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Intersex people have called for action. It’s time to listen.

The broader queer community needs to get serious about fighting with, and for, intersex people.

By Simon Copland

In early March, more than 20 intersex advocates from Australia and Aotearoa/New Zealand came together for a groundbreaking retreat in Darlington, Sydney. The gathering, a first of its kind, produced a declaration of the policy goals for intersex people in the two countries, one which queer people and allies alike must take listen to.

The Darlington Statement’ presents policy demands across a range of key areas, including health, sex classification, marriage, and anti-discrimination legislation.

At its core is a focus on the continued practice of normalisation surgeries facing intersex people. The statement contains an unambiguous demand for the “immediate prohibition as a criminal act of deferrable medical interventions, including surgical and hormonal interventions, that alter the sex characteristics of infants and children without personal consent.” This demand follows the ‘Carla case’ in Australia last year, in which the Family Court of Australia stated that parents could authorise the sterilisation of a 5-year-old child, despite medical evidence that did not support the decision.

The other key focus of the document is the continued practice of official gender and sex classification, which the document argues are “upheld by structural violence”. Contrary to a lot of current policies, the Darlington Statement argues that “attempts to classify intersex people as a third sex/gender do not respect our diversity or right to self-determination.” Instead, the Statement proposes a range of potentially radical measures, with a final goal of the elimination of sex and gender on birth certificates and other identification documents. While current classifications exist, the statement argues that sex/gender assignments must be regarded as ‘provisional’, with the ability of people to be able to change their classification “through a simple administrative procedure”.

Beyond these two big ticket items, the Darlington Statement also discusses a number of other key issues, including legislative protection from discrimination and harmful practices on grounds of sex characteristics, an end to genetic discriminations such as higher life insurance premiums for intersex people, the right for all people to marry and form a family regardless of sex characteristics, and for an official apology and reparations from state and federal governments for the treatment of people born with variations of sex characteristics.

The Darlington Statement presents the first comprehensive policy platform for intersex people in Australia and Aotearoa/New Zealand. In doing so, it is an essential document for a community whose continued discrimination and oppression is finally starting to receive some international recognition and action.

For the rest of us, however, the question is whether we will listen. While intersex people long ago entered the ‘LGBTIQ acronym’, discussions around intersex issues have remained largely non-existent, with young intersex children continuing to face intrusive and unnecessary medical interventions. Simultaneously, debates on sex and gender classifications have often ignored the voices of intersex people, particularly concerning the challenges behind legislation that provides for third sex classifications on birth certificates and other official documents.

This reality was noted in the Darlington Statement itself. The document said:

“Intersex is distinct from other issues. We call on allies to actively acknowledge our distinctiveness and the diversity within our community, to support our human rights claims and respect the intersex human rights movement, without tokenism, or instrumentalising, or co-opting intersex issues as a means for ends. ‘Nothing about us without us.’”

This is the challenge that we as a broader queer community must now finally face. The Darlington Statement is not just a policy platform, but also a call that if we are to include intersex people into broader queer politics, we must be serious about fighting with, and for, intersex people.

The Darlington Statement gives us a clear outline of what needs to be done. It is up to us a community to take it seriously.

Complete Article HERE!

What do men really think about sex? This is why we need better education

We asked men how they learned about sex, and found that puerility and pornography have always trumped the facts. Mandatory sex education is most welcome

‘Alan, now aged 79, was evacuated to the countryside at the age of five – and spotted a bull mounting a cow. “It was a significant part of my sex education,” he said.’

It was announced this month that sex and relationship education is to become mandatory in schools for children aged four to 15. About time too. It’s never been easy for children who have wanted to learn credible information about sex.

We’ve recently been interviewing men for a project to find out what they really think, feel and do about sex, and found the early information they received was, in many cases, baffling. “Women don’t like it,” Bill was told as a teenager in the 1960s, “but you can do it all the same … [and] you only do it on Sundays when the children are out.”

Back in the 1940s, communicative adults were hard to come by, and children had to solve the mystery by themselves. Alan, aged 79, was evacuated from London to the countryside, aged five. There he spotted a large bull mounting a cow. “It was very significant,” he said. “I have never forgotten it.”

At primary school Bill, now 75, believed boys stood behind girls to do “it” (he was basing this on his observation of dogs). He was hugely embarrassed when told to stand behind a girl in a school folk-dance performance. “I thought that was very dirty.”

It was a rare grown-up who suggested that sex might be something pleasant, or something to look forward to; rather, a child’s sex education was more likely to elicit feelings of fear, danger and shame – and would often involve a lonely search for the facts. By the late 1950s, parental guidance was still fairly non-existent. At 14, Michael remembered finding a “dirty book” belonging to his father: “The Kama Sutra was an excellent source of information, but often mind-boggling too … the contortions! The big penises! And the pleasure shown on women’s faces. I couldn’t believe it could be like that!”

‘The Kama Sutra was an excellent source of information – but mind-boggling, too!’

While Michael was studying the Kama Sutra, the only sex still being taught in the classroom involved plants and rabbits, and was often expressed in Latin. Several more decades were to pass before human genitalia and procreation were bravely described in English. Not until the early 1990s did the national curriculum specify that sex education must be taught. But just the mechanics. Nothing about relationships. And making the subject even more shambolic was the decision that each school could have its own individual policy, and each teacher was stuck with their own capabilities, experiences, terrors and confusions in conveying this information.

The easy way out was to explain that sex happened “when people loved each other and wanted babies”. Pleasure, variety and consent were rarely mentioned. But some teachers bravely tried to further enlighten the children. In 1994, in his last year of junior school, Dean, who was then aged 10, went to a sex education lesson in which his teacher tried her very best to take an innovative, practical and robust approach.

“Miss Woods asked the class if they knew of any ‘barrier methods’. I didn’t really know what they were, but someone said ‘condoms’. Miss Woods said, ‘Yes, anything else?’ Then a boy called Dave said, ‘You can get them with feathers on the end, Miss.’ Miss Woods looked cross, and said, ‘No you can’t’ – but Dave went on and on, saying, ‘Yes you can, they’re called French ticklers, I read in my Mum’s book. It had pictures in,’ and then Miss butted in, and said ‘Nonsense’, so Dave had to shut up.”

Here was Miss Wood’s chance to grasp the nettle. But even then, in the late 20th century, she could not. Although bolder than many teachers, she was still not able to respond to any surprises that might crop up.

Even if teachers now manage to describe sex as pleasant, it sometimes seems to frighten and shock, rather than enthuse the children. Informed, six years ago, by a comparatively enlightened teacher, that people had sex “because it felt lovely”, eight-year-old George was horrified. “Miss made a terrible mistake,” he told his Grandma, with great authority and concern. “She said it felt nice! She’s got it really wrong!”

Age specificity hadn’t really been thought through. Slightly older, more intrepid boys, sensing that they still weren’t quite getting at the truth, or any satisfactory explanations – either from each other, or from adults – now gained access to a greater selection of more flamboyant, salacious, almost cartoonish information: porn.

“I think as boys we’d seen a few porno films here and there,” said Jason. “The first stuff I saw was on a video. I was 13, and the tape started doing the rounds – we thought that was the way you did it.”

As the years have passed, and porn has become more widely available online, younger and younger children have been seeing such imagery. In 2001, Jack, then aged 10, learned about sex from pornography. “Everyone was looking at it,” he said. “That’s how I found out I was gay. I didn’t want to look at the girls.”

Despite the overwhelming flood of pornography – and the continuing lack of guidance – there do appear to be a few glimmers of hope. The importance of relationships and feelings is now creeping into sex education at last, and it is a relief to find the idea of consent has surfaced. Many of the young men interviewed in the BBC3 documentary Sex on Trial were sympathetic when shown footage of a young woman whose consent had not been clearly given. In fact, they were more sympathetic than the young women. That’s reason to be hopeful, at least where young men are concerned.

Unfortunately, most sex education is still passed between children themselves, taught by the “naughty” peers who seem to have found out more than anyone else. Or are pretending that they have. Boasting has always been, and still seems to be for many boys, the beginning of proving that you are a proper man. Frequency, volume, conquest and size still matter to them. How are young men to understand women if they have never been taught to understand themselves, and the people teaching them have been taught even less?

Hopefully the new national curriculum mandatory sex education plans will bring about change for the better. It might help if lessons could be conducted in small groups, with the sexes separated. It would need to be age-appropriate, of course – with less emphasis on the mechanical details, and more on the importance of relationships, with appropriately trained teachers, prepared for anything the children might say, know or have experienced. They also need to be unshockable.

Complete Article HERE!

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!

The way we teach sex-ed is old and ineffective. Here’s how to fix it.

By Stephanie Auteri

In a predictable bit of news, the results of a study released this past September show that students consider most sex-education programs to be out-of-touch, outdated, and lacking in the information that might actually prove useful to them. Among the deficiencies reported by teenagers were a focus on fear-based lesson plans, curricula that alienate LGBTQ+ students, instructors untrained in actually providing useful sex-ed, and a failure to acknowledge that some young people are  —  spoiler alert  —  sexually active.

When it comes down to it, though, these inadequacies do not stem from lack of trying on the part of certified sexuality educators. There are disparities in curricula, and in resources: Federal funding for sex-education flows to both abstinence-only and evidence-based approaches, and decisions about curricula are made on a state-by-state  —  and district-by-district  —  basis. There are still only 13 states that require sex-education to be “medically accurate.”

In fact, in the past year, 23 bills were introduced with the intention of restricting the quality of sex-ed. Such restrictions included moves to limit access to information about reproductive health options, and to exclude qualified sexuality educators from schools based upon their affiliation with abortion providers.

While the majority of these bills failed to advance, in many cases, educators continue to be hamstrung by red tape. And they worry that  —  in the wake of the most recent presidential election  —  their jobs will only become more difficult. What is an enterprising, conscientious sex-educator to do?

Recently, I attended the National sex-ed Conference in Atlantic City, New Jersey, where I saw sexuality educator Francisco Ramirez present a keynote on “hacking” sexual health. During his talk, Ramirez spoke about how educators might possibly shake things up, in some cases taking sex-ed outside the classroom in order to reach those who need it most. Happily, many educators are already doing this, systematically toppling many of the barriers that have long stood in their way. Throughout the conference, I was reminded of the many forms such resourcefulness can take. Here are the six most important fixes currently happening in American sex-ed.

1. Where can students get the answers they crave without fear of embarrassment or other negative repercussions? These days: their phones.

Sex-educators often employ anonymous question boxes in their classrooms, but the new-media generation is taking this idea of anonymity to the place where it thrives best: social media. I recently wrote about a variety of new social-media applications, YouTube series, and other online resources that allow teens to seek out accurate sexuality information anonymously. Since then, it seems that not a day goes by where I don’t hear about a new sex-ed app.

What’s important to remember about any of these sex-ed hacks is that just because a program works in one place, that doesn’t mean it will work in every community.

One of the more recent ones to catch my eye is Capptivation’s Reach Out, an app that provides sexual assault survivor resources to college-age students. According to Capptivation, a similar app for high schoolers is on its way. And the Healthy Teen Network — a membership-based advocacy organization  —  is in the process of developing two phone apps, one for high school-aged teens, and one for people who are older. They were inspired to do so after receiving an RFP (a request for proposal — a document from an agency soliciting a proposal for a specific commodity or service) from the Centers for Disease Control and Prevention (CDC). Alongside the United States Department of Health and Human Services, the CDC has been looking to fund the development of a mobile app that would support teen pregnancy prevention.

This push for sex-ed apps is not without precedent. A 2016 study on mobile phone-based interventions for smoking cessation showed that mobile interventions can lead to positive behavioral changes. And additional research  —  including a 2016 paper published in BMC Public Health  —  has shown that sexual-health apps remove certain barriers youth often feel in seeking out sexual-health services: namely, embarrassment. HTN is in the midst of conducting its own randomized control trials in order to determine the efficacy of its apps.

2. How can students take a leadership role in their own sex-education? Through peer-led sex-ed.

A recent review of 15 peer-led sexual-health education programs shows that peer-to-peer sex-ed can be successful at improving teens’ knowledge and attitude about sexual health  —  which is good news, considering that many teens don’t think adults are doing the best job. And just as with social-media apps, new peer-to-peer training programs are popping up all around the country. Teen PEP, which operates in both New Jersey and North Carolina, is one such program that trains teens to provide sex-ed to their peers at school. Another example is the team out of Planned Parenthood of North, Central, and South New Jersey, which leads an annual Teen Conference that students travel to on a one-day field trip.

In Austin, Texas, the Peer 2 Peer Project trains teens to teach both on school grounds and at other locations within their communities, going so far as to pay them for their efforts. In Baltimore, Maryland, the Healthy Teen Network and its subsidiary, the Healthy Teen Leadership Alliance, also empower teens to influence the field of sexual health. These are just a handful of programs among many that are handing the reins over to teens. It can be difficult to keep track of all the peer-led programs popping up around the country, but Advocates for Youth  —  an advocacy organization with its focus on adolescent sexual health  —  has gathered the results of numerous studies on the impact of peer education. These studies show how peer education reduces risky sexual behaviors and empowers teens, who seem to find their peers to be more credible than adult educators.

Complete Article HERE!

Inadequate sex education creating ‘health time bomb’

‘Shockingly high’ numbers of STI diagnoses prompt councils to call for compulsory sex education in UK secondary schools

A school nurse giving sex education advice to year 10 students at a school in Devon.

By

Inadequate sex and relationships education (SRE) in schools is creating “a ticking sexual health time bomb”, councils are warning, amid concern over high numbers of sexually transmitted infections (STIs) among young people.

The Local Government Association (LGA), which represents 370 councils in England and Wales, has joined the growing clamour urging the government to make sex education compulsory in all secondary schools. Currently it is mandatory in local authority-maintained schools, but not in academies and free schools which make up 65% of secondaries.

Izzi Seccombe, chair of the LGA’s community wellbeing board, said it was a major health protection issue. “The lack of compulsory sex and relationship education in academies and free schools is storing up problems for later on in life, creating a ticking sexual health time bomb, as we are seeing in those who have recently left school.

“The shockingly high numbers of STI diagnoses in teenagers and young adults, particularly in the immediate post-school generation, is of huge concern to councils.

The LGA argues that it is a health protection issue, with 141,000 new STI diagnoses for 20- to 24-year-olds in England in 2015 and 78,000 for those aged 15-19. Sexual health is one of local government’s biggest areas of public health spending, with approximately £600m budgeted annually.

The LGA appeal came as the government was reported to be close to making an announcement regarding SRE and PSHE (personal, social, health and economic education), after the education secretary, Justine Greening, flagged up the issue as a priority for government.

Campaigners hope the announcement will be made during the next stage of the children and social work bill, which is passing through parliament. An amendment with cross-party support was tabled last week which, if carried, would would amount to the biggest overhaul in sex education in 17 years, but it is not yet clear what the government announcement will amount to, and crucially whether it will make SRE compulsory.

Seccombe said: “We believe that making sex and relationship education compulsory in all secondary schools, not just council-maintained ones, could make a real difference in reversing this trend, by preparing pupils for adulthood and enabling them to better take care of themselves and future partners.”

The LGA says while SRE should be made compulsory for secondary school children, with statutory guidance on key issues including sexual health, parents should still be given the option of taking their children from the lessons.

Tory MP Maria Miller was among those proposing the amendment to the bill last week. It followed an inquiry by the women and equalities committee, chaired by Miller, which heard that most children have seen online pornography by the time they leave primary school and two thirds will have been asked for a sexual digital image of themselves before they leave secondary school.

According to Miller, research has shown that just one in four children at secondary school receives any teaching on sex and relationship issues, and Ofsted has said that when it is taught the quality of teaching is often poor.

“Different interest groups cannot agree on a way forward that suits them and in the meantime we are letting down a generation of children who are not being taught how to keep themselves safe in an online, digital world,” said Miller.

“We are not teaching them that pornography isn’t representative of a typical relationship, that sexting images are illegal and could be distributed to child abuse websites and how to be aware of the signs of grooming for sexual exploitation.

“Overwhelmingly parents and children are fed up and want change. They want compulsory lessons in school to teach children and young people about consent and healthy relationships.”

Complete Article HERE!