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Why LGBT-inclusive relationships and sex education matters

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By Hannah Kibirige​

Today the Government launched a public consultation on what relationships and sex education should look like in England’s schools. While that might not be the first thing on your Christmas list, it’s been hanging around at the top of ours for a while, and is a vitally important step forward for all young people.

So why is it something we should all care about? Earlier this year, the Government committed to making age-appropriate relationships and sex education compulsory in all of England’s schools in 2019.

Currently, only certain secondary schools are required to teach this subject, and the guidance for teachers has sat untouched since 2000. To say that plenty has changed in those 17 years would be an understatement. Back then, Bob the Builder was Christmas number one, Facebook was just a twinkle in Mark Zuckerberg’s eye, and Section 28 – the law which banned the so-called ‘promotion’ of homosexuality – was still in force.

It was a different world – and the guidance reads that way. It makes little mention of online safety, and no mention at all of LGBT young people and their needs. We have, however, made progress. At primary level we work with hundreds of schools to help them celebrate difference. This includes talking about different families, including LGBT parents and relatives.

Teaching about the diversity that exists in the world means that children from all families feel included and helps all young people understand that LGBT people are part of everyday life. Lots of schools, including faith schools, have been doing this work for years. Different families, same love. Simple.

At secondary level, a growing number of schools are meeting the needs of their LGBT pupils. But Stonewall’s research shows that these schools are in the minority: just one in six LGBT young people have been taught about healthy same-sex relationships, and many teachers still aren’t sure whether they are allowed to talk about LGBT issues in the classroom.

Too many LGBT pupils still tell us that relationships and sex education simply doesn’t include them. As LGBT young people are left unequipped to make safe, informed decisions, most go online to find information instead. It will come as no surprise that information online can be unreliable, and sometimes unsafe.

In schools that teach about LGBT issues, LGBT young people are more likely to feel welcomed, included and accepted. When young people see themselves reflected in what they learn, it doesn’t just equip them to make safe, informed decisions, it helps them feel like they belong and that who they are isn’t wrong or defective. Providing all young people with inclusive relationships and sex education as part of PSHE is a key way to do this.

Every young person needs to feel accepted, understood and included. The Government has recognised that, and is clear that future relationships and sex education will be LGBT-inclusive. Now is our chance to have a say on what that should look like. Now is our chance to give all young people the information and support they need to be safe, happy and healthy, now and in the future.

Complete Article HERE!

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Cancer diagnosis affects person’s sexual functioning

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Cancer can put a patient’s life on hold, especially among young adults who are just starting their careers or families.

 

A cancer diagnosis affects a person’s sexual functioning, according to a research.

The study, led by the University of Houston, found that more than half of young cancer patients reported problems with sexual function, with the probability of reporting sexual dysfunction increasing over time.

The study discovered that two years after their initial cancer diagnosis, nearly 53 percent of young adults 18 to 39 years old still reported some degree of affected sexual function.

“We wanted to increase our understanding of what it’s like to adjust to cancer as a young adult but also the complexity of it over time,” said Chiara Acquati, lead author and assistant professor at the UH Graduate College of Social Work.

“Cancer can put a patient’s life on hold, especially among young adults who are just starting their careers or families.”

The study also found that for women, being in a relationship increased the probability of reporting sexual problems over time; for men, the probability of reporting sexual problems increased regardless of their relationship status.

“We concluded that sexual functioning is experienced differently among males and females. For a young woman, especially, a cancer diagnosis can disrupt her body image, the intimacy with the partner and the ability to engage in sex,” Acquati said.

At the beginning of the two-year study, almost 58 percent of the participants were involved in a romantic relationship. Two years after diagnosis, only 43 percent had a partner. In addition, psychological distress increased over time.

She says it’s important to research how psychological and emotional developments are effected so tailored interventions and strategies can be created. Detecting changes in the rate of sexual dysfunction over time may help to identify the appropriate timing to deliver interventions.

Failure to address sexual health, the study concludes, could put young adults at risk for long-term consequences related to sexual functioning and identity development, interpersonal relationships and quality of life.

Acquati said health care providers might find it challenging to discuss intimacy and sex because of embarrassment or lack of training, but she believes addressing sexual functioning is vital soon after diagnosis and throughout the continuum of care.

“Results from this study emphasize the need to monitor sexual functioning over time and to train health care providers serving young adults with cancer in sexual health,” said Acquati.

“Furthermore, patients should be connected to psychosocial interventions to alleviate the multiple life disruptions caused by the illness and its treatment.”

The findings have been published in the American Cancer Society journal Cancer.

Complete Article HERE!

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New treatments restoring sexual pleasure for older women

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By Tara Bahrampour

When the FDA approved Viagra in 1998 to treat erectile dysfunction, it changed the sexual landscape for older men, adding decades to their vitality. Meanwhile, older women with sexual problems brought on by aging were left out in the cold with few places to turn besides hormone therapy, which isn’t suitable for many or always recommended as a long-term treatment.

Now, propelled by a growing market of women demanding solutions, new treatments are helping women who suffer from one of the most pervasive age-related sexual problems.

Genitourinary syndrome, brought on by a decrease in sex hormones and a change in vaginal pH after menopause, is characterized by vaginal dryness, shrinking of tissues, itching and burning, which can make intercourse painful. GSM affects up to half of post-menopausal women and can also contribute to bladder and urinary tract infections and incontinence. Yet only 7 percent of post-menopausal women use a prescription treatment for it, according to a recent study.

The new remedies range from pills to inserts to a five-minute laser treatment that some doctors and patients are hailing as a miracle cure.

The lag inaddressing GSM has been due in part to a longstanding reluctance among doctors to see post-menopausal women as sexual beings, said Leah Millheiser, director of the Female Sexual Medicine Program at Stanford University.

“Unfortunately, many clinicians have their own biases and they assume these women are not sexually active, and that couldn’t be farther from the truth, because research shows that women continue to be sexually active throughout their lifetime,” she said.

With today’s increased life expectancy, that can be a long stretch – another 30 or 40 years, for a typical woman who begins menopause in her early 50s. “It’s time for clinicians to understand that they have to bring up sexual function with their patients whether they’re in their 50s or they’re in their 80s or 90s,” Dr. Millheiser said.

By contrast, doctors routinely ask middle-aged men about their sexual function and are quick to offer prescriptions for Viagra, said Lauren Streicher, medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause.

“If every guy, on his 50th birthday, his penis shriveled up and he was told he could never have sex again, he would not be told, ‘That’s just part of aging,’” Dr. Streicher said.

Iona Harding of Princeton, New Jersey, had come to regard GSM, also known as vulvovaginal atrophy, as just that.

For much of their marriage, she and her husband had a “normal, active sex life.” But after menopause sex became so painful that they eventually stopped trying.

“I talked openly about this with my gynecologist every year,” said Mrs. Harding, 66, a human resources consultant. “There was never any discussion of any solution other than using estrogen cream, which wasn’t enough. So we had resigned ourselves to this is how it’s going to be.”

It is perhaps no coincidence that the same generation who first benefited widely from the birth control pill in the 1960s are now demanding fresh solutions to keep enjoying sex.

“The Pill was the first acknowlegement that you can have sex for pleasure and not just for reproduction, so it really is an extension of what we saw with the Pill,” Dr. Streicher said. “These are the women who have the entitlement, who are saying ‘Wait a minute, sex is supposed to be for pleasure and don’t tell me that I don’t get to have pleasure.’”

The push for a “pink Viagra” to increase desire highlighted women’s growing demand for sexual equality. But the drug flibanserin, approved by the FDA in 2015, proved minimally effective.

For years, the array of medical remedies has been limited. Over-the-counter lubricants ease friction but don’t replenish vaginal tissue. Long-acting mosturizers help plump up tissue and increase lubrication, but sometimes not enough. Women are advised to “use it or lose it” – regular intercourse can keep the tissues more elastic – but not if it is too painful.

Systemic hormone therapy that increases the estrogen, progesterone, and testosterone throughout the body can be effective, but if used over many years it carries health risks, and it is not always safe for cancer survivors.

Local estrogen creams, suppositories or rings are safer since the hormone stays in the vaginal area. But they can be messy, and despite recent studies showing such therapy is not associated with cancer, some women are uncomfortable with its long-term use.

In recent years, two prescription drugs have expanded the array of options. Ospemifene, a daily oral tablet approved by the FDA in 2013,activates specific estrogen receptors in the vagina. Side effects include mild hot flashes in a small percentage of women.

Prasterone DHEA, a naturally occurring steroid that the FDA approved last year, is a daily vaginal insert that prompts a woman’s body to produce its own estrogen and testosterone. However, it is not clear how safe it is to use longterm.

And then there is fractional carbon dioxide laser therapy, developed in Italy and approved by the FDA in 2014 for use in the U.S. Similar to treatments long performed on the face, it uses lasers to make micro-abrasions in the vaginal wall, which stimulate growth of new blood vessels and collagen.

The treatment is nearly painless and takes about five minutes; it is repeated two more times at 6-week intervals. For many patients, the vaginal tissues almost immediately become thicker, more elastic, and more lubricated.

Mrs. Harding began using it in 2016, and after three treatments with MonaLisa Touch, the fractional CO2 laser device that has been most extensively studied, she and her husband were able to have intercourse for the first time in years.

Cheryl Edwards, 61, a teacher and writer in Pennington, New Jersey, started using estrogen in her early 50s, but sex with her husband was painful and she was plagued by urinary tract infections requiring antibiotics, along with severe dryness.

After her first treatment with MonaLisa Touch a year and a half ago, the difference was stark.

“I couldn’t believe it… and with each treatment it got better,” she said. “It was like I was in my 20s or 30s.”

While studies on MonaLisa Touch have so far been small, doctors who use it range from cautiously optimistic to heartily enthusiastic.

“I’ve been kind of blown away by it,” said Dr. Streicher, who, along with Dr. Millheiser, is participating in a larger study comparing it to topical estrogen. Using MonaLisa Touch alone or in combination with other therapies, she said, “I have not had anyone who’s come in and I’ve not had them able to have sex.”

Cheryl Iglesia, director of Female Pelvic Medicine & Reconstructive Surgery at MedStar Washington Hospital Center in Washington D.C., was more guarded. While she has treated hundreds of women with MonaLisa Touch and is also participating in the larger study, she noted that studies so far have looked only at short-term effects, and less is known about using it for years or decades.

“What we don’t know is is there a point at which the tissue is so thin that the treatment could be damaging it?” she said. “Is there priming needed?”

Dr. Millheiser echoed those concerns, saying she supports trying local vaginal estrogen first.

So far the main drawback seems to be price. An initial round of treatments can cost between $1,500 and $2,700, plus another $500 a year for the recommended annual touch-up. Unlike hormone therapy or Viagra, the treatment is not covered by insurance.

Some women continue to use local estrogen or lubricants to complement the laser. But unlike hormones, which are less effective if begun many years after menopause, the laser seems to do the trick at any age. Dr. Streicher described a patient in her 80s who had been widowed since her 60s and had recently begun seeing a man.

It had been twenty years since she was intimate with a man, Dr. Streicher said. “She came in and said, ‘I want to have sex.’” After combining MonaLisa Touch with dilators to gradually re-enlarge her vagina, the woman reported successful intercourse. “Not everything is reversible after a long time,” Dr. Streicher said. “This is.”

But Dr. Iglesia said she has seen a range of responses, from patients who report vast improvement to others who see little effect.

“I’m confident that in the next few years we will have better guidelines (but) at this point I’m afraid there is more marketing than there is science for us to guide patients,” she said. “Nobody wants sandpaper sex; it hurts. But at the same time, is this going to help?”

The laser therapy can also help younger women who have undergone early menopause due to cancer treatment, including the 250,000 a year diagnosed with breast cancer. Many cannot safely use hormones, and often they feel uncomfortable bringing up sexual concerns with doctors who are trying to save their lives.

“If you’re a 40-year-old and you get cancer, your vagina might look like it’s 70 and feel like it’s 70,” said Maria Sophocles, founding medical director of Women’s Healthcare of Princeton, who treated Mrs. Edwards and Mrs. Harding.

After performing the procedure on cancer survivors, she said, “Tears are rolling down from their eyes because they haven’t had sex in eight years and you’re restoring their femininity to them.”

The procedure also alleviates menopause-related symptoms in other parts of the pelvic floor, including the bladder, urinary tract, and urethra, reducing infections and incontinence.

Ardella House, a 67-year-old homemaker outside Denver, suffered from incontinence and recurring bladder infections as well as painful sex. After getting the MonaLisa Touch treatment last year, she became a proslyter.

“It was so successful that I started telling all my friends, and sure enough, it was something that was a problem for all of them but they didn’t talk about it either,” she said.

“I always used to think, you reach a certain age and you’re not as into sex as you were in your younger years. But that’s not the case, because if it’s enjoyable, you like to do it just as much as when you were younger.”

Complete Article HERE!

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Sex and relationship education should be about rights and equity not just biology

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For decades, researchers, young people, and activists have campaigned for better sex and relationships education. Yet still today children and young people rarely have the high quality lessons they need in schools around the world.

International research has found that for it to be effective, sex and relationships education needs to start early, as well as be adaptable and needs-led. It must be delivered by well-trained and confident teachers, in partnership with external providers. It also needs to be of sufficient duration – not one-off sessions – as well as relevant, engaging and participatory. And, most importantly, it must be held in a safe, respectful and confidential learning environment, and embedded in a whole school approach.

But if we know what is needed, why are these lessons not in UK schools already? At present, the future of what the sex and relationship education curriculum will look like is still being discussed by politicians in England. Wales, however, is starting to make some headway.

Major reforms in Wales

Since education was devolved to the Welsh government in the 1990s, Wales has sought to embed policy and guidance on its sex and relationships education into a social justice model of rights, equity and well-being.

In March 2017, an expert panel – which I was invited to chair – was established by the Welsh Assembly’s cabinet secretary for education, Kirsty Williams. We were tasked with reporting on how teachers could be supported to deliver high quality sex and relationships education more effectively in schools in Wales. As well as help inform the development of the future curriculum in this area.

Drawing on the available national and international research, we found significant gaps between the lived experiences of children and young people, and the sex and relationships education they receive in school. We also found that the quality and quantity of these lessons vary widely from school to school.

Our panel has now made a series of recommendations to the Welsh government which collectively constitute a major overhaul of sex and relationship education in Wales. This is in line with significant curriculum and teacher training reforms, and is supported by the fact that health and well-being will be a core part of the 2021 Welsh curriculum, with equal status to other areas of the curriculum.

Living curriculum

In our report, we have outlined a vision for a new holistic, inclusive, rights and equity-based sexuality and relationships education curriculum. We concluded that what children and young people need now is a “living curriculum”, relevant to their lives and real world issues.

The idea is that this living curriculum would respond to children and young people’s lives, and enable them to see themselves and each other in what they are learning. It will also evolve to meet changing biological, social, cultural and technological issues and knowledge.

Importantly, we have recommended that sexuality and relationships education should not be relegated to an individual lesson or subject. It should be embedded across the whole curriculum. This means that any subject – science, humanities, or any other – should be able to address key areas of learning about gender, sexuality and relationships. Issues like rights, identity, body image, safety, care, consent, among others will be taught across the school timetable.

To ensure that learning is reinforced beyond the classroom, we have recommended that sexuality and relationships education provision is part of a whole school approach. We also suggest that content and assessment is co-produced with children and young people themselves.

We have also suggested that the name is changed to “sexuality and relationships education”. This is important for children and young people who say that current provision is narrowly focused on the biological at the expense of learning about the social, cultural and political aspects of sexuality.

Making sexuality and relationships education a statutory part of the curriculum is a start, but to achieve all this we need to ensure that those who are delivering it are well-trained, supported and confident. There should be a sexuality and relationships specialist lead educator in every school and local authority. This is in addition to protected time in the curriculum for the topic, so that what is planned for can be delivered on, and not squeezed out by other subjects.

These are significant reforms which will demand investment and planning. But the outcome will be an inclusive, relevant and empowering curriculum that can learn from, respond to and support all children and young people’s needs. Our vision is a sexuality and relationship education curriculum for life long learning and experience.

Complete Article HERE!

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We May Have Just Identified Genetic Evidence of Male Sexual Orientation

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But that still doesn’t mean there’s a ‘gay gene’.

By PETER DOCKRILL

Scientists are reporting what could amount to be the firmest evidence yet of genetic links to male sexual orientation, in the first published genome-wide association study (GWAS) examining the trait.

Researchers recruited more than 2,000 men of both homosexual and heterosexual orientation and analysed their DNA, identifying two genetic regions that appear to be linked to whether individuals are gay or straight.

“Because sexuality is an essential part of human life – for individuals and society – it is important to understand the development and expression of human sexual orientation,” says psychiatrist Alan Sanders from NorthShore University HealthSystem in Evanston, Illinois.

“The goal of this study was to search for genetic underpinnings of male sexual orientation, and thus ultimately increase our knowledge of biological mechanisms underlying sexual orientation.”

To do so, Sanders’ team studied 1,077 homosexual men and 1,231 heterosexual men of primarily European ancestry, who were respectively recruited from community festivals and a nationwide survey.

For the purposes of the study, the men’s sexual orientation was based on their self-reported sexual identity and sexual feelings. Each individual taking part provided a sample of their DNA in the form of blood or saliva samples, which were genotyped and analysed.

When the researchers sifted through the data, they isolated several genetic regions where variations called single nucleotide polymorphisms (SNP) signalled single-letter changes in the DNA, with two of the most prominent congregations located near chromosomes 13 and 14.

“The genes nearest to these peaks have functions plausibly relevant to the development of sexual orientation,” the researchers explain in their paper.

On chromosome 13, the variants were located next to a gene called SLITRK6, which is expressed in the diencephalon – a part of the brain that’s previously been shown to differ in size depending on men’s sexual orientation.

While the mechanisms here aren’t fully understood, the researchers explain the SLITRK gene family is important for neurodevelopment and could be of relevance for a range of behavioural phenotypes, not just sexual orientation.

On chromosome 14, the strongest associations were centred around the thyroid stimulating hormone receptor (TSHR) gene, and it’s thought the cluster of SNP variants here could conceivably affect sexual orientation due to altered expression in the hippocampus – in addition to producing atypical thyroid function.

It’s not the first time scientists have examined our genetic code looking for hints as to predictors of sexual persuasion.

While there are numerous environmental factors to consider, previous research – that has not yet been replicated – linked a genetic marker in the X chromosome called Xq28 to male sexual orientation back in the 1990s.

This gave rise to the idea of the so-called ‘gay gene’, even though that’s technically a misnomer, since the Xq28 band actually contains several genes, and the science on the region remains unclear.

More recently, a controversial study presented in 2015 by UCLA researchers suggested an algorithm analysing epigenetic markers that affect gene expression could predict male sexual orientation with up to 70 percent accuracy, but the findings were never published.

Similarly controversial – but in a completely different field of science – researchers from Stanford University made headlines in September when they claimed an AI they had developed could correctly distinguish between gay and heterosexual men and women (81 percent of the time and 74 percent of the time respectively).

While those findings produced an uproar, the claims – if true – serve as another illustration that our biology may contain innumerable clues about things like our sexual orientation that science is only beginning to reveal.

In terms of the new results, there’s bound to be a lot of interest in the study, but the researchers are eager to emphasise their findings are largely speculative for now, since there’s still a lot we don’t know about what these genetic variations really mean.

There’s also the relatively small size and skewed European basis of the sample – not to mention the fact that it’s all men – which limit what it can tell us about genetic underpinnings to sexual orientation more broadly across race and sex lines.

Despite those shortcomings, there’s a lot for other researchers to consider here, and the team hopes this could lay the groundwork for future investigations that could more deeply penetrate the genetic factors that help influence our sexual identities.

“What we have accomplished is a first step for GWAS on the trait, and we hope that subsequent larger studies will further illuminate its genetic contributions,” says Sanders.

“Understanding the origins of sexual orientation enables us to learn a great deal about sexual motivation, sexual identity, gender identity, and sex differences, and this and subsequent work may take us further down that path of discovery.”

The findings are reported in Scientific Reports.

Complete Article HERE!

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