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British Columbian study reveals unique sexual healthcare needs of transgender men

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by Craig Takeuchi

While HIV studies have extensively examined issues related to gay, bisexual, and queer men, one group missing from such research has been transgender men.

Consequently, Vancouver and Victoria researchers undertook one of the first such Western Canadian studies, with the findings published on April 3 in Culture, Health, and Sexuality. This study allowed researchers to take a look at HIV risk for this population, and within the Canadian context of publicly funded universal access to healthcare and gender-related public policies that differ from the U.S.

The study states that trans men have often been absent from HIV studies due to small sample sizes, eligibility criteria, limited research design, or the misconceptions that trans men are mostly heterosexual or are not at risk for HIV. What research that has been conducted in this area has been primarily U.S.–based.

The Ontario-based Trans PULSE Study found that up to two-thirds of trans men also identify as gay, bisexual, or queer.

The researchers conducted interviews with 11 gay, bisexual, and queer transgender men in Vancouver who were enrolled in B.C. Centre for Excellence in HIV/AIDS’ Momentum Health Study.

What they found were several aspects unique to gay, bisexual, and queer transgender men that differ from gay, bisexual, and queer cisgender men and illustrate the need for trans-specific healthcare.

None of the participants in the study were HIV–positive and only two of them knew of trans men who are HIV–positive.

Participants reported a variety of sexual behaviours, including inconsistent condom use, receptive and insertive anal and genital sex, trans and cisgender male partners, and regular, casual, and anonymous sex partners.

The gender identity of the participants’ partners did influence their decisions about sexual risk-reduction strategies, such as less barrier usage during genital or oral sex with trans partners.

While trans men shared concerns about HIV and sexually transmitted infections with gay cisgender men, bacterial vaginosis and unplanned pregnancy were additional concerns.

Almost all of the participants used online means to meet male partners. They explained that by doing so, they were able to control the disclosure of their trans status as well as experiences of rejection or misperception. Online interactions also gave them greater control over negotiating safer sex and physical safety (such as arranging to meet a person in public first or in a sex-positive space where others are around).

When it came to healthcare, participants reported that regular testosterone therapy monitoring and transition-related care provided opportunities to include regular HIV– and STI–testing.

Some participants, however, experienced challenges in finding LGBT–competent healthcare services, with issues arising such as clinic staff using birth names or incorrect pronouns, insistence on unwanted pap testing, and a lack of understanding of the sexual practices of trans men.

The researchers note that these findings indicate the need for trans-inclusive services and trans-specific education, particularly within services for gay men.

Complete Article HERE!

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Sexual assault awareness | Sex in the Suburbs

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April is Sexual Assault Awareness Month — and here’s what you can do.

By

1. Believe survivors:

If someone comes to you and discloses sexual assault, believe them. Don’t ask what they were wearing. Don’t ask what they were thinking. Tell them you are sorry that it happened. Tell them it’s not their fault. And most of all, believe them.

Why?

Sexual assaults are dramatically under-reported in our society, for a variety of reasons. According to RAINN, a national anti-sexual violence organization, less than a third of sexual assaults are reported to police. One of the most prominent reasons is the concern that the survivor will not be believed. Consider the recent expose by the Salt Lake Tribune about BYU’s Honor Code, used against sexual assault survivors. More than two dozen survivors told the paper that they did not report crimes committed against them because they, the survivors, would get in trouble. Believing survivors is important.

2. Engage your voice:

Teens — lift your voice to counter any messages that any sexual assault is the survivor’s fault. Talk about consent with your friends and peers. Have speakers in to your school and other organizations to teach about consent. Don’t be silent.

Parents — talk with your teens about consent. Let them know that they can come to you safely if they are uncomfortable in a situation, even if they have broken a house rule. Think about it: Would you rather have a child who has had a few drinks call you for help and a ride, or would you rather have a child who didn’t want to get in trouble end up sexually assaulted?

Coaches — use your authority to counter cultural messages that pressuring people into sexual activity is OK. It isn’t. Make that clear with your teams and students, no matter what gender they are. Athletes are often leaders in their schools and popular. Help create an atmosphere that makes clear consent popular, too.

Fraternities and sororities — get educated and keep getting educated. Traditions can be wonderful, and they can be harmful. Make a commitment to work together in your organizations to create a healthier culture around consent, including caring for each other when alcohol is involved. Be smart. Engage your voices together.

Religious leaders — make a difference by shattering the silence so prevalent in our religious communities about talking about sex. Create healthy faith communities by having clear boundaries, smart supervision policies for children and youth, and engaging your voices in conversations around healthy relationships, communication and consent.

3. Get involved:

• Learn more by going to www.nsvrc.org to find ways to engage on social media, download posters for coloring, download postcards with healthy messages and more.

• Consider hosting a viewing and discussion of the movie “Spotlight.”

• Learn more about sexual assault, types of sexual violence, laws in Washington and the effects of sexual violence at www.rainn.org/about-sexual-assault.

Now is not the time to be silent. Engage your voice. Take action to become more aware of and to prevent sexual assault.

Complete Article HERE!

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What to do when your teen tells you they have a sexually transmitted infection

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By now, most parents likely know that not talking about sex with their teens will not stop them from doing it. And, as a parent, you might even have done some reading on how to have The Talk with your kids. Maybe you think you’ve done everything right when it comes to having important conversations with your teen. Or maybe you’ve been avoiding the discussion because you’re not sure where to start.

No matter which category you fit into, you may still find yourself as the parent whose kid comes home and tells them they think they might have a sexually transmitted infection (STI), or that they have contracted an STI. The way you respond to that bombshell can make all the difference for your child going forward — in their relationship with you, with future partners, and with themselves. “Often, the response of the people that you confide in when you first have a diagnosis shapes how you see your condition from then on out,” says Myisha Battle, a San Francisco-based sex coach. “It’s important that parents have a response that can potentially produce a positive outcome for kids when they’re disclosing.”

That, of course, is easier said than done. Heather Corinna, founder of Scarleteen, a sex ed web site for youth, and author of S.E.X.: The All-You-Need-To-Know Sexuality Guide to Get You Through Your Teens and Twenties, says that the groundwork for a positive response begins before your child ever receives a diagnosis. In fact, the way you talk about STIs from the beginning may determine whether your child even comes to you if they’re worried about their sexual health. And that, says Corinna, includes things like not talking about any infectious illness in a stigmatized way. “The closer we get to people, the more susceptible we are to infections,” Corinna explains. So if you wouldn’t talk about getting the chicken pox or a cold from someone as something gross, you shouldn’t talk about STIs that way, either. “When STIs come up in media or if people make a stigmatizing joke, correct it,” Corinna says. “Also important is not assigning value to people who do or don’t have an STI.”

And, no matter how many safer sex conversations you have (or haven’t) had with your kid, even people who do everything right can contract an STI. “STIs can happen even if you use protection and get tested,” says Ella Dawson, a writer who was diagnosed with herpes at 20. According to the CDC, nearly all sexually active people will contract HPV in their lifetime; two in three people worldwide have herpes simplex I and half of new infections are genital. The CDC considers both chlamydia and gonorrhea to be common infections. But, as Corinna points out, “The tricky thing is that when we talk about STIs, we’re talking about easily treatable illnesses like chlamydia versus [something like] HIV.”

Something else that might affect how involved a parent is or needs to be is how a young person contracted their STI in the first place. Often, STIs are contracted during consensual sexual interactions, but they can also be contracted during abuse or an assault. Corinna says that the biggest concern that they hear at Scarleteen from teens who have STIs is that their parents or caregivers will be disappointed in them. But, more serious than that, are fears that they may be kicked out of their house for having sex. Or, “if it happens in a wanted or ongoing relationship,” says Corinna, “there is the fear that their parents will punish them by refusing to let them see the person anymore.” All of these things may prevent a young person from disclosing their status to their parent or caregiver, or to avoid seeking medical attention all together.

“Teens with STIs need two things,” says Dawson. Those things are “access to medical care, and support. Make sure that your child has gotten a quality diagnosis from a medical professional, and also make sure that they are being treated with respect by their physician,” she says. Then, bombard them with unconditional love and support. It’s also important to do what you can to avoid adding to the shame and stigma your child might already be feeling. “Believe me, they don’t need you to confirm their own feelings of shame and regret,” Dawson warns.

Of course, it’s normal for parents to panic when their kid comes to them with an unexpected revelation like an STI diagnosis, but “it’s important to keep that freak out away from your kid,” says Battle. Corinna encourages parents to put aside their emotional reaction and get themselves educated so they can best help the young person in their lives. “If you’re in denial about [your] young person having sex, try to move past it and help them with what they need. If it’s about you controlling their health care and not giving them access, fix that,” Corinna says. “If you didn’t have conversations about what it means to be sexual with someone else, it’s time to have this conversation.”

Everyone agrees that the best way to be helpful as a parent is to take your lead from your child. “If they are upset, validate that. If they don’t feel bad about it, don’t make it a big deal,” suggests Corinna. Demonizing the transmitter, especially if that person is a partner, is not a helpful tactic and may alienate your child. Also not helpful? Trying to implement behavior modifications that same day, like taking them immediately to buy condoms, because it may feel like blaming. Also, going behind the young person’s back and calling their healthcare provider or their partner or telling a co-parent without getting explicit permission are surefire ways to lose a teen’s trust.

If your child isn’t sure what their diagnosis means, it can be a great time to get educated together. If they’re unsure if they might have an STI, “ask, ‘What are your symptoms? Let’s go to trusted website and find out what next steps should be.’ Or if it’s a diagnosis, it’s still an opportunity to sit down and ask what they learned at the doctor and what they know, so you can understand the next steps,” says Battle. Check out the resources on Scarleteen, the CDC’s website, or the American Social Health Association.

If you haven’t had great sex education yourself, learn along with your teen. After there is some distance, you can initiate another conversation about safer sex and make sure your teen has access to the appropriate supplies to help them avoid an STI in the future.

At the end of the day, what’s most important is letting your child know that an STI does not change the way you see them. This “does not mean your child has erred, ruined their future, or shown their true, negative character. Anyone can get an STI, even if you’re on the Dean’s list,” says Dawson. “What’s really important is that your kid is having a respectful, consensual and healthy sex life.”

Complete Article HERE!

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Reality Check: Anal Sex

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First it was shocking, then it was having a cultural moment, now it’s practically standard in the modern bedroom repertoire—or so a quick scan of any media, from porn to HBO, will tell you. But the reality about anal is not, actually, that everyone’s doing it, says research psychoanalyst and author Paul Joannides, Psy.D., whose comprehensive book on sexuality, The Guide to Getting it On!, is used in college and medical school sex-ed courses across the US and Canada. The book is amazing not just for its straight-up factual information on practically any aspect of sex you can think of, but also for its easy, nonjudgmental, at-times humorous tone.

The CDC reports that the number of heterosexual men and women who’ve tried it vacillates between 30 and 40 percent (oddly, the CDC doesn’t report on how many homosexual men have tried it, except in a statistic that weirdly combines it with oral). If anal turns you on, you are definitely not alone, but its prevalence doesn’t change the fact that it’s the riskiest sexual behavior in terms of HIV and other STDs. Here, Joannides talks us through the realities of making anal both as safe and as pleasurable as possible.


A Q&A with Paul Joannides, Psy.D.

Q

When did heterosexual anal start to become a thing?

A

In the 80’s, I remember hearing from a friend that he had a videotape of anal porn. This seemed shocking at the time. (This was pre-Netflix: Everything was on videotape, from porn to Disney movies to highlights from the Olympics. Video rental stores were everywhere.) I’m not sure there are too many middle schoolers today who would be shocked or even surprised to watch anal sex on Pornhub or Xhamster.

Since porn became as easy to access as YouTube, porn producers have had to fight for clicks, and so porn has become more extreme. I’d say that by 2005, porn had totally blurred the distinction between a woman’s anus and vagina. This wasn’t because women were begging their lovers for anal, it’s because porn producers were afraid you’d click on someone else’s porn if they weren’t upping the ante in terms of shock value.


Q

Does the popularity of anal in porn reflect reality in both homosexual and heterosexual couples?

A

No. There are some couples who enjoy anal sex a lot, maybe 10 percent to 15 percent of all straight couples. But if you ask them how often they have anal vs. vaginal intercourse, they’ll say maybe they have anal one time for every five or ten times they have vaginal intercourse. We occasionally, as in once a year, hear from women who say they have anal as often as vaginal, but that’s unusual.

As for gay men, statistics vary widely, and studies aren’t always consistent in how they collect data—some might be looking at different levels of frequency, i.e. have you had anal once in the past year, or do you have it regularly? I’ve seen studies suggesting that 65 percent of men have anal sex, and others that suggest the figure is less than 50 percent. So, I don’t have exact figures for hetero or homosexual couples, but there is data suggesting that a good percentage of gay men would rather give and receive blowjobs than have anal sex.


Q

How should we modify the anal sex we see modeled in porn to best suit an in-real-life couple?

A

The way the rectum curves shortly after the opening tells us we need to make a lot of adjustments for anal to feel good. Also, the two sets of sphincter muscles that nature placed around the opening of the anus to help humans maintain their dignity when in crowded spaces (to keep poop from dropping out) mean there’s an automatic reflex if you push against them from the outside.

So one of the first things a woman or man needs to do if they want to be on the receiving end of anal sex is to teach their sphincter muscles to relax enough that a penis can get past their gates. This takes a lot of practice.

Also, unlike the vagina, the anus provides no lubrication. So in addition to teaching the sphincters to relax, and in addition to getting the angle right so you don’t poke the receiver in the wall of the rectum, you need to use lots of lube.

They show none of this in porn. Nor do they show communication, feedback, or trust. Couples who do not have excellent sexual communication, who don’t freely give and receive feedback about what feels good and what doesn’t, and who don’t have a high level of trust should not be having anal sex.


Q

What are the health risks of anal?

A

A woman has a 17-times-greater risk of getting HIV and AIDS from receiving anal intercourse than from having vaginal intercourse. So your partner needs to be wearing a condom and using lots of lube, unless both of you are true-blue monogamous, with no sexual diseases. Any sexually transmitted infection can be transmitted and received in the anus. Because of the amount of trauma the anus and rectum receive during anal intercourse, the likelihood of getting a sexually transmitted infection is higher than with vaginal intercourse.

Unprotected anal sex, regardless of whether it is practiced by straight or gay couples, is considered the riskiest activity for sexually transmitted diseases because of the physical design of the anus: It is narrow, it does not self-lubricate, and the skin is more fragile and likely to tear, allowing STDs such as HIV and hepatitis easy passage into the bloodstream.


Q

Are those risks all mitigated by the use of condoms and lube, or are there still issues, even beyond that?

A

The risks are substantially reduced by the use of condoms and lube as long as they are used correctly, but you won’t find too many condoms that say “safe for anal sex” because the FDA has not cleared condoms for use in anal sex. That said, research indicates that regular condoms hold up as well as thicker condoms for anal sex, so there’s nothing to be gained from getting heavy-duty condoms.

As for using the female condom for anal sex—studies report more slippage and more pain than with regular condoms.

Do not use numbing lube, and do not have anal sex while drunk or stoned. Pain is an important indicator that damage can occur if you don’t make the necessary adjustments, including stopping. If there is pain, perhaps try replacing a penis with a well lubed and gloved finger. The glove will help your finger glide more easily, and might be more pleasurable for the person on the receiving end. Also, this allows a woman to do anal play on a male partner. (When it comes to anal sex, what’s good for the goose should be good for the gander.)


Q

Are there known health consequences of anal practiced over the long-term? Can you do it too much?

A

One of the urology consultants for my book believes that unprotected anal sex can be a way for bacteria to get into the man’s prostate gland. He prefers the person with the penis that’s going into the other person’s butt use a condom.

Also, small chunks of fecal matter can lodge into the man’s urethra. So if the couple has vaginal intercourse following anal intercourse without a condom, the male partner should pee first in addition to washing his penis with soap and water.


Q

Do pre-anal enemas make a difference in terms of health safety? What about preventing accidents?

A

I know of no studies on the relationship between pre-anal enemas and health outcomes. As for its general wisdom, people seem as divided on that as on politics in Washington. So I would say, to each her own. Also, some people use a “short shot,” which is a quick enema with one of those bulb devices instead of using a bag and going the full nine yards. In any case, accidents are likely to happen at one time or another.


Q

What tests should people be getting if they practice anal?

A

There’s “should” and there’s reality. If I were on the receiving end of anal sex, I would want to be sure my partner did not have HIV before I’d even let him get close to my bum with his penis.


Q

Probably more people try anal today than in the past—are there ways to make a first experience a good one?

A

Both of you should read all you can about it first. Spend a few weeks helping the receiving partner train her/his anal sphincters to relax. Make sure you and your partner have great sexual communication, trust, and that you both want to do it, as opposed to one trying to pressure the other, or not wanting to do it but doing it because you are afraid your partner will find someone else who will. Do not do it drunk or stoned, and do not use lube that numbs your anus. If it doesn’t feel good when it’s happening, stop.


Q

Do people orgasm from anal stimulation? Is it common or uncommon?


A

Some women say they have amazing orgasms from anal, but usually they will be stimulating their clitoris at the same time.


Q

Does it usually take a few tries to enjoy anal? Are there positions that make it easiest?

A

It depends on how much you are willing to work on training the receptive partner’s anal sphincters to relax, how good your communication is, how much trust there is, and probably on the width or girth of the dude’s penis. Common sense would tell you it should go way better if a guy is normal-sized as opposed to porn-sized.


Q

What should we be telling our kids about anal?

A

We don’t tell them about the clitoris, about women’s orgasms, about masturbation, about the importance of exploring a partner’s body, and learning from each other. We don’t tell them that much of what they see in porn is unreal, and we don’t talk to them about the importance of mutual consent. So I don’t see anal being at the top of most parents’ “should talk to our kids about” lists. There are more important things we need to be talking about first.

Paul Joannides, Psy.D. is a psychoanalyst, researcher, and author of the acclaimed Guide to Getting it On!, which is now in its ninth edition and is used in college courses across the country. He’s also written for Psychology Today Magazine and authors his own sex-focused blog, Guide2Getting.com. Dr. Joannides has served on the editorial board of the Journal of Sexual Medicine and the American Journal of Sexuality Education, and was granted the Professional Standard of Excellence Award from The American Association of Sex Educators, Counselors and Therapists. Joannides also lectures widely about sex and sexuality on college campuses.

Complete Article HERE!

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This Sex-Positive YouTuber Is Taking Sex-Ed Online

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The personal is political

by Miranda Feneberger

California native Laci Green started uploading videos to her very first YouTube channel at age 18. Nearly 10 years later, Laci owns and operates the number one sex education channel on YouTube: LaciGreen. With more than a million subscribers, a Webby award-winning spinoff series for MTV, and content produced on behalf of Planned Parenthood and Discovery News, Green is now the reigning queen of the online sex-ed industry.


 
It all started while Green was studying law at UC Berkeley; while there, she also taught a course on Human Sexuality, organized peer-led sexual health programs for local high schools, and launched her Streamy award-winning sex-ed series, Sex+. She got a certificate in domestic violence and rape crisis counseling from the state of California in 2010 and was also featured last year in TIME magazine’s list of the 30 Most Influential People on the Internet.

Green approaches topics like masturbation, contraception, BDSM, and sexuality with the relatability of a sister and the credentials of an expert. Her channel is informative, fun, and, best of all, positive. Can you see why we’re obsessed with her? Below, we speak with Green all about online activism, sexual health, and how young people can join the sex-ed conversation.

How do you feel the internet, and YouTube specifically, has changed the way young people learn about sex?
The internet is amazing because it has offered an open platform to talk about sexuality in ways we haven’t been able to before. Whatever has been kept in the shadows is on full display online—for better or worse. It’s great in the sense that it’s more accessible, and people who live in sex-negative communities can just hop online to find community and information. But the openness of the internet has also created new challenges, like distinguishing fact from fiction.

Have you, over the years, seen a change in the way the high school and college students are responding to sex-ed, feminism, and LGBTQI+ issues?
Yes! I think the conversation is elevating, and some of the more basic myths about anatomy, safer sex, and sexual assault are slowly being debunked. My experience is that young people are, and have been as long as I’ve been doing this, very positive toward LGBT and feminist causes.

What are the resources you would recommend to young people who have questions about sexual health?
Go Ask AliceScarleteen, and Planned Parenthood are fantastic non-YouTube internet resources. As for books, every young woman should own a copy of Our Bodies Ourselves.

What is the most important thing young people should know about sexual health?
Taking care of your sexual health is just as important as taking care of your overall physical health. Things like STI screenings, birth control, and Pap smears are nothing to be embarrassed about; they’re part of adulting.

What do you think is at the root of the recent YouTube censorship of LGBTQI+ and feminist content?
Based on YouTube’s comments about this, I don’t believe it was deliberate. I think LGBT content got swept up in an algorithm change that was meant to offer parents a way to moderate the content that very young kids see. I don’t think there’s a problem with such a feature, but they need to figure out how to make sure LGBT content, couples, and creators are not targeted by the filter in ways that straight couples are not.

What advice would you give to a young person who might be interested in changing the way sex-ed is delivered at their school?
Politics are the reason sex education is so terrible, so it’s really important to hold our city and state level politicians accountable. Google who your representatives are, and pay attention to what they are doing. Reach out to them directly to voice your opinion. Talk to administrators at your school as well and ask questions. Remember, government officials work for you, not the other way around.

Complete Article HERE!

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