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Female Sexual Dysfunction Is A Fictional Disorder


Name: Sharon
Gender: female
Age: 30
Location: PA
I’ve been reading a lot lately about FSD, or female sexual dysfunction. Is there such at thing? It strikes me as a fictitious “ailment” that is being promulgated to sell pharmaceuticals to unsuspecting women. What are your thoughts?

I share your skepticism. I think that, for the most part, female sexual dysfunction, or FSD, is a fictional disorder. I also think pharmaceutical companies are trying to hit on a female version of Viagra to treat this imaginary disorder so they can make a bundle, just like they did with as the male version.

body as art

So much of female sexuality is caught up with the cultural context of a women’s role in society — family obligations, body image and patriarchal views of marriage, etc. For the most part, men aren’t nearly so encumbered. So when one talks about female sexuality, particularly when the notion of a condition or a disorder arises; ya gotta ask yourself, what’s going on here?

I too have been noticing a lot of discussion in the popular culture lately about female sexual dysfunction. My first response is to ask myself, who’s raising the issue and why? Sure some women, like some men, experience difficulties in terms of desire, arousal and orgasm, but what of it? Is it a syndrome? Is it really a dysfunction? I personally don’t think so. The sexual difficulties most people experience can be explained and dealt with in a less dramatic way then with drugs?

And here’s an interesting phenomenon; the repeated appearance of the term female sexual dysfunction in the media lately actually gives the concept legitimacy. I’m certain the pharmaceutical industry is hoping that it will. If they can make the connection in the public mind between what women experience in terms of desire, arousal and orgasm concerns and what men describe as erectile dysfunction, then most of the work is done. In other words, I think the entire effort is a marketing ploy.

female sxualityI think we can safely say that, in order to determine what female sexual dysfunction might be, one has to clearly understand what a “normal” sexual response is for a woman. This is where we traditionally run into problems. Sex science is notoriously lacking in this endeavor. One thing for certain, although both women and men have a discernable sexual response cycle, a woman’s sexual response is not the same as a man’s. Even though we can’t say with certainty what “normal” is, therapists are famous for turning difficulties into disorders. And once you have a disorder it becomes the basis for developing a drug therapy. So you can see how this becomes a self-fulfilling prophecy.

Currently there’s a real buzz among clinicians concerning the efficacy of Addyi, the so-called “female Viagra”. But most sexologists, myself included, are unimpressed. Basically, the drug in question is an antidepressant. When I heard that, red flags began to fly. Antidepressants are notorious for their adverse side effects, especially in terms of sexual arousal in both men and women. The second problem with the study was the whole notion of desire and distress. Lots of women experience diminished sexual arousal but are not distressed by it. But if there’s no distress, clinically speaking, then it can’t be considered a disorder. You see where I’m going with this, right? If there’s not a “disorder” there’s no need for a pharmaceutical intervention.FUCK

According to the research some of the women in the clinical studies leading up to the approval of the drug claimed they were less distressed by their “condition,” Hypoactive Sexual Desire Disorder, than they were at the beginning of the study. According to clinical trials of Addyi held in 2013, only 8% – 13% of the women experienced “much improved” sexual desire and only about 2 more satisfying sexual encounters per month were had. In other words, when behaviors were studied, the actual number of satisfying sexual episodes reported by these less distressed women hardly changed of all. This indicates to me that the antidepressant helped lift the spirits of the distressed women, but did nothing to increase their satisfaction with their sexual outlet.

Twice the FDA rejected Addyi for its severe side effects and marginal ability to produce the effect that it is being marketed for. And despite the fact that the drug is now available, those side effects still exist. Women who take the pill are likely to experience dizziness, nausea, drowsiness, fainting spells, and falling blood pressure. Coupled with alcohol and even hormonal contraceptives the odds of these potential side effects occurring increase. Persons with liver ailments, or taking certain other medicines, such as types of steroids are also at higher risk. On the other hand Viagra has very mild side effects that may include headaches, indigestion, blue-tinted vision and in some cases a stuffy nose.

While a man can pop Viagra an hour or so before he plans to have sex, women who are looking for increased sexual desire need to take Addyi daily for up to a month before they should expect to see any effects.

Good luck

This Sex Researcher Says Scientists Are Scared of Criticizing Monogamy

Monogamous people catch STDs just as often as swingers, but use condoms and get tested less often, a new survey suggests. Some sex researchers say a scholarly bias toward monogamy makes studies like this all too rare.


People in monogamous relationships catch sexually transmitted diseases just as often as those in open relationships, a new survey suggests, largely due to infidelity spreading infections.

Reported in the current Journal of Sexual Medicine, the survey of 554 people found that monogamous couples are less likely to use condoms and get tested for STDs — even when they’re not being faithful to their partner.

“It turns out that when monogamous people cheat, they don’t seem to be very good about using condoms,” Justin Lehmiller, a psychologist at Ball State University and author of the study, told BuzzFeed News by email. “People in open relationships seem to take a lot of precautions to reduce their sexual health risks.”

The finding matters because people who think they are in monogamous relationships may face higher odds of an infection than they suspect, Lehmiller and other researchers told BuzzFeed News. And a stigma around open relationships that views such couples as irresponsible — even among researchers who conduct studies — may be skewing the evidence.

One in four of the 351 monogamous-relationship participants in Lehmiller’s survey said they had cheated on their partners, similar to rates of sexual infidelity reported in other surveys. About 1 in 5, whether monogamous or not, reported they had been diagnosed with an STD. Participants averaged between 26 to 27 years old, and most (70%) were women.

For people in supposedly exclusive relationships, Lehmiller said, “this risk is compounded by the fact that cheaters are less likely to get tested for (STDs), so when they pick something up, they are probably less likely to find out about it before passing it along.”

Psychologist Terri Conley of the University of Michigan told BuzzFeed News that the survey results echoed her team’s findings in a 2012 Journal of Sexual Medicine study that found people in open relationships were more likely to use condoms correctly in sexual encounters than people in exclusive relationships.

To bolster confidence in the results, Conley said, more funding is needed to test research subjects for STDs directly, rather than relying on their own notoriously unreliable self reporting of infections.

She compared just assuming that monogamous relationships are safer to assuming abstinence education will really stop teenagers from having sex: “Sure, abstinence would be great, but we know that isn’t reality.”

To put it another way, Lehmiller said, “there’s a potential danger in monogamy in that if your partner puts you at risk by cheating, you’re unlikely to find out until it’s too late.”

Sex researchers don’t want to criticize monogamy, Conley added, making funding a definitive study more difficult.

In a commentary on Lehmiller’s study in Journal of Sexual Medicine, Conley argued that sex researchers are “committed to the the belief that monogamy is best” and are “reluctant to consider contradictory evidence.”

“I’m not saying monogamy is bad,” Conley said. “What I found is that the level of hostility among reviewers to suggesting people in consensual non-monogamous relationships are more responsible is really over the top.”

Conley said she initially struggled to publish her 2012 study. When she changed the framing of its conclusion to find that “cheaters” in monogamous relationships were more irresponsible, the study was suddenly published.

“Even in a scientific review process, challenging researchers’ preconceived notions is perilous,” she wrote in her commentary.

Other relationship researchers disagree, however, saying that sociologists have cast shade on monogamy — finding declines in happiness, sexual satisfaction, and frequency of intercourse — for decades. “This is about as widespread a finding as one gets,” Harry Reis, a psychologist at the University of Rochester, told BuzzFeed News. He called the idea that social scientists are biased against studies showing the value of non-monogamous relationships was “poppycock.”

Sex researcher Debbie Herbernick of Indiana University echoed this view, saying funding is not an issue: “I’ve never seen much negative reaction or pushback.”

More critically, Reis said, reviewers might be dubious about the data collected on open relationships, given their relative rarity making reliable data collection difficult.

Although Lehmiller published his study, he agreed with Conley that a stigma still marks open relationships, even in science. “People, including many sex researchers,” he said, “have a tendency to put monogamy on a pedestal and to be very judgmental when it comes to consensual non-monogamy.”

Complete Article HERE!

Mistress Matisse is Doing the Lord’s Work on Behalf of Sex Workers

By Noah Berlatsky

Mistress Matisse

At the end of July, Neal Falls booked an appointment with a sex worker named Heather in West Virginia. He planned to kill her, as police believe he may have murdered as many as nine other sex workers in Ohio, Illinois and Nevada. But with Heather he failed. But with Heather, finally, he failed. When he attacked her, she fought back, got his gun and killed him.

Falls’ death was national news but, as such things do, it soon faded out of the headlines. Heather, though, was still bruised and traumatized, unable to work and in difficult financial straits.

Luckily, not everyone forgot about Heather. Mistress Matisse, a writer and dominatrix in Seattle, heard about Heather’s experience and was determined to help. Through other sex workers she tracked Heather down, called her and booked a flight to West Virginia. She showed up at Heather’s door and hasn’t really left. She’s organized fund-raising, lined up medical assistance and connected Heather with nonprofit help.

This isn’t a new role for Matisse. She’s worked as a sex worker in various capacities since she was 19. But as she’s gotten established in Seattle, she says, “I have gotten to the point in my career where it is in many ways self-sustaining.”

As a result, she’s had more time to devote to activism. Matisse was there to help Heather because she’s made it her business to help sex workers who are in crises.

I talked to Matisse about her activism, her work with Heather and why sex workers are the best ones to help sex workers.

Most of your activism is independent, rather than directly working with non-profits or sex worker organizations. Why is that?

I get a lot out of sex worker organizations as a participant. I couldn’t be who I am without the sex work community. At a certain point it became clear to me that I should do sex work activism the way I do business.

I play well with others, but I’m also an introvert, and I don’t do well in people’s systems. I do well in my own system.

As a dominatrix, my work is creative. Someone is going to walk in, and you have a very short time where you sit and talk to them and kind of go, ‘What is it that you want and that you need? And how can that fit into things that I do, or am willing to do, in a way that’s creative and sexy and fun?’ In like five minutes, OK we’re doing that thing. It’s a very quick assessment. Make a plan. Make it happen. And that’s a dynamic that I do well with, and I enjoy it.

So for me what happens a lot is that I hear or see that there’s a sex worker who’s in a crisis, and I just reach out to her and say, ‘What do you need? How can I help you?’ And there’s a connection with her, and then I begin to address her needs at an individual level.

Working with an organization, you’re committed to working at a certain pace. They’re writing policy changes they want, or they’re lobbying in a very directed way to an elected official. They are process-oriented things, and I really want people to do them. It’s just that I’m not good at doing them. It just feels like slogging through mud to me.

So you’re working directly with Heather now?

Heather’s a case that moves me. My heart’s always very involved. And that’s why I like working the way I do. It’s emotionally very rewarding for me. Some people get rewarded from having written a really great policy, but that’s not rewarding for me.

I saw Heather on the news and I immediately knew — every woman who works alone, like I do, that’s the worst fear, is that you open the door to a murderer. And every time you see a new client, that thought is in your mind. I mean, I’ve opened thousands of doors over my career, to thousands of men, and crossed my fingers and hoped to God that it wouldn’t be one of those guys.

I’ve never been harmed by a client, but there have been a few cases where I have been very frightened, and that fear that you feel when you think, ‘Oh my god, is this guy going to hurt me? Am I going to be one of those girls?’ You never forget how that feels. So when I read this story…

This guy had a list of names of who he’s going after next. So Heather saved all those women’s lives. And it’s only sheer luck that the guy decided to go to West Virginia instead of Seattle. As far as I’m concerned, Heather saved my life and the lives of all the people I know in sex work, just as surely as she saved her own and the women on that list. This guy had been at it for a while. He’s a professional. So this is very emotional for me and very personal for me, and I decided that I was going to take care of it and make sure that she got everything she needed.

I started to call people (in the sex worker community) on the East Coast asking, ‘Who knows this girl? Who knows who she is? Who has met her?’ After a couple of days of calling around we came up with her phone number, so I called her and said, ‘You don’t know me, but I saw what you did and I’m a sex worker, too, and I would like to help you.’

Is it important that sex workers be the ones to reach out to help sex workers in need?

Well, for Heather, she was having a problem because there were some people local to her who had started a fundraiser for her, they said, but they were being really weird and controlling about the money. They weren’t going to let her have it unless she fulfilled certain things that they thought they should do.

They wanted her to give interviews, when she was clearly in no shape to give interviews. She told me they had bought her this dress they wanted her to wear. They wanted her to look like a nice respectable girl. They wanted to rescue her in the way, ‘We’re going to change your life. We’re going to change who you are, and we’re going to save you from this life.’

The reason that sex workers are the best people to help other sex workers is that we do it from a place of respect for the individual, and we understand that someone has to consent to being helped, at every stage of the way.

Trying to force ‘solutions’ on us that aren’t solutions just makes our lives more difficult. And most of the time, when you get a non-SW trying to help a sex worker who’s in trouble, they focus on sex work BEING the problem.

If someone wants to stop doing sex work, then we want options made available to them. But even in that situation, it’s crucial that you not shame someone who’s done sex work to survive. Like calling them a victim, even if that’s not how they identify, and focusing on how awful it must have been, asking for horror stories instead of just saying, ‘OK, so what do you want to be doing, and how can we get you there?’

I approach helping someone like I approach the BDSM scene. There’s a person here who I think wants me to take control of the situation. But you have to get consent for that. So I can say to you that I see that you’re having some trouble here, if you allow me to, I can do anything I can to alleviate these problems. Do you give me your consent to do that? Yes. You have to get the consent, and you have to go on getting the consent throughout the process.

These people wanted to get money for Heather, that’s great, but she didn’t even know them before they started doing that. And they were talking about her on the news and stuff. And they were going to hold onto the money until she did all these things they wanted her to do. What you’re doing to her she’s not consenting to, so it’s not really help.

I can look at Heather’s house, and say, moving out of here should be your first priority because a terrible thing happened here, and she’s like, ‘No, it’s not my first priority. X is my first priority.’ So that’s what we’ll do.

Do you consider your activism —helping sex workers— to be feminist activism?

The concept of feminism is kind of like the concept of God. There’s all this doctrine and dogma and stuff. And then there’s what people do. And everyone’s version of God is a little different. I’m very much in favor of a lot of the stated goals of feminism, just as I’m in favor of many of the stated goals of religion, which is be kind to other people, don’t lie and murder. It’s those ten commandment style things that I think we’re all on board with.

But mainstream feminism rejects sex work as an acceptable choice. So for me being a sex worker and being a feminist is kind of like being an immigrant who votes Republican. Even if you happen to agree with the rest of the party platform, there’s the small issue that they want to kick you out of the country. So I don’t describe myself as an adherent to a political philosophy that wants to eliminate me.

What can people do to help Heather if they’d like to contribute?

We’ve put together a crowdfund specifically to cover medical expenses; people can contribute to that here.

Complete Article HERE!

Sexuality and Illness – Breaking the Silence

(This is a Companion piece to yesterday’s posting. You’ll find yesterday’s posting HERE!)

By: Anne Katz PhD

Sexuality is much more than having sex even though many people think only about sexual intercourse when they hear the word. Sexuality is sometimes equated with intimacy, but in reality, sexuality is just one way that we connect with a spouse or partner we love (the true meaning of intimacy). Our sexuality encompasses how we see ourselves as men and women, who we are attracted to emotionally and physically, what turns us on (eroticism), our thoughts and fantasies, and yes, also what we do when we are sexually active, either alone or with a partner. Our sexuality is connected to our image of ourselves and it changes over the years as we age and face threats from illness and disability and, eventually, the end of life.seniors_men

Am I still a sexual being?

Illness can affect our sexuality in many different ways. The side effects of treatments for many diseases, including cancer, can cause fatigue. This is often identified as the number one obstacle to sexual activity. Other symptoms of illness such as pain can also affect our interest in being sexually active. But there are other perhaps more subtle issues that impact how we feel about ourselves and, in turn, our desire to be sexual with a partner or alone, or if we even see ourselves as sexual beings. Think about surgery that removes a part of the body that identifies us as female or male. Many women state that after breast cancer and removal of a breast (mastectomy), they no longer feel like a woman; this affects their willingness to appear naked in front of a partner. Medications taken to control advanced prostate cancer can decrease a man’s sexual desire. Men in this situation often forget to express their love for their partner in a physical way, no longer touching them, kissing them, or even holding hands. This loss of physical contact often results in two lonely people.  Humans have a basic need for touch; without that connection, we can end up feeling very lonely.

Just talk about it!

seniors_in_bedCommunication lies at the heart of sexuality. Talk to your partner about what you are feeling, how you feel about your body, and what you want in terms of touch. Ask how you can meet your partner’s needs for touch and affection. The most important thing you can do is to express yourself in words. Non-verbal communication and not talking are open to misinterpretation and can lead to hurt feelings. Our sexuality changes with age and time and illness; we may not feel the same way about our bodies or our partner’s body that we did 20, 30 or more years ago. That does not mean we feel worse – with age comes acceptance for many of us – but we do need to let go of what was, and look at what is and what is possible.

The role of health care providers

Health care providers should be asking about changes to sexuality because of illness or treatment, but they often don’t. They may be reluctant to bring up what they see as a sensitive topic and think that if it’s important to the patient, then he or she will ask about it. This is not good. Patients often wait to see if their health care provider asks about something and if they don’t, they think that it’s not important. This results in a silence and leaves the impression that sexuality is a taboo topic.senior intimacy02

Some health care providers are afraid that they won’t know the answer to a question about sexuality because nursing and medical schools don’t provide much in the way of education on this topic. And some health care providers appear to be too busy to talk about the more emotional aspects of living with illness. This is a great pity as sexuality is important to all of us – patients, partners, health care providers. It’s an important aspect of quality of life from adolescence to old age, in health and at the end of life when touch and love are so important.

Ask for a referral

If you want to talk about this, just do it! Tell your health care provider that you want to talk about changes in your body or your relationship or your sex life! Ask for a referral to a counselor or sexuality counselor or therapist or social worker. It may take a bit of work to get the help you need, but there is help.

Complete Article HERE!

Sexuality at the End of Life

By Anne Katz RN, PhD

In the terminal stages of the cancer trajectory, sexuality is often regarded as not important by health care providers. The need or ability to participate in sexual activity may wane in the terminal stages of illness, but the need for touch, intimacy, and how one views oneself don’t necessarily wane in tandem. Individuals may in fact suffer from the absence of loving and intimate touch in the final months, weeks, or days of life.head:heart

It is often assumed that when life nears its end, individuals and couples are not concerned about sexual issues and so this is not talked about. This attitude is borne out by the paucity of information about this topic.

Communicating About Sexuality with the Terminally Ill

Attitudes of health care professionals may act as a barrier to the discussion and assessment of sexuality at the end of life.

  • We bring to our practice a set of attitudes, beliefs and knowledge that we assume applies equally to our patients.
  • We may also be uncomfortable with talking about sexuality with patients or with the idea that very ill patients and/or their partners may have sexual needs at this time.
  • Our experience during our training and practice may lead us to believe that patients at the end of life are not interested in what we commonly perceive as sexual. How often do we see a patient and their partner in bed together or in an intimate embrace?
  • We may never have seen this because the circumstances of hospitals and even hospice may be such that privacy for the couple can never be assured and so couples do not attempt to lie together.

intimacy-320x320For the patient who remains at home during the final stages of illness the scenario is not that different. Often the patient is moved to a central location, such as a family or living room in the house and no longer has privacy.

  • While this may be more convenient for providing care, it precludes the expression of sexuality, as the patient is always in view.
  • Professional and volunteer helpers are frequently in the house and there may never be a time when the patient is alone or alone with his/her partner, and so is not afforded an opportunity for sexual expression.

Health care providers may not ever talk about sexual functioning at the end of life, assuming that this does not matter at this stage of the illness trajectory.

  • This sends a very clear message to the patient and his/her partner that this is something that is either taboo or of no importance. This in turn makes it more difficult for the patient and/or partner to ask questions or bring up the topic if they think that the subject is not to be talked about.

Sexual Functioning At The End Of Life

Factors affecting sexual functioning at the end of life are essentially the same as those affecting the individual with cancer at any stage of the disease trajectory. These include:go deeper

  • Psychosocial issues such as change in roles, changes in body- and self-image, depression, anxiety, and poor communication.
  • Side effects of treatment may also alter sexual functioning; fatigue, nausea, pain, edema and scarring all play a role in how the patient feels and sees him/herself and how the partner views the patient.
  • Fear of pain may be a major factor in the cessation of sexual activity; the partner may be equally fearful of hurting the patient.

The needs of the couple

Couples may find that in the final stages of illness, emotional connection to the loved one becomes an important part of sexual expression. Verbal communication and physical touching that is non-genital may take the place of previous sexual activity.

  • Many people note that the cessation of sexual activity is one of the many losses that result from the illness, and this has a negative impact on quality of life.
  • Some partners may find it difficult to be sexual when they have taken on much of the day-to-day care of the patient and see their role as caregiver rather than lover.
  • The physical and emotional toll of providing care may be exhausting and may impact on the desire for sexual contact.
  • In addition, some partners find that as the end nears for the ill partner, they need to begin to distance themselves. Part of this may be to avoid intimate touch. This is not wrong but can make the partner feel guilty and more liable to avoid physical interactions.

Addressing sexual needs

senior intimacyCouples may need to be given permission to touch each other at this stage of the illness and health care providers may need to consciously address the physical and attitudinal barriers that prevent this from happening.

  • Privacy issues need to be dealt with. This includes encouraging patients to close their door when private time is desired and having all levels of staff respect this. A sign on the door indicating that the patient is not to be disturbed should be enough to prevent staff from walking in and all staff and visitors should abide by this.
  • Partners should be given explicit permission to lie with the patient in the bed. In an ideal world, double beds could be provided but there are obvious challenges to this in terms of moving beds into and out of rooms, and challenges also for staff who may need to move or turn patients. Kissing, stroking, massaging, and holding the patient is unlikely to cause physical harm and may actually facilitate relaxation and decrease pain.
  • The partner may also be encouraged to participate in the routine care of the patient. Assisting in bathing and applying body lotion may be a non-threatening way of encouraging touch when there is fear of hurting the patient.

Specific strategies for couples who want to continue their usual sexual activities can be suggested depending on what physical or emotional barriers exist. Giving a patient permission to think about their self as sexual in the face of terminal illness is the first step. Offering the patient/couple the opportunity to discuss sexual concerns or needs validates their feelings and may normalize their experience, which in itself may bring comfort.

More specific strategies for symptoms include the following suggestions. senior lesbians

  • Timing of analgesia may need to altered to maximize pain relief and avoid sedation when the couple wants to be sexual. Narcotics, however, can interfere with arousal which may be counterproductive.
  • Fatigue is a common experience in the end stages of cancer and couples/individuals can be encouraged to set realistic goals for what is possible, and to try to use the time of day when they are most rested to be sexual either alone or with their partner.
  • Using a bronchodilator or inhaler before sexual activity may be helpful for patients who are short of breath. Using additional pillows or wedges will allow the patient to be more upright and make breathing easier.
  • Couples may find information about alternative positions for sexual activity very useful.
  • Incontinence or the presence of an indwelling catheter may represent a loss of control and dignity and may be seen as an insurmountable barrier to genital touching.

footprints-leftIt is important to emphasize that there is no right or wrong way of being sexual in the face of terminal illness; whatever the couple or individual chooses to do is appropriate and right for them. It is also not uncommon for couples to find that impending death draws them much closer and they are able to express themselves in ways that they had not for many years.

Complete Article HERE!

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