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What to do when your teen tells you they have a sexually transmitted infection

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By now, most parents likely know that not talking about sex with their teens will not stop them from doing it. And, as a parent, you might even have done some reading on how to have The Talk with your kids. Maybe you think you’ve done everything right when it comes to having important conversations with your teen. Or maybe you’ve been avoiding the discussion because you’re not sure where to start.

No matter which category you fit into, you may still find yourself as the parent whose kid comes home and tells them they think they might have a sexually transmitted infection (STI), or that they have contracted an STI. The way you respond to that bombshell can make all the difference for your child going forward — in their relationship with you, with future partners, and with themselves. “Often, the response of the people that you confide in when you first have a diagnosis shapes how you see your condition from then on out,” says Myisha Battle, a San Francisco-based sex coach. “It’s important that parents have a response that can potentially produce a positive outcome for kids when they’re disclosing.”

That, of course, is easier said than done. Heather Corinna, founder of Scarleteen, a sex ed web site for youth, and author of S.E.X.: The All-You-Need-To-Know Sexuality Guide to Get You Through Your Teens and Twenties, says that the groundwork for a positive response begins before your child ever receives a diagnosis. In fact, the way you talk about STIs from the beginning may determine whether your child even comes to you if they’re worried about their sexual health. And that, says Corinna, includes things like not talking about any infectious illness in a stigmatized way. “The closer we get to people, the more susceptible we are to infections,” Corinna explains. So if you wouldn’t talk about getting the chicken pox or a cold from someone as something gross, you shouldn’t talk about STIs that way, either. “When STIs come up in media or if people make a stigmatizing joke, correct it,” Corinna says. “Also important is not assigning value to people who do or don’t have an STI.”

And, no matter how many safer sex conversations you have (or haven’t) had with your kid, even people who do everything right can contract an STI. “STIs can happen even if you use protection and get tested,” says Ella Dawson, a writer who was diagnosed with herpes at 20. According to the CDC, nearly all sexually active people will contract HPV in their lifetime; two in three people worldwide have herpes simplex I and half of new infections are genital. The CDC considers both chlamydia and gonorrhea to be common infections. But, as Corinna points out, “The tricky thing is that when we talk about STIs, we’re talking about easily treatable illnesses like chlamydia versus [something like] HIV.”

Something else that might affect how involved a parent is or needs to be is how a young person contracted their STI in the first place. Often, STIs are contracted during consensual sexual interactions, but they can also be contracted during abuse or an assault. Corinna says that the biggest concern that they hear at Scarleteen from teens who have STIs is that their parents or caregivers will be disappointed in them. But, more serious than that, are fears that they may be kicked out of their house for having sex. Or, “if it happens in a wanted or ongoing relationship,” says Corinna, “there is the fear that their parents will punish them by refusing to let them see the person anymore.” All of these things may prevent a young person from disclosing their status to their parent or caregiver, or to avoid seeking medical attention all together.

“Teens with STIs need two things,” says Dawson. Those things are “access to medical care, and support. Make sure that your child has gotten a quality diagnosis from a medical professional, and also make sure that they are being treated with respect by their physician,” she says. Then, bombard them with unconditional love and support. It’s also important to do what you can to avoid adding to the shame and stigma your child might already be feeling. “Believe me, they don’t need you to confirm their own feelings of shame and regret,” Dawson warns.

Of course, it’s normal for parents to panic when their kid comes to them with an unexpected revelation like an STI diagnosis, but “it’s important to keep that freak out away from your kid,” says Battle. Corinna encourages parents to put aside their emotional reaction and get themselves educated so they can best help the young person in their lives. “If you’re in denial about [your] young person having sex, try to move past it and help them with what they need. If it’s about you controlling their health care and not giving them access, fix that,” Corinna says. “If you didn’t have conversations about what it means to be sexual with someone else, it’s time to have this conversation.”

Everyone agrees that the best way to be helpful as a parent is to take your lead from your child. “If they are upset, validate that. If they don’t feel bad about it, don’t make it a big deal,” suggests Corinna. Demonizing the transmitter, especially if that person is a partner, is not a helpful tactic and may alienate your child. Also not helpful? Trying to implement behavior modifications that same day, like taking them immediately to buy condoms, because it may feel like blaming. Also, going behind the young person’s back and calling their healthcare provider or their partner or telling a co-parent without getting explicit permission are surefire ways to lose a teen’s trust.

If your child isn’t sure what their diagnosis means, it can be a great time to get educated together. If they’re unsure if they might have an STI, “ask, ‘What are your symptoms? Let’s go to trusted website and find out what next steps should be.’ Or if it’s a diagnosis, it’s still an opportunity to sit down and ask what they learned at the doctor and what they know, so you can understand the next steps,” says Battle. Check out the resources on Scarleteen, the CDC’s website, or the American Social Health Association.

If you haven’t had great sex education yourself, learn along with your teen. After there is some distance, you can initiate another conversation about safer sex and make sure your teen has access to the appropriate supplies to help them avoid an STI in the future.

At the end of the day, what’s most important is letting your child know that an STI does not change the way you see them. This “does not mean your child has erred, ruined their future, or shown their true, negative character. Anyone can get an STI, even if you’re on the Dean’s list,” says Dawson. “What’s really important is that your kid is having a respectful, consensual and healthy sex life.”

Complete Article HERE!

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Undoing the STIgma: Normalizing the discourse surrounding STIs

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April is STD/STI Awareness Month.

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Let’s talk about sex. It’s fun, it’s natural.

Now, considering that April is STD/STI Awareness Month, let’s take it one step further and talk about sexually transmitted diseases and infections, or STDs/STIs.

They’re not so fun and not “natural,” per se, but they can and do happen to many people. In fact, according to the American Sexual Health Association, or ASHA, “one in two sexually active persons will contract an STD/STI by age 25” and “more than half of all people will have an STD/STI at some point in their lifetime.”

Yet for the most part, society hasn’t entirely accepted the reality of STIs. Instead, mainstream conversations about STIs rely on seeing them as punchline. This quote from “The Hangover” is a good example: “Remember what happens in Vegas stays in Vegas. Except for herpes. That shit’ll come back with you.”

If STIs aren’t portrayed as comical, then they’re seen as shameful.

“Some people believe that having an STI is horrible and people who have them are bad,” explained John Baldwin, UC Santa Barbara sociology professor and co-author of “Discovering Human Sexuality.”

In other words, there is a stigma associated with STIs.

“It’s not a death sentence.”

– Reyna Perez

Reyna Perez, the clinic lead for UC Berkeley’s Sexual Health Education Program, or SHEP, defined STI stigma as “shame with oneself (about) having an STI or amongst other people.”

“(They think) they’re ‘dirty’ or (use similarly) negative terms,” Perez said.

She went on to explain that campus students often think contracting an STI is the end of their sex lives and lives in general. But this is not true.

“It’s not a death sentence,” Perez said. “Most of them are curable or at least treatable.”

Despite the prevalence of STIs, people don’t know much about them. This lack of understanding reinforces the misconceptions surrounding them.

To help resolve this issue of ignorance, Baldwin first shed light on the difference between STDs and STIs.

“STD is the common language that a lot of people use and (the Centers for Disease Control and Prevention, or the CDC) uses because it communicates with large numbers of people, but medical doctors sometimes like to use ‘STI,’ ” Baldwin explained.

According to Baldwin, the term “STI” is more inclusive because it also considers people who don’t have symptoms but are infected and could infect others.

It’s true: People can be asymptomatic and transmit STIs to their partners.

“Large numbers of Americans have HIV and no symptoms and have sex with lots of others and infect others,” Baldwin said.

Additionally, sexual intercourse isn’t the only method by which STIs can be transmitted, a fact that more people should be aware of. There are many ways in which STIs can be spread, but they often go unnoticed.

According to Perez, “(People) don’t realize how you can contract them and there’s a gap in knowledge.”

Perez said STIs can be transmitted through oral sex or, in rare instances, fingering, which many people are unaware of. She also pointed out that HIV can be spread through non-sexual bodily fluids such as blood and breastmilk.

STIs can also be transmitted by something as simple as skin contact — Elizabeth Wells, lead and co-facilitator of the Sex 101 DeCal, said genital warts and herpes can be spread this way.

Even when it comes to sexual intercourse, the way by which most people believe STIs are spread, people don’t always take preventative measures.

“It’s not like everyone is consistently using condoms or barrier methods,” Perez said.

Another notable fact is that some STIs aren’t even viewed as STIs at all. For instance, cold sores on the mouth region are a form of herpes.

“They don’t realize it until someone brings it up to them,” Perez said. “Once you attach the title of ‘STI,’ suddenly it becomes something to be ashamed of. But it shouldn’t be that way.”

When the facts are laid out like this, it becomes apparent that there’s no reason to make STIs something to feel ashamed about. Many people contract them at some point, and although there are preventative measures such as condoms and other barrier methods, there are many possible avenues through which people can get them.

“Shit happens,” Wells said. “Who are we as individuals and society and people who are sex positive to vilify people that made decisions in the heat of the moment, or it just happens (that) the condom breaks?”

Yet the stigma surrounding STIs persists, largely because of the long societal tradition of suppressing discussions surrounding sex as a whole.

Baldwin expressed his belief that the stigma stems from the Judeo-Christian tradition. Judeo-Christian culture has been a prominent force that has shaped society’s views for hundreds of years. It frowns upon sexual activity, and looking down on STIs — perceived to be spread through sexual means alone — is part and parcel of that general disapproval.

“Society doesn’t evolve very fast in terms of thinking that I think you still see that mindset permeating today,” Wells said. “(STI stigma) is rooted in this idea that we’re not going to be talking about sex.”

Delving even deeper into the issue of STI stigma shows that it is further problematic because it is linked to racism.

According to a 2015 report by the CDC, STIs are more prevalent among certain racial or ethnic minorities than they are among white people. Being part of a racial or ethnic minority group also entails a plethora of issues that make it generally more difficult to find and receive appropriate sexual health services.

“It’s largely an issue of access, and you’re seeing a lack of comprehensive sexual education in those areas,” Wells said.

To vilify someone for getting an STI when they don’t even have the resources to know how to prevent them is to vilify them for not having access to sexual health resources. It is to vilify them for structural inequalities in access to education — inequalities which they did not ask for and cannot control.

“Being part of a racial or ethnic minority group also entails a plethora of issues that make it generally more difficult to find and receive appropriate sexual health services.”

Not only is it problematic to treat STIs as a taboo subject when this attitude stems from sexually repressive and prejudiced notions, but STI stigma also is harmful because it inhibits people from seeking medical treatment.

“If someone has an STI, we shouldn’t stigmatize them,” Baldwin explained. “We should try to help them get the best medicine and treatment.”

STI stigma also causes “intense emotional distress,” according to Perez.

“It’s so difficult to start support groups at the Tang Center because there’s stigma,” Perez said.

Considering all these facts and issues, the obvious final question is, “How do we get rid of the stigma surrounding STIs?”

One key component is awareness.

Awareness that people with STIs can and do lead normal lives helps. Modern science has allowed for medication that can either cure or treat STIs.

“It’s a world changer,” Perez said.

When engaging in sexual activity during an outbreak, there is also world of possibilities.

“There are creative ways to have sex while having an outbreak,” Perez explained.

She expanded upon this statement to say that, for instance, partners could use strap-on dildos when the involved parties are having a herpes recurrence.

“I believe that we are moving away from the preceding era of ignorance and successfully moving to have more scientific knowledge of STIs and their treatment so that more people are, in fact, getting good care,” Baldwin said. “Our society is moving in the right direction.”

“The need for action if you are diagnosed with an STI is further reason to destigmatize STIs –– so people can recognize the symptoms and be unafraid to seek help.”

To promote awareness, according to Perez, the Tang Center and SHEP offer programs for people who are curious to find out more about STIs as well as for people who have already been diagnosed with an STI who desire health coaching and/or emotional and mental support.

Awareness includes being conscious of preventative measures.

“Just being aware of sexual health resources (is) also really important,” Wells said. “A lot of people don’t know about it because it’s not talked about, because sex isn’t talked about.”

Wells explained that, for instance, people can take pre-exposure prophylaxis, or PrEP, before having sex with someone who has HIV or AIDS. This will lower the chance that the partner without HIV/AIDS will also get the infection. Similarly, taking post-exposure prophylaxis, or PEP, after sex with someone who has HIV/AIDS will help prevent transmission of the disease.

Although STIs aren’t the end of the world, if left undiagnosed or untreated, they can become serious health risks. The need for action if you are diagnosed with an STI is further reason to destigmatize STIs –– so people can recognize the symptoms and be unafraid to seek help.

According to Wells, on the last Friday of every month, the Tang Center offers free STI tests that take approximately 20 minutes. She clarified that there is, however, a six-month period after the initial infection in which the tests might not detect its presence.

Another key factor to destigmatizing STIs is simply talking about them. To emphasize this point, Wells quoted a SHEP saying: “Communication is lubrication.”

In other words, people need to start talking about STIs so that it will become acceptable to talk about them as well as to prevent them.

“It shouldn’t be uncomfortable for people because the way I see it, it’s mutual respect within relationships,” Perez explained. “I’m respecting my partner and getting myself tested and taking preventative measures, and my partner should respect me back by also being open to talking about STIs and … getting tested and (taking) those preventative measures as well.”

The way in which the discussion around STIs is being framed is also something to consider. For instance, discerning between STDs and STIs is important. Likewise, it’s crucial not to define people by their STIs.

“We don’t even like to use the word ‘HIV-positive,’ ” Perez said. “We like to use the phrase ‘a person living with HIV’ because they’re a person first before their STI.”

Awareness and communication aimed at undoing the stigma around STIs are imperative for the sake of public health but also for the sake of true sex positivity.

Complete Article HERE!

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Maybe Monogamy Isn’t the Only Way to Love

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In the prologue to her new book, What Love Is and What It Could Be, philosopher Carrie Jenkins is walking through Vancouver, from her boyfriend’s apartment to the home she has with her husband. She wonders at how the romantic love she experiences firsthand is so different than the model presented by popular culture and academic theory alike. “If indeed romantic love must be monogamous, then I am making some kind of mistake when I say, ‘I’m in love with you’ — meaning romantically — to both my partners,” she writes. “I am not lying, because I am genuinely trying to be as honest as I can. But if romantic love requires monogamy, then despite my best intentions, what I’m saying at those moments is not, strictly speaking, true.”

Her book examines the long, sometimes awkward legacy of philosophers’ thinking on romantic love, and compares that with a new subfield in close-relationships research — consensual nonmonogamy, or CNM. While singers and thinkers alike have been riffing on a “one and only” for decades, she argues that space is being made in the cultural conversation to “question the universal norm of monogamous love, just as we previously created space to question the universal norm of hetero love.” These norms are more fluid than they appear: In Jenkins’s lifetime alone same-sex and cross-ethnicity relationships have become common.

When I asked Jenkins to describe how it feels to have both a husband and a boyfriend — she rejects the “primary relationship” moniker altogether — she said that it’s like having more loving relationships in your life, like a close family member or friend. She and her boyfriend, whom she’s been with for about five years, used to work in the same building; he was teaching creative writing on the floor above her philosophy department, though they didn’t meet until they matched on OkCupid. While both men have met each other, they’re not close; Jenkins describes the relationship as having a “V shape,” rather than a triangle. Both helped in the development of the book: husband refining philosophical arguments; boyfriend editing the writing, and helping her to sound like a normal person, rather than an academic.

Still, CNM faces lots of stigma; even the study of it is stigmatized. Yet in the limited yet rich vein of research out there, the evidence suggests that it’s a style that, in some populations, leads to greater relationship satisfaction than monogamy. In any case, the researchers tell me, the insights into what makes more-than-two relationships work can be applied to any given dyad, given the communicative finesse required when three or more hearts are involved.

In a forthcoming Perspectives in Psychological Science paper, Terri Conley, a University of Michigan psychologist who’s driven the field, defines CNM as “a relational arrangement in which partners agree that it is acceptable to have more than one sexual and/or romantic relationship at the same time.” That’s distinguished from the “polygamy” practiced by some religious groups, where it’s not always clear whether wives can opt out of the relationship.

I was surprised to discover how common it is: A 2016 study of two nationally representative samples of single Americans — of 3,905 and 4,813 respondents, respectively — found in each case that about one in five people had practiced it during their lifetime. A 2016 YouGov poll found that 31 percent of women and 38 percent of men thought their ideal relationship would be CNM in some way. Other research indicates that around 4 to 5 percent of Americans in relationships are in some sort of CNM, be it swinging, where partners have sex with people outside their relationship at parties and the like; an open relationship, where it’s cool to have sex with other people but not grow emotionally attached to them; or polyamory, where both partners approve of having close emotional, romantic, and sexual relationships outside of the couple itself. People are curious, too: From 2006 to 2015, Google searches for polyamory and open relationships went up. Other data points to how sticking to the boundaries of monogamy doesn’t come easily to lots of people: A 2007 survey of 70,000 Americans found that one in five had cheated on their current partner.

Jenkins says that as a tenured philosophy professor at the University of British Columbia, she’s in a unique, privileged position to openly talk about being in a nonmonogamous marriage. She’d been interested in being in more than one relationship ever since she can remember, but it used to seem like some sort of impossible dream situation — she didn’t realize it could be an option in her real life until she was about 30. (She’s now 37.)

Jenkins met her husband, Jonathan, who’s also a philosopher, back in 2009, at a philosophy workshop that he organized at the University of St. Andrews in Scotland; they later got married in the same hall the conference took place. They took one another’s last names as middle names.

Now married for almost eight years, they talked about polyamory early on, though defining the relationship that way came later. As philosophers are wont to do, they soon wrote a bit of a manifesto about their arrangement. They observed that even if their wedding guests were woke in any number of ways — not batting an eyelid if a colleague was gay or bi, eschewing heteronormative assumptions, and the like — there’s still the shared assumption that a nonmonogamous relationship is less sexually safe and less committed than a regular ol’ monogamous one. “Even our very liberal pocket of our relatively liberal society is massively — and, to us, surprisingly— mononormative,” they write. “Acquaintances, friends, and colleagues are constantly assuming that our relationship, and indeed every relationship that they think of as ‘serious’, is a sexually monogamous one.”

To Jenkins, the biggest struggle with polyamory isn’t from managing multiple relationships — though Google Calendar is a crucial tool — but rather the strong, sometimes violently negative reactions that she gets, especially online. When I spoke with her by phone, she was struck by a comment to a YouTube interview of hers, where a pseudonymous user invited “everyone” to read her column in the Chronicle of Higher Education about having multiple loves.

“THIS WOMAN IS A DISGUSTING ANIMAL,” the troll wrote. “Every bit as twisted and queer as the Mormons with their multiple lives [sic]. This femme-pig is the spectral opposite of Trump; a far far left-wing freak that desires to completely overthrow Western Christian Civilization.” Jenkins walked me through a deep reading of the bile: Bundling in politics — the “left-wing freak” bit — with the monogamy norms signals to her that there’s a judgment of what it means to be a good person in here, since politics is about living correctly, collectively. Plus “if you’re an animal, you’re out of the range of humanity,” she says. She’s also gets a lot of “get herpes and die, slut” suggestions, she says, which speaks to the hypersexualization of CNM. Nonmonogamy leads to lots of sex, the presumption goes, and with that STIs, and it proceeds from there. The way news articles covering CNM tend to be illustrated with images of three or four people in a bath or bed doesn’t help, either.

“The way we normally think about romantic love, we don’t imagine that it’s entirely about sex,” she says. “For a lot of people sex is a part of it; if we’re just having a hookup or a friend with benefits, we don’t call that romantic love. When it comes to polyamorous relationships, if you’re in love with more than one person, the same applies — to fall in love with someone is not the same as to sleep with them. We’re clear with that distinction in monogamous relationships, but in CNM that distinction between love and sex gets collapsed.”

Researchers who have studied stigma around CNM have found lots. In a 2012 paper, Conley and her colleagues found that monogamous relationships were better rated on every metric by different sets of the population, including nonmonogamous people. When 132 participants recruited online read relationship vignettes that were identical except for one being monogamous and the other not, the CNM was seen as riskier sexually, more lonely, less acceptable, and having a lower relationship quality. People in CNM were also seen as worse with non-relational things, like making sure to walk their dog or paying their taxes on time. Amy Moors, a co-author on the paper, says it had some of the biggest effect sizes she’s seen in her research. Elisabeth Sheff, a leading polyamory researcher who left academia for lack of grant funding, now frequently serves as an expert witness in custody battles; she says that often a grandmother or a former spouse will find out that a co-parent has multiple relationships, be scandalized, and demand to take the kids — even though her longitudinal research, reported in The Polyamorists Next Door: Inside Multiple-Partner Relationships and Families, indicates that kids who grow up in polyamorous families aren’t any more screwed up than average American children.

That same paper finds that there were no differences in relationship functioning between monogamous and nonmonogamous couples. People in CNM had lower jealousy and higher trust — yet also lower sexual satisfaction with their partner. Polyamorists were more satisfied than people in open relationships, perhaps because it’s hard to block of feelings for people you sleep with frequently. Polyamorous people were a special case, with higher satisfaction, commitment, trust, and passionate love than monogamous individuals, though they had lower sexual satisfaction. CNM people also had higher sexual satisfaction with their secondary partners than their primary partners, though that difference fell away when controlling for relationship time, with primary relationships averaging three times the length of secondary relationships.

“Overall, the standard for human responses for relationships is habituation,” Conley says. “That involves a loss of sexual attraction, and we can tell that from stats from therapy. And to the extent that a couple is frustrated sexually, it spills over to other parts of life.”

There are other explanations for high satisfaction scores for polyamorous people, she adds. It could be that they’re just acting out a social desirability bias, given that they’re participating in a study about CNM and want the lifestyle to look good; it could also be that people who enter into polyamory have self-selected themselves into a hypercommunicative population — all the poly self-help books emphasize the importance the need to explicitly talk things out. “People interested in polyamory are more relationship-y than the average person,” she says. “They like thinking about relationships, talking about relationships. That’s great in monogamy, but needed in polyamory.”

All this suggests the kind of people that are the right fit for CNM. Beyond being relationship-y, a Portuguese study out this year found that people with a high sociosexuality, or disposal to casual sex, had less relationship satisfaction when in a monogamous relationship, but those effects disappeared if they were in CNM. Still, they were just as committed to their relationships — signaling that exclusivity and commitment may not be one and the same. Harvard sexologist Justin Lehmiller has found that people who are more erotophilic — i.e., that love sex — will be a better fit for CNM; same with if they’re sensation-seeking.

Amy Moors, the Purdue psychologist, has found that people with higher avoidant attachment — where you’re just not that into intimacy — have positive feelings about and a willingness to engage in polyamory, but they were less likely to actually partake of it. While a correlational study, Moors explained that from a subjective perspective, it makes sense: “When you have avoidant attachment, you like a lot of emotional distance, physical distance, time by yourself,” Moors says, which is not a fit for the relationship-y remands of a poly lifestyle. Also, there’s reason to believe that folks who have relational anxiety, and are thus sensitive to separation, might be prone to the jealousy that’s known to flare up in CNM, though it’s not like that doesn’t happen in monogamy, too.

What motivated Jenkins to write What Love Is, she says, was a gap — or silence — in the philosophical literature, that polyamory was rarely discussed or even acknowledged as a possibility. “Noticing these philosophical silences and denials, while simultaneously being made aware of how society at large viewed me for being a polyamorous woman, made me realize there was something important here that I needed to do,” she says. “To do it meant bringing my personal life and my philosophical work into a conversation with one another. The familiar slogan says that the personal is political, but the personal is philosophical, too.”

Two key themes emerge from reading the book: that love is dual-layered, with social scripts overlaying evolutionary, physiological impulses. And that the “romantic mystique,” like the feminine one before it, assumes that love is mysterious and elusive and corrupted from examination — a sentiment that protects the status quo. But with investigation, and conversation, the mechanics of love reveal themselves, and norms can change socially, and be tailored locally. Like Jenkins, you can custom-fit your relationships to your life — if you dare to talk about them.

Complete Article HERE!

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Middle-aged sex without the mid-life crisis

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More people are dating in middle age, but are they looking after their sexual health?

A regular, happy sex life can benefit our physical, mental, emotional and social wellbeing, improving health and prolonging life

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With more middle-aged people dating, or starting new relationships than ever before, are we taking enough care and consideration of our sexual health?

When we think of the faces behind recent statistics that are showing a rise in sexually transmitted diseases (STDs), we probably picture someone young. Those irresponsible students and twentysomethings playing around and not thinking through the consequences of their actions. But not so much. It is becoming clear that a large proportion of people contributing to those statistics are in fact, middle-aged. The Irish Family Planning Association (IFPA) annual report highlighted an increase in women aged over 50 coming to the clinics for sexual health services, including sexually transmitted infection screening and menopause check-ups.

The association said there was a perception that once women reached menopause, that they no long needed sexual health services. But that’s not the case. Minding our sexual health all through our life is as important as looking after our physical and mental health.

Unplanned pregnancies

For many women, perhaps coming out of a long marriage or relationship, they perhaps don’t seem to think they have to go back to the good old days of contraception and protection. Yet there are more unplanned pregnancies in the 40-plus age group than the younger ages.

“We definitely see an innocence and a lack of knowledge in middle-aged women seeking our services,” says Caitriona Henchion, medical director of the IFPA. “We see women not knowing if they need emergency contraception or whether they are experiencing menopausal symptoms. They’re not sure even in their late 40s and early 50s whether they still need contraception.”

The recommendation for contraception is very simple, yet perhaps not widely known. Until you have not experienced periods for two full years and you are under the age of 50, or one full year without periods after the age of 50, you need to still consider contraception. Amid constant talk of falling fertility as we age, many women are confused about their contraception needs.

This lack of knowledge about sexual health needs is apparent not just in the number of unplanned pregnancies in older women, but the rise of STDs in that age group as well. According to Henchion, advice from GPs can sometimes vary in quality and quantity, and so any sexually active woman over the age of 40 needs to seriously consider both her health risks and contraception needs.

Regular screening

The recommendation is that anyone who is sexually active needs regular screening. This seems to be something that many women feel unable to do. But emerging from a marriage or long-term relationship where the partner may have had other sexual partners means that STD screening is imperative.

“Discovering an unfaithful partner is a really common reason that we see older women coming to our clinics for screening,” says Henchion. “Our advice would be that the first thing to consider when starting with new partners is to ensure you have safer sex with condoms.”

But condoms don’t protect against everything, so the recommendation from the IFPA would be that if in sexual relationships you need to have testing twice a year.

“Obviously the people I see are a self-selecting group who are sexually active and attending our services, but certainly I would see a lot more people in the 50-plus [group] who are openly talking about their wants and needs and their problems with it, which is great,” explains Henchion. Who they do not see are the men and women not seeking sexual health services, or asking openly about their needs

One of the reasons there is a rise in general of STDs is because far more tests are being carried out, and therefore, more positive results. The tests are better now for chlamydia and gonorrhoea, so whereas a few years ago tests had less than 75 per cent detection rate, today it is 99 per cent. The tests themselves are simple. For men with no symptoms it is a straightforward urine sample and blood test, and for a woman, a vaginal swab and blood test in a nurse-led clinic.

Simple rule

According to Henchion, “the simple rule would be if you have a new partner for a few weeks, get tested.” But for many people, we perhaps don’t even know what to look for.

The top three STDs in terms of prevalence would be chlamydia, warts and herpes, and although many of the symptoms are obvious such as bleeding or physical warts, in more than 50 per cent of cases there are no symptoms. How many cases are picked up is through automatic testing when going for certain contraception options such as the coil.

Henchion believes we need better sex education and awareness for all generations. “I see 21-year-olds coming in with no understanding of how STDs such as herpes and warts can still be spread even though they are using condoms. And for sexually active people in middle age, there is often a significant lack of knowledge.”

For now, until sexual health education is more widely available, there are plenty of support services including GPs, well woman/well man sexual health clinics and the Guide Clinic at St James’s Hospital. The IFPA offers free advice, and there are plenty of online services such as HealthyIreland.ie.

“The key message is that early detection makes a huge difference in reducing risk of pelvic infection and obviously reducing the risk of passing it on,” warns Henchion. “Anyone, whatever age, who is sexually active needs to mind their sexual health.”

Middle-aged, single and on fire – or talking ourselves celibate?

For many women who have reached the supposed sexual prime of their 40s and 50s, their body image is shattered along with their energy. A recent survey suggested some women in this age bracket have the lowest confidence of any other age group regarding body image, and it’s affecting their sex lives. Yet another survey highlighted the fact that some women in middle age are having the best sex of their lives. If both surveys are right, is it all just down to attitude, and can changing your attitude change your sexual mojo?

In the two decades since the iconic shenanigans of the “man-eater” Samantha shocked a nation in Sex and the City (while women everywhere sniggered at the delight of it), middle-age sex is becoming mainstream. The BBC were at it with Happy Valley, and even Cold Feet caught up. First time round, Adam and co were in their youth, but now that they are heading towards 50, who is the one having all the sex? Karen. Middle-aged, single and on fire. Now that ordinary middle-aged women are being shown to be – gasp! – sexual, it begs the question: what does this mean for us? Is this liberating or intimidating?

It seems your answer to that question is the difference between having an active sex life in and beyond middle age and putting away the sexy knickers and taking out the comfy slippers.

Like tight skin and fashionable clothes, sex used to be the domain of the young. But now middle-aged women can have tight skin, fashionable clothes and sex as well. It all depends on your attitude. If you think your sex life is over at 50, it will be.

“Attitude is so important,” says sex therapist Kate McCabe. “I see women challenging traditional values and beliefs that you are past it sexually after a certain age. Women are having babies later, new relationships later, are mentally and physically healthier and anxious to be active and participate fully in every aspect of their lives.”

In fact, a regular, happy sex life can benefit our physical, mental, emotional and social wellbeing, improving health and prolonging life. This generation of middle-aged women have opportunities to redefine what stereotype they fit into, experiencing greater sexual, financial, social and intellectual freedom than at any previous time. Contraception has meant we are not overburdened with childbearing, and openness about sex means that issues which might have caused discomfort and difficulty can be addressed. The increase in divorce and separation now means that middle-aged dating is an acceptable social norm.

So why are all middle-aged women not taking advantage of the chance to flirt their 50s away and sex up their 60s

“Sex must be worth it,” explains McCabe. “I see women who come into therapy to see how they can best improve their sex life, even to the extent that they’ll bring in their partners and manage to engage in that conversation.

And it’s women of all ages. McCabe has clients in their 60s and 70s. “They are definitely getting out there, and they want really good, honest information on how to make the most of their sexual potential.”

But what about those women who are talking themselves celibate because of lack of confidence? Media plays a huge part in how women can often rate themselves. According to McCabe, feeling sensual has nothing to do with how you look.

“Finding intimacy is a brave step. Overcoming hang-ups to really explore our own sensuality is vital. And much of it relies on getting the right attitude.”

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

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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?”

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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.”

Complete Article HERE!

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