Search Results: Huge Dick

You are browsing the search results for huge dick

Female Orgasms Are Not Puzzling Enigmas, Study Helpfully Concludes

Share

By Tom Hale

The female orgasm is apparently a subject of great mystery and bewilderment for many men and women alike. But after you break through the old myths, taboos, and prudishness, it’s not quite as complicated as the glossy gossip magazines and hearsay makes out.

A new study by sexual health experts at Indiana University looked into female orgasms and the sexual preferences of a “nationally representative” group of 1,055 women in the US from the ages of 18 to 94 to demystify the idea female orgasms are complicated and encourage people to communicate what works for them.

It turns out, the female orgasm is hardly a riddle, wrapped in a mystery, inside an enigma. However, that’s not to say that women don’t have their own preferences. Just like music, food, art, and all the best things in life, we all like different things.

According to the study, just under 1 in 5 women said that sexual intercourse alone was sufficient for orgasm, over 36 percent reported clitoral stimulation was necessary for orgasm during intercourse, and an additional 36 percent suggested clitoral stimulation was not needed during sex but it made the orgasm all the better. A considerable number of the women, almost 1 in 10, said they did not climax during intercourse at all.

Basically, the long and short of it was that different women enjoy different things: some can orgasm during sex, some can orgasm from stimulating the clitoris during sex, some women do not have orgasms easily (or have gone through periods of life where it was difficult to climax).

The study even investigating different ways women liked to be touched. Once again, while there were certainly different preferences, it isn’t the enigma it’s occasionally made out to be. The huge majority of women enjoyed a light to medium pressure of touch, while nearly 16 percent said all pressures felt good and 10 percent liked firm pressure. Around two-thirds of women enjoyed touching in a up-and-down movement, 50 percent like circular movements, and 30 percent indicated a preference for a side-to-side motion.

The study authors explain that the real importance of the study is “underscoring the value of partner communication to sexual pleasure and satisfaction.” The only real requirement to have fun in the bedroom is the ability to communicate, embrace, and not shy away from finding out what works for you.

The researchers add that they hope their study helps to break down some of these boundaries, making it easier for women and men alike to comfortably communicate about sex, suggesting developing a “more specific vocabulary for discussing and labeling their preferences could empower them to better explore and convey to partners what feels good to them.”

Complete Article HERE!

Share

‘I’m 62 and my sex life is more important now than ever’

Share

‘I don’t believe I shouldn’t have a sex life just because I haven’t met ‘the one’’

By

Sex is just as important for women after 50: that’s what the European Court of Human Rights made clear when it ruled that the judges who reduced a 50-year-old woman’s compensation for a botched gynaecological operation had discriminated against her.

Maria Morais, who is Portuguese and has two children, sought compensation on the grounds that she was unable to continue a normal sex life, but the judges in the original case had argued that the importance of sex declines for women as they get older.

The European Court of Human Rights found that this constituted sexual discrimination, and that the judges had “ignored the physical and psychological importance of sexuality for women’s self-fulfilment and other dimensions of women’s sexuality”.

Sex doesn’t stop at a certain age

In popular culture, portrayals of relationships among older people are becoming more common, implying a greater acknowledgement of older women’s sexuality

In popular culture, portrayals of relationships among older people are becoming more common, implying a greater acknowledgement of older women’s sexuality. The film It’s Complicated (2009) starred Meryl Streep (inset), whose character has an affair with her ex, played by Alec Baldwin, decades after their divorce. This year, Hampstead saw Diane Keaton as a widow falling in love with a man living wild on Hampstead Heath, played by Brendan Gleeson.

Data backs up her case, too. In 2014, a Saga survey of 9,685 people aged over 50 found three-fifths are sexually active and 23 per cent are having sex once a week.

Research released by the Longevity Centre in 2016 showed that 60 per cent of men and 37 per cent of women aged over 65 had sexual activity in the past year.

Caitlin (not her real name), 62, needs no court ruling or Hollywood film to tell her that her sex life is important. She has been in a number of monogamous relationships, but is now having intimate relationships with more than one man.

Having an active sex life makes me feel alive. There’s a deliciousness about it.

I’m single and I have sex regularly, but I’ve been celibate in an earlier relationship when my partner lost interest. I have also been a mistress, where I discovered the thrill of coming to terms with my non-vanilla side. I feel more in touch with my sexuality now than I ever have done.

Sex is not the be all and end all. While I’m passionate about sex for those who want it, I’m also very aware that other people can get satisfaction from other things. But I think if one has the desire, sex is such a fabulous, life-enforcing thing at any age. It’s just a marvellous sensation.

Being 62 doesn’t mean I have to settle

I talk openly about my sex life with my close friends; it’s a running joke with them about what my neighbours would make of me.

I’m not hankering for my ‘one and only’. If I met them, that would be delightful. But I don’t believe I shouldn’t have a sex life just because I haven’t met ‘the one’. You can have good enough relationships that are absolutely fine without being the big thing. I don’t like compromising – just because I’m 62, it doesn’t mean I have to settle.

It would be fabulous to meet somebody who ticks all of the boxes, but I don’t feel I’m missing out because I haven’t got that. Having a sense of adventure and not knowing who I may meet is great fun.

I wanted to be open minded about sex

‘I was stood in the college library and thought, ‘I’m going to go and masturbate’

I grew up in a village South Wales and lost my virginity aged 18 to the man I thought I was going to marry. It was a huge thing because I was still a practising Catholic and it was not the done thing to have sex at school.

At that age, I wanted to be open minded about sex. I enjoyed it. I loved the power of being able to turn a man on, But with everything around you [at that age] you have a patriarchal version of sexuality. The whole thing of ‘what is sexy’ comes from the images you see.

I never masturbated as a teenager – I think I was quite proud that I didn’t. Then I got into this relationship and started to think there must be more to sex than this. When I was 19, I was stood in the college library and thought, ‘I’m going to go and masturbate.’ And I went back to my room and I did!

I began exploring my sexuality in my forties

‘I set myself a goal of being able to use a computer.’

I’ve always had sexual fantasies about spanking, which meant I had a life time of growing up with these suppressed fantasies that I thought were sort of dangerous.

I began exploring my sexuality in my forties when I posted adverts in a magazine. I met someone I thought I was going to be with for the rest of my life when he responded to my advert.

He already knew that I had these fantasies from reading my advert. Our sex life was completely vanilla but fantastic and very active until about six years in, when he developed an illness and went off sex. He seemed almost relieved of the burden.

I cared about him and so I put up with it and set myself a couple of personal goals. One was to learn to use a computer properly. Another was to start creative writing – I had always wanted to write erotica.

Things changed with this exploration of female sexuality and fantasies. I realised I wasn’t going to bring the world crashing down because I have sexual fantasies.

Age 56, I started advertising for lovers

‘I discovered this community out there with the same interest.’

Writing erotica was fun and I was curious to find out if what worked for me sexually worked for other people. I discovered this community out there with the same interest and it brought me back to life.

I started communicating with a man online. We discovered we were both in sexless relationships. I had never been unfaithful and took monogamy very seriously but I was getting to the point where I couldn’t continue like this. I told my partner I was going to struggle to stay faithful if our relationship remained non-sexual.

Suddenly, we had a fantastic sex life again. But it only lasted a fortnight.I told my partner again that I would not be able to be faithful in a sexless marriage and he left me. The man I was talking to online became my lover.

I began putting adverts out online to meet other people and started having other sexual partners. I was 56 at this time.

Sex has to be intimate

We have the rituals you have as a couple; going out together, watching TV, going on holidays

For me, there has to be a level of intimacy in sexual encounters. I met a couple of guys where there was a coldness and that is just not right for me. But there can be a level of intimacy without love.

There’s a chap I’ve been seeing for a few years and we’re very comfortable with each other. We have the rituals you have as a couple; going out together, watching TV, going on holidays.

I see other people because the time we have together is limited and I want more. The ages of the people I see varies; I recently stopped seeing someone who was five years older. The oldest chap I was seeing was about 69. But I’ve also had relationships with people in their thirties and forties.

I’ve now moved back to the village where I grew up. I’m part of the Women’s Institutes and I’ve done relatively serious things work wise. It’s just nice that there is this other part of you that is private, such fun and so life-enhancing.

Complete Article HERE!

Share

What straight couples can learn from gay couples

Share

By
When I embarked on the seven-year journey that would result in a trilogy of comedy shows and my first book, I had no idea what a huge part sexual orientation would play.

Yes, I’m a lesbian and that has influenced much of how I’ve socialised and dated for the 20 years or so since I came out. Yet, as I talked to more and more LGBT people – particularly those a little older than me who had experienced way more discrimination – I realised that being forced to think ‘outside the box’ around the concepts of love and family had resulted in some very self-aware, savvy and compassionate strategies for coping with the complexities of human relationships.

While I welcome the progressive legal changes that have seen a huge rise in acceptance for LGBT people, I worry that a blanket assumption that we all aspire to marry, have children and be ‘normal’ means that we might lose sight of some of the very best of these pioneering ideas.

Gwyneth Paltrow and Chris Martin used the term ‘consciously uncoupling’

Open relationships can be incredibly successful. Gay men fairly typically negotiate sexually open partnerships and have done for many decades. However, what is less widely-reported is just how good they are at remaining emotionally faithful to a primary partner. Their separation rates are the lowest of any section of society. Figures from 2013, from the Office of National Statistics, showed that civil partnership dissolution rates were twice as high for female couples as they were for male. While early divorce statistics in the UK evidence that ratio increasing further still.

So what are the relationships lessons straight couples can learn from the gay community?

1. An ex can be a best friend

Long before American author and family therapist Katherine Woodward Thomas devised the phrase ‘conscious uncoupling’ and Gwyneth Paltrow made it famous, lesbians were the godmothers of the concept of compassionate endings.

Recently, Dr Jane Traies conducted the first comprehensive study of older lesbians in the UK. She told me, “It’s not uncommon for a lesbian’s ex-partner to be her best friend.” She described one couple, now in their seventies, one of who had previously been in a straight marriage. The other had always been openly gay and had many more significant exes, who they would regularly spend time with. The central relationship seemed to be richly rewarded by having this framework of other ongoing connections supporting it.

2. ‘Living Apart Together’ can be great

Although the idea of ‘LAT’ couples is now more widely discussed, it was the LGBT community who originally piloted this idea. As my friend, the gay poet Dominic Berry, points out, “Perhaps if people are doing something widely viewed as deviant, making another deviance from the norm isn’t too big a jump.”

A lot of the automatic assumptions that are made about relationships – that you must get married, be monogamous, have children, move in together – have been cheerfully dispensed with. In many cases, an alternative romantic framework suited the individuals in the relationship much better.

Some straight couples can be reluctant to talk openly about sexuality

3. Talking about love, desire and sex is good

When I conducted a survey for my comedy show, I asked respondents if they actually  discussed sex and fidelity with a partner. One straight woman wrote, ‘Good lord no! It’s one thing to do the deed but we’re too uptight to actually talk about it. Thank goodness.’

My gay friends, by contrast, tend to have spent so many years agonising about their sexual identity that discussion of it with friends and families has been essential as part of the ‘coming out’ process. In many cases, this had lead to a readiness to air other really important questions around desires, boundaries and consent once they were in an adult relationship.

4. ‘Family’ doesn’t have to mean blood

When I arrived in London as a young student in the Nineties, the LGBT community provided me with the strongest sense of belonging I have ever experienced.

In the face of prejudice and discrimination, gay people historically partied hard together and took more care of one another within the bubble of separatism. They cultivated a concept of ‘friends as family’, something the writer Armistead Maupin refers to as ‘logical family’.

5. Love isn’t like it is in the movies

Because films depicting same-sex relationships have generally been far-removed from the sugary rom-com ideal, gay people are more pragmatic and realistic about the extreme challenges of falling in and out of love and staying together.

In 2017, we may not be facing quite as much adversity as the characters depicted in Carol or Brokeback Mountain, but we know that the ‘fairy tale’ romance is a load of old hokum.

6. Rules are made to be broken

When the activism group Gay Liberation Front formed in the early Seventies, they gleefully celebrated their difference from the oppressive, beige ‘norms’ that most of society were having to follow. This resulted in an inclusive, embracing atmosphere and a sense of fun and freedom for anyone who wanted to reinvent and rethink traditional relationships and try out different models of being together.

Complete Article HERE!

Share

A new way to love: in praise of polyamory

Share

Polyamory isn’t monogamy and it isn’t swinging, it’s being open to having loving relationships with different people of different sexes at the same time, and in that way learning to love yourself, too

‘It’s like any normal relationship, except with more time management’: Elf Lyons.

By Elf Lyons

I have never enjoyed typical monogamy. It makes me think of dowries and possessive prairie voles who mate for life, and historically all monogamous relationship models have owned women in some way, with marriage there for financial purposes and the ownership of property.

For the last few years I’ve defined myself as a polyamorist. Friends before defined me as a “friendly philanderer”. I love to kiss people. Friends usually, or women who wear polo-necks. Polyamory is consensual non- monogamy. It’s a philosophy. Rather than the active pursuing of multiple partners in a lascivious way, it’s the embracing and understanding that it’s possible to fall in love, and have relationships, with more than one person at the same time.

Alongside developing CEO-worthy skills in multitasking, polyamory is the most empowering way of loving that I have encountered. It gives women more autonomy than other relationship models ever have. Although monogamous relationship models work for many, they’re not the only way to have relationships in society. In non-monogamous relationships, their success relies on everything being on the table from the start. I believe that it could be the huge relationship revolution that the feminist movement needs.

Many think it’s about sex – it’s not. It’s not swinging. It’s not Pokémon Go, you don’t have to catch them all. It’s about the freedom to be honest about the evolving ways you feel. It opens up the boundaries between friend and lover in a safe and transparent way.

‘As a teen I questioned what it was to be adulterous. I saw infidelities on a different level to other friends’: Elf Lyons.

As a teen I questioned what it was to be adulterous. I saw infidelities on a different level to other friends. When partners mentioned they found other people attractive, I never minded. It made sense. “Why wouldn’t you want to kiss Stephanie? She’s a legend!” Apparently that was not considered a normal way to react.

If I had known as a teenager it was possible to love more than one person, it would have saved so much anxiety, guilt and time spent writing awful poetry. I spent years beating myself up about it. It often caused me to end relationships rashly, giving excuses like “I’m not ready to be in a relationship,” or “I have commitment issues,” or “I’m not into Warhammer as much as you think.” I didn’t want to end the relationships, but admitting how I felt seemed a worse betrayal, so I would lie, breaking friendships in the process.

I discovered polyamory when I was 23. I met a parliament of poly performers at the Adelaide Festival who were hippyish, liberal and kind. These performers spoke about their partners, children, poly-families. There were ex-couples who were working together on shows while their other poly families toured elsewhere, married couples who had live-in partners, triumvirates where they all balanced an equal partnership. I was entranced by their openness. It seemed symbolic of our changing global world, and most peoples developing nomadic lifestyles where we travel for work and find love with others on the way.

So when I went to study at theatre school in Paris (fresh out of a relationship with a 45-year-old French father of three), I decided to embrace my inner Barbarella. And the reality? Non-monogamy is rather ordinary and occasionally dull. Stereotypes of weird Eyes Wide Shut sex parties and Sartre/de Beauvoir/Olga ménages à trois aside, it’s like any normal relationship, except with more time- management, more conversations about “feelings” and more awkward encounters with acquaintances at parties who try to use you as their “Sexual Awakening Friend Bicycle”, ie that shy girl from book club will get drunk and put her hand on your leg, before leaning in to kiss you, hiccuping: “I really loved Orange Is the New Black…”

‘Sexual awakenings do not mean the absence of consent’: Elf Lyons.

There are misconceptions – a date once grabbed me for a kiss unexpectedly despite the fact I had made it clear I was in no way interested (my words were exactly: “This is not going to work. We have entirely different opinions on the EU and you have just told me I am ‘very funny for a woman’.”) When I pushed him away he was shocked. He believed because I was “sexually awakened” he could do what he liked. Luckily my experiences have meant that I am more vocal and confident, and able to stand up for myself. Yes I am open about my relationships and desires, but that doesn’t mean anyone’s allowed to touch me without my permission. Sexual awakenings do not mean the absence of consent.

I must admit, when I first dipped my toes into polyamory I misunderstood, went overboard with Tinder. The experience was stressful and would involve me asking awkward questions like: “Do you think crabs think fish can fly?” while wandering around the National Gallery for the third time that month. (There is no denying that polyamory suits the self-employed schedule). I learned that when people don’t know what polyamory is, they misunderstand it as another term for “hook up”, which it’s not. So previous partners have usually been friends I trust.

People often ask: “How can you truly love someone if you want to be with someone else?” and “Don’t you get jealous?” I think these statements enforce unhealthy relationship ideals. I feel it’s dangerous to think that you’re the only person that can complete someone else’s life, and be their confidant, their friend, their support network and their sexual partner. It’s too much pressure! When you take a step back, drop your ego and realise you’re one unique component of someone’s life, it’s liberating and freeing. Jealousy ebbs away and you realise that, of course, they may find another person attractive, because we’re all different pieces of a puzzle. This has made me more comfortable about myself – I am not holding myself up to standards about traditional female beauty, because I can experience it in a hundred different ways.

Of course, there have been tears, heartbreaks, existential crises and moments when I felt left out. I’ve wondered if it was actually making me more free, or more insecure, with jealousy popping up at the most inconvenient times. I’ve dated people who have lied and I’ve had relationships that have ended because they didn’t trust or believe in polyamory.

But, despite the downs, non-monogamy has revolutionised the way I view love. First, it made me less ashamed of my sexuality. I fancied girls way before I fancied boys. But as a teenager at house parties I remember being made to think that female sexual relationships were purely to turn men on. We’d all seen that scene in Cruel Intentions. I remember girls kissing at parties and the guys cheering. It was performative. Except, I wanted to kiss girls because I liked girls.

When I started getting to know people in the poly community it was as liberating as taking off an underwired bra. I have had partners of both genders. I didn’t have to “choose”: the people I met understood that it was possible to give infinite, equal love to both sexes. My confidence soared. I wasn’t hiding. Men and women had equal place in my life. I no longer felt like a pendulum, swinging from one to another. This refreshing awakening did result in many awkward conversations with my mum and dad though, which would go something like this:

Elf: “Mum and Dad, I am queer.” [Mum puts the hummus down.]

Mum: “What does that mean?”

Elf: “It means I have relationships with men and women”. [Mum picks the hummus up.]

Mum: “Oh! Well, I’m queer. Your father’s queer, your grandmother’s queer, we’re all queer darling!”

Elf: “No you don’t understand. I mean I have sex with men and women.” [Mum drops the hummus.]

Mum: “Oh Elfy… No wonder you’re so tired.”

Although I love sex, because of past unpleasant experiences I’m also mildly afraid of it. So when I started experimenting with non-monogamy the idea of being intimate emotionally as well as physically with more than one person was a challenge. But, the choice gave me a power and ownership over my wants which I felt I had lost and been made to feel ashamed about. I’m not saying I jumped in the sack with everyone I met. God no. I’m too busy. But through being less judgemental on myself, I relaxed, opened up to the people I trusted and started loving myself again. It forces you to be really honest, to live life with an undefended heart.

It’s not been plain sailing. But to quote RuPaul: “If you can’t love yourself, how the hell can you love anyone else” – this is integral to non-monogamy. You can’t use multiple relationships to fill the void and give you the gratification that you should be able to give yourself. More love doesn’t mean better love. If you are dating multiple people in order to enhance your self-worth, you end up feeling like out-of-date hummus, feeling jealous anytime anyone chooses to spend time with anyone else, resulting in you treating your partners badly and without respect.

We shouldn’t feel ashamed about being socially and sexually confident. Women have been made to feel embarrassed for their desires for too long. It’s about having the trust to speak our minds and behave the way we want to. The moment you start to crumble you need to stop and ask exactly what it is you want and if it makes you happy. Being loved and loving multiple people should make you feel stronger, not weaker.

In a time of censorship on women, increases in assault and constant critiques on how we should behave, polyamory and its manifesto of embracing our evolving feelings, sharing responsibility and communicating and working effectively with people from all around the world could help revolutionise the way we tackle privilege, inequality and control of women’s rights.

I have an authority and a voice that I didn’t feel I had before. My friendships are better, my health is better. Through being polyamorous and being a part of the community I have been made aware of issues, both personal and political, that need to be uncovered and addressed.

The world would be a better place if everybody was more open to polyamory. As well as that traditional idea, that it takes a village to raise a child, it would mean we’d all love more, and love better. Loving different people at the same time is like learning a different language. There are different rules every time and it’s always open for discussion. You start to realise that love is infinite. Every time you say “I love you” to someone it takes on a new meaning. It’s retranslated, and it’s wonderful.

Complete Article HERE!

Share

What gay trans guys wish their doctors knew

Share

Vancouver study peers into the lives and troubles of trans MSM

Sam Larkham organizes sexual health clinics across Metro Vancouver with the Health Initiative for Men (HIM). He says he was once referred by his doctor to a trans health care clinic that had been closed for years.

By Niko Bell

Speaking to gay and bisexual trans men, the word “invisibility” comes up a lot. Invisibility in the bathhouse and on dating apps, invisibility among cisgender people, straight people, trans people and gay people. And, too often, invisibility in the doctor’s office.

“I have tried just going to walk-in clinics and stuff like that to ask questions or request tests,” one trans man recently told researchers in Vancouver. “And I just found the doctors were generally confused about me and my body. And I had to go into great detail. That made me not so comfortable talking to them about it because they were just kind of sitting there confused.”

“People have tried to talk me out of testing . . . saying I was low-risk behaviour,” another man told the researchers. “They didn’t understand my behaviour really. . . I’ve had practitioners as well say they don’t know what to do; they don’t know what to look for.”

Both men were speaking to researchers for a new study on the sexual health of trans men who have sex with men — a group social scientists know remarkably little about. Many of the men spoke about being on the margins of mainstream culture, gay culture and of the healthcare system.

It should be no surprise, then, that the study happened almost by accident. When PhD student Ashleigh Rich started work with the Momentum Health Study — a five-year, in-depth research project on the sexual health of men who have sex with men (MSM) conducted out of the BC Centre for Excellence in HIV/AIDS — she never intended to write a paper about trans MSM.

But a small group of trans men volunteered for the study, some pointing out ways the Momentum researchers could change their surveys to be more inclusive.

There were too few for quantitative research — only 14 — but Rich asked if they would sit down for an hour and talk about their experiences. Eleven agreed.

The result is a slim, 11-page paper that hints at a world of things we don’t yet know about transgender gay and bisexual men. We do know they form a large part of the trans population; nearly two thirds of trans men say they are not straight. We also know trans MSM participate in the same rich world of sexuality as other men who have sex with men — from dating apps to anonymous sex to sex work and a broad range of sexual behaviour.

We don’t know much about trans MSM risk for HIV; estimates range from much less than cisgender gay and bi men to somewhat more. We also don’t know much about how a combination of stigma, invisibility and limited healthcare options may be affecting trans men’s health.

Rich is cautious about drawing any broad conclusions from her study. Not only is it a tiny sample, but the men she spoke to are also mostly urban, white and educated. This study was less about answering questions, and more about figuring out which questions to ask.

A few themes, though, emerge clearly. One is that trans MSM often find themselves falling through the cracks when it comes to sexual health. Doctors are increasingly aware of how to talk to gay men, but don’t always see trans gay men as “real” MSM. They assume trans men are heterosexual, or fail to bring up sexual health altogether.

Some doctors give trans men information on PrEP — a preventative anti-HIV medication that can drastically reduce the risk of contracting HIV if taken every day — based on studies on cisgender men, without checking to see if different anatomy requires different doses. When trans men come in for HIV tests, they are sometimes urged to get pap smears instead.

“We come in with specific issues we want to talk about in a health care consult, and sometimes once people discover we’re trans they’ll want to do a pregnancy test or something,” says Kai Scott, a trans inclusivity consultant who collaborated on the study with Rich. “And we’re not there for that. They’re giving us things we don’t want, and not telling us the things we do need to know.”

Sam Larkham, a trans man who organizes sexual health clinics across Metro Vancouver with the Health Initiative for Men (HIM), says he was once referred by his doctor to a trans health care clinic that had been closed for years. Experiences like that make him think the best path for trans MSM is to rely on queer-focused health care providers like HIM.

“It would be ideal if it were the whole medical system, but that’s impossible,” Larkham says. “I think we have to look at what we can do, and that’s have specific places where we have nurses who are well trained to handle trans MSM. I think that’s the more doable thing. I would love to have every clinic be culturally competent, but that’s not the reality and never will be.”

Scott is more sanguine. He points to Trans Care BC, a provincial health program that has pushed for more education for doctors. Education needs to happen on both fronts, Scott says, among MSM organizations and in the health care system at large.

Lauren Goldman is a nurse educator for Trans Care BC. Since she was hired last fall, she’s been giving workshops to healthcare providers on how to treat trans patients. For now, though, the workshops are aimed at small groups of sexual health professionals, such as at the BC Centre for Disease Control or HIM. Goldman wants the program to expand to include everyone.

“We know trans patients are accessing care through a number of places all across the province,” she says. “We want everyone to have access to this information as soon as possible.”

Goldman says Trans Care is designing an online course that could bring trans cultural competency to primary care doctors everywhere as part of mandatory continuing education. Trans Care has also designed a primary care “toolkit” for doctors, and is in talks with UBC’s medical school about including trans-focused sexual health education for doctors in training.

Without specialized knowledge, Goldman says, there’s a lot doctors can miss. Testosterone can make vaginal tissue more sensitive and inflexible, for example, meaning trans men might have special difficulties with genital sex. Bacterial vaginosis is more common, and the usual antibiotics given to cis women may not solve the problem. Vaginal and rectal tissue may need different doses of PrEP to be effective.

And, most importantly, doctors need trans patients to know they will be heard.

“We need to be providing really obvious cues that show people that our services are trans inclusive,” Goldman says. “Including how we design our services, how we market our services, how we educate our clinicians, what signs we hang up, letting people know that our clinicians have a greater understanding of gender diversity.”

While Goldman is educating doctors, the trans men Rich studied were already very well educated about their own sexual health. They told Rich about careful risk assessments they make around sex, sharing information with other men, and advocating for STI screening to their reluctant doctors.

One man described slipping in HIV tests while getting regular testosterone-level screening: “Yeah, oh, I’m already getting blood drawn. I probably need to get tested, let’s just draw two more vials for HIV and syphilis.”

It’s not surprising that many trans men are so health-conscious, Scott says. “We’ve had to be champions of our own bodies for a while, and so that ethos carries through when it comes to health information.”

But it would be a mistake to overstate how safe trans MSM are, he adds. For one, the urban, white and well-educated men in Rich’s study may be more likely to have access to resources and care than less wealthy or more rural trans people. Also, the very reason trans MSM seem so safe might be because they aren’t getting the opportunities for sex they want.

“To some extent, we’re still on the sidelines,” Scott says. “I don’t think that systemic rejection should be the means of HIV prevention for trans and nonbinary people. We’re dealing with a lot of rejection, and so I don’t think we’ve really had the opportunity to be exposed to that risk.”

The theme of rejection is echoed frequently by the study subjects.

“I remember meeting this one guy at a friend’s party and we were flirting the whole time,” one participant recounted. “He was like, ‘Oh we should totally go for a beer’ and so we connected and then I told him I was trans and he was like, ‘Oh I’m not looking for anything.’”

“Cis men often shut down immediately, out of a sort of fear of the unknown, and being unaware of what can and can’t happen,” Scott says. “They can assume all trans guys are bottoms, which isn’t true.”

Constant rejection can wear trans men down, Larkham says. Not only does it damage mental health, but constant rejection can weaken trans men’s resolve to negotiate sexual safety.

Many trans men, the study notes, rely on online hookup sites, where they can be upfront about being trans, and avoid rejection by anyone who isn’t interested.

The burden of rejection is one reason trans MSM need better mental health services too, Larkham says. Too many men show up to sexual health clinics after being exposed to sexual risks. Mental health support, he thinks, could reach people earlier.

But again, Scott strikes a positive note. “It’s a source of celebration to me that despite huge barriers we’re still having the sex that we want,” he says.

In the end, the clearest message to emerge from Rich’s study is that there’s a lot more to learn. She hopes to get more answers from the next stage of the Momentum study, which will recruit a larger sample of MSM from across Canada. That study, she hopes, will be large enough to deliver the kind of precise, quantitative answers that this one couldn’t.

Scott is also eager to move forward.

“There’s so much you want to pack in and so much you want to report on,” he says. “There’s such a dire need to research these issues. People are really hurting, and I really feel that. But you’ve got to take it one step at a time.”

Complete Article HERE!

Share