Search Results: Sexual Anxiety

You are browsing the search results for sexual anxiety

Why Do So Many Bisexuals End Up In “Straight” Relationships?

FacebookTwitterGoogle+PinterestTumblrShare

By Kristina Marusic

001

When I started dating a woman for the first time after years of happily dating men, I had a go-to joke ready for when I was called upon to explain my sexual orientation to the confused: “I’m half gay. Only on my mom’s side of the family.”

I’m one of those people who’d always misguidedly “hated labels,” and I actively eschewed the term “bisexual” for years. I went on to date a number of trans guys, and in my mind, “bi” was also indicative of a gender binary I didn’t believe existed. I’ve since come to understand that actually, the “bi” implies attraction not to two genders, but to members of both one’s own and other genders, and that the bisexual umbrella includes a wide rainbow of labels connoting sexual fluidity. These days, I wear the “bisexual” label proudly.

Given all that struggle and growth, my current situation might come as a surprise: I’m in a committed, long-term relationship with a cisgender man who identifies as straight—just like a startling majority of other bisexual women.

Dan Savage once observed that “most adult bisexuals, for whatever reason, wind up in opposite-sex relationships.” Whether or not you’re a fan of Savage (or his sometimes dubious takes on bisexuality), the statistics support his assertion: The massive 2013 Pew Research LGBT Survey found 84 percent of self-identified bisexuals in committed relationships have a partner of the opposite sex, while only 9 percent are in same-sex relationships.

As someone who has spent way too much time convincing people—gay and straight alike—that my bisexuality actually exists, that “for whatever reason” modifier of Savage’s has long vexed me. What is the reason? Because on the surface, the fact that 84 percent of bisexuals eventually wind up in opposite-sex partnerships could appear to support the notion that bisexuality is, as people so often insist, actually either “just a phase” or a stepping-stone on the path to “full-blown gayness.” Knowing that wasn’t true, I decided to investigate.

Some of my initial suppositions included internalized homophobia, fear of community and family rejection, and concerns over physical safety. Although being bisexual doesn’t necessarily mean you’re equally attracted to multiple genders, it does seem feasible that these sorts of concerns could push a person with fluid attractions in the direction deemed more socially acceptable.

Although there’s a dearth of research into whether these factors are actually prompting bisexuals to choose relationships that appear “straight” to the outside world, there’s no shortage of research revealing that bisexuals live under uniquely intense pressures within the LGBTQ community: In addition to facing heightened risks for cancer, STIs, and heart disease, bisexuals also experience higher rates of anxiety, depression, and substance abuse, and are significantly more likely to engage in self-harming behaviors or attempt suicide than heterosexuals, gays, or lesbians. It isn’t difficult to imagine that for some, the promise of a bit more social currency and safety could be compelling reasons to seek out an opposite-sex partner, even unconsciously.

But there’s actually a much simpler, more obvious, and more likely explanation for the reason so many bisexuals wind up in opposite-sex partnerships: The odds fall enormously in their favor.

Americans have a well-documented tendency to drastically overestimate the percentage of queer folks among us. Polls have revealed that while most people believe LGBTQ people make up a full 23 percent of the population, but the number is actually closer to a scant 3.8 percent. So not only is it statistically more likely more likely that a bisexual person will wind up with a partner of the opposite sex; it’s equally likely that they’ll wind up with someone from the over 96 percent of the population who identifies as straight.

As anyone currently braving the world of dating knows, finding true love is no easy feat. There likely aren’t a ton of people on this planet—let alone within your geography or social circles—whose moral compass, sense of humor, Netflix addictions, dietary restrictions, and idiosyncrasies sync up with yours closely enough to make you want to hitch your wagon to them for the long-haul (and the internet is making us all even picker). Add to that the fact that due to persistent biphobia, a large number of gay men and lesbians still flat-out refuse to date bisexuals, and it becomes even more apparent that the deep ends of our relatively narrow dating pools are, for bisexuals, overwhelmingly populated by straight people—folks who, for bi women at least, are also more likely to boldly swim on over and ask us out.

It’s also worth keeping in mind that although plenty of bisexuals enjoy monogamy, not all people in committed relationships choose to be monogamous. Bisexuals in committed, opposite-gender relationships (including marriages) may very well have arrangements with their partners that allow them to enjoy secondary relationships with members of the same gender.

That said, we have to remember that even within monogamous opposite-sex relationships, if one or both parties identify as bisexual, that partnership doesn’t invalidate anyone’s bisexual identity—after all, we’d never tell a gay man practicing abstinence that he “wasn’t really gay” just because he wasn’t currently sleeping with men.

Ultimately, a relationship with a bisexual in it isn’t ever really “straight” anyway—by virtue of the fact that there’s at least one person in there queering the whole thing up. At our best, bisexuals are queer ambassadors: We’re out here injecting queer sensibilities into the straight world, one conversation and one relationship at a time.

Complete Article HERE!

Shaming Men Doesn’t Build Healthy Sexuality

By David J Ley Ph.D

StandingNudeMaleTorso

Male sexuality is intensely under attack, in the increasingly vitriolic social dialogue related to pornography. Though women watch and make pornography, most of the current debates focus on aspects of masculine sexual behaviors. These behaviors include masturbation, use of pornography, prostitutes or sexual entertainment like strip clubs. Promiscuity, sex without commitment, and use of sex to manage stress or tension are all things that are frequently a part of male sexuality, whether we like it or not. But, male sexuality is not a disease, not a public health crisis, it is not evil, and it does not overpower men’s lives or choices. Shaming men for these behaviors isolates men, and ignores powerful, important and healthy aspects of masculinity.

There is a common perception of male sexuality as intrinsi­cally selfish, overly focused on “scoring” and sexual conquests, on anonymous, “soulless” sex, and on the outward manifestations of virility.  But there are other, oft neglected sides of male eroticism. Straight men are far more focused upon women’s needs, and upon closeness with women, than we give them credit for. Nancy Friday wrote that “Men’s love of women is often greater than their love of self.” Men give up friends and male camaraderie and accept a life of economic support of women, even leading up to an earlier death, all in order to be with women. More than half of all men describe that their best sexual encounters came when they “gave a woman physical pleasure beyond her dreams.” Men redi­rect their selfishness away from their own satisfaction, and toward a sense of fulfillment and accomplishment, by giving sexual satisfaction. Male sexuality often involves an intense focus on the needs of their partners, and men gain great pleasure, even a strong sense of manliness, from giving their lover sexual pleasure.

In fact, men’s desire to sexually satisfy their partners comes at the price of their own satisfaction. When a man is unable to make his partner orgasm, many men report incredible frustration, disappointment, and self-doubt. Women even complain that men put so much pressure and intent upon helping the woman achieve orgasm that the act ceases to be pleasurable and starts to feel more like childbirth. In such cases, women fake orgasms, not for themselves, but to satisfy their partner’s needs. Until a woman has an orgasm, a man doesn’t think he’s done his job, and his masculinity hangs in the balance.

Franz_Von_Stuck_-_SisyphusMen are taught from a young age that they must be sexually competent and sexually powerful with exaggerated and impossible ideals. Surveys of sex in America find that, compared to women, men are far more insecure and anxious about their sexual performance. Nearly 30 percent of men fear that they ejaculate too soon, most men sometimes experience erectile dysfunction connected to anxiety, and one man in every six reports significant worries about his sexual abilities to satisfy his partner. These are huge burdens that men carry, and are just one reason why many men pursue other forms of sex such as masturbation to pornography.

Compared to women, men actually experience greater pain and psychological disruption from the ups and downs of romantic relationships. Not only do the negative aspects of a romantic relationship hurt men more than women, but the positive aspects and benefits of that relationship have greater impact upon the man than the woman. Because women are better able to access outside support from friends and family, they often fare better than men. Men are often isolated and burdened with the expectation that they shouldn’t feel pain, or if they do, they must suffer alone.

For men, physical affection and sex is one of the main ways we feel loved, accepted, and regarded. For many men, it is only through physical love that we can voice tenderness and express our desire for togetherness and physical bonding. Only in sex can we let down boundaries and drop our armor enough to be emotionally vulnerable.

Sex plays a greater role in the lives of men as a form of acceptance and mutual regard than it does for women. Women touch each other all the time, with hugs, holding hands, closer body contact, and smaller “personal space.” Men shake hands. Really good friends might, at best, punch each other in a loving way, do a careful “man hug,” or even swat each other’s buttocks, if it’s during an approved masculine sporting event. (Many homosexual men experience this differently, when they come out and are part of the LGBTQ community) So the body-to-body contact that sex offers feeds an appetite, a craving, one that is often starved near to death in men.

Male sexuality is portrayed as something that men must guard against, and describe it as though it is a demonic force, lurking within our souls, which must be constrained, feared and even rejected. Men are portrayed as powerless to control themselves, in the face of sexual arousal that is too strong. Men are painted as weak, harmed and warped by sexual experiences such as pornography. As a result, men are told to be ashamed of the sexual desires that society has called unhealthy, and told to forego those condemned sexual interests. But an essential part of man is lost when we encourage men to split them­selves from their sexuality.

Unfortunately, as we teach men to be men, to understand, accept, and express their masculinity, we rarely attend adequately to the loving, nurturing, and amo­rous side of men. The most positive way that society and media currently portray male sexuality is when it is depicted as bumbling and stupid-making, a force that turns men into fools, easily led by our penises. But more often, male sexuality is depicted as a force that hovers just on the edge of rape, rage and destruction.

What is necessary for a healthy man, for complete masculinity, is the in­tegration, consolidation, and incorporation of ALL the varied aspects of our sexuality. When we try to externalize our desires for love and sex, excising them from ourselves as something external and dangerous, we run the real risk of creat­ing men without compassion, without tenderness, and without the ability to nurture. It is easy to suggest that what we are trying to excise are the base, primitive parts of men’s eroticism, those desires to rape, dominate, and sat­isfy oneself selfishly. But in truth, those desires, as frightening as they can be, are integrally linked to male emotional desires for safety, acceptance, protection of others, and belonging.

A_ShipwreckThose things that make men admired and respected—their strength, courage, independence, and assertiveness—are the same things which contribute to the differences in male and female sexuality. By condemning these characteristics, we run the real and frightening risk of abolishing qualities that are essential to healthy masculinity.

A healthy sexual male is one who accepts and understands his erotic and sexual desires, along with his drive for success, dominance (and often submission as well) and excellence. Healthy sexual choices come from internal acceptance and awareness, not rejection and shame. Research has shown that all men have the ability to exercise control over their levels of sexual arousal and sexual behavior, but no men can fully suppress their sexual desire. Healthy men can be men who go to strip clubs, visit prostitutes and watch pornography. They are men who make conscious sexual choices, accepting the consequences of their actions.

Our culture needs a sexual ethic focused on personal relationships and social justice rather than particular sexual acts. All persons have the right and responsibility to lead sexual lives that express love, justice, mutuality, commitment, consent and pleasure. Grounded in respect for the body and for the vulnerability that intimacy brings, this ethic fosters physical, emotional and spiritual health. It accepts no double standards and applies to all persons, without regard to sex, gender, color, age, bodily condition, marital status or sexual orientation. The Religious Institute

We need to begin encouraging personal integrity, responsibility, self-awareness and respect, both for oneself and one’s sexual partner(s). This is, I think, the goal for all men – to make their sexual choices an integrated part of who they are, and the kind of man they desire to be. Unfortunately, as long as we continue to shame and condemn men in general, and specific sexual acts, we are merely isolating men. Further, we are exacerbating the problem, because removing porn or shaming men for their desires or fantasies, does not teach men how to be a sexually healthy man.

Complete Article HERE!

The Effects of Rape & Sexual Abuse on the Male

By Male Survivors Trust

Slowly but surely, the common myth held that sexual abuse/rape happens to women only is fading, but when a man is sexually assaulted or raped, and grows up believing that myth, he feels even more isolated and alone. This page tackles some of the issues that are rarely talked about, yet have a huge impact on almost all male survivors, and if left unsaid and sorted out, can stop them from recovering fully, leaving a residue of bad feelings and fears behind. Some of the things that can trigger you off and leave you feeling as if you’re back at the point of being abused are as follows.

bryan_tony_boxThe smell of others, especially aftershave or other body smells, can cause you to flashback and trigger bad memories Many male survivors state that when having sex with a partner, that they feel dirty, and unclean once they have reached ejaculation, and this is connected to the sight, feel and sensation of seeing their semen, which reminds them of being abused, and that alone can ruin any sexual relationships they may have.

You may also feel wrong, bad and dirty, so will need to bathe often, usually after having sex with partners, and if masturbating, will only do so as a function, not for pleasure, because the sensation and good feelings have been taken away and you’re left feeling dirty and ‘wrong’ again. There’s also the fact that you can get obsessed with masturbation , not just once a day, but several times a day, which can increase when you feel stressed, lonely, screwed up, etc.

Many male survivors hide behind the fact that they remain non sexual, and in doing so, are not seen as being sexual beings, Others eat, drink, misuse drugs to stop people getting too close to them. By taking on the work that’s needed, you can remove the ghosts of the past and can regain control of your life

Male Survivors share many of the same feelings of female sexual assault survivors. Common feelings such as;

BODY IMAGE* Do you feel at home in your body?* Do you feel comfortable expressing yourself sexually with another?* Do you feel that you are a part of your body or does your body feel like a separate entity?* Have you ever intentionally and physically hurt yourself?* Do you find it difficult to listen to your body?

EMOTIONS * Do you feel out of control of your feelings?* Do you feel you sometimes don’t understand all the feelings you are experiencing?* Are you overwhelmed by the wide range of feelings you have?

RELATIONSHIPS * What’s your expectations of your partner in a relationship?* Find it too easy to trust others?* Find it too hard to trust anyone?* Find it difficult in making commitments?* Still feel alone, even though in a relationship?* Is it hard for you to allow others to get close to you?* Are you in a relationship with some-one who reminds you of the abuse, or who is no good for you?

SELF-CONFIDENCE * Do you find it difficult to love yourself?* Do you have a hard time accepting yourself?* Are you ashamed of yourself?* Do you have expectations of yourself that aren’t realistic?

SEXUALITY * Do you enjoy sex, really enjoy it?* Do you find it difficult to express yourself sexually?* Do you find yourself using sex to get close to someone?* End up having sex because it’s expected of you?* Does sex make you feel dirty?* Are you “present” during sex?

MAJOR SEXUAL SYMPTOMS OF SEXUAL ABUSE

  1. Difficulties in becoming aroused and feeling sensations
  2. Sex feels like an obligation
  3. Sexual thoughts and images that are disturbing
  4. Inappropriate sexual behaviors or sexual compulsivity
  5. Inability to achieve orgasm or other orgasmic difficulties
  6. Erection problems or ejaculatory difficulty
  7. Feeling dissociated while having sex
  8. Detachment or emotional distance while having sex
  9. Being afraid of sex or avoiding sex
  10. Guilt, fear, anger, disgust or other negative feelings when being touched

EXISTING EFFECTS ON MALE SURVIVORS.

Listed below are some of the current effects that sexual abuse, and after-effects it has upon a male Survivor.

Nightmares, (Intense, violent, sexual) – A real fear that everyone is a potential attacker. Intense shame. – Intense anger. – Intense guilt. – Fear in expressing anger/difficulties in being angry. A need to be in control. – A need to pretend they are not in control. A fear of being seen/fear of exposure.- Running away from people/situations. A fear of intimacy. – “Avoidism”. – Memories of physical pain. – Intense sexual flashbacks. Intruding thoughts. – Sexual dysfunction. – Asexual feelings. – Feeling unreal. – Self doubt. – Jealousy. – Envy. Sexual acting out. – Fear of men. – Fear of women. – Fear of speaking out. – Inability to relax. Disconnection with feelings. – Feeling alone. – Poor choice of partners. – “Out of body” experiences. Linking abuse to love. – Keeping secrets. – Forgetting childhood experiences. – Detached from reality. Inability to comfort their children. – Feeling inadequate. – Unable to accept compliments. – Low self esteem. Isolation. – Addictions/crime. – No emotions. – Fear of others motives. – Inability to say no. – Fear of rules.

pat_jack_elle_box

COMMON REACTIONS TO SEXUAL ABUSE/RAPE

Emotional Shock: Feeling numb. Being able to stay so calm? Unable to cry.

Disbelief and/or Denial: Did it really happen? Why me? Maybe I just imagined it. It wasn’t really abusive.

Embarrassment: What will people think? I can’t tell my family or friends.

Shame or Guilt: Feeling as if it’s your fault, or you should’ve been able to stop it. If only you had…

Depression: How are you going to get through the day. Feeling so tired! It feels so hopeless.

Powerlessness: Will you ever feel in control again?

Disorientation: You don’t even know what day it is. You keep forgetting things.

Flashbacks: Re-living the assault! Keep seeing and feeling like it’s happening again.

Fear: Scared of everything. Can’t sleep, Having nightmares. Afraid to go out. Afraid to be alone.

Anxiety: Panic attacks. Can’t breathe! Can’t stop shaking. Feeling overwhelmed.

Anger: Feel like hurting the person who attacked you!

Physical Stress: Stomach (or head or back) aches all the time. Feeling jittery and don’t feel like eating.

UNIQUE ISSUES FACED BY MALE SURVIVORS
There is great denial of the fact that men are sexually abused. Other than in prisons, most of us don’t ever hear about the topic of male sexual abuse. The need to deny is often deeply rooted in the mistaken belief that men are immune to being victimized, that they should be able to fight off any attacker if they are truly a “real man.” Another related ‘belief’ is that men can’t be forced into sex. These mistaken beliefs allow many men to feel safe and invulnerable, and to think of sexual abuse as something that only happens to women. Unfortunately, these beliefs also increase the pain that is felt by a male survivor of sexual abuse. These ‘beliefs’ leave the male survivor feeling isolated and ashamed. Below are some of the unique problems and concerns that male survivors do experience: For most men the idea of being a victim is extremely hard to handle. Boys are raised to believe that they should be able to defend themselves against all odds, or that he should be willing to risk his life or severe injury to protect his pride and self-respect. How many movies or TV shows depict the hero prepared to fight a group of huge guys over an insult or name-calling? Surely then, men are supposed to fight to the death over something like unwanted sexual advances…right?

These beliefs about “manliness” and “masculinity” are deeply ingrained in many men and lead to intense feelings of guilt, shame and inadequacy for the male survivor of sexual abuse. Some male survivors even question whether they deserved to be sexually abused because, as they think that they failed to defend themselves. Male survivors see their assault as a loss of manhood and feel disgusted with themselves for not “fighting back.” These feelings are normal but the thoughts attached to them are not true. Remind yourself that you did what seemed best at the time to survive–there’s nothing un-masculine about that.” As a result of guilt, shame or anger some men may punish themselves by exhibiting self-destructive behaviour after being sexually abused. For some men, this means increased alcohol or drug use. For others, it means increased aggressiveness, like arguing with friends or co-workers or even picking fights with strangers. Some men pull back from relationships and wind up feeling more and more isolated. Male survivors may also develop sexual difficulties after being sexually abused. It may be difficult to resume sexual relationships or start new ones because sexual contact may trigger flashbacks, memories of the abuse, or just plain bad feelings. It can take time, so don’t pressure yourself to be sexual before you’re ready.

For heterosexual men, sexual abuse almost always causes some confusion or questioning about their sexuality. Since many believe that only gay men are sexually abused, a heterosexual survivor may believe that he must be gay or that he will become gay. Furthermore, abusers often accuse their victims of enjoying the sexual abuse, leading some survivors to question their own experiences. Being sexually abused has nothing to do with sexual orientation, past, present or future. People do not “become gay” as a result of being sexually abused. However, there are certain issues that are different for men:

Concerns about sexuality and/or masculinity

Medical procedures

Reporting crime to law enforcement agencies

Telling others

FINDING RESOURCES AND SUPPORT

No matter what is said or done, no one “asks for” or deserves to be assaulted. Sexual abuse/rape is nothing to do with someone’s present or future sexual orientation. Sexual abuse comes from violence and power, nothing less. Unfortunately, the health profession are reluctant to recognise that men can be sexually assaulted. This also includes the Police Forces, though that is slowly improving at last This attitude, combined with ignorance affects the way they treat men who have been raped/sexually abused, often using a stereotyped view of masculinity, rather than focus on the physical assault, the crime becomes the focus of the medical exam or police investigation.

WHAT YOU CAN DO

Recognize that men and boys can and are sexually assaulted.

Be aware of the biases and myths concerning sexual abuse.

Recognize that stereotypes create narrow definitions of masculinity, and make it even harder for male survivors to disclose their rape/abuse.

As individuals and as a community, that we work harder to combat and challenge those attitudes.

It is important that male rape survivors have support, and are allowed to make their own decisions about what course of action to take. All too often, they feel forced to make statements or act against their abusers, without having had the time and space to think it through. I never advocate they prosecute their abusers, I suggest they perhaps begin their personal journey to recover from the traumas they are left with.

NOTHING JUSTIFIES SEXUAL ABUSE!

It doesn’t have to be this way though, you can overcome the issues listed and can recover. Just in case you need a reminder;

Men of all ages, and backgrounds are subjected to sexual assaults and rape.

Offenders are heterosexual in 98% of the cases.

Both heterosexual and homosexual men get raped.

Rape occurs in all parts of society.

Men are less likely to report being raped.

A PERSONAL VIEW.

The belief that the male population is the stronger sex, especially when it comes to sex, is deeply ingrained, believed, and supported within our culture, but not all men and boys are physically or emotionally strong, which explains why there are male “victims” of sexual abuse/rape. Male child sexual abuse is perpetrated by both men and women, of any sexual persuasion, with no regard towards the “victims” sexuality or safety. It holds scant regard for who we are, and is about gaining power and control over the “victim”. As children, we are placed in the care of our parents/guardians, family, family friends, schools, and more often than not, sometimes strangers. The ‘Danger Stranger’ campaign focused on the danger of strangers, with the intent of scaring children into not trusting strangers, but plainly ignored the fact that parents, siblings, family members, and those other “nice people” especially those people known as the “Pillars of Society”, are much more likely to sexual abuse children. As a result of our sexual abuse, we grow up with many mistaken beliefs, and many Survivors have fallen into a myriad of roles that include alcoholism, crime, depression, self harming, people pleasing, hardworking, etc. But, far from being powerless, we have drawn upon considerable reserves of inner strength to deal with, adjust and cope with the invasion of our bodies and minds.

Our previous actions in dealing with life may not have been what we wanted to do, and may have caused more pain on the way, but surely we have arrived at a time when we all need to face our past, forgive OUR actions, and move away from the guilt, shame and fear that has haunted us for so long. This possibly took many forms, but is something that we all need to forgive ourselves for, as long we don’t intend to ‘return there’. Some thoughts to have plagued male survivors have been “Perhaps I was to blame” “I should have told someone” “I was in the wrong place, at the wrong time” “I deserved it” “Maybe I gave out the wrong signals” “Maybe I’m gay”………,What we don’t want to hear is pity, or told “how awful” “so sad”, “poor little boy” as that concept is dis-empowering and perpetuates pity for the ‘victim’ and we are then seen as “not quite right”.

We are OK, we are capable of living our lives, and we are more than capable of overcoming the traumas that our abuser(s) left behind. I subscribe to the belief that in order to heal fully you have to face your abusive past, however difficult that may be, but in doing so, you can move on emotionally, forgive your actions, find inner peace, and be the person you want to be, not who ‘they’ wanted you to be. Please break the silence and demand the right to be recognized! If you want to join, we will support you in your struggle, be ‘here’ for you when you need us, and help you understand who you are, and what you want to be. The next step is from victim, to SURVIVOR, which is possible. It’s not easy, and involves you telling someone else all those deep hidden secrets, but once started, DON’T STOP!

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!