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Time for a Sexual Revolution In Health Care Treatment

Why is care for sexual health issues considered a luxury when it’s a necessary part of population health?

By Zachary Hafner

When Americans seek care for most common health conditions, there is rarely much question about coverage. Every day, consumers—including those on Medicaid and Medicare—seek care for sore joints, depression, and even acne without worrying about whether or not their insurance will cover their doctor visits and medications. For the most part, coverage for sexual health issues is less straightforward—but why? Is it because sexual health issues are not considered legitimate illnesses? Because the costs are significant? Or is it because raising the topic of sexual health can offend certain personal and organizational values? Whatever the reason, it is time for a change.

It’s hard to deny the human and economic burden of sexually transmitted infections (STIs) on this country. The CDC estimates that 110 million Americans are infected with an STI, resulting in direct medical costs of $16 billion annually. The most common and fastest growing STI in this country is human papillomavirus (HPV), and it is estimated that half of sexually active men and women will get HPV at some point in their lives. In 2006, a vaccine for HPV was introduced and now there are several. CDC guidelines recommend administering a multi-dose series, costing about $250–450, to all boys and girls at age 11 or 12. (Some states require the vaccine for school admission.) It was included in mandatory coverage under the ACA. Since the HPV vaccine was first recommended in 2006 there has been a 64% reduction in vaccine-type HPV infections among teen girls in the United States.

It seems clear that this kind of care for sexual health is necessary for public health and is also part of caring for the whole individual, a central tenet of population health. But what about sexual health care that doesn’t involve infectious disease? Is it still a population health issue if there’s no communicable disease involved?

Let’s take erectile dysfunction (ED) for example. It is nearly as common in men over 40 as HPV is in the general population—more than half of men over 40 experience some level of ED, and more than 23 million American men have been prescribed Viagra. With a significant portion of the population suffering from ED, is it important for payers and providers to consider ED treatment to be essential health care and to cover it accordingly? Medications like Viagra and Cialis are an expensive burden at upwards of $50 per pill. Medicare D does not cover any drugs for ED, but some private insurers do when the medications are deemed medically necessary by a doctor. A handful of states require them to do so, but they are typically listed as Tier 3 medications—nonessential and with the highest co-pays.

Almost 7 million American women have used infertility services. Coverage for infertility diagnosis and treatment is not mandated by the ACA, though 15 states require commercial payers to provide various levels of coverage. The cost of infertility treatments is highly variable depending on the methods used but in vitro fertilization treatments, as one measure, average upward of $12,000 per attempt.

Are treatments for ED and infertility elective or necessary? In an age of consumerism and heightened attention to the whole patient across a broader continuum of care, organizations that support the availability of a broad set of sexual health services to a diverse group of consumers will have a big competitive advantage, but they may face challenges balancing the costs. Health care has advanced in both technical and philosophical ways that allow people to manage their diseases, cure their problems, and overcome limitations. It has also shone light on the significant advantages to considering a diagnosis in the context of the whole individual—their social and emotional health as well as coexisting conditions. Studies have shown, for example, that infertility, ED, and STIs all have a significant relationship with depression and anxiety.

It’s time sexual health was folded in to the broader definition of wellness instead of marginalized as a separate issue. For too many Americans, it’s too big an issue not to address.

Complete Article HERE!

Sex and parenthood for people with disabilities

By Kristin Linton

Do people with disabilities have sex? Should they marry and have children?

As part of a research project, Emily Hops, a graduate of CSU Channel Islands, and I interviewed eight college students with disabilities about their general experiences with intimacy and sexual health last spring.

Each student expressed his or her own internal struggle with whether or not they should bear children themselves.

One said, “Is it selfish to have a kid? Even if your kid doesn’t have a disability, are you putting that burden on that kid to one day take care of you because you have a disability?”

Some students shared stories about professionals, even teachers, who dissuaded them from developing intimate relationships with others.

Even though California passed the Healthy Youth Act of 2015, which mandates adapted sex education for students with disabilities, I wonder if we have fully embraced the sexual rights of people with disabilities — especially considering California’s dark past with something called the “eugenics movement.”

Eugenics is essentially selective breeding in order to increase the occurrence of desirable inherited characteristics. California was a leader in the eugenics movement, which resulted in the sexual sterilization of 20,000 people in the state between 1909 and 1979. Seventy percent of those sterilized without their consent had various disabilities, spanning from schizophrenia to a casual diagnosis of being “feeble-minded.”

With a total of 60,000 sterilizations across the U.S., California was responsible for a third of all the procedures. Castrations and tubal ligations were common procedures performed. Some even argue that the U.S. led the way for Nazi Germany’s mass use of sexual sterilizations during the Holocaust.

Along with sexual sterilization laws in the eugenics movement came laws prohibiting marriage between people with disabilities, with the assumption being that reproduction was the reason for marriage.

California passed an annulment law, which specifically stated physical or mental capacity and consent as reasons for deeming a marriage null and void.

While there were other reasons that a marriage could be annulled, physical and mental capacity as well as lack of consent were the only reasons that involved third parties, such as parents or physicians.

These third parties could argue that either the bride or groom was “physically incapable of entering into the marriage state” or “was of unsound mind” at the time of marriage, and the marriage could be annulled.

If third parties were aware of a couple with disabilities planning a marriage, those third parties could make an argument about the incapacity of the bride and/or groom before the marriage date and shut it down altogether. In the early 1900s, 28 percent of marriages were annulled on these grounds.

The law is still on the books. Although rarely enforced today, these reasons for annulment remain in the wording of California Family Code Section 2210.

Not only is marriage annulment due to disability still lawful, but our history of perceiving people with disabilities as “asexual” beings still lives on today.

My hope is that we can learn to appreciate all people with disabilities as sexual beings with full sexual citizenship in hopes that they themselves do not question their own rights as human beings.

Complete Article HERE!

Do Nice Guys Have More Sex?

Surprising Attributes Lead to Luck in Bed

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When it comes to sex, we are quite the shallow bunch: Something as simple as the smell of your sweat, the dilation of your pupils or the proportion of your waistline can make all the difference.

Yet science also shows that personality traits matter at least some of the time, both in the long-term partners we choose and our shorter-term, umm, relationships.

So say you want to have more sex — hypothetically, of course. Should you offer flowers or act aloof?

The answer is complicated. Here’s just some of what science has figured out about the mating game and personality. The findings are as diverse — and as seemingly contradictory — as we humans.

Nice Men (and Women) Can Seal the Deal

Recent research published in the British Journal of Psychology showed that altruism may put you in the best position (ahem) to find a willing partner. The results of two trials conducted by Canadian researchers showed that men and women who scored higher on altruism also said they were more desirable to the opposite sex.

Men who scored higher on altruism also reported more sexual partners, and more casual hook-ups compared to female participants. If altruistic participants were in long-term relationships, those altruistic men and women said they had more sex over the last 30 days.

Researchers didn’t just take their word for it. Watch the video above for more.

Honesty Is Sexy

Let’s be real. Humans are drawn to other humans they find physically attractive. But there may be more going on than simple hotness, according to a study published in the journal Personality and Individual Differences.

Researchers from China divided 120 study participants into into three groups. Before the experiment began, all of these participants, 60 men and 60 women, were asked to rate 60 random Google photographs of Chinese women. The faces were unfamiliar to the study participants, and all the women in the photos had neutral expressions.

Two weeks later, the study participants were asked to look at the photos again. But this time, one group of participants was given the same photos with descriptions of positive personality traits such as decent and honest. Another group was given the photos that now contained negative personality traits including evil and mean. A third group was given no information about personality.

The researchers found no difference among the groups during the first cycle of the experiment. But in the second cycle, those photos that contained positive descriptions of personality traits scored high on attractiveness. Those with negative descriptors scored lowest.

The researchers say “what is good is beautiful,” and this so-called “halo effect” shows that desirable personality traits are reflected in facial preference.

But We Like The Dark Side, Too

Men (and women) may say they like nice humans, but sometimes what we do tells a different story. When it comes to mating, both sexes seem to be drawn to (cue the theme from Jaws) “The Dark Triad.” That psych-speak for the personality traits of Machiavellianism, narcissism and psychopathy.

We know it’s true: Mean girls and bad boys can be pretty popular, at least for a while. It seems the Dark Triad may boost short-term mating prospects for men, and, importantly, women too, despite being “fundamentally callous, exploitative traits that deviate from species-typical cooperation,” explains Dr. Gregory Louis Carter, a lecturer in Psychology at York St John University.

Narcissism, for example, is related to good physical and mental health and longer life while Machiavellianism is linked to social flexibility. Psychopathy results in impulsivity and sensation-seeking, which can be extremely seductive, he says.

So men and women who score high on the Dark Triad scale may appeal to because they are confident, persistent, have a higher-ranking status and look pretty darn good.

The ‘Big Five’ Traits That Mean More Action

If you want to learn about your personality traits, most psychologists suggest looking at the “Big Five.” That’s a group of descriptors that include openness, conscientiousness, extraversion, agreeableness, and neuroticism. Taken together those Big Five can influence our health as well as our sex lives.

In a study of newlyweds, researchers from Florida State University shed some light on how a couples’ personalities influenced how often newlyweds had sex. Although the study did not look at non-married individuals, there is a good chance the results would hold true, says co-author Dr. Andrea Meltzer, Assistant Professor of Psychology at Florida State University.

The study included data on 278 newlywed heterosexual couples, all of whom were married less than six months. They kept a two-week journal detailing their life and how often they had sex. The couples also took a Big Five test to figure out their individual personalities.

Here’s what they found. There was absolutely zero link between the man’s personality traits and how often the couple had sex. But higher levels of the traits of agreeableness and openness among wives led to more frequent sex.

“Openness refers to the willingness to explore new idea and experiences,” says Meltzer, adding these folks tend to like art and abstract ideas, often try new and different foods, and love novelty.

Agreeableness means you can get along well with others and maintain social harmony. These folks are often perceived as kind, generous, and trustworthy, she says.

No surprise that husbands and wives who scored low on neuroticism were more satisfied with their sex lives. But husbands who scored low in openness also were more satisfied with their sex lives. Maybe these guys just weren’t into novelty.

Make ‘Em Laugh

Humor always ranks near the top of seemingly any list of what men and women find attractive in each other.

Some research shows that humor gets us hot because it may reveal intelligence, a creative bent, and robust genes that equate to not only good health but also good parenting traits.

Although humor is almost universally appealing, there are sex differences. “Women want to be made to laugh more than men,” says Carter. “Men want to be able to induce laughter, though probably not in the bedroom.”

Complete Article HERE!

A Man’s Perspective of Male Sexuality Throughout Life

There’s such an unhealthy attitude towards men and sex in society.

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Through my years growing up I’ve often felt repressed sexually. As I look back and I think about my youth that would be an adequate description of the feelings that were coming to the surface. I mean I had absolutely no idea what I was feeling, only that it was uncomfortable and I didn’t like it. Society had a certain expectancy for me as a man, to act in a certain way. As a young man, I was such a conformist because anything that differed from the general view of normality I was really scared of.

Normality was good for me. Because if I was normal then I could blend into the crowd, do as everyone else was doing and just get on with my life, unseen. Yet there’s always been something about me, that I can’t put my finger on, but it has always rejected normality. And that wasn’t good, because that would separate me from the group and have me in a spotlight. I didn’t like spotlights, because then you were open to scrutiny, and if I was scrutinised then perhaps my mask would slip away and people would see me for who I really was. No-one. A has been, someone with no interest to anyone.

There was always SUCH emphasis on sex. There still is. No-one tells you to just be yourself and have fun exploring one another. My friends, probably out of their own insecurity, would tell me all the ways in which they’ve had their previous partners screaming in pulsating Orgasms. I’d read in the newspapers, and the glossy magazines.

“50 ways to please your woman in bed”

Or

“Is your man not doing it right? Here’s why …”

And let’s not forget those films that I was introduced to by some older kids, where almost every scene ended in the woman having the time of her life, screaming and writhing and bucking in ecstasy. All this pressure, to get it right first time. I always felt really out there. It seemed such a responsibility on me as a man, to get it right, first time. And when the time finally did come, I think it was over and done within milliseconds, first times are never awesome, no matter who tells you that. Or at least it wasn’t for me.

And I look back now and see the unevenness. For instance, people would ask me the naughty things I did to her in bed, and she would get asked was I good in bed? Why doesn’t anyone ask me if my time beneath the sheets with her was enjoyable? A more experienced man will tell you that because some people think a man’s ejaculation is the end result for him, and it is, to an extent, but since then I’ve experienced extremely pleasurable sex, and know the difference between them both, yet, all through my life, less than a handful of friends have asked me that question, and it’s almost always been focused on the shenanigans.

There’s such an unhealthy attitude towards men and sex in society. I had a period of celibacy for about two years, not through choice, but it was the way it turned out. That’s not to say that I didn’t have a few opportunities in between, just that I wasn’t interested in making that bond. For me, sex is personal, and after that I develop feelings. I can’t do no-strings attached. But because I was declining offers I was being viewed as homosexual, and that I wasn’t interested in women. Because all men want sex, right?

What we often forget is that men aren’t cold and brainless sex robots, we have thoughts and feelings too, and regardless of what popular culture will tell you, we’re picky and choosy about who we take to bed with us. But I don’t blame you. I blame the small minority that spoil it for the rest of us men. That small minority you see on TV that literally sleep with hundreds/thousands of women, and those men that leave women husbandless for another partner.

It gives guys like me a bad name. Because we weren’t highly sought after in High School, we were the kids left in the fields plucking forget me nots asking ourselves whether she loved us or not whilst the popular kids ran around doing what we could only dream of. We had to learn to be nice to people to get by. We had to learn to obey the hierarchy to have our social needs met, there was no escaping this, and we learned the cruel harsh reality of bitter rejection from a young age. But in my opinion this was a good thing, and gave us better life skills than a lot of the ‘cool’ kids.

And when the women become bored of tirelessly being let down by someone that thinks the world revolves around them they seek us out, but our sexual habits are often categorised neatly with our predecessors, and that just isn’t the case. Men differ wildly in the sexuality department, as do our tastes. We’re very vain, but then what we describe as a ‘beauty’ can vary insanely too, just like women and their likes for men’s personalities.

For me, I just feel that it’s a small amount of men churning the old stereotype wheel. I think most men, or at least the ones I know of, genuinely want to please and respect their partners. And it would be really nice to just be judged as a person, on my actions, on the day. Not as a ‘man’ because when you categorise people that widely, then you are doing yourself the disservice of getting to know some really awesome people on both sides of the fence.

Be awesome to each other.

Complete Article HERE!

How a Cervical Cancer Scare Made Me Take My Sexual Health More Seriously Than Ever

My doctor’s advice on how to not get HPV again threw me for a loop.

By Rachel Bowyer

Before I had an abnormal Pap smear five years ago, I didn’t even really know what that meant. I’d been going to the gyno since I was a teenager, but I never once really thought about what a Pap smear was actually testing for. I just knew I’d have a “twinge” of discomfort, as my doc always says, and then it would be over. But when my doctor called me to tell me I needed to come back in for more testing, I was pretty concerned. (Here, find more on how to decipher your abnormal Pap smear results.)

She assured me that abnormal Paps are actually quite normal, especially for women in their 20s. Why? Well, the more sexual partners you have, the more likely you are to get human papillomavirus (HPV), which is what generally causes the abnormal results. I quickly found out that it was the cause of mine, too. Most of the time, HPV resolves on its own, but in some cases, it can escalate into cervical cancer. What I didn’t know at the time is that there are several steps between testing positive for HPV and actually having cervical cancer. After having a couple of colposcopies, procedures where a tiny bit of tissue is removed from your cervix for closer examination (yes, it’s as uncomfortable as it sounds), we discovered that I had what’s known as high-grade squamous intraepithelial lesions. That’s just a technical way of saying that the HPV I had was more advanced and more likely to turn into cancer than other kinds. I was scared, and I got even more scared when I found out I had to have a procedure to remove the tissue on my cervix that was affected, and that it needed to be done ASAP—before it got worse. (According to new research, cervical cancer is deadlier than previously thought.)

Within two weeks of finding out about my abnormal Pap, I had something called a loop extrosurgical excision procedure, or LEEP for short. It involves using a very thin wire with an electrical current to cut away precancerous tissue from the cervix. Normally, this can be done with local anesthesia, but after an attempt that went awry (apparently, local anesthetic isn’t as effective for everyone as it’s supposed to be, and I found that out the hard way…), I had to make a second trip to the hospital to have it done. This time, I was sedated. After six weeks, I was declared healthy and ready to go, and told I needed to have a Pap smear every three months for the next year. Then, I’d go back to having them once yearly. Let’s just say I’m not a great patient, so after all was said and done I knew I never wanted to have to go through this process again. Since there are over 100 strains of HPV, I knew it was a real possibility that I could contract it again. Only a small number of the strains cause cancer, but at that point, I really didn’t want to take any chances.

When I asked my doctor how to prevent this situation from happening again, her advice really surprised me. “Become monogamous,” she said. “That’s my only option?” I thought. I was dealing with the perils of the New York City dating scene at the time, and at that point couldn’t even imagine meeting someone I’d want to go on more than five dates with, let alone finding my mate for life. I had always been under the impression that as long as I was *safe* about sex, opting not to settle down wouldn’t be detrimental to my health. I almost always used condoms and got tested for STIs regularly.

Turns out, even if you use a condom every single time you have sex, you can still get HPV because condoms don’t offer complete protection against it. Even when used correctly, you can still have skin-to-skin contact when using a condom, which is how HPV is passed from one person to another. Pretty crazy, right? I didn’t think there was anything wrong with not wanting to be monogamous (and still don’t), so it was hard to grasp the fact that my ideological stance on sex was directly opposed to what was best for my sexual health. Was my only option truly to settle down at 23 and decide to only have sex with one person for the rest of my life? I wasn’t ready for that.

But according to my doctor, the answer was essentially, yes. To me, this seemed extreme. She repeated to me that the fewer partners you have, the lower your risk of contracting HPV. Of course, she was right. Though you can still get HPV from a long-term partner that could take years to show up, once your body clears whatever strains they have, you won’t be able to get it from them again. As long as you and your partner are only having sex with each other, you’re good to go in terms of re-infection. At the time, I was pretty taken aback by the fact that the best thing I could do to protect my sexual health was basically to not have sex until I found “the one.” What if I never found that person? Should I just be celibate forever!? For the next couple of years every time I even thought about having sex with someone, I had to ask myself, “Is this really worth it?” Talk about a mood killer. (FYI, these STIs are much harder to get rid of than they used to be.)

Truthfully, it didn’t turn out to be such a bad thing. Whenever I decided to have sex with someone in the years after that, not only did I follow safe-sex practices to the letter, but I also knew that I had strong enough feelings about the other person for it to be worth the risk I was facing. Basically, that meant I was genuinely emotionally invested in every person I slept with. While some would say that’s how it should be all the time, I don’t really subscribe to that school of thought—in principle. In practice, however, I did save myself a ton of heartache. Since I had fewer partners who I got to know better, I dealt with less post-sex ghosting. Some people might not mind that, but even when I wasn’t super-invested in someone, the ghosting part almost always sucked.

Now, five years later, I happen to be in a long-term monogamous relationship. While I can’t say that it happened directly because of my experience or my doctor’s advice, it’s certainly a relief when what your heart wants and what’s best for your health happen to match up. And not having to constantly worry about HPV the way I once did? Love.

Complete Article HERE!