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Same-sex couples experience unique stressors

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Study by SF State professor finds that institutionalized discrimination has lasting effects

Professor of Sociology Allen LeBlanc

By Lisa Owens Viani

Stressors faced by lesbian, gay and bisexual (LGB) individuals have been well studied, but San Francisco State University Professor of Sociology Allen LeBlanc and his colleagues are among the first to examine the stressors that operate at the same-sex couple level in two new studies conducted with support from the National Institutes of Health. “People in same-sex relationships are at risk for unique forms of social stress associated with the stigma they face as sexual minority individuals and as partners in a stigmatized relationship form,” said LeBlanc.

In the first study, recently published in the Journal of Health and Social Behavior, LeBlanc and colleagues conducted in-depth interviews with 120 same-sex couples from two study sites, Atlanta and San Francisco, and identified 17 unique pressures that affect LGB couples. Those range from a lack of acceptance by families to discrimination or fears of discrimination at work, public scrutiny, worries about where to live and travel in order to feel safe, and experiences and fears of being rejected and devalued. The researchers also found that same-sex couple stressors can emerge when stress is contagious or shared between partners and when stress “discrepancies” — such as one partner being more “out” than the other — occur.

“We wanted to look beyond the individual, to look at how stress is shared and how people are affected by virtue of the relationships they’re in, the people they fall in love with and the new ways couples experience stress if they’re in a stigmatized relationship form,” said LeBlanc. “One of those is feeling that society doesn’t value your relationship equally.”

“Changing laws is one thing, but changing hearts and minds is another.”

That perception is the focus of a second study just published in the Journal of Marriage and Family. LeBlanc found that feelings of being in a “second-class” relationship are associated with mental health issues — such as greater depression and problematic drinking — even after taking into account the beneficial impact of gaining legal recognition through marriage. In 2015, the U.S. Supreme Court legalized same-sex marriage, but the effects of long-term institutionalized discrimination can linger, according to LeBlanc.

“Our work is a stark reminder that legal changes will not quickly or fully address the longstanding mental health disparities faced by sexual minority populations,” said LeBlanc. “Changing laws is one thing, but changing hearts and minds is another.”

Even though people in same-sex relationships experience many unique challenges, research also shows that having a good primary intimate partnership is important for a person’s well-being, which is true for both heterosexual and LGB couples. “The unique challenges confronting same-sex couples emanate from the stigma and marginalization they face from society at large, not from anything that is unique about their relationships in and of themselves,” said LeBlanc. LeBlanc’s study builds on an emerging body of research suggesting that legal recognition of same-sex relationships is associated with better mental health among LGB populations — as has long been suggested in studies of legal marriage among heterosexual populations. “This new research suggests that legal marriage is a public health issue,” said LeBlanc. “When people are denied access in an institutionalized, discriminatory way, it appears to affect their mental health.”

LeBlanc said transgender individuals were not included in the studies because of other stressors unique to them; he noted that another study focused specifically on trans- and gender-nonconforming individuals is underway. He hopes his research will help people better understand and support not just same-sex couples but also other stigmatized relationships, including interracial/ethnic relationships or partnerships with age differences or different religious backgrounds. “It’s not just about civil rights for LGB persons,” he explained. “It’s about science and how society can be more supportive of a diversity of relationships that include people from all walks of life.”

Complete Article HERE!

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Doctors Are Failing Their Gay Patients

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by Liz Posner

You’re supposed to be able to tell your doctor anything. But how are patients supposed to know what to tell their doctors if the doctors don’t ask the necessary questions in the first place? When it comes to sexual health screening, many doctors either missed the class in medical school that was supposed to teach them to ask patients about sexual health questions, or their lack of attention to sexual health is a conscious choice. Bespoke Surgical recently conducted a study of 1,000 Americans of various ages and sexual identities to hear what they’ve been asked by their doctor on the topic. The results suggest few doctors are asking questions about sexual health at all, and that LGBTQ patients, in particular, are being neglected.

The survey asked participants what kinds of questions their primary care physician focused on when they brought up sexual health during physical exams. The results varied based on the sexual orientation of the patient, as the graph below shows.

There are some outliers here that should be noted, but first, take a second to note how low these numbers are overall. Over half of heterosexual respondents said they were never asked about basic sexual health questions like HPV and STD exposure—a number that’s surprising, especially since 79 million Americans have HPV, a condition that can lead to cancer in both men and women. In general, it seems like doctors aren’t asking patients the right questions about sexual health.

But consider the shocking numbers revealed in the chart above. Of the physicians who saw homosexual patients last year, only 13 percent asked their patients if they had received the PrEP HIV prevention drug. Nearly half of all gay and lesbian respondents said their doctor had not asked them about HPV/Gardasil, anal pap smears, PreP/Truvada, or prior STD exposure. Only 40 percent of patients gay, straight and bi said they were asked if they used any kind of protection during sex.

When they do ask the right questions, the survey suggests doctors are asking them of the wrong people. In all but one of the above sexual health categories, bisexual patients were more likely to be asked about sexual health conditions. This could be because, as the Advocate explains, there’s a myth that bisexual people are more promiscuous than other people. The survey authors affirm this: “the ‘B’ in LGBTQ+ is often misrepresented in a variety of settings, including sexual promiscuity.”

Undoubtedly, doctors aren’t asking their patients a full range of questions because they aren’t able to spend enough time with them in the first place. People of all sexual orientations have experienced the rotating door model of doctor visits. Some primary care doctors say they treat 19 patients a day. With a full roster of 2,500 patients total, the Annals of Family Medicine says each doctor would have to “spend 21.7 hours per day to provide all recommended acute, chronic and preventive care” for that many patients. A 2016 study found that most doctor’s office visits only last 13-16 minutes. Professor Bruce Y. Lee at Johns Hopkins calls the average crammed doctor’s visit “archaic” in an article for Forbes, and says, “there is little time to actually listen or talk to patients and maybe not enough time to carefully examine them.”

The LGBTQ population seems to be catching on to the fact that primary care physicians may not know the right questions to ask their patients. That would explain why gay, lesbian and bisexual respondents were 20-30 percent more likely than straight respondents to rate having a doctor with the same sexual identity as them as “very important.” LGBTQ people are especially vulnerable to discrimination and may face barriers to health care that heterosexual people don’t. Some technology, like the entrepreneurs who launched an app to connect LGBTQ patients to gay-friendly doctors, is helping to make this easier. But it’s a quick fix to a much more systemic problem, considering so many primary care physicians don’t ask about sexual health problems at all.

Complete Article HERE!

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5 Simple Sex Positions You Actually Haven’t Tried Yet

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By Anthea Levi

Trying something new in bed can be intimidating. But attempting the unknown between the sheets comes with thrilling benefits. Besides giving you the chance to discover new erogenous zones and orgasm triggers, “it’s a great way to practice asking or telling your partner what you want,” says Nicole Tammelleo, a psychotherapist specializing in sexuality and women’s health at Maze Women’s Sexual Health in New York City.

Here, Tammelleo shares five sex moves that aren’t crazy hard to pull off. Here’s why: “Most of these are variations on things you’ve probably already been doing,” she says. Read on for the hottest positions you didn’t know you needed to try, then give them a very thorough test drive.

CAT (coital alignment technique)

Get into the standard missionary position, with you on your back and your partner on top of you. “What’s different is that the man moves upward, so his whole body sits a little bit farther up against your body, with his head slightly past yours,” explains Tammelleo. The goal is to align your pelvises so the base of his penis and pubic bone stimulate your clitoris as he thrusts up and down—rather than in and out.

Besides giving you the direct clitoral action most women need to reach orgasm during intercourse, your partner’s penis is able to enter your vagina at a higher angle so it’s more likely to reach your G-spot too, she says. Win-win!

Swinging bishop

Don’t let the name scare you off. The swinging bishop position is a sexy spin on good-old cozy spoon style. As you and your partner are spooning on your right side, lift your top (left) leg and move it behind you slightly so that it drapes over your SO’s legs. “This allows the man to penetrate even deeper, and also allows for better access to her clitoris, either with a vibrator or fingers,” says Tammelleo.

One-legged stork

If you like the way it feels to have your legs high in the air but hate the cramping that can result, this one’s for you. Lie down on the bed on your back, and have your partner face you while resting on his knees, explains Tammelleo. “Instead of you putting both legs up in the air, keep one stretched out straight on the bed and lift the other.”

The benefit? Many women find it painful on the lower back to keep both legs extended toward the ceiling; going halfsies can be more comfy. The more comfortable the position, the longer you can get it on, so you’ll have plenty of time for a slow build to a hot orgasm.

The accordion

Let’s just say the accordion makes all those #legday squats worth it. Have your partner rest on his back with his knees bent in the air. From there, you basically squat on top of him, straddling his legs so your thighs are hugging his, your feet flat on the bed.

“This is a variation of girl on top that similarly allows the woman to be in control,” says Tammelleo. Don’t feel bad if your thighs start to burn stat. “What often happens is that you start in accordion and then move onto something else.” Try this squat-centric position and work yourselves up, then transition into a more comfy pose when it’s time to reach the finish line, like cowgirl.

Good vibrations

Doing it doggie style lets you relax and enjoy every sensation as your SO does most of the work. But most women can’t reach orgasm from intercourse alone, confirms Tammelleo, so unless you stimulate yourself during the action (or your partner reaches around and does it for you while he’s thrusting), you might miss out on climaxing.

The solution is to tuck a small clitoral vibrator between your pelvis and the bed. Let it rest against your clitoris or labia, and let the vibrator help you hit that high note while you focus on how awesome sex feels. Of course, you can use a vibrator to enhance any position. But when it’s underneath your body during doggie style, it’ll feel less intrusive and more like a sexy secret.

Complete Article HERE!

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Our shame over sexual health makes us avoid the doctor. These apps might help.

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We’re taught to feel shame around our sexuality from a young age, as our bodies develop and start to function in ways we’re unfamiliar with, as we begin to realize our body’s potential for pleasure. Later on, women especially are taught to feel ashamed if we want “too much” sex, or if we want it “too early,” or if we’re intimate with “too many” people. Conversely, women and men are shamed if we don’t want nearly as much sex as our partner, or if we’re inexperienced in bed. We worry that we won’t orgasm, or that we’ll do so too soon. We’re afraid the things we want to do in bed will elicit disgust.

This shame can also keep people from getting the health care they need. For example, a 2016 study of college students found that, while women feel more embarrassed about buying condoms than men do, the whiff of mortification exists for both genders. Another 2016 study found many women hide their use of health-care services from family and friends so as to prevent speculation about their sexual activity and the possibility that they have a sexually transmitted infection (STI).

While doctors should be considered crucial, impartial resources for those struggling with their sexual health, many find the questions asked of them during checkups to be intrusive. Not only that but, in some cases, doctors themselves are uncomfortable talking about sexual health. They may carry conservative sexual beliefs, or have been raised with certain cultural biases around sexuality. It doesn’t help that gaps in medical school curriculums often leave general practitioners inadequately prepared for issues of sexual health.

So how do people who feel ashamed of their sexuality take care of their sexual health? In many cases, they don’t. In a study on women struggling with urinary incontinence, for example, many women avoided seeking out treatment — maintaining a grin-and-bear-it attitude — until the problem became “unbearable and distressing to their daily lives.”

Which may be why smartphone apps, at-home testing kits and other online resources have seen such growth in recent years. Now that we rely on our smartphones for just about everything — from choosing stock options to tracking daily steps to building a daily meditation practice — it makes sense people would turn to their phones, laptops and tablets to take care of their sexual health, too. Websites such as HealthTap, LiveHealth Online and JustDoc, for example, allow you to video chat with medical specialists from your computer. Companies such as L and Nurk allow you to order contraceptives from your cellphone, without ever going to the doctor for a prescription. And there are a slew of at-home STI testing kits from companies like Biem, MyLAB Box and uBiome that let you swab yourself at home, mail in your samples and receive the results on your phone.

Bryan Stacy, chief executive of Biem, says he created the company because of his own experience with avoiding the doctor. About five years ago, he was experiencing pain in his genital region. “I did what a lot of guys do, and did nothing,” he says, explaining that, while women visit their gynecologist regularly, men generally don’t see a doctor for their sexual health until something has gone wrong. “I tried to rationalize away the pain, but it didn’t go away.” Stacy says he didn’t want to talk to a doctor for fear of what he would learn, and didn’t know who he would go to anyway. He didn’t have a primary care physician or a urologist at the time. But after three months of pain, a friend of his — who happened to be a urologist — convinced him to see someone. He was diagnosed with chlamydia and testicular cancer. After that, he learned he wasn’t the only one who’d avoided the doctor only to end up with an upsetting diagnosis. “What I found is that I wasn’t strange,” Stacy says. “Everyone has this sense of sexual-health anxiety that can be avoided, but it’s that first step that’s so hard. People are willing to talk about their sexual health, but only if they feel like it’s a safe environment.”

So Stacy set out to create that environment. With Biem, users can video chat with a doctor online to describe what they’re experiencing, at which point the doctor can recommend tests. The user can then go to a lab for local testing, or Biem will send someone to their house. The patient will eventually receive their results right on their phone. Many of the above-mentioned resources work similarly.

Research shows there’s excitement for tools like these. One study built around a similar service that was still in development showed people 16 to 24 years old would get tested more often if the service was made available to them. They were intrigued by the ability to conceal STI testing from friends and family, and to avoid “embarrassing face-to-face consultations.”

But something can get lost when people avoid going in to the doctor’s office. Kristie Overstreet, a clinical sexologist and psychotherapist, worries these tools — no matter their good intentions — will end up being disempowering in the long run, especially for women. “Many women assume they will be viewed by their doctor as sexually promiscuous or ‘easy,’ so they avoid going in for an appointment,” she says. “They fear they will be seen as dirty or less than if they have an STI or symptoms of one. There is an endless cycle of negative self-talk, such as ‘What will they think about me?’ or ‘Will they think that I’m a slut because of this?’ If people can be tested in the privacy of their own home without having to see a doctor, they can keep their symptoms and diagnosis a secret,” Overstreet says, which only increases the shame.

As for the efficacy of these tools, Mark Payson, a physician and co-founder of CCRM Northern Virginia, emphasizes the importance of education and resources for those who do test positive. These screening tests can have limits, he says, noting that there can be false negatives or false positives, necessitating follow-up care. “This type of testing, if integrated into an existing physician relationship, would be a great resource,” Payson says. “But for patients with more complex medical histories, the interactions of other conditions and medications may not be taken into account.”

Michael Nochomovitz, a New York Presbyterian physician, shows a similar level of restrained excitement. “The doctor-patient interaction has taken a beating,” Nochomovitz says. “Physicians don’t have an opportunity to really engage with patients and look them in the eye and talk to them like you’d want to be spoken to. The idea is that tech should make that easier, but in many cases, it makes it more difficult and more impersonal.” Still, he sees the advantages in allowing patients to attend to their health care on their own terms, rather than having to visit a doctor’s office.

Those who have created these tools insist they’re not trying to replace that doctor-patient relationship, but are trying to build upon and strengthen it. “We want people to be partnering with their doctor,” says Sarah Gupta, the medical liaison for uBiome, which owns SmartJane, a service that allows women to monitor their vaginal health with at-home tests. “But the thing is, these topics are often so embarrassing or uncomfortable for people to bring up. Going in and having an exam can put people in a vulnerable position. [SmartJane] has the potential to help women feel they’re on a more equal footing when talking to their doctor about their sexual health.”

“If you come in with a positive test result,” says Jessica Richman, co-founder and chief executive of uBiome, “it’s not about sexual behavior anymore. It’s a matter of medical treatment. It’s a really good way for women to shift the conversation.”

This can be the case for men and women. While many will use these options as a means to replace those office visits entirely, their potential lies in the ability to improve the health care people receive.

Complete Article HERE!

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Raising Sex-Positive Kids

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My daughter is 12 years old, and she has already been groped. It happened at a local water park last summer in the wave pool, the kind of swimming pool where mechanically generated waves simulate the swell of the ocean. As one wave lifted her up, she felt the hand of a teenage boy grabbing her bikinied butt. How strange, she thought. It must have been a mistake; maybe the wave had carried him into her. Yet the same thing happened to her 11-year-old friend who was swimming nearby. Then they heard two more girls remarking loudly that the boy had touched them, too. Apparently, this young man was groping every female buttock in the pool like he was testing for ripe fruit at the farmers’ market. Soon, the two lifeguards on duty were frantically blowing their whistles. The waves stopped and the red-handed boy, standing by the lifeguard station with his father, was told to leave the water park immediately.

While the news that my young daughter had been groped horrified me, I couldn’t have imagined a better outcome. She was with a friend and her friend’s mother, able to share and process the experience and even laughed about it a little. More important, the teenage offender was caught, confronted, and suffered the consequences. He was publically shamed for his stupid and intrusive acts, as he deserved to be. And yet, my girl had been groped. She had been initiated into the world of women everywhere who are plagued by men behaving badly. Or in the words of a recent “Saturday Night Live” skit, “Welcome to Hell.”

The recent spate of news stories about women (and some men) being sexually harassed in the entertainment industry and in politics may be painful to witness, but it’s also liberating. The #metoo movement has broken the code of silence and unleashed a formidable backlash against many men who have unfairly wielded their power. Women and men are talking; mothers and fathers are talking. And many of us are wondering: How did we get here, and how can we stem the tide of sexual misconduct for the generations to come? How can we do things a little more mindfully so that we can raise girls who are empowered and expressive, and boys who are enlightened and empathetic?

A True Yes and a True No

Alicia Muñoz, a psychotherapist and couples’ counselor based in Falls Church, Virginia, sees one solution in the growing trend toward raising sex-positive kids. “Sex positive” is a relatively new buzz-phrase that’s gaining traction in the therapy world and beyond. “It’s about helping your children grow up with a sense of sexuality as a natural, normal, healthy, pleasurable part of being alive, of being a human being,” says Muñoz. “That’s easier said than done, especially in a culture that is so weighted toward sex negativity and gender biases and power differentials that are unfair. It’s a tall order, but an important thing.”

One essential message of sex positivity is that any sexual activity, and any touching of body parts, should be consensual. “Taking the shame out of sexuality is part of what provides a foundation for the awareness of consent,” says Muñoz. “It’s being able to grow up in an environment where you’re not ashamed of your own sexuality, or of sexuality in general. That’s part of what empowers you to have a voice, and having a voice means you’re connected to your right to give a true yes or a true no in different situations, including sexual ones. And on the other side of it, you’re primed to respect another’s true yes or true no when you view sex as a positive, integral, normal part of being human.”

Raising kids to be sex positive is a lifestyle that begins at the onset of parenthood. Many parents worry about when to have “the talk” with their children, but, in a sense, we’re already talking about sex to our kids before they have language. “From the moment they’re born, babies and kids are receiving data related to sex and sexuality and gender—through their senses, touch, longings, hunger, their relationship to their body, and their parents’ or caregiver’s relationships to their bodies,” says Muñoz. Yet the time will come when children want to put sex into words they can understand. And the sex-positive way for parents is to start talking about sex as soon as a child starts asking about it. “When a child asks a question, even if that child is just two and a half or three, you answer it in simple, true language,” says Muñoz. “You call a vulva a vulva, a penis a penis. You don’t call it a wee-wee or a pee-pee or another nickname. You show that, even in the naming of body parts, there’s no need to hide it.”

While the goal is to remove any negativity and evasiveness from sexuality, it’s important not to take the message too far and give your child more than he or she is ready to handle. Talk about sex should be age-appropriate, keeping in mind what young brains need. “Little kids need short-sentence explanations rather than long lectures,” says Muñoz. “For a four-year-old who asks where babies come from, a short answer might be that babies are created by a man and a woman giving each other a special kind of hug.” Yet with sex positivity, the aim is to always expand the lens of sexuality and give a sense of inclusiveness beyond limited cultural norms or biases. So, parents might want to add that some babies are created by a man’s seed that’s put with the help of a doctor into a woman, and then that baby might be raised by two men, or it might be raised by two women. Then no matter which path the child takes later in terms of sexual preference or gender identity, the stage is set for a sense of normalcy and acceptance from the outset.

Following Your Child’s Lead

With so much buzz about sexual harassment and assault in the news and popular culture, parents may wonder how to talk about such heavy issues with their children—and how to protect them from the bullying and power imbalances that start as early as elementary school. “Most kids don’t pay attention to what happens in the news, so in terms of discussing something disturbing with your child, it’s best to wait until the child raises up the issue themselves,” says Stanley Goldstein, PhD, a child clinical psychologist based in Middletown and the author of several books including Troubled Children/Troubled Parents: The Way Out 2nd edition (Wyston Books, 2011). The idea is to follow the child’s lead; equally important is to speak with them rather than to them, even when you’re laying down guidelines designed to keep them safe—such as explaining to your teenage daughter why you don’t want her to walk alone at night.

“It’s crucially important not to say to a child or teenager, ‘Do this because I say so.’ If you do that, then you repress the capacity for abstract thinking. Instead, say, ‘Do it because…’ and express your concerns. Explain that the world is generally a safe place, but you have to be cautious. If you feel that they’re not ready to do certain things, tell them no and tell them why.” While many parents believe that the major influence for teenagers is their peer group, Goldstein posits that the major influence for healthy teenagers remains the parents. “They might say, ‘Joey does this, so why can’t I do it?’ They might give you a hard time, but they’ll appreciate it. There’s nothing worse for a child than feeling like their parent doesn’t care.”

In the same spirit, parents are modeling behaviors to their children all the time, without speaking. Empathy is not something that you can inculcate into a child, but they’ll develop the capacity for it through osmosis, says Goldstein. “If the child sees a healthy interaction between the parents, sees them supporting each other and talking about their feelings, they’ll grow up with these kinds of capacities. Empathy is something that really derives from the family experience.” Yet some things do need to be put into words, and in a world where sexual misconduct is rampant, therapists tend to agree about one thing to tell your kids unequivocally: “The hard and fast rule is that you don’t have the right to put your hands on someone else, period. And no one should put their hands on you. Period.”

The Power of Speaking Out

Parents are not the only influencers; cultural messaging is very powerful as well. Terrence Real, a psychotherapist who wrote I Don’t Want to Talk About It: Overcoming the Secret Legacy of Male Depression (Scribner, 1998) and other books, says that boys lose their hearts when they’re five or six, and girls lose their voices when they’re 11 or 12. “Five or six is when the socialization process starts to really impact boys as they get shamed for doing things they were allowed to do when they were younger,” says Muñoz. “They might be called weak or girly. So, when you have a boy, how do you keep him connected to his heart yet still have him belong in his circle of peers? How do you keep your girls raising their hands in class rather than becoming wallflowers? How do you keep them speaking up when the society says that if you speak up you’re a bitch, or you’re not as attractive?”

Expressiveness in girls is crucial to encourage for two main purposes: their ability to share difficult experiences, and their empowerment in speaking out and defending themselves. “Letting your child lead the conversation, or lead the play when they are younger, creates a space where your child trusts you to share things such as, ‘Oh, one of the boys grabs my behind at school’ or ‘I saw a video with naked people on the internet.'” Parents can practice not reacting in fear or letting their anxiety show, but opening a space to calmly help and guide them. In turn, some self-defense teachers have girls practice yelling on the top of their lungs and using their voice, so if they are assaulted or groped in the subway or on the street, they can call attention to the perpetrator and get help if help is needed.

To raise sex-positive kids requires some work from the parents, and not all of it is easy. If a parent has any sexual trauma or abuse in their own past, it’s essential for them to be willing to face and work through it, not only for their own sake but for their children’s sake. Otherwise, says Muñoz, “In your well-intentioned desire to protect your children, you’re going to be communicating a lot of sex-negative messages to them.” Another challenge for parents is resisting the impulse to impose their power as adults over their children in everyday interactions. “What they learn there is, ‘Oh, I have to obey somebody more powerful than me even if it doesn’t feel good,'” says Muñoz. “Not telling your child they have to obey isn’t the same thing as having the inmates run the asylum. Instead it’s telling them, ‘I’m with you. We work as a team.'”

Complete Article HERE!

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