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For Some With Intellectual Disabilities, Ending Abuse Starts With Sex Ed

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Katy Park, who runs arts and wellness programs for Momentum — a community service program for people with intellectual disabilities — starts a class on healthy sexuality by asking her students to define what they want in a relationship.

by Joseph Shapiro

In the sex education class for adults with intellectual disabilities, the material is not watered down. The dozen women and men in a large room full of windows and light in Casco, Maine, take on complex issues, such as how to break up or how you know you’re in an abusive relationship. And the most difficult of those issues is sexual assault.

Katy Park, the teacher, begins the class with a phrase they’ve memorized: “My body is my own,” Park starts as the rest join in, “and I get to decide what is right for me.”

People with intellectual disabilities are sexually assaulted at a rate more than seven times that for people without disabilities. NPR asked the U.S. Department of Justice to use data it had collected, but had not published, to calculate that rate.

At a moment when Americans are talking about sexual assault and sexual harassment, a yearlong NPR investigation finds that people with intellectual disabilities are one of the most at-risk groups in America.

“This is really an epidemic and we’re not talking about it,” says Park, a social worker who runs arts and wellness programs for Momentum, an agency based in Maine that provides activities in the community and support services for adults with intellectual disabilities. Those high rates of abuse — which have been an open secret among people with intellectual disabilities, their families and people who work with them — are why Park started this class about healthy relationships and healthy sexuality.

Because one of the best ways to stop sexual assault is to give people with intellectual disabilities the ability to identify abuse and to know how to develop the healthy relationships they want.

“Let’s talk about the positive parts of being in a relationship,” Park says, holding a marker while standing at a whiteboard, at the start of the class. “Why do we want to be in a relationship?”

“For love,” says one man. “And sexual reaction.”

“Romance,” adds a woman.

“How about support?” asks Lynne, a woman who speaks with a hushed voice and sits near the front of the class.

“Having support, right?” Park says, writing the word on the board. “We all want support.”

A participant helps Park hang the agenda on the wall at the start of class.

From working with the men and women here, Park realized they want to have relationships, love and romance. They see their parents, siblings and their friends in relationships. They see people in relationships when they watch TV or go to the movies. They want the same things as anyone else.

But it’s harder for them. When they were in school, most of the adults in this room say, they didn’t get the sex ed classes other kids got. Now, just going on a date is difficult. They probably don’t drive or have cars. They rely on public transportation. They don’t have a lot of money. They live at home with their parents or in a group home, where there’s not a lot of privacy.

And then there’s the one thing that really complicates romance for people with intellectual disabilities: those high rates of sexual abuse.

“Oftentimes, it actually is among the only sexual experience they’ve had,” says Park. “When you don’t have other healthy sexual experiences, how do you sort through that? And then the shame, and the layers upon layers upon layers.”

This class, she says, is about “breaking the chain, being empowered to say, ‘No. This stops with me.’ “

“I Think People Take Advantage”

The women and men come to Momentum during the week for different programs. They go kayaking and biking; they go to the library and do volunteer work at the local food bank. There’s a range of disability here. You can look at some of the men and women — maybe someone with Down syndrome — and see they have a disability. Others, even after you talk to them, you might not figure out they have an intellectual disability.

Like one small woman with short, choppy dark hair, streaked red.

She’s 22 now, but when she was 18, her boyfriend was several years older. She says he was controlling. He didn’t let her have a cellphone or go see her friends.

“He was strangling me and stuff like that,” says the woman. (NPR is not using her name.) “And he was, the R-word — I hate to say it, but rape.” She says he raped her eight times, hit her and kicked her. “So I don’t know how I’m alive today, actually. He choked me where I blacked out.”

She thinks she was an easy target for him, because of her mild intellectual disability. “I think people take advantage,” she says. “They like to take advantage of disabilities. I have disabilities, not as bad as theirs. But I think they like to take advantage, which is wrong. I hate that.”

A student takes notes in Park’s Relate class.

She says the class helped her better understand what she wanted, and had a right to, in a relationship. She’s got a kind and respectful boyfriend now.

Her friend Lynne listens and says she would like to find a boyfriend. But in her past, she has experienced repeated sexual abuse.

She talks about a time when she was 14 and “this older guy that knew us” forced her to have sex. She says she told people but no one believed her. The next year, when she was 15, she was sexually assaulted — this time by a boy at her school. “I was trying to scream,” she says, “but I couldn’t because he had his hand over my mouth, telling me not to say anything to anybody.”

Lynne, who is 38, says those rapes and others left her unable to develop relationships. “I couldn’t trust anyone,” she says. Lynne (NPR has agreed to identify her by her middle name) says this class has helped her realize she wants a real, romantic relationship and has taught her how to better find one.

“There’s A Lot Of Loneliness”

Katherine McLaughlin, a New Hampshire sex educator, developed the curriculum used by Momentum. She wrote it so that it uses concrete examples to describe things, to match the learning style of people with intellectual disabilities. It shows pictures and uses photographs.

McLaughlin says the main desire of adults with intellectual disabilities is to learn “how to meet people and start relationships. There’s a lot of loneliness.”

That loneliness leaves them vulnerable to getting into abusive relationships, she says, or to rape.

Sometimes, especially when they’re young, they can’t name what happened to them as a sexual assault. Because they didn’t get the education to identify it. “We don’t think of them as sexual beings. We don’t think of them as having sexual needs or desires,” McLaughlin says. “Often they’re thought of as children, even when they’re 50 years old.”

Sheryl White-Scott, a New York City internist who specializes in treating people with intellectual disabilities, estimates that at least half of her female patients are survivors of sexual assault. “In my clinical experience, it’s probably close to 50 percent, but it could be as high as 75 percent,” she says. “There’s a severe lacking in sexual education. Some people just don’t understand what is acceptable and what’s not.”

Most of the women and men at the class in Maine say they didn’t get sex ed classes, like other kids, when they were in school. Or if they did, it was the simplistic warnings, like the kind given to young children. “It’s easy to fall back on ‘good touch-bad touch’ sex ed,” says Michael Gill, the author of “Already Doing It: Intellectual Disability and Sexual Agency.” “That’s a lot of what they get.” And the usual warning about “stranger danger” can be unhelpful, because it’s not strangers but people they know and trust who are most likely to assault them.

Most rapes are committed by someone a victim knows. For women without disabilities, the person who assaults them is a stranger 24 percent of the time. NPR’s data from unpublished Justice Department numbers show the difference is stark for people with disabilities: The abuser is a stranger less than 14 percent of the time.

“Parents get this; professionals don’t,” says Nancy Nowell, a sexuality educator with a specialty in teaching people with developmental disabilities, an umbrella term that includes intellectual disability but also autism.

Park asks her students to weigh in on agreements with a thumbs up or a thumbs down during class.

Parents have significant reason to worry: Figuring out what’s a healthy relationship is difficult for any young person, and it can be even trickier if a person has an intellectual disability. People with intellectual disabilities are vulnerable to problems from rape to unwanted pregnancy. Some people with intellectual disabilities marry. A small number have children — and rely on family or others to support them as parents.

Still, says McLaughlin, parents often are reluctant to talk to their children with intellectual disabilities about sex. “Parents often feel, if I talk about it they will go and be sexual,” she says, and they fear that could make them targets for sexual assault.

But educators such as McLaughlin, Gill and Nowell argue the reverse: that comprehensive sexuality education is the best way to prevent sexual assault. “If people know what sexual assault is,” says Gill, an assistant professor of disability studies at Syracuse University, “they become empowered in what is sexuality and what they want in sexuality.”

Respect

Gill argues that a long history of prejudice and fear gets in the way. He notes early 20th century laws that required the sterilization of people with intellectual disabilities. That came out of the eugenics movement, which put faith in IQ tests as proof of the genetic superiority of white, upper-class Americans.

People with intellectual disabilities were seen as a danger to that order. “Three generations of imbeciles are enough,” Supreme Court Justice Oliver Wendell Holmes famously wrote in a 1927 opinion that ruled the state of Virginia could forcibly sterilize a young woman deemed “feebleminded.”

Carrie Buck was the daughter of a woman who lived at a state institution for people with intellectual disabilities. And when Buck became pregnant — the result of a rape — she was committed to a state institution where she gave birth and was declared mentally incompetent to raise the child. Buck was then forcibly sterilized to prevent her from getting pregnant again. There was evidence that neither Buck, nor her daughter, Vivian, was, in fact, intellectually disabled. In the first half of the 20th century, impoverished women who had children outside marriage were often ruled by courts to be “feebleminded.”

There was another myth in popular culture that people with intellectual disabilities were violent and could not control their sexual urges. Think about that staple of high school literature classes, John Steinbeck’s “Of Mice and Men.” The intellectually disabled Lennie can’t control himself when the ranch hand’s wife lets him stroke her hair. He becomes excited, holding her too tight, and accidentally strangles her.

The class in Maine aims to help these adults know what’s a healthy relationship and how to communicate how they feel about someone.

The main way this class differs from a traditional sex ed class is that — to help people with intellectual disabilities learn — the material is broken down and spread out over 10 sessions. Each class lasts for 2 1/2 hours. But the adults in the class are completely attentive for the entire session.

They do take a couple of very short breaks to get up and move around, including one break to dance. Everyone gets up when Park turns on the tape recorder and plays — just right for this group asking to be treated like adults — Aretha Franklin singing “Respect.” There is joyous dancing and shouts. And when the song is over, they go back to their seats and get back to work.

Complete Article HERE!

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9 Sex Resolutions Every Woman Should Make for the New Year

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By Danielle Friedman

For those of us who make New Year’s resolutions, we too often focus on doing less—eating less sugar, drinking less booze, spending less time in pajamas binge-watching The Crown. And while those goals may be worthy (though, really, The Crown is pretty great), this year, we’d also like to encourage women to do more—when it comes to pleasure.

As research consistently shows, the “orgasm gap” between men and women is real. A study published this year in the journal Archives of Sexual Behavior found that, while 95 percent of heterosexual men said they usually-to-always orgasm when sexually intimate, only 65 percent of heterosexual women said the same. Meanwhile, along with simply feeling good, orgasms bring an impressive list of health benefits, from decreased stress to better sleep. “There’s freedom in pleasure,” Kait Scalisi, MPH, a sex educator and counselor and instructor at the Institute for Sexual Enlightenment in New York City, tells Health.

Convinced yet? We culled sexual health research and called on Scalisi’s expertise to bring you nine tips for getting the pleasure you deserve in 2018.

Carve out time for solo pleasure

If masturbation feels self-indulgent, that’s because it is—in the best way possible. Still, in a recent national survey out of Indiana University, one in five women said they had never masturbated in their lifetime—and only 40.8% said they had masturbated in the past month. In the year ahead, consider devoting more time exclusively to solo sexual satisfaction.

“The more you learn about your body and what feels good—and what doesn’t feel good—the more you can bring that into partner sex,” says Scalisi. And if you aren’t having sex with a partner, well, “the more you are able to bring yourself oodles of pleasure.”

Try a vibrator

Thanks to lingering stigmas around sex and pleasure, many women still feel too shy to purchase a vibrator. But research shows this is changing: In the same Indiana University survey, about half of women said they had used a sex toy. And that’s a good thing!

“Vibrators give us one more way to explore what feels good and what doesn’t,” says Scalisi. And the more methods we experiment with, “the more flexible we’ll be in terms of our ability to experience pleasure.” If you haven’t given one a whirl, why not start now?

Focus on foreplay

For the majority of women, research has shown that intercourse alone isn’t enough to orgasm—but a little bit of foreplay can go a long way. “One of the most common things I hear from clients is that [sex moves] too fast, from kiss kiss to grab grab,” says Scalisi. “Most women need time to transition from their day to sexy time. And that’s really what foreplay allows.”

Foreplay can start hours before the act. “When you say good-bye in the morning, have a longer, lingering hug,” she says. Send flirty texts during the day, or read or listen to erotic novels on your commute. As for in-the-moment foreplay, make time for kissing, touching, and massaging. “That allows the body to really experience a higher level of pleasure, and then satisfaction.”

Resolve to never fake an orgasm

If you’ve faked it during sex, you’re not alone. But chances are, if you’re feigning an orgasm, whether to avoid hurting a partner’s feelings or to hurry sex along, you’re missing out on having a real one. And if you want to be having a real one, that’s a situation worth remedying. “If [your partner isn’t] stimulating you in the way you enjoy, have that conversation,” says Scalisi. Maybe not in the heat of the moment, but at a later time when you’re feeling connected.

Don’t apologize for body parts you don’t like

When we’re self-conscious about our bodies during sex, we’re distracted from the act itself—and when we’re distracted, research shows, the quality of sex can suffer.

“So much of what impacts sex has nothing to do with the mechanics of sex,” says Scalisi. A very worthy goal for sex in 2018 is to “learn to be with your body as it is. You don’t necessarily have to be totally in love with it, but just be with it as it is. That allows you to be present, and to process sensation in a more pleasurable way.”

Try a new move or position

Changing up your sexual routine can feel daunting if you’re not especially sexually adventurous, but a tiny bit of risk can bring big rewards. Just the act of trying something new together can help you feel more connected to your partner, “no matter how it turns out!,” says Scalisi. “It can be a tweak to a position that you already know and love or an entirely new position. It can be as big or as small, as adventurous or as mundane, as you and your partner are comfortable with.”

Discover a new erogenous zone

Women’s bodies are filled with erogenous zones—some of which you may only stumble upon if you go looking! (Did you know the forearm ranks among women’s most sensitive parts?) “Have a sexy date night in,” says Scalisi. “Strip down and take the time to explore your partner’s body from head to toe. … The goal here is not orgasm. The goal is to answer the question: What else feels good? What else turns me on?”

Watch woman-directed porn

When women call the shots in porn—literally and figuratively—the final product tends to be “a bit more realistic and a bit more body- and sex-positive” than male-directed porn, says Scalisi, “and that means you can see a bit more of yourself of it.” Not only is women-directed porn excellent for stoking desire and arousal, but it can also inspire new ideas for your IRL sex life.

Speak up if you’d like your partner to touch you differently

It doesn’t have to be awkward! And even if it is, it’s worth it in the long run. “If you’re in the moment, rather than focus on the negative stuff, focus on what would feel good,” says Scalisi. “So rather than say, ‘I don’t like that you’re doing this,’ say ‘It would feel so good if you stroked me softly.’” Then, later, consider having a conversation about your likes and dislikes.

Complete Article HERE!

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Why do half of women have fantasies about being raped?

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There’s a wide range of sexual fantasies people have, ranging from entirely unrealistic to applicable to real life, sex with Superman through to banging on a plane.

But the fantasy of being raped, also known as nonconsent and forced sex fantasies, is common.

Sexual fantasies let you explore your sexuality, they’re what we use to get off in those harsh, cold wifi-free winters, and we get to use them in roleplay scenarios to make our sex lives even more fulfilling.

But this common fantasy is one that few of us feel comfortable sharing. It puts people on edge and makes us feel a bit wrong.

Recent research indicates that between 31% and 57% of women have fantasies in which they are forced into sex against their will. For 9% to 17% of those women, rape fantasies are their favourite or most frequent sexual fantasy.

It’s natural if that makes you feel alarmed.

In real-life contexts, rape – meaning sex against your will – is deeply traumatising. It’s not at all ‘sexy’. It’s an intense violation that causes high levels of distress.

Content warning: Those who find discussions of rape and sexual assault may find this article triggering. 

It seems strange that we’d use rape as the basis for our sexual fantasies – and yet so many of us do.

And it’s incredibly important to note that while rape fantasies are common, this does not mean that women secretly want to be raped. There is a huge difference between acted out role-play, imagined scenarios, and real-life experiences. No one asks to be raped, no one deserves to be raped, and how common forced sex fantasies are in no way justifies unwanted sexual contact of any nature.

It’s difficult to know exactly what these fantasies entail, because, well, they’re going on in someone else’s mind.

But the women we spoke to mentioned that their fantasies of forced sex steered away from experiences that would be close to reality.

Rather than lines of consent being crossed by friends or bosses, we fantasise about high drama situations in which we are forced to have sex to survive, entering into sexual contracts rather than having our right to consent taken away from us outright.

Amy*, 26, says a common fantasy is being kidnapped and held hostage, then having one of the guards forcing her into sex to keep her safe.

Tasha, 24, fantasises about thieves breaking into her house and being so attracted to her they have to have sex with her against her will.

In both scenarios, the women said they start out by resisting advances, then begin to enjoy the sex midway through. It’s giving up the fight and giving in to desire that’s the turn on, rather than the very real trauma of real-life rape.

But for other women, fantasies are more true to life. For some it’s not about feigned struggle, but imagining consent and control being ripped away as a major turn on.

Why is this? Why are so many of us aroused by forced sex when we’d be horrified by the reality of it? Why do we find the idea of rejecting sex then doing it anyway a turn on?

Dr Michael Yates, clinical psychologist at the Havelock Clinic, explains that there are a few theories.

The first is that women’s fantasies of nonconsensual sex are down to lingering guilt and shame around female sexuality.

‘For centuries (and sadly still all too regularly today), young women are taught to hide sexual feelings or encouraged to fit narrow gender stereotypes of the acceptable ways that female sexuality can be expressed in society,’ Michael tells Metro.co.uk. ‘As a result sex and sexual feelings are often accompanied by anxiety, guilt or shame.

‘One theory is that rape fantasies allow women to reduce distress associated with sex, as they are not responsible for what occurs, therefore have less need to feel guilt or shame about acting upon their own sexual desires or feelings.’

Essentially, lingering feelings of shame around taking agency over our own sexual desires can make us want to transfer them on to another body, thus giving us permission to fantasise about sexual acts. In our minds, it’s not us doing it, it’s all the other person, meaning we don’t have to feel guilty or dirty.

This explains why most rape fantasies don’t tend to be extremely violent, and why the women I asked reported resisting at first before having an enjoyable experience (which real-life rape is definitely not).

‘More often than not, most people who have rape fantasies imagine a passionate scene with very little force, based around the “victim” being so desirable that the “rapist” cannot control themselves, while the victim generally does not feel the terror, confusion, rage and disgust of an actual rape,’ says Michael.

The second theory is down to the dominant narratives shown in media and porn. It’s suggested that because our media and porn so often show men being dominant and losing control around a meek, deeply attractive woman, that’s simply how we envision ideal sex in our fantasies.

Take a flip through classic erotic literature, or even just look at the covers, and you’ll be confronted by strong men grabbing weak, swooning women.

‘Although rarely do these novels portray rape or sexual assault explicitly, they do play into the idea of a female sexual role as succumbing to the dominant role of male sexuality,’ notes Michael. ‘One whereby men can act upon their sexual urges at the point they choose (with the female having little power to object).’

So that might be the why – but what about the who? Does having fantasies about being raped mean anything about us? Are certain types of women more likely to have fantasies of being raped?

As with most sexual fantasies, it’s really not something to panic about.

Complete Article HERE!

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Japanese macaques grinding on deer can teach us to be more open-minded about sex

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So if macaques do it, dolphins do it, birds and probably even bees do it, why do humans still have so much difficulty talking about sexual pleasure?

by Lux Alptraum

If you grew up in America, there’s a good chance that you learned that sex is, first and foremost, a reproductive act. Sure, it feels good, but that’s just a way for our bodies to trick us into breeding. Many church doctrines will inform you that any sexual experience that doesn’t stand a chance of resulting in pregnancy is sinful, perverse, and unnatural.

But someone might want to tell that to nature.

A recently released study documented multiple instances of adolescent female macaques in Japan having “sexual interactions” with sika deer – or, not to put too fine a point on it, macaques humping the backs of deer like a pre-teen girl with a pillow. Researchers are still trying to figure out why the monkeys are doing this, as NPR explains: “It might be a way for a less-mature monkey to practice for future sex with other monkeys,” or an option for a monkey that doesn’t have any other sexual partners at the moment. It’s also possible that the monkeys, which hitch rides on deer for non-sexual reasons, too, simply discovered by accident that grinding on the deers’ backs felt good.

The discovery has prompted a lot of marveling from the media. But if you’re surprised to learn that animals like to pleasure themselves, you’re not paying attention. There are numerous documented instances of animal masturbation, a habit enjoyed by primates as well as creatures including dolphins, elephants, penguins, and bats. (Although the role of the sika deer adds a layer of complexity: Can a deer consent to interspecies frottage? “Most deer were nonchalant, continuing to eat or stand passively during the thrusting,” Quartz observes.)

It’s impossible for us to know exactly what the deer think about all this. That matter aside, there are a lot of animals out there who are, if you will, spanking the monkey. So if macaques do it, dolphins do it, birds and probably even bees do it, why do humans still have so much difficulty talking about sexual pleasure?

Even those of us who’ve gotten past the idea that sex outside the bonds of heterosexual marriage is a one-way ticket to hell still have difficulty talking about pleasure. Sex education curricula rarely venture beyond discussions of condoms, birth control, and puberty (if they even cover condoms and birth control); for many of us, the idea of discussing masturbation seems particularly prurient and unseemly. It’s been twenty-three years since Jocelyn Elders was forced to resign from the post of surgeon general in the US after daring to suggest that young people be taught to think of masturbation as a form of safer sex. And in spite of all the progress we’ve made since the early 1990s, it’s still hard to imagine a government official coming out in favor of masturbation. (Not that I necessarily want to hear a member of the Trump Administration talking about double-clicking the mouse.)

Our reticence on the subject of masturbation is particularly damaging for women. Copious amounts of ink have been spilled about the gender orgasm gap, with lots of hand-wringing about how straight men are letting their female partners down in bed. But it’s not just straight male selfishness that fuels the orgasm gap. One of the main reasons why women are less likely to find pleasure in bed is that we rarely discuss the tools to access our own pleasure, or even an understanding that pleasure can, and should, be a primary goal in our sex lives.

When sexual pleasure is discussed, it’s almost always from a straight male perspective, rationalized as an added bit of biological incentive intended to encourage men to spread their seed. As Peggy Orenstein writes in her recent book Girls & Sex, American culture teaches girls that men pursue sex and pleasure, while women passively provide it. “When girls go into puberty education classes, they learn that boys have erections and ejaculations and girls have periods and unwanted pregnancies,” Orenstein told Quartz in 2016. And when women do experience orgasms, it’s frequently positioned as the result of a partner’s skill, rather than something we’re naturally wired to actively pursue, all by ourselves, for our own selfish reasons.

These macaques throw all of these assumptions into disarray. Not only are they animals getting off just for fun, they’re female animals going to unusual lengths in pursuit of their own sexual pleasure. What we should take away from this is that sexual pleasure isn’t an also-ran to reproduction; it’s an essential part of many animals’ life experiences—regardless of our species, sex, or gender.

So instead of getting Puritanical on the macaques, let’s use them as a jumping-off point for discussions about just how natural it is to pursue sexual pleasure. Whether we’re monkeys or men—or women!—we’re all wired to seek out sensations that feel good.

Complete Article HERE!

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Our shame over sexual health makes us avoid the doctor. These apps might help.

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We’re taught to feel shame around our sexuality from a young age, as our bodies develop and start to function in ways we’re unfamiliar with, as we begin to realize our body’s potential for pleasure. Later on, women especially are taught to feel ashamed if we want “too much” sex, or if we want it “too early,” or if we’re intimate with “too many” people. Conversely, women and men are shamed if we don’t want nearly as much sex as our partner, or if we’re inexperienced in bed. We worry that we won’t orgasm, or that we’ll do so too soon. We’re afraid the things we want to do in bed will elicit disgust.

This shame can also keep people from getting the health care they need. For example, a 2016 study of college students found that, while women feel more embarrassed about buying condoms than men do, the whiff of mortification exists for both genders. Another 2016 study found many women hide their use of health-care services from family and friends so as to prevent speculation about their sexual activity and the possibility that they have a sexually transmitted infection (STI).

While doctors should be considered crucial, impartial resources for those struggling with their sexual health, many find the questions asked of them during checkups to be intrusive. Not only that but, in some cases, doctors themselves are uncomfortable talking about sexual health. They may carry conservative sexual beliefs, or have been raised with certain cultural biases around sexuality. It doesn’t help that gaps in medical school curriculums often leave general practitioners inadequately prepared for issues of sexual health.

So how do people who feel ashamed of their sexuality take care of their sexual health? In many cases, they don’t. In a study on women struggling with urinary incontinence, for example, many women avoided seeking out treatment — maintaining a grin-and-bear-it attitude — until the problem became “unbearable and distressing to their daily lives.”

Which may be why smartphone apps, at-home testing kits and other online resources have seen such growth in recent years. Now that we rely on our smartphones for just about everything — from choosing stock options to tracking daily steps to building a daily meditation practice — it makes sense people would turn to their phones, laptops and tablets to take care of their sexual health, too. Websites such as HealthTap, LiveHealth Online and JustDoc, for example, allow you to video chat with medical specialists from your computer. Companies such as L and Nurk allow you to order contraceptives from your cellphone, without ever going to the doctor for a prescription. And there are a slew of at-home STI testing kits from companies like Biem, MyLAB Box and uBiome that let you swab yourself at home, mail in your samples and receive the results on your phone.

Bryan Stacy, chief executive of Biem, says he created the company because of his own experience with avoiding the doctor. About five years ago, he was experiencing pain in his genital region. “I did what a lot of guys do, and did nothing,” he says, explaining that, while women visit their gynecologist regularly, men generally don’t see a doctor for their sexual health until something has gone wrong. “I tried to rationalize away the pain, but it didn’t go away.” Stacy says he didn’t want to talk to a doctor for fear of what he would learn, and didn’t know who he would go to anyway. He didn’t have a primary care physician or a urologist at the time. But after three months of pain, a friend of his — who happened to be a urologist — convinced him to see someone. He was diagnosed with chlamydia and testicular cancer. After that, he learned he wasn’t the only one who’d avoided the doctor only to end up with an upsetting diagnosis. “What I found is that I wasn’t strange,” Stacy says. “Everyone has this sense of sexual-health anxiety that can be avoided, but it’s that first step that’s so hard. People are willing to talk about their sexual health, but only if they feel like it’s a safe environment.”

So Stacy set out to create that environment. With Biem, users can video chat with a doctor online to describe what they’re experiencing, at which point the doctor can recommend tests. The user can then go to a lab for local testing, or Biem will send someone to their house. The patient will eventually receive their results right on their phone. Many of the above-mentioned resources work similarly.

Research shows there’s excitement for tools like these. One study built around a similar service that was still in development showed people 16 to 24 years old would get tested more often if the service was made available to them. They were intrigued by the ability to conceal STI testing from friends and family, and to avoid “embarrassing face-to-face consultations.”

But something can get lost when people avoid going in to the doctor’s office. Kristie Overstreet, a clinical sexologist and psychotherapist, worries these tools — no matter their good intentions — will end up being disempowering in the long run, especially for women. “Many women assume they will be viewed by their doctor as sexually promiscuous or ‘easy,’ so they avoid going in for an appointment,” she says. “They fear they will be seen as dirty or less than if they have an STI or symptoms of one. There is an endless cycle of negative self-talk, such as ‘What will they think about me?’ or ‘Will they think that I’m a slut because of this?’ If people can be tested in the privacy of their own home without having to see a doctor, they can keep their symptoms and diagnosis a secret,” Overstreet says, which only increases the shame.

As for the efficacy of these tools, Mark Payson, a physician and co-founder of CCRM Northern Virginia, emphasizes the importance of education and resources for those who do test positive. These screening tests can have limits, he says, noting that there can be false negatives or false positives, necessitating follow-up care. “This type of testing, if integrated into an existing physician relationship, would be a great resource,” Payson says. “But for patients with more complex medical histories, the interactions of other conditions and medications may not be taken into account.”

Michael Nochomovitz, a New York Presbyterian physician, shows a similar level of restrained excitement. “The doctor-patient interaction has taken a beating,” Nochomovitz says. “Physicians don’t have an opportunity to really engage with patients and look them in the eye and talk to them like you’d want to be spoken to. The idea is that tech should make that easier, but in many cases, it makes it more difficult and more impersonal.” Still, he sees the advantages in allowing patients to attend to their health care on their own terms, rather than having to visit a doctor’s office.

Those who have created these tools insist they’re not trying to replace that doctor-patient relationship, but are trying to build upon and strengthen it. “We want people to be partnering with their doctor,” says Sarah Gupta, the medical liaison for uBiome, which owns SmartJane, a service that allows women to monitor their vaginal health with at-home tests. “But the thing is, these topics are often so embarrassing or uncomfortable for people to bring up. Going in and having an exam can put people in a vulnerable position. [SmartJane] has the potential to help women feel they’re on a more equal footing when talking to their doctor about their sexual health.”

“If you come in with a positive test result,” says Jessica Richman, co-founder and chief executive of uBiome, “it’s not about sexual behavior anymore. It’s a matter of medical treatment. It’s a really good way for women to shift the conversation.”

This can be the case for men and women. While many will use these options as a means to replace those office visits entirely, their potential lies in the ability to improve the health care people receive.

Complete Article HERE!

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