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We must acknowledge adolescents as sexual beings

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As a teenager, Dr. Venkatraman Chandra-Mouli experienced shame and was often denied access when he tried to purchase condoms. Forty years later, adolescents around the world still face barriers to contraceptive access. In this blog, Dr. Chandra-Mouli discusses those barriers and how they can be overcome.

Dr. Venkatraman Chandra-Mouli recalls feeling shame and was often denied access when he tried to purchase condoms as a teenager.

By Dr. Venkatraman Chandra-Mouli

I grew up in India. While in my late teens and studying to be a doctor, I met the girl whom I married some years later. A year or so into our relationship we started to have sex. We decided to use condoms. Getting them at a government-run clinic was out of question. They were known to provide free condoms called Nirodh, which were said to be as smelly and thick as bicycle inner tubes. Asking our family doctor was also out of question. He knew my mother and I had no doubt that he would tell.

So, I used to walk to pharmacies, wait until other customers had left, and then muster up the courage to ask the person behind the counter for upmarket Durex condoms. Sometimes I was successful and walked out feeling like a king. Other times, I was scolded and sent away. I still recall my ears burning with shame. That was 40 years ago, but I know from adolescents around the world with whom I work that they continue to face many barriers to obtaining contraceptives.

Different adolescents, different barriers

In many societies, unmarried adolescents are not supposed to have sex. Laws and policies forbid providing them with contraception. Even when there are no legal or policy restrictions, health workers refuse to provide unmarried adolescents with contraception.

Married adolescents are under pressure to bear children. Many societies require girls to be nonsexual before marriage, fully sexual on their marriage night, and fertile within a year. In this context, there is no discussion of contraception until they have one or more children, especially male children.

Most societies do not acknowledge the sexuality of groups such as adolescents with disabilities or those living with HIV. Neither do they acknowledge the vulnerability of adolescent girls and boys in humanitarian crises situations.

Finally, no one wants to know or deal with non-consensual sex, resulting from either verbal coercion or physical force by adults or peers. Girls who are raped may need post-exposure prophylaxis for HIV, emergency contraception, or safe abortion—all of which are taboo subjects.

Overcoming these barriers

These powerful and widespread taboos have resulted in limited and inconsistent progress on improving adolescent contraception access. This has to change. We must acknowledge adolescents as the sexual beings they are. We must try to remember what a joy it was to discover sex when we were adolescents. We must give adolescents the information, skills, and tools they need to protect themselves from unwanted pregnancies and sexually transmitted infections.

With that in mind, I recommend the following:

  • We need to provide adolescents with sexuality education that meets their needs.
  • We need to change the way we provide adolescents with contraceptives by offering them a range of contraceptives and helping them choose what best meets their needs, and use a mix of communication channels—public, private, social marketing and social franchising to expand their availability. We must go beyond one-off training to use a package of evidence-based actions to ensure that health workers are competent and responsive to their adolescent clients.
  • We need to address the social and economic context of girls’ lives. In many places, adolescent girls do not have the power to make contraception decisions. Even when they are able to obtain and use contraception, an early pregnancy in or out of union may be the best of a limited set of bad options – when they are limited education and employment prospects.

To reach the 1.2 billion adolescents in the world, we must move from small-scale short-lived projects to large-scale and sustained programs. For this, we need national policies and strategies, and work plans and budgets that are evidence-based and tailored to the realities on the ground. Most importantly, we need robust implementation so that programs are high quality and reach a significant scale while paying attention to equity.

We need government led programs that engage and involve a range of players including adolescents. For this to happen, coordination systems must be in place to engage key sectors such as education, draw upon the energy and expertise of civil society, recognize the complementary role that the public, the private sector and social marketing programs can play, and to meaningfully engage young people.

Some countries have shown us that this can be done. Over a 15-year period, employing a multi-component program including active contraceptive promotion, England has reduced teenage pregnancy by over 50%. This decline has occurred in every single district of the country.

Ethiopia is another outstanding example. Civil war and famine in the mid-1980s had catastrophic effects on the country. However, over a 12 year-period, with an ambitious basic health worker program, Ethiopia has increased contraceptive use in married adolescents from 5% to nearly 30% . It has also halved the rate of child marriage and female genital mutilation, although this decline is more marked in some provinces than in others. These countries have shown that with good leadership and strong management progress is possible.

There will be logistic and social challenges in moving forward. Understanding and overcoming them will require leadership and good management, which is why a strong and sustained focus on implementation must be combined with monitoring and program reviews to generate data that could be used in quick learning cycles to shape and reshape policies and programs.

There is likely to be backlash from those that oppose our efforts to provide adolescents with contraceptive information and services, and to empower them to take charge of their lives. We must do our best to bring these individuals and organizations on board. But we must not be silenced or stopped. We must stand our ground and we must prevail. We owe that to the world’s adolescents.

Complete Article HERE!

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Writing Graphic Sex Scenes Can Be a Feminist Act

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‘We don’t put enough value on female pleasure in our culture’

By Stef Penney

Why is there explicit sex in my new book? Because I’m a feminist.

Under A Pole Star, my third book, is a novel about late 19th century arctic explorers that features, alongside ice, ambition and rivalry, more than one sexual relationship. And there’s a lot of detail. My central characters fall in love, and yes, they have a lot of sex. I was nervous about how the passages would be received. One Amazon reviewer has already complained about “copious quantities of copulation.” The specter of the Literary Review’s Bad Sex Award, given annually to authors of “poorly written, perfunctory or redundant passages of sexual description in modern fiction,” hovers over us all, tittering. Some judge writing explicitly about sex to be less than literary — or worse, discrediting of female characters. But why should achieving romantic and sexual satisfaction — one of the most difficult challenges we face as humans — be redacted or blurred?

There’s a problem with leaving “it” up to the reader’s imagination: Every reader will fill your tasteful ellipsis with something different — possibly with unachievable fantasy, with prejudices, with bad experience, with pornography. I wasn’t going to do that to my characters. I felt I owed it to readers to treat the characters’ intimacy with the same precision and seriousness I would any other intense human experience.

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I’ve read too much bad sex in otherwise good books: bizarre, metaphorical sex; coy, breathless sex; baffling, what-just-happened-there sex; most of all, phallocentric, male-experience-dominated sex. Too often, in sex scenes between a man and a woman, the woman’s sensations are barely mentioned, as if her experience is incomprehensible or irrelevant. It’s important to ask why this is — and the fact that a lot of those writers are male is not a satisfactory answer. We don’t put enough value on female pleasure in our culture. The way we write about sex only exacerbates that problem.

In my quest for knowledge and precedent, I sought out scientific research, erotic poetry and literature. I trawled the Internet as much as I could bear. I wanted to dissect the composition of sex scenes — and waded through many, many passages that didn’t come close to answering essential questions: Did she climax? Has this man heard of a clitoris? What were they using for contraception? Some uncovered even more questions about our culture’s perception of female sexuality: Did men in D.H. Lawrence’s time really accuse women of “withholding” their orgasms, as happens to Lady Chatterley? Because that’s absurd.

There’s so much ignorance, confusion and frustration out there. Delving into sex forums online, I was shocked by the prevalence of questions from women like, “How do I know if I’m having an orgasm?” The fact that so much confusion prevails is no surprise: studies have found that more men orgasm more frequently than women and 40% of women have sexual dysfunction, which can make it difficult to achieve climax. One study found that 80% of women fake orgasms.

The more I read, the more I realized how important it would be for me to write my scenes in steamy, awkward, mutual and real graphic detail. I wanted to write about a sexual relationship in a way that convinced me and reflected what I know to be true about female sexuality — that it’s complicated, beautiful and worth equal attention. So I included accounts of great sex, horrible sex, indifferent sex, sex that just doesn’t work despite both partners’ best intentions — and I showed how and why they were different.

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I wanted to create a story that honored the sexual biographies of both partners from both points of view, that showed how they reach the point where they come together and why their relationship is the way it is. And while we’re on the subject of coming together, simultaneous orgasm was one myth I encountered over and over again in my research that was never going to get an outing here.

When my friends began to read my book and wanted to talk about it, I learned things I’d never known about them, and I became more forthright in turn. We tumbled through a flood of questions. Why had we never talked about our sexual pleasure in explicit detail before? Why did we not achieve good, orgasmic sex until our mid-twenties, or later? Why were we too ignorant, too embarrassed to ask? Why did we expect so little in bed?

One reason, we all agreed, was that we’d had to learn about good sex through trial and error, because that behavior wasn’t modeled for us in a healthy, explicit way.

We need to be able to talk, teach, learn, write and read about sex, honestly and seriously, without — or in spite of — derision and censure. Unless we share specifics, we’ll never understand one another’s experiences. You can’t support women’s empowerment without frank and open discussion of their sexuality.

Complete Article HERE!

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9 Reasons You Might Not Be Orgasming

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By Sophie Saint Thomas

While orgasms don’t define good sex, they are pretty damn nice. However, our bodies, minds, and relationships are complicated, meaning orgasms aren’t always easy to come by (pun intended). From dating anxiety to medication to too little masturbation, here are nine possible culprits if you’re having a hard time orgasming — plus advice on how to deal.

1. You expect vaginal sex alone to do it for you.

One more time, for the cheap seats in the back: Only about 25 percent of people with vaginas come from penetration alone. If you’re not one of them, that doesn’t mean anything is wrong with you or your body. As licensed psychotherapist Amanda Luterman has told Allure, ability to come from vaginal sex has to do with the distance between the vaginal opening and the clitoris: The closer your clit is to this opening, the more vaginal sex will stimulate your clit.

The sensation of a penis or a dildo sliding into your vagina can be undeniably delightful. But most need people need that sensation paired with more direct clitoral stimulation in order to come. Try holding a vibrator against your clit as your partner penetrates you, or put your or your partner’s hands to good use.

2. Your partner is pressuring you.

Interest in your partner’s pleasure should be non-optional. But when you’re having sex with someone and they keep asking if you’ve come yet or if you’re close, it can throw your orgasm off track. As somatic psychologist and certified sex therapist Holly Richmond points out, “Being asked to perform is not sexy.” If your partner is a little too invested in your orgasm, it’s time to talk. Tell them you appreciate how much they care, but that you’re feeling pressure and it’s killing the mood for you.

It’s possible that they’re judging themselves as a partner based on whether or not you climax, and they may be seeking a little reassurance that they’re making you feel good. If they are, say so; if you’re looking to switch it up, this is your opportunity to tell them it would be so hot if they tried this or that thing next time you hop in bed.

3. Your antidepressants are messing with your sex drive.

As someone who continues to struggle with depression, I can’t emphasize enough how important it is to seek treatment and take medication if you and your care provider decide that’s what’s right for you. Antidepressants can be lifesavers, and I mean that literally.

However, certain medications do indeed affect your ability to come. SSRIs such as Zoloft, Lexapro, and Prozac can raise the threshold of how much stimulation you need to orgasm. According to New York City sex therapist Stephen Snyder, author of Love Worth Making: How to Have Ridiculously Great Sex in a Long Lasting Relationship. “For some women, that just means you’re going to need a good vibrator,” says New York City sex therapist Stephen Snyder, author of Love Worth Making: How to Have Ridiculously Great Sex in a Long Lasting Relationship. “For others, it might mean your threshold is so high that no matter what you do, you’re just not going to be able to get there.”

If your current medication is putting a dramatic damper on your sex life, you have options, so talk to your doctor. Non-SSRI antidepressants such as Wellbutrin are available, while newer medications like Viibryd or Trintellix may come with fewer sexual side effects than other drugs, Snyder says. I’m currently having excellent luck with Fetzima. I don’t feel complete and utter hopelessness yet can also come my face off (a wonderful way to live).

4. Your birth control is curbing your libido.

Hormonal birth control can also do a number on your ability to climax, according to Los Angeles-based OB/GYN Yvonne Bohn. That’s because it can decrease testosterone levels, which in turn can mean a lower libido and fewer orgasms. If you’re on the pill and the sexual side effect are giving you grief, ask your OB/GYN about switching to a pill with a lower dose of estrogen or changing methods altogether.

5. You’re living with anxiety or depression.

“Depression and anxiety are based on imbalances between neurotransmitters,” OB/GYN Jessica Shepherd tells Allure. “When your dopamine is too high or too low, that can interfere with the sexual response, and also your levels of libido and ability to have sexual intimacy.” If you feel you may have depression or an anxiety disorder, please go see a doctor. Your life is allowed to be fun.

6. You’re not having sex for long enough.

A good quickie can be exciting (and sometimes necessary: If you’re getting it on in public, for example, it’s not exactly the time for prolonged foreplay.) That said, a few thrusts of a penis inside of a vagina is not a reliable recipe for mutual orgasm. Shepherd stresses the importance of foreplay, which can include oral, deep kissing, genital stimulation, sex toys, and more. Foreplay provides both stimulation and anticipation, making the main event, however you define that, even more explosive.

7. You’re recovering from sexual trauma.

Someone non-consensually went down on me as part of a sexual assault four years ago, and I’ve only been able to come from oral sex one time since then. Post-traumatic stress disorder is common among survivors of sexual trauma; so are anxiety and orgasm-killing flashbacks, whether or not the survivor in question develops clinical PTSD. Shepherd says sexual trauma can also cause hypertonicity, or increased and uncomfortable muscle tension that can interfere with orgasm. If you’re recovering from sexual trauma, I encourage you to find a therapist to work with, because life — including your sex life — can get better.

8. You’re experiencing body insecurity.

Here’s the thing about humans: They want to have sex with people they’re attracted to. Richmond says it’s important to remember your partner chooses to have sex with you because they’re turned on by your body. (I feel confident your partner loves your personality, as well.) One way to tackle insecurity is to focus on what your body can do — for example, the enormous pleasure it can give and receive — rather than what it looks like.

9. You’re shying away from masturbation.

Our partners don’t always know what sort of stimulation gets us off, and it’s especially hard for them to know when we don’t know ourselves. If you’re not sure what type of touch you enjoy most, set aside some time and use your hands, a sex toy, or even your bathtub faucet to explore your body at a leisurely pace. Once you start to discover how to make yourself feel good, you can demonstrate your techniques to your partner.

Complete Article HERE!

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GQ Suggests ‘Having Sex with Men Doesn’t Make You Gay’

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In 2017, it’s weird to think that straight men are still asking the question, “Does having sex with a man make me gay?” Our friends at GQ recently investigated a bit deeper into the subject.

GQ interviewed a few guys who identify as straight who’ve all had same-sex sex with other men (gay or straight). Even after having sex with men, they still lean towards the straight side of the spectrum and identify as heterosexual.

So, what makes someone gay? According to GQ, it depends on how you define the “label.” In this day and age, everything has a label — too many if you ask me. Regardless of social labeling, it’s important to recognize how people associate that label within their self-identities — “if we remove the label of ‘gay’ from sex acts we traditionally assume are only the domain of gay men, does this mean you can take part in them and still be straight?”

James, a 28-year-old man who participated in the study, said he used to get regular blowjobs from a gay pal when he was a teenager. As a 17-year old, blowjobs weren’t exactly hidden around every corner, but for a coming of age teen with raging hormones, it seemed like the perfect deal for both him and his straight counterpart.

Another participant named Mark, also 28, said that his colleague’s boyfriend once went down on him in a club bathroom. Another time, he got a blowjob from a stranger in front of his girlfriend at a sex party. Even now, he says he knows he’s straight.

GQ asserts that at the end of the day, having sex with a man isn’t a sign of queerness — just as imagining pushing your evil boss under a truck means you’re a homicidal maniac. When people find themselves in sexually charged situations, primal instinct takes over, and shit happens.

Is sex just sex? If you ask me, the answer is yes.

There’s a difference between sexuality and orientation. Sexuality exists within us all; sometimes, we have sex with people we don’t necessarily find physically attractive; at times we do it to pass the time, and other times we have it because we crave sex. This is normal human sexuality — gay, straight, male, female; we can get off on all of it any given time.

Having sex with a man doesn’t mean you’re gay, but don’t forget the sacrifices your gay brothers make so you can have that freedom to choose.

However, orientation is the sexual compass we use to navigate the sensual universe; it’s who we are in our hearts. It’s how our spirits identify itself in life, and that affects whom we love, how we love and how we live. It’s larger than just sex.

“Gay sex acts aren’t something to be ashamed of,” GQ suggests. “If you’re man enough to do it and still call yourself straight, be man enough to talk about it. Don’t let it be a dirty little secret; own your sexuality — whatever that may by — with pride.”

Men are sexual people. Why have we created this stupid notion that getting off diminishes our manhood? Trust me; it’s an ideology crafted by religion, cultural norms and, most importantly, habit.

Let’s break the habit.

Complete Article HERE!

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Long-term sexual satisfaction: What’s the secret?

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Once the flutters of a new relationship are over, for many, the slog of everyday life sets in. But how do you keep the spark alive?

Sex is a key factor in most romantic relationships. In fact, earlier this year, Medical News Today reported that the “afterglow” that newlywed couples feel for up to 2 days after having sex is associated with greater marital satisfaction.

But last week, a new study showed that 34 percent of women and 15 percent of men who had lived with their partner for at least 1 year had lost interest in sex.

There are many factors that can affect sexual desire. Find out how much sex has the greatest effect on happiness, why some people lose interest, and what factors contribute to long-term sexual satisfaction.

How much sex is enough?

In a 2016 paper, Amy Muise, Ph.D. – a postdoctoral fellow in the Department of Psychology at the University of Toronto Mississauga in Canada – explains that there is plenty of evidence that “[…] the more sex people reported, the happier they felt.”

However, Dr. Muise also questions whether trying to have sex as “frequently as possible” is actually going to have the desired effect, particularly in light of the busy lives that many people lead.

Is the pressure of having frequent sex getting in the way of happiness?

Dr. Muise reports a clear relationship between the frequency of sex and happiness. What she found was that people who had sex once per week or more often were significantly happier than those who had sex less often.

But study participants who had sex on several occasions per week were not happier than those who had sex once each week.

The results were true for individuals who were in a romantic relationship, including women, older participants, and those in long-term relationships who tend to have less sex.

Interestingly, having sex had a greater effect on the participants’ happiness than income. So if sex makes us happy, why do so many people lose interest?

Who loses interest in sex?

There is plenty of evidence that being in a long-term relationship, being a woman, and increasing age are linked to a drop in sexual frequency.

Last year, MNT reported that women’s sexual desire decreased in long-term relationships. However, over the 7-year study period, the participants’ ability to reach orgasm improved – especially in those who had been in the same relationship the entire time.

So, for women, staying with a partner means better orgasms but less interest in sex, according to the research.

Last week, we reported on a new study published in BMJ Open that adds to the body of evidence showing that women’s interest in sex decreases in relationships.

Prof. Cynthia Graham, from the Centre for Sexual Health Research at the University of Southampton in the United Kingdom, found that more than 34 percent of women who had lived with their partner for at least 1 year lacked interest in sex, while only 15 percent of men did.

The biggest turn-offs

Prof. Graham identified a number of factors that were associated with the drop in sexual desire found in her study.

For women, these were having young children, having been pregnant in the past year, living with their partner, being in a longer relationship, not sharing the same level of sexual interest, and not sharing the same sexual preferences.

For both genders, health conditions (including depression), not feeling close to their partner during sex, being less happy with their relationship, and having sex less often than they were interested in all contributed to a drop in sexual interest.

Age was another factor. Men experienced the lowest levels of interest in sex between the ages of 35 and 44, while for women, this was between 55 and 64.

Julia Velten, Ph.D. – a postdoctoral fellow at the Mental Health Research and Treatment Center at Ruhr University Bochum in Germany – reported that when men felt that their partner expected them to always initiate sex, it had a negative effect on their sexual satisfaction.

Sexual desire discrepancy, which is the difference between the actual and desired frequency of sex, was a negative factor for both men and women.

Sexual function also played a role for the couples in Dr. Velten’s study. Men were affected by their partner’s lack of sexual function, such as lack of arousal, while women were more affected by the partner’s distress about their own sexual problem, such as erectile dysfunction.

How does masturbation fit into the picture?

On this topic, research findings do not agree. In a study involving couples living in Prague, Kateřina Klapilová, Ph.D. – from the Department of General Anthropology at Charles University in Prague – found that for women, masturbation negatively affected their sexual satisfaction.

But masturbation had no effect on men in these couples.

Meanwhile, Prof. Graham found that men who had recently masturbated were less interested in sex, while masturbation was not related to a change in women’s sex drive.

Prof. Graham told MNT that in her previous research, she had “found striking gender differences in factors associated with frequency of masturbation in men and women.”

She added that “when men were having less partnered sex, they tended to masturbate more often, whereas the reverse was true for women.”

With 51.7 percent of male and 17.8 percent of female participants reporting to have masturbated in the 7 days prior to study interviews, this is clearly a factor that is important in many relationships.

But just how masturbation contributes to or distracts from long-term sexual satisfaction remains to be seen.

With significant levels of both men and women reporting a drop in sexual interest and satisfaction, is there a secret to keeping the spark alive?

The secret to sexual satisfaction

Dr. Klapilová’s study found that for both men and women, penile-vaginal intercourse and the consistency of being able to reach vaginal orgasm were associated with sexual satisfaction.

She points to the “special role that vaginal orgasm (as distinct from other orgasm triggers) had in maintaining higher-quality intimate relationships.”

Anik Debrot, Ph.D. – alongside Dr. Muise and other colleagues from the University of Toronto Mississauga – recently studied the link between affection and sexual activity.

In her study paper, which was published this year in the journal Personality and Social Psychology Bulletin, she explains that “when engaging in sex, people not only seek an intimate connection, but indeed experience more affection, both when having sex and in the next several hours.”

“Thus, sex within romantic relationships provides a meaningful way for people to experience a strong connection with their partner,” she adds.

To her, this indicates that sex is important in romantic relationships because of the emotional benefits that we feel. Dr. Debrot suggests, “[When sex may be impaired], affection could help maintain well-being despite decreased sex frequency.”

The effect of time

A study by Prof. Julia Heiman, from the Department of Psychological & Brain Sciences at Indiana University in Bloomington, studied 1,000 couples in five countries (Brazil, Germany, Japan, Spain, and the United States).

Although the length of the couples’ relationships ranged from 1 to 51 years, half had been together for at least 25 years.

Prof. Heiman found that “[w]omen reported significantly more sexual satisfaction than men and men more relationship satisfaction.” In particular, “Men who valued their partner’s orgasm were more likely to report relationship happiness.”

Women’s sexual satisfaction increased from 40 percent at the start of the relationship to 86 percent once they had been with their partner for 40 years.

From these studies, penile-vaginal sex, affection, and the time spent in the relationship are key ingredients to a happy sex life. But there is one more factor that could be key: open communication.

Talking about sex

In Dr. Velten’s study, open communication about sexual wishes and frequencies had a positive effect on the quality of sex that the participants reported.

Likewise, participants in Prof. Graham’s study who found it easy to talk about sex with their partner were more interested in sex.

She told MNT that “[their] findings underline that open communication with a partner about sex is one of the most important things you can do to try to maintain sexual interest in a relationship.”

Sexual desires and preferences are, by nature, intrinsically personal and individual. Research in this field is complex, and while studies can show associations and trends, they will not be able to tease apart the reasons for an individual’s sexual satisfaction.

I don’t think that there is any ‘secret’ to long-term sexual satisfaction! Human sexuality is too diverse and ‘fluid’ for this to be the case – but […] open communication about sex with a partner should go some way to preventing sexual problems from developing.”

— Prof. Cynthia Graham

Talking about sex may be a good starting point. Finding a way to fit sex into the pressures of daily life may be challenging, but affection and time together might well help.

Complete Article HERE!

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