerable, she says. The rules are to make sure everyone feels safe, comfortable and encourage people to talk. “A big problem with consent is people assume it’s something you don’t have to verbalize,” she says. In fact, when it comes to sex, there’s lots that people don’t talk about — but should.

Mechtab, a queer woman who has explored swinging and polyamorous relationships in the past, says these types of strict rules — don’t make assumptions, ask before touching — are common in “the lifestyle,” a term for consensually nonmonogamous couples. And, she says, rules make relationships better.

Couples and the locations they go to play have to create an environment in which all parties feel not only safe, but also heard. These boundaries take away the grey areas, forcing couples to say what they do or don’t want and what they need from sexual encounters. And there’s a lot non-swingers can learn from them about building a healthy (and satisfied) relationship.

A successful swinging relationship is based on constant communication, says Carol Hunt, founder of VenusCouples, a Montreal-based online forum for “sex-positive” exploration of the lifestyle. She and her husband have been swinging for a decade. Before any party or outing, they agree upon a set of boundaries (such as they’ll always be in the same room during sex) and expectations for the evening (be it sex with another person or a night observing others). Afterwards, they always break their experience down: what they liked, what they didn’t like, and what would they like to try in the future?

While it might seem exhausting to always talk about sex, Hunt says it means both parties feel their needs are being heard. If her husband wants to try something new, but she’s not interested, the decision isn’t shut down entirely. Instead, they discuss both points of view and try and find a happy middle ground in which they can explore. No always means no — but that’s only the start of the conversation.

That consensus building trickles out of the bedroom, says Edward Fernandes, a professor of sexuality specializing in swingers, at Barton University in North Carolina. “I’ve had people say, ‘We used to have trouble with our finances — we couldn’t talk about this,’ and once we went into swinging, that (inability to communicate) went away,’” says the Toronto expat. “Now, they’re able to talk about everything.” If you can talk about a taboo topic like sex freely, there’s nothing to stop you from vocalizing issues with the chores, he says.

One 2014 study from the University of Oklahoma, which compared monogamous and consensually nonmonogamous couples, found those in open relationships rated their happiness and health higher than their counterparts. Another study from 2000, found 90 per cent of couples said their marriage became happier after they started swinging.

“People will often avoid talking about things, because they don’t know how (their partner) is going to respond,” says Fernandes. “So we hide. Swinging tends to pull that curtain, and allows them to have direct communications with each other.”

Write your own sexy rule book

  • Hunt suggests couples looking to spice up their bedroom can start small: make it a point to go to a sex shop, for example, to discuss what both parties might enjoy or not. To avoid embarrassment, make it a rule that neither party can wander off on their own: you’re in it together and that can decrease the awkwardness.
  • Watching porn can be a great way to get both parties in the mood. But before hitting play, Hunt suggests setting expectations: you’ll only watch for an hour, and collectively pick one act to try and re-create.
  • If you’re trying something new and don’t enjoy it the first time, Hunt say don’t shut it down right away. Commit to revisiting the act at least once at a later date, and if you still don’t enjoy it, then it’s OK to take it off the table for the future.
  • Great relationships need work, she says. Set aside a couple hours each week just to be with each other. No television, no distractions (and if you want, no clothes).
  • Make a relationship rule to do one sexy thing a day — even if it’s just kissing each other deeply for a few minutes, Hunt says. It doesn’t have to be anything more than that, but it ensures a daily connection with your partner.

Complete Article HERE!