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A new way to love: in praise of polyamory

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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!

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How To Talk To Your Doctor About Sex When You Have Cancer

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More people are surviving cancer than ever before, but at least 60 percent of them experience long-term sexual problems post-treatment.

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So you’ve survived cancer. You’ve endured brutal treatments that caused hair loss, weight gain, nausea, or so much pain you could barely move. Perhaps your body looks different, too—maybe you had a double mastectomy with reconstruction, or an orchiectomy to remove one of your testicles. Now you’re turning your attention back to everyday life, whether that’s work, family, dating, school, or some combination of all of those. But you probably aren’t prepared for the horrifying side-effects those life-saving measures will likely have on sex and intimacy, from infertility and impotence, to penile and vaginal shrinkage, to body shame and silent suffering.

More than 15.5 million Americans are alive today with a history of cancer, and at least 60 percent of them experience long-term sexual problems post-treatment. What’s worse, only one-fifth of cancer survivors end up seeing a health care professional to get help with sex and intimacy issues stemming from their ordeal.

Part of the challenge is that the vast majority of cancer patients don’t talk to their oncologists about these problems, simply because they’re embarrassed or they think their low sex drive or severe vaginal dryness will eventually go away on their own. Others try to talk, but end up with versions of the same story: When I went back to my doctor and told him I was having problems with sex, he replied, ‘Well, I saved your life, didn’t I?’ And many oncologists aren’t prepared to answer questions about sex.

“Sex is the hot potato of patient professional communications. Everyone knows it’s important but no one wants to handle it,” says Leslie Schover, a clinical psychologist who’s one of the pioneers in helping cancer survivors navigate sexual health and fertility. “ When you ask psychologists, oncologists and nurses, ‘Do you think it’s important to talk to patients about sex?’ they say yes. And then you say, ‘Do you do it routinely?’ They say no. When you ask why, they say it’s someone else’s job.”

Schover spent 13 years as a staff psychologist at the Cleveland Clinic Foundation and nearly two decades at the University of Texas MD Anderson Cancer Center. After retiring last year, she founded Will2Love, a digital health company that offers evidence-based online help for cancer-related sex and fertility problems. Will2Love recently launched a national campaign called Bring It Up! that offers three-step plans for patients and health care providers, so they can talk more openly about how cancer treatments affect sex and intimacy. This fall, the company is collaborating with the American Cancer Society on a free clinical trial—participants will receive up to six months of free self-help programming in return for answering brief questionnaires—to track the success of the programs.

Schover spoke to Newsweek about the challenges cancer patients face when it comes to sex and intimacy, how they can better communicate with their doctors, and what resources can help them regain a satisfying sex life, even if it looks different than it did before.

NEWSWEEK: How do cancer treatments affect sex and intimacy?
LESLIE SCHOVER: A lot of cancer treatments damage some of the systems you need to have a healthy sex life. Some damage hormone levels, and surgery in the pelvic area removes parts of the reproductive system or damages nerves and blood vessels involved in sexual response. Radiation to the pelvic region reduces blood flow to the genital area for men and women, so it affects erections and women’s ability to get lubrication and have their vagina expand when they’re sexually excited.

What happens, for example, to a 35-year-old woman with breast cancer?
Even if it’s localized, they’ll probably want her to have chemotherapy, which tends to put a woman into permanent menopause. Doctors won’t want her to take any form of estrogen, so she’ll have hot flashes, severe vaginal dryness and loss of vaginal size, so sex becomes really painful. She’ll also face osteoporosis at a younger age. If she’s single and hasn’t had children, she’s facing infertility and a fast decision about freezing her eggs before chemo.

What about a 60-year-old man with prostate cancer?
A lot of men by that age are already starting to experience more difficulty getting or keeping erections, and after a prostatectomy, chances are, he won’t be able to recover full erections. Only a quarter of men recover erections anything like they had before surgery. There are a variety of treatments, like Viagra and other pills, but after prostate cancer surgery, most men don’t get a lot of benefit. They might be faced with choices like injecting a needle in the side of the penis to create a firm erection, or getting a penile prosthesis put in to give a man erections when he wants one. If he has that surgery, no semen will come out. He’ll have a dry orgasm, and although it will be quite pleasurable, a lot of men feel like it’s less intense than it was before. These men can also drip urine when they get sexually excited.

Why are so many people unprepared for these side-effects?
If you ask oncologists, ‘Do you tell patients what will happen?’ a higher percentage—like in some studies up to 80 percent—say they have talked to their patients about the sexual side-effects. When you survey patients, it’s rare that 50 percent remember a talk. But most of these talks are informed consent, like what will happen to you after surgery, radiation or chemotherapy. And during that talk, people are bombarded by so many facts and horrible side-effects that could happen, they just shut down. It’s easy for sex to get lost in the midst of this information. By the time people are really ready to hear more about sex, they’re in their recovery period.

Why is it so hard to talk about sex with your oncology team?
It takes courage to say, ‘Hey, I want to ask you about my sex life.’ When patients get their courage together and ask the question, they often get a dismissive answer like, ‘We’re controlling your cancer here, why are you worrying about your sex life?’ Or, ‘I’m your oncologist, why don’t you ask your gynecologist about that?’ Patients have to be assertive enough to bring up the question, but to deal with it if they don’t get a good answer. Sexual health is an important part of your overall quality of life and there’s nothing wrong with wanting to solve or prevent a problem.

What’s the best way for people to prepare for those conversations?
First, because clinics are so busy, ask for a longer appointment time and explain that you have a special question that needs to be addressed. At the start of the appointment, say, ‘I just want to remind you that I have one special question that I want to address today, so please give me time for that.’ Bring it up before the appointment is over.

Second, writing out a question on a piece of paper is a great idea. If you feel anxious or you’re stumbling over your words, you can take it out and read it.

Also, some people bring their spouse or partner to an appointment. They can offer moral support and help them remember all the things the doctor or nurse told them in answering the question.

So you’ve asked your question. Now what?
Don’t leave without a plan. It’s easy to ask the question, get dismissed, and say, I tried. Have a follow-up question prepared. For example, ‘If you aren’t sure how to help me, who can you send me to that might have some expertise?’ Or, ‘Does this particular hospital have a clinic that treats sexual problems?’ Or, ‘Do you know a gynecologist or urologist who’s good with these kinds of problems?’ If you want counseling, ask for that.

What happens if you still get no answers?
I created Will2Love for that problem! It came out of my long career working in cancer centers and seeing the suffering of patients who didn’t get accurate, timely information. When the internet became a place to get health info, it struck me as the perfect place for cancer, sexuality and fertility. Sex is the top search term on the Internet, so people are comfortable looking for information about sex online, including older people or those with lower incomes.

Also, experts tend to cluster in New York and California or major cancer centers. I only know of six or seven major cancer centers with a sex clinic in the U.S. and there are something like 43 comprehensive cancer centers!

We offer free content for the cancer community, including blogs and forums and resource links to finding a sex therapist of gynecologist. We also charge for specialized services with modest fees. Six months is still less than one session with a psychologist in a big city! We’re adding telehealth services that will be more expensive, but you’re talking to someone with expert training.

What can doctors do better in this area?
For health care professionals, their biggest concern is, ‘I have 40 patients to see in my clinic today and if I take 15 extra minutes with four of them, how will I take good care of everybody?’ They can ask to train someone in their clinic, like a nurse or physician’s assistant, who can take more time with each patient, so the oncologist isn’t the one providing sexual counseling, and also have a referral network set up with gynecologists, urologists and mental health professionals.

 

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I’m not that sexually experienced. How can I be more confident in bed?

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Buck up, champ: Feeling a little anxious about your sexual history (or lack thereof) is totally normal. Here are 10 ways to improve your sexual performance without having to have sex first.

by Vanessa Marin

Everyone has anxiety about being great in bed, but when you don’t have much sexual experience that anxiety can feel sky high. For some guys, that concern about experience turns into a horrible cycle: You don’t feel confident about your sexual experience, so you end up not having sex, and your experience level remains the same.

Here’s the good news: Experience is a good teacher, but you can still learn how to be great in bed without it. Here’s how.

1. Put it in context

As a sex therapist, I can tell you that just about everyone has self-confidence issues when it comes to sex—even people with a lot of experience. The insecurities are different from person to person, but they’re insecurities nonetheless. And keep in mind that many of the women you’re intimate with may be inexperienced or insecure as well. You’re certainly not alone.

2. Do your research

You can school yourself on how to have great sex without having any experience whatsoever. I also recommend Guide To Getting It On: Unzipped by Paul Joannides or The Big Bang by Nerve for general sex education topics like STIs and pregnancy prevention, anatomy, communication, and consent. She Comes First by Ian Kerner is a fantastic guide to the art of pleasuring a woman, and I recommend it to almost every man in my sex therapy practice. Come As You Are by Emily Nagoski is a great book about female sexuality in general.

One caveat: Don’t get your sex education from porn! Porn is meant to be entertainment, not education. Porn sex has very little resemblance to real sex. It’s all about angles, lighting, and editing. Most of the moves you see in porn simply won’t go over well in the real world.

3. Take care of your body

One of the best things you can do to improve your confidence is to take great care of your body. Sex is a physical act. Not only do you need endurance, but you also have to feel comfortable and confident in your own skin. You already know what you should be doing—eat right, get enough sleep, and exercise regularly. Exercise, in particular, can also have added sexual benefits, like increasing your sex drive and improving your erections and your orgasms.

Grooming is important too. Wear clothes that flatter your body and make you feel good. Get your hair cut and your beard trimmed. The better you feel about yourself and your body, the more confident you’ll feel in bed.

4. Masturbate

Yes, masturbation can improve your partnered sex life! Most men masturbate pretty thoughtlessly, zoning out to porn while they try to get the job done as quickly as possible. This actually serves to disconnect you from your body, and decreases your control over your erection and orgasm.

Instead, you can use masturbation to help increase your stamina. First, think of how long you’d like to last with a partner. That becomes your new masturbation session length. During that time, really pay attention to your body. Notice what it feels like when you start getting close to orgasm, and train yourself to back off when you’re on the edge.

You can also practice purposefully losing your erection, then getting it back again. This will help decrease anxiety about losing your erection with a partner.

5. Go slow

When you’re feeling anxious about sex, you’re more likely to rush. Lots of inexperienced men have the tendency to jump right to intercourse, but it’s so much more fun to take your time and go slow. Spend plenty of time on kissing, touching, and performing oral sex, and even slow down your physical movements. A slower pace will help dramatically decrease your anxiety levels.

Plus, keep in mind that most women feel more physical pleasure from oral sex and fingering than from intercourse, and a lot of women love being teased. She’ll appreciate your pace, too.

6. Focus on her pleasure

Being fantastic in bed means genuinely caring about your partner’s pleasure. It’s arguably the most important quality in a great lover. If you spend time specifically focusing on her body—taking your time with her, kissing her all over, fingering her, going down on her—you’re going to impress her way more than the guy who has a ton of experience but is selfish in bed. Plus, seeing the pleasure that you bring her will naturally help you feel more confident.

7. Treat her like an individual

I’m all about sharing sex tips and techniques, but the reality is that every woman likes different things. No one technique is going to work for every woman. This is great news for you because it shows that experience only goes so far. We’re all beginners when we have sex with someone brand new. Try to explore her body with openness and curiosity. Pay attention to how she responds to your touch. Does she moan? Does she start breathing more heavily? Does she arch her body toward you? Don’t be afraid to ask her what she wants or likes! One super-simple way to ask for feedback is to try two different things on her, and ask her, “Do you like it better when I do this or this?”

8. Keep it simple

So many men overly complicate sex, especially when they’re feeling anxious. Technique is important, but you don’t need to go crazy trying out a million different things on her. The key to female orgasm is actually consistency, not complicated tongue maneuvers or finger gymnastics. Switching things up usually throws her off and distracts her. Find something simple that seems to be working for her, and stick with it. Increase your pace and pressure gradually, but stick to the same basic technique.

9. Don’t think of it as a performance

One of the biggest mistakes that sexual newbies make is thinking of sex as a performance. They get overly fixated on the idea of maintaining a perfect erection, having the utmost control over their orgasms, and mastering their technique. But the truth is that no one likes feeling like they’re having sex with a robot. She doesn’t need you to perform for her like a circus animal. She wants to feel connected to you, and she wants to have fun. You can do that, even without any prior sexual experience.

10. Have a sense of humor

Sex is never perfect, no matter how much experience you have. Sex can be awkward, weird, and sometimes downright hilarious. You’re bound to try out a position that doesn’t work, bump foreheads, or get a cramp in your leg. Having a sense of humor is so important in those moments. If you can laugh it off, you’ll get back to the fun much faster.

Complete Article HERE!

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Tie Me Up, Tie Me Down

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Rope play is a great way to be a bondage top when you’re five-foot-five.

By Jorge Vieto

Consensual rope bondage, specifically as a top, is one of the most intimate types of play I’ve engaged in with other human beings in the realm of kink and BDSM.

The instant shift in power is a turn-on like no other for me. (Thankfully, it’s not hard to find folks willing to be tied up in this town.) However, when the person I’m interested in getting naked with has never been tied up, has limited experience, or is hesitant to be bound in my rope, things become a bit more intriguing. It’s my job to make being tied up with rope sound approachable, safe, sexy, and fun — and generally, that’s not hard to do. The art of negotiating a bondage scene with a “rope virgin” is what I call the chase.

Rope bondage binds me to another individual. If I am “showing my ropes” to someone I’ve never tied up before and who I just met for the first time, it instantly connects us. If I am tying up someone I have played with before, it brings us even closer. The amount of trust all my willing “victims” place in me shows their confidence in my skill is immense. They trust me so deeply as to let me take some, if not most, of their mobility away. They are left in a very vulnerable state — and to me, vulnerability is sexy as fuck.

Combining the power dynamic and vulnerability that’s inherently a part of consensual rope bondage together with the contrast of different body sizes together is extremely hot to me, especially if the person that I am tying up is much larger and taller than myself. The beauty of using rope, and often blindfolds, is that — once placed on my bound prize — I become any size their imaginations make me in their blind, immobilized state. Or, if they like, they can also relish the difference in size as well.

As a rope-bondage top, it doesn’t matter to me that I’m only five-foot-five and 120 pounds — nor does it matter that most of the folks I tie up in my encounters are men who are twice my size (and sometimes more). With enough rope and know-how, I can tie them down like the six-inch-tall Lilliputians tied down Gulliver during his travels. And as a bear and a chubby-chaser who happens to be shorter and smaller than most people I know, having rope skills make it easier to have sex with men who tower over me. These skills come in handy in so many ways, especially if you want to tie them down and use them as your personal dildo or mount them without having to bring out your stepstool. I’m sure you get the picture.

Chasing down such beautifully massive “prey” is hard work. So having the ability to tie them down easily and quickly for inspection, exposing their naughty bits for me to enjoy and explore, is important. I can engineer an instant “portable fuck sling” with rope. Making their whole ride a lot more comfortable and enjoyable is key. Comfort increases the chances they’ll spend at least a few hours in captivity, being teased, tortured with pleasure, and forced to blow multiple loads. Over the years, I’ve adapted to tying up bigger bodies, learned to use thicker and longer pieces of rope, and memorized a few quick ways to extend rope and work with different levels of flexibility or lack thereof. These are all important things if you enjoy tying not only bigger folks, but also folks with different mobility and flexibility concerns. Once my prized catch is secured in whatever rope contraption I’ve decided to put him in, the real fun begins.

One quarter of the fun comes from the chase, another quarter from tying down my catch, and another from figuring out what makes them moan with pleasure the loudest. The last quarter comes from deciphering how to get them close to coming, so that I can bring them to the cusp and stop! Then, I start the process of bringing them close to climax over and over again until they have no choice to blow their load. For many, simply having my crotch buried in their face while I jack them off is good enough. For others, stimulation with an electric butt plug and conductive pads on their cock does the trick. For others, a good old-fashioned ass pounding by yours truly is just what they need. I get off on helping someone else get off, so if none of the above activities is going to get the job done, chances are, I will be able find something that will. That’s if they want to get off; if bondage snuggles or 100 gentle kisses strategically placed on their body is all they need, then I can do that, too.

As long as they’re tied up.

Once I’m done with them, I can release them unharmed. They can then go back to their natural habitats, tired, sweaty, and weak, sporting big smiles on their faces.

Complete Article HERE!

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A new way to think about dementia and sex

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There’s an urgent need for a new ethic of dementia care that supports the facilitation of sexual expression.

By and

Persons living with dementia don’t have sex. Or they have weird sex. Or they have dangerous sex, in need of containment.

When it comes to dementia and sexuality, negative language and apocalyptic warnings abound. The aging population has been described in the media as a “rape case time-bomb.” Health practitioners often respond in punishing ways to sexual activity in residential care. And the sexual rights of persons living with dementia are largely ignored within residential care policy, professional training and clinical guidelines.

As critical social researchers, we argue that a new ethic of dementia care is urgently needed, one that supports the facilitation of sexual expression.

Practitioners and administrators often hold negative and judgmental attitudes about dementia and aged sexuality

Our research at the University of Toronto and the Toronto Rehabilitation Institute-University Health Network investigates embodiment, relationality, ethics and dementia. We are motivated by a shared concern about the reductive focus of dementia care on basic physical needs, and our desire to foster a more humane and life-enriching culture of care. We have explored how the sexualities of persons living with dementia are poorly supported in long-term residential care settings such as nursing homes.

Sex and dementia in the media

When we see persons living with dementia and sex linked in the media, it tends to be in high profile cases of

Institutional policies, structures and practices must support sexual expression.

alleged abuse. One example is the legal trial of Henry Rayhons, an Iowa lawmaker found not guilty of sexually abusing his wife who at the time was living with dementia in a nursing home. Another example is the wider investigation into sexual assaults in nursing homes in Ontario.

Vital as such investigations are to the safety of residents in long-term care, we rarely see sexual expression valued or as fundamental to human flourishing.

Our research has explored how these negative representations of the sexualities of persons living with dementia are also found within long-term residential care settings such as nursing homes.

Practitioners and administrators often hold negative and judgmental attitudes about dementia and aged sexuality. When faced with sexual activity, they can intervene in threatening and punishing ways. And long-term care policies, professional training and clinical guidelines tend to ignore the sexual rights of persons with dementia.

The problem with biomedical ethics

The sexualities of persons living with dementia are considered troubling partly because long-term care polices are shaped by biomedical ethics. This ethical approach relies on four core principles: autonomy, beneficence, non-maleficence and justice. These principles support intervening in residents’ sexual expression if it will cause harm to themselves or cause harm or offence to others.

However, this approach sets the bar for practitioners’ interference excessively high. It can restrict voluntary sexual expression by residents living with dementia in nursing homes.

Biomedical ethics also ignore the performative, embodied and relational aspects of ethical reasoning. It assumes that people are rational autonomous beings. It also assumes that self-expression, including sexuality, results only from cognitive and reflective decision making. Given that dementia involves progressive cognitive impairment, persons living with dementia may be unfairly discriminated against by this approach to sexual decision making.

A duty to support sexual expression

We use a model of relational citizenship to create an alternative ethic in which sexuality is seen as embodied self-expression. It is an ethic that recognizes human beings as embodied and embedded in a lifeworld. And one that views sexuality as an important part of being human.

Social and leisure activities supportive of the development of intimate relationships are essential within nursing homes.

This new ethic broadens the goals of dementia care. No longer do health professionals just have the duty to protect persons with dementia from harm. There is also a duty to support their right to sexual expression.

We argue that institutional policies, structures and practices must also support sexual expression. These should facilitate sexual rights. We must also introduce education for health professionals and the broader public — and policy initiatives to counteract the stigma associated with sexuality and dementia.

Social and leisure activities that are supportive of sexual expression and the development of intimate relationships are also essential within nursing homes.

Of course, protection from unwanted contact or sexual harm is still important. However, freedom of sexual expression should only be restricted when necessary to protect the health and safety of the individuals involved.

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