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Sit and Stay…Longer

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Podcasting will resume next week Monday with a swell Q&A Show. Today, however, I want to pay tribute to my long-time companion, Ginger The Dog, who died last Friday, one month shy of her 14th birthday. She was so much a part of my life that she often appeared in my posting and provided sound effects in numerous podcasts. Here’s one such posting, re-posted from January 2005. This particular column remains one of my most popular postings ever.

 

 

Anyone the least bit familiar with Dr Dick’s wacky household will know all about Ginger. For the uninitiated, Ginger is a 5 year old German Shorthair Pointer, who believes she’s the center of the universe and who daily runs the good doctor into the ground.24604.jpg Ginger is special. She’s no one’s pet — least of all mine.

She doesn’t even think of herself as a dog — except when she forgets herself and takes off after a squirrel or a rabbit. And she makes a point of reminding me, several times a day, that she doesn’t “belong” to me. Rather, it is I who have the great privilege to share a domicile with her. I tell you all of this by way of introducing today’s topic. No, it’s not bestiality, ferchrisake! It’s behavior modification and sexual response. Ya know — learning how to last longer.

Here we’ll discuss the remedy for that pesky premature ejaculation problem everyone is talking about. Ginger was a year and a half old when she moved in and took over the joint. She had been abandoned and was, for all intents and purposes, completely feral when she arrived. Once here, Dr Dick tried to imprint a more civilized behavior pattern on his new housemate using several tried and true dog-training methods. Which, for all intents and purposes, are simply behavior modification techniques for doggies.

Successful behavior modification is dependent on the consistency of the stimulus. Consistent stimuli — a command and a treat — are supposed to create the desired response —sitting and staying. Sadly, this approach wasn’t overly successful for Ginger and me. In fact, about the only one who got trained/modified was Dr Dick. Ginger remains blissfully resistant to all efforts to civilize her.

The following correspondents, we hope, will succeed in modifying their sexual response with greater ease than my attempts to train Ginger The Dog. What differentiates them from the dog is that each of my correspondents has the motivation to change. Ginger, on the other hand, has no such motivation. She thinks she’s perfect just the way she is.

Hey Doc,I have a major problem that I hope I could get some advice from you. It’s about my sexual issue. Whenever I’m having sex, I can’t control my nerves. It means I can’t relax. And I come too fast and rapidly. I can’t have foreplay or enjoy sex. Do you know any medications or anything that would help me to prevent this? I guess my problem is what people called “premature ejaculation”. I can ejaculate rapidly, at first I thought it was really good. But later I figured out that wasn’t good. And that it’s a sickness. Please help me. Hope to hear from you soon.Thanks Dylan

Hey Dylan,Your premature ejaculation concern is not a sickness. In fact, it’s a very common complaint. Learning to last longer is a relatively easy thing to accomplish if that’s really what you want. Motivation is key.Let’s start with how you jack-off. If I had to guess these little sessions are speedy affairs, right? Quick jack-off sessions, just to relieve sexual tension can be a good thing, but they are also modifying your sexual response and interfering with your partnered pleasure.

Premature_Ejaculation_ManIf your body is being sensitized to cuming quickly, like while jerkin’-off, then that’s how it will respond later, when you are at play with a partner.I suggest that you take a different approach to your self-pleasuring activity. Some, if not all, of your masturbation should be dedicated to full body masturbation. That is, while you’re diddlin’ yourself with the one hand, your other hand is busy exploring the rest of your body. The object is to play with the sex tension and move it around. Some people call this edge play or edging.

The object here is to avoid an ejaculation. Move the sexual energy all over your body, touch and pleasure your whole body while stroking you cock. A nice massage lotion will add to the enjoyment. Make this time last as long as you can. As you approach the point of ejaculation, stop stroking your dick and continue to play with another part of your body, your tits, ass hole, prostate, feet, etc. When the urge to cum subsides, you can start to stroke your dick again. Practice this method over and over until you can last 30 minutes.

Successful behavior modification is dependent on the consistency of the stimulus.5431362.jpg Consistent stimuli — full body masturbation — will create the desired response — lasting longer.You are teaching your body a new way to respond to sexual stimulation. This will no doubt also increase your stamina when you’re with a partner. When you’re having sex with a partner do the same thing as when you are masturbating. Encourage your partner to spread the sexual energy around. Discourage her/him from concentrating on your dick. Work at stalling your orgasm. If you’re getting close to cuming, have him/her turn his/her attention to another pleasurable activity.

Don’t get frustrated if you can’tt regain control over your sexual response right away. This is gonna take some practice, but I think it’s worth the effort. Once you mastered this technique, there are other more advanced methods that I can tell you about later.Good luck.

Hi Richard,

My question is in two parts. 1. How can I orgasm more quickly? 2. How can I orgasm easily when someone else is doing the stimulation?I know this question might sounds strange because many guys are trying to not cum too quickly.Here’s some background; over the years, I have gotten very in-touch with my physical sexual side. I have learned control the build up to orgasm and my orgasm. Having this control is amazing for the most part — it allows long periods of edge play, which I really enjoy.

However, the disadvantage is that I can’t easily orgasm quickly and usually can’t orgasm at all when someone else is doing the stimulation. These two limitations haven’t been a big concern until recently. My orgasm isn’t necessarily the most important part of sex for me. Unfortunately, many times my limitations are disappointing to a sex partner. He wants to see me cum and/or wants to make me cum. Both of these desires are totally understandable — I really enjoy doing the same for him.Is it possible for me to “learn” to cum more quickly and is it possible to “learn” how to cum from the stimulation of someone other than myself? Any suggestions or advice would be greatly appreciated!!

Jim

Hey Jim,

What an interesting predicament you present. As you suggest, I’m forever hearing from guys who have the opposite problem as you. They what to prolong their sex play before 180402.jpgcoming. Your message to me proves my point to them; our sexual response is altered, for good or for worse, by how we stimulate ourselves.Curious enough, the answer to your query resides in the detail you present about your particular sexual practices. Clearly, you have conditioned your body, and thus your sexual response cycle, to last a very long time, perhaps too long. I guess that’s the downside of long periods of edge play.

How does one remedy this? Gosh, you’ve conditioned yourself so successfully; there may be little you can do to reverse this.

Orgasms, as you know, are not things we can will to happen or not to happen. However, you could try to find a stroke or a type of stimulation that you could use to successfully bring yourself to climax. Concentrate on that stroke with the intention of getting yourself off ASAP. You would then have to show your partner(s) this technique if you wanted them to get you off. Just a thought, does ass play and prostate massage speed up your orgasm? It does for lots of other men. So if you’re not already doing so, perhaps you could incorporate some…or more of this.

What you’re gonna want to do here is reverse some of the conditioning you’ve done and relearn a new sexual practice or response. It can be done. Will it take determination? You betcha!

Good luck

Merrily We Roll Along!

Hey sex fans,

I hope ya’ll survived the holidays. I did! Although I can’t tell you how glad I am that all that nonsense is over.

Before we begin, I just want to remind you that my podcasts will resume next Monday, January 07. I have a slew of interesting questions that have been piling up over the past couple of weeks. So I can guarantee you it will be a juicy podcast. Don’t miss it!

Name: Fay
Gender: Female
Age: 23
Location: LA
I met this guy on the Internet and he seemed nice and all, but I wasn’t that turned on to him. All I remember is he was pretty nerdy and had really sweaty palms. We went out a couple of time, nothing serious. He just wasn’t my type. So I stopped responding to his calls. Last week I was out at this club with some friends and I saw Mr. Nerdy with this other chic. And I was like, wait a minute, that skank’s hornin’ in on my stuff! I know I wasn’t returning his calls, but still, I saw him first. It was like totally freaky, how they were all kissy-kissy right there in everyone’s face. What should I do?

Seriously? What should you do? How about getting a life. you vacuous twit? And Iwoman_screaming.jpg mean that in the nicest sort of way.

If you could just pull your head out of your ass long enough for you to listen to yourself; your misguided notions about dating and your fundamental lack of respect for the feelings of others would surly grate on you as much as it does me. Your mindless chatter is like fingernails on a blackboard. I mean REALLY!

Think about what you are suggesting here. You’re gettin’ all territorial about some guy you could barely bring yourself to give the time of day to and then blew off like he was excess baggage. You didn’t bother to take the time to look beyond his nerdy-ness and his sweaty palms like this other woman have done. Had you done so, you might have discovered what this other “skank,” as you so lovingly refer to her, has found. But ya didn’t!

Like most nerds, this guy probably developed other means of making himself attractive and interesting to compensate for his nerdy-ness. Maybe he’s got a big ol’ dick, or he’s great in the sack. Maybe he got a big bank account or maybe he simply has a handle on the basic social graces, something that you, dear Fay, have yet to grasp.

Your jealousy is neither cute nor charming. It does, however, mark you as self-centered and childish. For the most part, jealousy is a byproduct of a person’s lack of self-confidence and self-esteem. Here’s a tip: try and develop a healthier sense of self, so that you’ll mature into someone who can interact with others in a respectful manner that is befitting another human being.

Oh, and have a nice day!

Name: Joanne
Gender: Female
Age: 25
Location: Toronto
I’m 25, 5-foot-7 and weigh 105 pounds. I take care of my body by eating right and exercising regularly. My problem is that I hate the way I look. I am actually repulsed by my body. I take very brief showers and avoid the mirror as much as possible. I’m not a prude. Others being nude is fine with me. But my body image issues are hindering my sexual encounters. I always want to wear a shirt or have the lights off.

My current boyfriend says that if I trust him enough to sleep with him I should trust him enough to let him see me naked. He also has told me that we can’t continue seeing each other if this doesn’t improve. But I let him see every part of my nude body — just not all at once. So he knows I’m not hiding some monstrous deformity or anything. I guess I thought my boyfriend would be more sensitive to my fear and let me stay covered up. Do I owe him nudity?

Hold on there, girlfriend, you think your BF is being insensitive because he wants to enjoy your body in the buff…with the lights on? You think that he’s sticking around just to needle you about your phobia? Honey, get over yourself!

Do you honestly think that your body-positive BF oughta facilitate and participatecrystal_pussy.jpg in your pathology? Yeah, like why don’t we all just sink to the lowest common denominator? And here’s a tip, doll: you do have a monstrous deformity. Perhaps it’s not a physical deformity, but it sure enough is a psychological one.

I concur with your boyfriend; your relationship is on the line here. You need to get a handle on your hang-ups, darlin’, or you can just say good-bye to whatever sex and intimacy you may currently be enjoying.

Listen, I have a thing about sex and intimacy being a gift one gives another. So I ask you, how can you give yourself as a gift to anyone if you are disgusted with the gift you’re giving? And you’ll never convince me that your body issues aren’t seeping into and sabotaging the sex you may be having with your long-suffering BF. I’ll betcha you don’t let him get too close to the body parts you begrudgingly expose to him…when the lights are out.

Joanne, like I suggest above, being repulsed by your own body is a sign of a deep psychological problem. I’d suggest you get to the bottom of this with a sex-positive therapist right away.

When I encounter this sort of thing in my practice, inevitably my client and I discover a past body related trauma to be at root of his or her current disgust. Left untreated, this aversion could easily morph into a desire to do yourself harm. It’s a common enough phenomenon; so don’t let that happen.

And to your closing question about do you “owe” him nudity; what the fuck is that? Is your sexuality and the intimacy you share with your BF something to be bid and bargained for, like beads in a bazaar? Sex and intimacy is either a gift freely given or it’s coerced.

If you’re feeling coerced about being naked with the man who loves you, you’d better set him free and get thee to a nunnery.

NEXT, ANOTHER SEXUAL ENRICHMENT TUTORIAL

Finessing That Ass Fuck — A Tutorial For a Top

Without further ado, here’s dr dick’s long awaited seminar on being a great ass fuckin’ top. This is a companion piece to an earlier tutorial for you novice bottoms out there — Liberating the BOB Within (That’s Big Old Bottom).

closeup1.jpgThis tutorial is for anyone who is considering being a top in butt fucking sex, regardless of whether the meat injection is 100% prime or a beef substitute — like a strap-on dildo, these words of wisdom are for you.

Some people are not open to experimentation when it comes to their precious asshole. They think it’s gonna be painful, or worse…the mere idea grosses them out. First off, you don’t want to try toppin’ one of these folks. A good top should know it makes no sense at all to try to force, or worse belittle an unwilling bottom to give up his or her rosebud if he/she is not inclined to do so. This is simply a waste of everyone’s time. Because if you do succeed in gettin’ the unwilling bottom to relent and the attempted fuck confirms the bottom’s earlier suspicions that this activity is indeed painful and/or gross; you will have won the skirmish, but you will have lost the war.

Second, before a top commences a fuck of any kind he or she oughta considerfemale_buttfuck.jpg whose pleasure is primary in this particular fuck-fest. There is a big difference between fucking for the top’s pleasure, for the bottom’s pleasure, or for mutual pleasure. If a top is trying to finesse a novice bottom into exploring his/her ass, that top needs to resign him or herself to concentrating on the bottom’s pleasure first and foremost.

Start by getting the bottom comfortable being touched where the sun don’t shine. Lubricate your hand and massage the outside of his or her hole. Make some lazy little circles with your fingers and drive your bottom wild with desire. When her sphincter starts to quiver, as it surely will, slowly penetrate your bottom’s butt with a lubricated finger tip. After a few minutes of just hangin’ out down there with your finger in his poop chute, you can begin to slowly slide your finger in and out. When you’re fingerin’ someone for the first time, be sure to take your time. Allow his or her muscles to adjust to being penetrated. You might want to incorporate a thin vibrating dildo and/or some expert rimming to pave the way for bigger things.

fingering.jpgWhen a top fingers a bottom like this, he or she ought consider the width of his dick or her strap-on while doing so. For example, once your bottom can take two fingers comfortably and three fingers with a minimum of discomfort he or she is ready to take a modest sized cock or dildo inside. If you’re very well endowed or you plan to strap on a dildo that resembles a floor lamp, you’d better adjust this finger formula based on the width of your fingers and your equipment.

A clean asshole is a happy and fuckable asshole. Hygiene is essential for both tops and bottoms. Bottoms need to anally douche beforehand. And tops, once your cock or your strapped on dildo has been inside your bottom’s ass, don’t go puttin’ that thang anywhere else (mouth, pussy, whatever) until you’ve washed it with soap and water. Carelessness in the hygiene department is just inviting a very serious infection.

Tops, be sure to use a good lube and make sure you have your favorite condoms near to hand. Getting your bottom into the right position, one that is comfortable for both of you is paramount. There are way too many positions for me cover here, but when choosing a position, consider —

  • your preference
  • the bottom’s preference
  • your cock and/or dildo size
  • your body type, and the bottom’s body type.

femalebutthole.jpgYou may find that a pillow or two will help support and prop up the bottom in most positions.

Painful fucking is a sign that something is being done incorrectly. It is definitely not a sign from god that ass fucking itself is wrong. In most cases pain is due to a few predictable reasons: the bottom is too tense and is tightening up. The top is being impatient and is pushing too hard. There may not be enough lubricant. Or the cock or strap-on is too big for the bottom’s experience level.

Obviously. both top and bottom should be comfortable and feel at least some pleasure in the fuck. However, it’s perfectly fine, on occasion, to concentrate on one person’s pleasure over the pleasure of the other. Just make sure you both agree on who’s pleasure is gonna be the focus of any given fuck.

Topping is a skill like any other. Practice will improve your technique. And while practicing, invite and then listen to the feedback coming from your bottom.

Ok, let’s review.

  1. Always use a lubricant…and a lot of it. Water-based lubes are latex-compatible and highly recommended.
  2. Stop immediately if your partner asks you to stop. I’m not suggesting that you stop trying altogether; just don’t push yourself onto your bottom when he or she wants you to stop. Find the source of the problem lubrication, position, whatever, resolve the problem, then resume the fuck.
  3. Take it slow. There is no need to rush, especially if you’re experimenting with anal sex for the first time.
  4. A bottom’s desire to be fucked does not insure pleasurable cornhole-ing. It’s nice that he or she might want to surrender his or her ass, but that’s not gonna make it happen on its own.
  5. Always communicate with your bottom. Keep your communication playful and smutty.
  6. Tops, be open about what you want and how it’s feeling. “Oh baby, that’s right you’ve got such a tight hole. You want my big meat in your ass? Yes you do! Open up for daddy…or momma…as the case may be.” Get the picture?

Some experienced bottoms can orgasm with ass fucking alone. Women do so through pelvic muscle contractions, men because of pressure applied to their prostate.

inthehay.jpgOh, and here’s something you need to know. We all have two sphincter muscles. If you insert a finger about one half-inch into your ass and press your fingertip against the side you’ll find them both. There is less than a quarter-inch between them.

The external sphincter is controlled by the central nervous system, which means you can tense and relax this sphincter at will. The internal sphincter is quite different. This muscle is controlled by the autonomic nervous system making it involuntary. This muscle responds to fear and anxiety. It may cause your bottom’s hole to tense up automatically even if he or she is trying to relax.

Tops, remember the rectum is not straight (no pun intended). After the short anal canal that connects the asshole to the rectum, the rectum tilts toward the front of the body, sometimes as much as 90 degrees. That’s way some people are anatomically less suited to ass fucking than others.

Finally, the best attribute a top can have is his or her sense of humor about the whole friggin deal. Fucking ain’t as easy as it looks, at least not at first. But perseverance will win the day.

Good luck ya’ll

A Very Surprising Gift

Name: Shauna
Gender: Female
Age: 38
Location: Des Moines, IA
I work with this really terrific girl, who’s around 10 years younger than I am. Lately, even though I am happily married, I find myself awkwardly attracted to her. I am actually masturbating while fantasying about her. Like I said, I am married to a great guy and I don’t want to hurt him, but I have to get advice on this. I’m so confused.

Anytime there is a noticeable change in one’s eroticism, regardless at what stage of life it happens, the shift can be a bit disconcerting. Here you are, a mature, confirmed, card-carrying straight married lady who has an unanticipated crush on a much younger female coworker. That can’t be sitting very well in your buttoned down world there in the heartland, huh?Lesbian Bed Death2

I suppose you could view this as a major problem or you could accept this as a gift. That’s right, a gift. This surprising event, even at your seriously advanced age of 38, indicates to me that you’re still growing. Personally, I think that’s wonderful. The fates have gifted you with this sweet, young sexy female muse. You can either reject the fates and deny yourself, or embrace this opportunity to explore the yet uncharted areas of your sexuality.

Even if you never act on your same-sex sexual impulses, I think it’s safe to say you are finally encountering your latent bisexuality. Don’t be too surprised by that; most all of us are naturally bisexual in one fashion or another. Unfortunately, our sex-negative society discourages and disallows these very natural tendencies. So when they pop up, as often they do, we are usually unprepared to acknowledge them, let alone accept and welcome them. Will you cave to the pressures of the popular culture, or buck the social trend? I’m in no position to guess. All I know is that this relatively benign sexual adventure could be an opportunity to expand your sexual options.

Like I said, there are several ways to proceed. You could deny yourself the adventure and sublimate your desires. I don’t recommend this, because it rarely works. Healthy, natural feelings like the ones you’re having can fester and embitter the one practicing the self-denial. Another option is to go with the fantasy, enjoy it for what it is worth. Keeping your bisexual proclivities fantasy material allows you to remain safe and pretty much maintains the status quo. Then there’s the option of pursuing your fantasy and making it a reality. Obviously, this option carries the greatest potential for disrupting your life.

Wild girls wild nightsIf you choose the path of keeping your bisexual urges a fantasy, you might want to pursue them to see if you are attracted to other women. You could do this through reading some hot lezzi-themed erotica, or checkin’ out some swell (authentic) Sapphic porn. If you discover you are not interested in other women, but that you only have a jones for your charming coworker of yours; you may be a situational bisexual. Regardless if you are a “real” bisexual or a “situational” bisexual, imagine the fun you’ll have with your little secret. My only caution would be to treat your coworker the way you would treat any other coworker you might have a crush on — the best thing to do is; do nothing. Workplace flings, of any stripe, rarely turn out happily. And of course, you also have your marriage to consider. Fantasies are fine as long as they don’t fuck up your real-life relationships.

One other thing, don’t automatically assume your husband would be put off by your newly awakened sexual tastes. That is if you ever get around to telling him. It might actually be a big turn-on for him too. Most straight guys get off on the idea of two women together. Some husbands encourage their wives’ occasional bisexual encounters for this very reason. Your husband may even be interested in a threesome with you and another woman somewhere down the line. Again I advise that it not your coworker, though.

In the end, this is an exciting time for you, Shauna. Is it challenging? You betcha! But it’s also very rewarding.

Good luck

10 Mind Blowing Ways To Improve Your Sex Life Like You Never Have Before

By Sasha Godman

man & woman

It has never defined me as a person, but my sexuality is a big part of who I am, I’ve always considered myself lucky to be so sexually free, co-workers, one night stands, it was all for fun. No one got hurt and not once did I sense impending danger.

Then that way of thinking was totally obliterated. In saying that, I bounced back so fucking well, people that I’ve confided in ask me if I’m alright and they give me a look of disbelief because I’ve got a drink in one hand, a smoke in the other and a smile on my face. I am doing well. I’m reassessing not only what makes me happy, but what will make 2015 a year of unforgettable sex.

1. Forget porn.

Un-see everything you’ve typed into your pornhub search. You don’t have headphones in, trying to fap as silently as possible, you’re with a living, breathing person, kiss everything, nibble everything, lick everything, in saying that…

2. Communicate.

Your clit isn’t as sensitive as he may assume? The best kind of hand job involves the mouth? We’re not mind readers, orgasms are so much more achievable when we abandon our embarrassments and outline what gets our rocks off.

3. Foreplay matters yo.

As much as I just want to climb on top of my boyfriend the moment I see him after a week hiatus, it’s not only hotter, but healthier (and a higher chance of orgasming!) to lengthily explore each others bodies before undergoing the main event.

4. Embrace lube!

I’m a little bit embarrassed to admit that I was just shy of my 23rd birthday before I even thought about purchasing a bottle of lube, but all I know now is that hand jobs will never be the same again. Just sayin’.

5. Look each other in the eye.

Whether it’s a casual hook-up or the culmination of a long awaited encounter with someone you deeply care about, sex reaches an incredibly intimate level when we forsake our anxieties over the dumb cum faces we’re pulling and we can actually look at the person we’re sharing pleasure with.

6. Sober sex is best sex.

Sure there is an indescribable level of horniness that alcohol seems to boost, but sober sex is 100% more focused and less sloppy.

7. Conjure a fuck-it list.

Why keep things private? Whether it’s a sacred document you’ve created with a partner or you have solo fantasies that you want to embark on, what’s the worst that could happen? Sex in the back row of the Foxcatcher screening* wasn’t as hot as I thought it would be, oh well, we tried! Tick!

*I am in no way encouraging sex in Events Cinemas or any other dignified establishment; these expeditions are just the spice of life and are not completely unheard of.

8. You’re not an Olympian.

Some positions work better than others, but it’s not always necessary to incorporate as many switches as possible, you’re not in a marathon. See number 2.

9. We’re all perverted little humans.

Can I take a photo while I’ve got you all tied up? Being attentive to each others desires is key to awesome sex, that and consent.

10. Sometimes sex doesn’t happen.

Sometimes he’s not hard enough, she’s not wet enough, sometimes it’s just nicer to hold hands or dry hump ourselves into bliss.

Sex can mean as a little or as much as you want it to, all I’ll say is that being comfortable within yourself should hit a big, mandatory tick before you embark on your ventures.

Complete Article HERE!

Doctors urged to advise patients about risks of abstinence-centric sex education

American Academy of Pediatricians’ new report is the clearest denouncement of the failures of not talking about STIs and pregnancy prevention

Across the US only 50% of high school students receive sex education that meets the recommendations of the federal Centers for Disease Control and Prevention.

Across the US only 50% of high school students receive sex education that meets the recommendations of the federal Centers for Disease Control and Prevention.

By

The country’s largest organization of pediatricians entered fraught political territory on Monday, with a call for doctors to use their time with patients to combat the potential health consequences of abstinence-centric sex education.

In a new report, the American Academy of Pediatricians (AAP) issued its clearest denunciation yet of sex education programs that fail to offer comprehensive information on topics such as sexually transmitted infections (STIs) and pregnancy prevention.

“This is the mothership telling pediatricians that talking about sex is part of your charge to keep children and adolescents safe,” said Dr Cora Breuner, a professor and pediatrician at Seattle Children’s research hospital and the report’s lead author.

“These guidelines give pediatricians in communities where people might say, ‘We don’t want you talking to our kids about this stuff,’ permission to say, ‘No, I can talk about this, I should talk about this, I need to talk about this.’”

The report is broadly a call for pediatricians to help fill in the gaps left by the country’s patchwork sex education programs. It urges pediatricians to teach not only contraception and the benefits of delaying sexual activity, but to cover topics such as sexual consent, sexual orientation and gender identity with school-aged children who may not receive any information in the classroom and involve their parents.

But the authors single out abstinence-heavy education, which sometimes excludes information about contraceptives, as a key concern for doctors looking to help adolescent patients avoid sexually transmitted infections and unintended pregnancy. As a result, it is likely to fuel an already contentious debate.

Groups that have advocated for sex education to emphasize abstinence instantly found fault with the new guidelines.

“A health organization like the AAP should not be affirming a behavior that can compromise the health of youth,” said Valerie Huber, the president of Ascend, a group that promotes abstinence-centric sex education and advocates for federal funding. The group was formerly known as the formerly the National Abstinence Education Association.

“They recommend ‘responsible sex’ for young adolescents. Exactly what is responsible sexual activity for adolescents? … The science is clear that teens are healthier when they avoid all sexual activity.”

Moreover, Huber said, programs that “normalize teen sex” are unpopular with many parents.

“Most communities do not support the type of sex education they recommend,” she said.

Still, others embraced the report as bringing the AAP’s recommendations more in line with the reality.

“This is a fantastic move,” said Chitra Panjabi, the president of the Sexuality Information and Education Council of the United States (SIECUS), a research group that supports comprehensive sex education. “It’s really important that our medical providers are standing up and saying, hey, the youth in our communities are coming to us because they’re not getting the information they need. And so we need to step in.”

The US does not enforce national standards for sex education and schools in many states are not required to teach it. Across the country, SIECUS estimates, only 50% of high school students receive sex education that meets the recommendations of the federal Centers for Disease Control and Prevention. The other half of students receive anything from an incomplete sex education, to education that emphasizes abstinence, to abstinence-only education, with a focus on delaying sex until heterosexual marriage.

In February, Barack Obama proposed a budget for 2017 that eliminated the $10m the department of health and human services spends on abstinence-only programs every year. But funding continues to flow to those programs from other sources. Title V, an abstinence-only program, allocates $75m a year to abstinence-only programs, money that states match by 75%.

In the last quarter-century, programs emphasizing abstinence as the optimal way to avoid pregnancy and STIs have received more than $2bn in funding from the federal government. Comprehensive sex education, by contrast, has no dedicated federal funding stream.

“It’s a political climate where people don’t want to talk about these issues,” said Breuner. “But it makes our job so much harder when we cannot coordinate our efforts with the schools. It takes time away from the other safety issues we need to be discussing. Don’t smoke weed. Don’t text and drive.”

Recently, two major surveys of existing research on sex education concluded that there was no evidence or inconclusive evidence to show that abstinence-centric programs succeeded in delaying sexual activity. One of the surveys found that comprehensive sex education was actually more effective than abstinence education at delaying sexual activity in teens. (Ascend points to select studies which show the opposite.)

A long-term study found that teens receiving abstinence-only programs were less likely to use contraceptives or be screened for STIs, although rates of infections were not elevated.

The studies helped compel the AAP to issue its first major guidance on sex education since 2001.

“It’s important for pediatricians to have the backing to say, ‘Look, I can’t support telling this stuff to children,’” Breuner said. “I have to deal with the aftermath, which is a 15-year-old who’s pregnant, or a 16-year-old who has a sexually transmitted infection he’s going to have for the rest of his life.”

Breuner said a number of her patients have suffered consequences from abstinence-only education. Many of them are pregnant teenagers and girls who, in the absence of accurate information, came to believe in common myths about pregnancy prevention.

“They’ll say, ‘I thought you couldn’t get pregnant when you were having your period,’ or, ‘I thought it took two or three years after you get your period to be able get pregnant.’ It’s heartbreaking, because I know with education, this could have been prevented.”

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