I’m delighted to welcome back Lance Navarro for Part 2 of his appearance for the Sex EDGE-U-cation podcast series. Last week we discussed his work in porn. This week we turn our attention to another aspect of his sex work, being an escort.
Like last week, Lance, with his trademark frankness dispels some of the myths surrounding this type of sex work. And if you thought last week’s program was provocative, hold on to your hats. Because this week is gonna totally blow you away.
But wait, you didn’t miss Part 1 of this amazing conversation, which appeared here last week at this time did you? Well not to worry if ya did, because you can find it and all my podcasts in the Podcast Archive right here on my site. All ya gotta do is use the search function in the header; type in Podcast #261 and PRESTO! But don’t forget the #sign when you do your search.
Porn and sex work are two hot button sex issues for most people. Everyone seems to have an opinion, but very few of those opinions come from more than gut reactions. Not many of us have any first-hand experience to guide us in sorting out our feelings and making up our mind. To remedy this, at least for you, my audience, I’ve been bringing you periodic interviews with porn stars and sex workers as part of this the Sex EDGE-U-cation podcast series. Because I think it’s important to hear from actual people in the business before we decide where we stand on these matters.
If you are a connoisseur of cutting edge fetish smut, then I’m gonna guess that you may already know our guest and his body of work. And if you don’t you have a treat in store for you. Because Lance now adds his unique voice to the ever-growing chorus of prominent educators, practitioners and advocates of unconventional sexual expressions and lifestyles that is this podcast series.
Transgender identity would instead be categorized under the sexual health umbrella, which could significantly impact acceptance of transgender individuals in health care and social spaces.
The World Health Organization is currently considering reclassifying transgender identity in its International Classification of Diseases. Though the WHO previously labeled transgender identity as a mental disorder, a recent Lancet Psychiatry study has led the organization to reevaluate that decision. Now, the WHO is discussing re-categorizing the term under its sexual health umbrella—which could have major implications for how transgender people are viewed in both health care and society.
This new conversation is the result of a study that shed light on the complex relationship between transgender identity and mental illness. The study, which drew on a sample of 250 transgender individuals, found that while many transgender people experience mental distress, most of that distress is linked to experiences associated with being transgender—like family, social, or work or scholastic dysfunction. It’s not that being transgender is a mental illness in and of itself, it’s that identifying as transgender can lead to rejection, violence and other things that cause mental distress. These findings clearly challenge the WHO’s decision to label transgender identity as a mental disorder, which is why the organization is currently rethinking its original designation—and why it’s doing so right now.
If this story sounds familiar, that’s because it is. Until the late 1980s, homosexuality was classified as a mental illness in the Diagnostic and Statistical Manual of Mental Disorders (DSM). While that’s not the same thing as the WHO’s ICD, the two serve a similar purpose: being the go-to resource for defining health conditions and tracking global health trends. The DSM renamed homosexuality as “sexual orientation disturbance” in 1973, and changed its name to “ego-dystonic homosexuality” before removing it from the list of mental disorders altogether in 1987. “I’ve never heard a gay person lament the loss of the diagnosis of homosexuality,” Diane Ehrensaft, a developmental and clinical psychologist specializing in gender, tells SELF. “[And I don’t] think we will find many transgender people—if any—[who] lament the disappearance of a mental health diagnosis—as long as we continue to ensure the provision of all medical services.” Ehrensaft explains that classifying transgender identity as a mental disorder “declares a mental illness where there is none,” which can leave transgender individuals facing increased stigma in an already rejecting world.
Though there’s no official count of how many Americans identify as transgender, LGBT demographer Gary Gates has estimated that the number falls around 700,000. (It’s worth noting that this data is based on two studies—one from 2007 and one from 2009—so it’s not necessarily representative of the actual transgender population in the U.S.) Regardless of the exact figure, the WHO’s decision has the potential to impact a significant number of Americans—and Americans who are disproportionately at risk for things like poverty, suicide, and various forms of discrimination, at that. “It is extremely damaging to label someone’s identity as a mental disorder,” Jamison Green, transgender rights activist, tells SELF. Stigmas associated with transgender identity and mental health can impact someone’s ability to get hired, receive a promotion, and to feel confident enough with the surrounding world. “There’s a huge, huge problem,” he says.
While the WHO hasn’t made any official decisions yet, reclassification could potentially have beneficial outcomes for members of the LGBT community. “What we have to look at is social ramifications of the experience of transgender people,” Green says. And one of the things the WHO’s decision would do, he says, is clear up some of the cross-cultural confusion surrounding gender and sexual orientation. “It’s a very complex subject, and there’s very little known about it from a clear technical perspective,” Green says. Still, moving away from classifying transgender as a mental disorder is a positive step, he says, because transgender identity is linked to a person’s physical nature (gender confirmation surgery, potential roots in endocrinology, etc.) in many ways.
That said, the decision to potentially re-categorize transgender identity under the sexual health umbrella is a little complicated—and could potentially be a step in the wrong direction. “I think it kind of misses the mark,” Green says. He mentioned that sexual health issues include things like the inability to orgasm and, in some cases, pregnancy—not gender identity. “There is nothing sexual about gender when it comes to health,” Ehrensaft reiterates. “It’s all about who you know yourself to be—as male, female, or other—and how you want to present your gender to the world. Anything having to do with sex organs and sexual functioning is a different issue.” Still, it’s a step nonetheless. “That’s sort of the mentality that we’re having to deal with—that’s there’s something wrong with a person if their gender doesn’t match the sex of their body,” Green says. “So where do we [classify] that so people can be properly treated in a humane fashion, rather than in a damaging one? There’s a struggle.”
So far, the proposed reclassification has been approved by every committee that’s discussed it—leaving it under review for the latest edition of the WHO’s ICD. Geoffrey Reed, a professor who worked on the Lancet Psychiatry study, told the New York Times that the re-categorization wasn’t receiving opposition from the WHO and suggested we might see the change as soon as May 2018, when the newly revised version of the ICD is approved.
“Trans people, like anybody else, have identities that need to be respected,” Green says. “And all of the people who are affected by these sex and gender misunderstandings—and our lack of scientific knowledge—do not deserve to be vilified or stigmatized or punished in any way. That’s what we’re trying to move toward in the awkward world of policy making.”
ATLANTA — Older adults in assisted-living facilities experience limits to their rights to sexual freedom because of a lack of policies regarding the issue and the actions of staff and administrators at these facilities, according to research conducted by the Gerontology Institute at Georgia State University.
Though assisted-living facilities emphasize independence and autonomy, this study found staff and administrators behave in ways that create an environment of surveillance. The findings, published in the Journals of Gerontology: Social Sciences, indicate conflict between autonomy and the protection of residents in regard to sexual freedom in assisted-living facilities.
Nearly one million Americans live in assisted-living facilities, a number expected to increase as adults continue to live longer. Regulations at these facilities may vary, but they share a mission of providing a homelike environment that emphasizes consumer choice, autonomy, privacy and control. Despite this philosophy, the autonomy of residents may be significantly restricted, including their sexuality and intimacy choices.
Sexual activity does not necessarily decrease as people age. The frequency of sexual activity in older adults is lower than in younger adults, but the majority maintain interest in sexual and intimate behavior. Engaging in sexual relationships, which is associated with psychological and physical wellbeing, requires autonomous decision-making.
While assisted-living facilities have many rules, they typically lack systematic policies about how to manage sexual behavior among residents, which falls under residents’ rights, said Elisabeth Burgess, an author of the study and director of the Gerontology Institute.
“Residents of assisted-living facilities have the right to certain things when they’re in institutional care, but there’s not an explicit right to sexuality,” Burgess said. “There’s oversight and responsibility for the health and wellbeing of people who live there, but that does not mean denying people the right to make choices. If you have a policy, you can say to the family when someone moves in, here are our policies and this is how issues are dealt with. In the absence of a policy, it becomes a case-by-case situation, and you don’t have consistency in terms of what you do.”
The researchers collected data at six assisted-living facilities in the metropolitan Atlanta area that varied in size, location, price, ownership type and resident demographics. The data collection involved participant observation and semi-structured interviews with administrative and care staff, residents and family members, as well as focus groups with staff.
The study found that staff and administrators affirmed that residents had rights to sexual and intimate behavior, but they provided justifications for exceptions and engaged in strategies that created an environment of surveillance, which discouraged and prevented sexual and intimate behavior.
The administrators and staff gave several overlapping reasons for steering residents away from each other and denying rights to sexual and intimate behavior. Administrators emphasized their responsibility for the residents’ health and safety, which often took precedence over other concerns.
Family members’ wishes played a role. Family members usually choose the home and manage the residents’ financial affairs. In some instances, they transport family members to doctor’s appointments, volunteer at the facility and help pay for the facility, which is not covered by Medicaid. They are often very protective of their parents and grandparents and are uncomfortable with new romantic or intimate partnerships, according to staff. Administrators often deferred to family wishes in order to reduce potential conflict.
Staff and administrators expressed concern about consent and cognitive impairment. More than two-thirds of residents in assisted-living facilities have some level of cognitive impairment, which can range from mild cognitive impairment to Alzheimer’s Disease or other forms of dementia. They felt responsible for protecting residents and guarding against sexual abuse, even if a person wasn’t officially diagnosed.
Co-authors of the study, Georgia State alumni, include Christina Barmon of Central Connecticut State University, Alexis Bender of Ripple Effect Communications in Rockville, Md., and James Moorhead Jr. of the Georgia Department of Human Services’ Division of Aging Services.
The study was supported by a grant from the National Institute on Aging at the National Institutes of Health.
Last Sunday, 07/24, I woke up feeling a bit wonky. Couldn’t quite put my finger on why I was feelin’ out of sorts; I just was. But I had a swell outing planned for the day, so I couldn’t flake. A couple of friends and I were planning on taking the ferry to Bainbridge Island for lunch. The weather was perfect for our little cruise across Puget Sound.
My friends and I met at Pikes Market, a famous landmark here in The Emerald City, and we walked to the ferry from there. I walk about four miles every day so the 15-minute walk should have been a breeze for me. But something was wrong. I felt lethargic and winded.
The 35-minute ferry ride was magical, as always, but upon disembarking and walking to the restaurant I began to really hurt. Not one to spoil the fun I marshaled my resources and made it to lunch.
The walk back to the ferry was excruciating. I was lightheaded, slightly nauseous, and completely winded. My heart was pounding like it wanted out of my chest. My companions became as worried as I was.
Once we docked in Seattle I had to once again disembark then walk to public transportation and to home. I was in a panic. The crush of the crowd around added to my distress. I thought for sure I was gonna faint, or barf, or worse. I was certain that my lungs were gonna give out on me. After many stops to catch my breath and buckets of sweat from the effort I finally made it home.
I’ve been monitoring my blood pressure for several months. (Ya gotta do this when you’re old, like me.) So once at home, I took a reading. My blood pressure was normal, but my pulse was unusually low, a reading of 49 to be precise. A couple of hours later it was 45. This was odd. I had never experienced anything like that before. Mostly my pulse rate hovers in the upper 70s and low 80s.
I felt much better on Monday. But come Tuesday, I was a total wreck. The least bit of exertion left me exhausted and prostrate. I knew it; my lungs were finally giving out. I put in a call to my doctor and got an expedited appointment for the very next day.
Tuesday’s blood pressure readings were slightly elevated, which was great, but my pulse was way down. I took several readings and each was in the mid 30s never over 40. I still didn’t get it. (This is probably why I’m not a brain surgeon.)
Wednesday turned out to be a nightmare. Unbeknownst to me I was about to began a headlong descent into the maw of the medical industry.
My doctor’s appointment was at 10:30am. The doc took one look at me and ordered an electrocardiogram (EKG). “HOLY SHIT!” She exclaimed. (Or something to that effect.) “How is it that you’re still standing?”
Needless to say, this got my attention right quick. “What?” I inquired. “Although you are not having a heart attack you are this close to the pearly gates. Your pulse is about to flat line, you monkey!” My doctor stuttered. (Ok, maybe she didn’t mention the pearly gates, or call me a monkey, but that was her drift for damn sure.)
Maybe it was the stress or shock of it, but I started to laugh. My doctor asked; “What’s so funny?” I said; “Did you ever see the movie, Death Becomes Her? Remember the scene in the emergency room?”
She gave a faint smile and said; “Yeah, I get it, but this is no laughing matter. Get thee to the Emergency Room ASAP!”
Off I went.
I got to Swedish Hospital (First Hill) Emergency Reception just before noon. The guy behind the desk asked what was wrong with me. I said; “Basically, I’m having a heart attack.” Apparently those are the magic words because the team swung into action. I was admitted immediately, blood was drawn, another EKG, x-rays were taken, and I was hooked up to a heart monitor. Diagnosis: Bradycardia with second-degree heart block.
You need a pacemaker IMMEDIATELY!
We’ll get you a room on the cardiac ward at our Cherry Hill campus, which is just a mile away, as soon as one is available.”
“Oh, OK, I guess,” said I as the severity of the situation finally began to dawn on me. As you can see, I’m not the sharpest pencil in the box.
Back in the emergency room I was laying on a gurney with electrodes and wires sprouting from my chest and back. I lay there for hours listening to the cries, screams, and moans of my fellow emergency patients. Codes blue and grey are being called with regularity and I can just imagine the human misery that surrounds me.
At 5:00pm one of the emergency nurses tells me that a room at the cardiac ward will be available at 7:00pm. “But, 7:00pm is the changing of the shift. So the soonest we could get you there is 7:30pm.”
7:30pm comes and goes. “What’s up?” I ask. “We’re trying to locate transport for you.” Was their retort. “But the Cherry Hill campus is just a mile away. I could walk there from here.” I countered. “But you need a special ambulance, one with a nurse on board, one that can monitor your heart in transit.” “You gotta be kidding!” Said I. “Not at all. You could flat line on the way to Cherry Hill and we’d be liable. Don’t worry, Richard, we will surely have the transport by 10:00pm.”
The transport didn’t actually arrive till 12:30am. That was twelve and a half hours on a gurney in the ER! And the fun is just beginning.
I finally get to the Cherry Hill campus at 1:00am. I am ushered into a room where I am then interrogated for 45 minutes. (Are you now, or have you ever been…) They called it an intake, but a rose by any other name. I haven’t eaten since breakfast at 5:00am the previous day with only water to drink. Now, even the water was being withheld. I guess they anticipated I would have my procedure later that (Thursday) morning.
Not so fast there buckaroo!
Thursday dawns, but nothing happens. I’m confined to my bed (the second worse bed in the world. The first being the ER gurney I left yesterday) and am attached to a heart monitor. I am faint from hunger and more than a little dehydrated. By noon they decide they need to feed me lest the hunger and dehydration kill me before the arrhythmia.
I scarfed down my lunch like a dying man…mostly because I was.
Allow me to pause my narration for a moment and comment on the cardiac nursing staff. They are superb! And even that superlative leaves me wanting. These women are freakin’ rock stars in my book. One in particular, Nurse Jen, totally got me. We both had the same gallows humor. She is my hero.
Eric Williams, MD, FHRS
Late Thursday afternoon Dr. Williams, a cardiac electrophysiologist, saunters into my room. He’s gonna be doing the cutting on me. He is a tall handsome black man with the most unassuming manner. He looks me in the eye and talks to me like I’m a human. I’m super impressed with his bedside manner. He tells me my blood work and enzymes are excellent. My x-rays show that my heart isn’t enlarged. (But wait! Every one tells me I have a huge heart.) And there’s no sign that I had a heart attack. We talk about the pacemaker and the procedure. He tells me it’s about the size of a silver dollar. (When I actually see the blasted thing the next day, just before they shove into my chest, I have to wonder where Dr. Williams gets his silver dollars.) The procedure is very routine; he tells me. “Yeah sure, for you maybe.” It’ll last approximately 45 minutes, during which I will be enjoying twilight anesthesia. “Twilight anesthesia, huh? That sounds delightful.” Better living through chemistry, I always say.
I get a sedative Thursday night to help me sleep in my little bed of torture. And nothing by mouth after midnight. (Oh no! Not that again.)
Friday morning my nurses prep me for surgery. First, they have to shave my manly chest, don’t cha know. Nurse Jen takes the lead with a maniacal gleam in her eye. This is more than a little awkward and also maybe a wee bit kinky.
Finally the fateful hour arrives. I get a second IV stent, because apparently one is not enough for these folks. Then I’m wheeled down to the bowels of the building where I disappear into one of the surgery suits.
Does this look like the size of a silver dollar? I don’t think so.
Two hours later I’m back in my room dopey as all get-out, but still kickin’.
I’m home now, i’m happy to report. They liberated me on Saturday, 07/30, afternoon. And I am only slightly worse for the wear. I have a very distinctive slash across my left pectoral. There’s an unsightly bulge just below it. It looks like i’m growing a third breast. And a nasty purple and brown bruise that runs from my shoulder to my sternum and from my collarbone to my nipple. I sound like a real attractive guy, huh?
The Moral Of The Story
My friends, life is short! Ought we not live every day like it’s our last? I think so. I have decided that I will try to be more kind to myself and those around me. Because, ya know what? In a twinkling of an eye, it can and most assuredly be over.