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Our shame over sexual health makes us avoid the doctor. These apps might help.

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We’re taught to feel shame around our sexuality from a young age, as our bodies develop and start to function in ways we’re unfamiliar with, as we begin to realize our body’s potential for pleasure. Later on, women especially are taught to feel ashamed if we want “too much” sex, or if we want it “too early,” or if we’re intimate with “too many” people. Conversely, women and men are shamed if we don’t want nearly as much sex as our partner, or if we’re inexperienced in bed. We worry that we won’t orgasm, or that we’ll do so too soon. We’re afraid the things we want to do in bed will elicit disgust.

This shame can also keep people from getting the health care they need. For example, a 2016 study of college students found that, while women feel more embarrassed about buying condoms than men do, the whiff of mortification exists for both genders. Another 2016 study found many women hide their use of health-care services from family and friends so as to prevent speculation about their sexual activity and the possibility that they have a sexually transmitted infection (STI).

While doctors should be considered crucial, impartial resources for those struggling with their sexual health, many find the questions asked of them during checkups to be intrusive. Not only that but, in some cases, doctors themselves are uncomfortable talking about sexual health. They may carry conservative sexual beliefs, or have been raised with certain cultural biases around sexuality. It doesn’t help that gaps in medical school curriculums often leave general practitioners inadequately prepared for issues of sexual health.

So how do people who feel ashamed of their sexuality take care of their sexual health? In many cases, they don’t. In a study on women struggling with urinary incontinence, for example, many women avoided seeking out treatment — maintaining a grin-and-bear-it attitude — until the problem became “unbearable and distressing to their daily lives.”

Which may be why smartphone apps, at-home testing kits and other online resources have seen such growth in recent years. Now that we rely on our smartphones for just about everything — from choosing stock options to tracking daily steps to building a daily meditation practice — it makes sense people would turn to their phones, laptops and tablets to take care of their sexual health, too. Websites such as HealthTap, LiveHealth Online and JustDoc, for example, allow you to video chat with medical specialists from your computer. Companies such as L and Nurk allow you to order contraceptives from your cellphone, without ever going to the doctor for a prescription. And there are a slew of at-home STI testing kits from companies like Biem, MyLAB Box and uBiome that let you swab yourself at home, mail in your samples and receive the results on your phone.

Bryan Stacy, chief executive of Biem, says he created the company because of his own experience with avoiding the doctor. About five years ago, he was experiencing pain in his genital region. “I did what a lot of guys do, and did nothing,” he says, explaining that, while women visit their gynecologist regularly, men generally don’t see a doctor for their sexual health until something has gone wrong. “I tried to rationalize away the pain, but it didn’t go away.” Stacy says he didn’t want to talk to a doctor for fear of what he would learn, and didn’t know who he would go to anyway. He didn’t have a primary care physician or a urologist at the time. But after three months of pain, a friend of his — who happened to be a urologist — convinced him to see someone. He was diagnosed with chlamydia and testicular cancer. After that, he learned he wasn’t the only one who’d avoided the doctor only to end up with an upsetting diagnosis. “What I found is that I wasn’t strange,” Stacy says. “Everyone has this sense of sexual-health anxiety that can be avoided, but it’s that first step that’s so hard. People are willing to talk about their sexual health, but only if they feel like it’s a safe environment.”

So Stacy set out to create that environment. With Biem, users can video chat with a doctor online to describe what they’re experiencing, at which point the doctor can recommend tests. The user can then go to a lab for local testing, or Biem will send someone to their house. The patient will eventually receive their results right on their phone. Many of the above-mentioned resources work similarly.

Research shows there’s excitement for tools like these. One study built around a similar service that was still in development showed people 16 to 24 years old would get tested more often if the service was made available to them. They were intrigued by the ability to conceal STI testing from friends and family, and to avoid “embarrassing face-to-face consultations.”

But something can get lost when people avoid going in to the doctor’s office. Kristie Overstreet, a clinical sexologist and psychotherapist, worries these tools — no matter their good intentions — will end up being disempowering in the long run, especially for women. “Many women assume they will be viewed by their doctor as sexually promiscuous or ‘easy,’ so they avoid going in for an appointment,” she says. “They fear they will be seen as dirty or less than if they have an STI or symptoms of one. There is an endless cycle of negative self-talk, such as ‘What will they think about me?’ or ‘Will they think that I’m a slut because of this?’ If people can be tested in the privacy of their own home without having to see a doctor, they can keep their symptoms and diagnosis a secret,” Overstreet says, which only increases the shame.

As for the efficacy of these tools, Mark Payson, a physician and co-founder of CCRM Northern Virginia, emphasizes the importance of education and resources for those who do test positive. These screening tests can have limits, he says, noting that there can be false negatives or false positives, necessitating follow-up care. “This type of testing, if integrated into an existing physician relationship, would be a great resource,” Payson says. “But for patients with more complex medical histories, the interactions of other conditions and medications may not be taken into account.”

Michael Nochomovitz, a New York Presbyterian physician, shows a similar level of restrained excitement. “The doctor-patient interaction has taken a beating,” Nochomovitz says. “Physicians don’t have an opportunity to really engage with patients and look them in the eye and talk to them like you’d want to be spoken to. The idea is that tech should make that easier, but in many cases, it makes it more difficult and more impersonal.” Still, he sees the advantages in allowing patients to attend to their health care on their own terms, rather than having to visit a doctor’s office.

Those who have created these tools insist they’re not trying to replace that doctor-patient relationship, but are trying to build upon and strengthen it. “We want people to be partnering with their doctor,” says Sarah Gupta, the medical liaison for uBiome, which owns SmartJane, a service that allows women to monitor their vaginal health with at-home tests. “But the thing is, these topics are often so embarrassing or uncomfortable for people to bring up. Going in and having an exam can put people in a vulnerable position. [SmartJane] has the potential to help women feel they’re on a more equal footing when talking to their doctor about their sexual health.”

“If you come in with a positive test result,” says Jessica Richman, co-founder and chief executive of uBiome, “it’s not about sexual behavior anymore. It’s a matter of medical treatment. It’s a really good way for women to shift the conversation.”

This can be the case for men and women. While many will use these options as a means to replace those office visits entirely, their potential lies in the ability to improve the health care people receive.

Complete Article HERE!

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When “No” Isn’t Enough And Sexual Boundaries Are Ignored

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Violence is so normalized that we often don’t even recognize sexual abuses in the moment.

By Sherronda J. Brown

I recently realized that sex is unhealthy for me. Not sex in theory. No, of course not. Sex is healthy for our bodies and even our hearts and minds.When I say that sex is unhealthy for me, I mean the kind of sex that I have experienced — an experience that I share with many women, femmes, and bottoms. The sex where my needs are neglected and my boundaries are ignored in favor of whatever desires my partner may have.

Not everyone experiences sex and the things surrounding it in the same way, for various reasons. Some of those reasons might include gender cultivation, (a)sexuality, choice of sexual expression, knowledge of self/knowledge one’s own (a)sexuality, or relationship with one’s own body. Some of those reasons might include how certain body types are deemed “normal” and acceptable while others are only ever fetishized or demonized.

Some of those reasons might include the fact certain folks are told that they should be grateful that anyone would even be willing to look at them, let alone touch or love them, while others are expected to always be available for sexual contact. Some of those reasons might include the fact that some people are afforded certain permissions to make decisions about their sex and love life without being eternally scrutinized, while others are nearly always assumed to be sexually irresponsible.

Some of those reasons might include past or current trauma and abuse. And a host of other reasons not mentioned here, or reasons that you or I have never even considered because they’re not a factor in our personal story.

I’m not straight. I’m just an asexual with a libido—infrequent as it may be—and a preference for masculine aesthetic and certain genitalia. Most of the sex that I have had is what we would consider to be “straight” sex, and I am fairly certain that I would enjoy the act more and have a healthier relationship with it if more sexual partners were willing to make the experience comfortable and safe for me. Instead, men seem to want to make sex as uncomfortable and painful as possible for their partners, whether consciously or unconsciously, regardless of whether or not that is what we want.

Many men seem to judge their sexual partners abilities the same way that they gauge how much we love them and how deep our loyalty goes — by how much pain we can endure. I say this based on my personal experience, as well as the experiences of many of the people around me who have been gracious and trusting enough to share with me their testimony. Many of us have been conditioned to measure ourselves in the same way, using our ability to endure pain as a barometer for our worth.

Not only do we need to address the fact that far too many women have sex when they don’t want to because it’s “polite”, but we also need to talk about how many of us, of various genders, are having sex that is painful and/or uncomfortable in ways that we don’t want it to be, but we endure it for the sake of being polite, amiable, or agreeable. Many times, we also endure it for our safety.

This goes beyond simply not speaking up about what we want during sex. It’s also about us not being able to speak up about our boundaries and limits without fear of the situation turning violent. The truth is that many of us have quietly decided in our heads, “I would rather suffer through an uncomfortable/painful sexual situation than a violent one, or one that I might not survive.” This is about too many men not being able to tell the difference between a scripted pornographic situation or a story of sexual violence.

There have been too many times when I have been engaged in sexual situations and told my partner that I did not want a particular sexual act done to me, and they proceeded to do it anyway, with no regard for my boundaries, comfort, or safety. I gave them a valid reason for why I did not want the particular sexual act done to me, but I didn’t have to. My “No” should have been enough.

I once had to blatantly ask a guy if he understood what the word “No” meant. He had been attempting to persuade me into performing a sexual act that I was not interested in and had already declined several times. Therefore, it seemed a valid question.

“Yea, I do,” He responded. “It means keep going.” His answer did not stop there, but I will spare you the totality of the violent picture that he painted for me with his subsequent vulgarities. His voice was steady with a seriousness I dared not question. There was anger behind it, but also excitement and pride. The very thought of ignoring my “No” seemed to arouse him, even as he was filled frustration at my audacity to ask him such a question. I abruptly ended the phone call, grateful that this conversation had not been in-person. A chill came over me and I felt the urge to cry. My head and neck ran hot and the rise and fall of my chest quickened. Anxiety gripped me as I remembered that he knew where I lived and my panic drew out for weeks.

This is only one of my stories. I have others that include blatant disregard of boundaries, harassment, and other forms of sexual misconduct. I spent much of the last year contemplating the many ways that I have been coerced, manipulated, or even forced into sexual situations or sexual acts in the past, and how this violence is so normalized that we often don’t even recognize these abuses in the moment. Instead, they come back to fuck with us days, weeks, months, years, decades, centuries after the fact.

It took me more than seven years to realize that the first guy I ever had sex with coerced me into it. Literally trapped me in his apartment and refused to take me home until I gave in. After this, he went on to violate my trust and disregard my sexual boundaries in other ways until I ended our “friendship.” It took me months to name the time a former partner admitted to having once removed the condom during our encounter without my knowledge or consent as a sexual violation.

Unfortunately, I don’t know a single woman who doesn’t have stories like mine. And these stories belong to many people of other genders, or without gender, as well. This is our “normal,” and that is not okay. We need a broader understanding of what sexual violence and misconduct look like, and we need to deal with the fact that they are more a part of our everyday lives and common experiences than some of us are willing to admit.

We have to stop thinking of sexual violence and misconduct as something that only happens when someone is physically assaulted, drugged, or passed out. It’s far more than being groped by your boss, or terminated or otherwise punished for rejecting their advances. In a world where people do not feel safe saying “No,” not only to sex itself but also to certain sexual acts and types of sex, we cannot go on talking about sexual violence as if rape and harassment are the only true crimes. In doing this, we are leaving people behind.

The ways in which our bodies and boundaries can be violated are abundant. Too abundant. Fuck everyone who ever made another person feel like they couldn’t safely say “No.”

Complete Article HERE!

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Some drugs can cause unwanted sexual side effects in men

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You might assume that erectile dysfunction, or ED, is a normal problem that men face as they age. But because men (and women) take more medications as they age, the experts at Consumer Reports’ Best Buy Drugs report that side effects from those drugs are a little-known yet common cause of ED.

“Many medications can affect things like erectile dysfunction, desire and ejaculation in different ways and through different mechanisms of action,” says J. Dennis Fortenberry, former chair of the board of the American Sexual Health Association and the Donald Orr Professor of Adolescent Medicine at Indiana University School of Medicine.

Medications that can have these effects include high blood pressure drugs such as beta blockers, including atenolol (Tenormin), clonidine (Catapres), metoprolol (Lopressor) and methyldopa (Aldomet), and diuretics such as hydrochlorothiazide (Hydrodiuril).

Popular antidepressants and anti-anxiety drugs such as alprazolam (Xanax), diazepam (Valium), duloxetine (Cymbalta), fluoxetine (Prozac) and paroxetine (Paxil) can cause sexual problems such as delayed ejaculation, reduced sexual desire in men and erectile dysfunction. Lesser-known drug types that can also cause such sexual problems include antihistamines such as diphenhydramine (Benadryl) and antifungal drugs such as ketoconazole (Nizoral).

Surprisingly, heartburn drugs, including famotidine (Pepcid) and ranitidine (Zantac) are known to reduce sexual desire in men. In addition, reduced desire and erectile dysfunction have been reported in men taking the powerful painkillers oxycodone (OxyContin) and hydrocodone (Vicodin), muscle relaxers such as baclofen (Lioresal), and even over-the-counter ibuprofen (Advil, Motrin).

And perhaps not surprisingly, the more drugs a man takes, the greater his odds are of experiencing an issue. For example, in a 2012 study of men ages 45 to 69, those who took three to five drugs were 15 percent more likely to have erectile dysfunction than men taking two or fewer. Men who took six to nine drugs were 51 percent more likely to have erection problems.

What you can do

Before making any change to your medications, talk with your doctor, says David Shih, a board-certified emergency medicine physician and executive vice president of strategy on health and innovation at CityMD, a network of urgent care centers in the New York metro area and Seattle.

If appropriate, your physician can make changes such as “lowering the medication dose, switching to a new medication or a combination therapy of lower doses each,” notes Shih.

Your doctor may also suggest temporarily stopping a medication — often referred to as taking a “drug holiday” — before having sex, if that is possible.

If you’ve just started taking a new drug, sexual side effects may disappear as your body adjusts. But if after a few months they don’t, discuss it with your physician. He or she will want to rule out other conditions that could cause your sex drive to take a nose-dive.

“The prescribing physician will need to explore if these symptoms are from cardiovascular disease, depressive disorder, diabetes, neurological disease and other illnesses,” says Shih.

Even suffering from sleep apnea is known to affect sexual interest or response.

That’s why, if you experience ED, it’s important to get to your doctor’s office for a detailed discussion about what could be causing it.

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All forms of sexual harassment can cause psychological harm

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“Being exposed to non-physical sexual harassment can negatively affect symptoms of anxiety, depression, negative body image and low self-esteem,” say Associate Professor Mons Bendixen and Professor Leif Edward Ottesen Kennair at the Norwegian University of Science and Technology’s (NTNU) Department of Psychology.

This applies to derogatory sexual remarks about appearance, behaviour and sexual orientation, unwanted sexual attention, being subject to rumouring, and being shown sexually oriented images, and the like.

The researchers posed questions about sexual experienced in the previous year and received responses from almost 3,000 high school students in two separate studies. The responses paint a clear picture.

Worst for girls. This is not exclusively something boys do against girls. It’s just as common for boys to harass boys in these ways.

Girls and boys are equally exposed to unpleasant or offensive non-physical sexual harassment. About 62 per cent of both sexes report that they have experienced this in the past year.

“Teens who are harassed the most also struggle more in general. But girls generally struggle considerably more than boys, no matter the degree to which they’re being harassed in this way,” Kennair notes.

“Girls are also more negatively affected by sexual harassment than boys are,” adds Bendixen.

Being a girl is unquestionably the most important risk factor when teens report that they struggle with anxiety, depression, or .

However, non-physical sexual harassment is the second most important factor, and is more strongly associated with adolescents’ psychological well-being than being subjected to sexual coercion in the past year or sexual assault prior to that.

Level of severity

Bendixen and Kennair believe it’s critical to distinguish between different forms of harassment.

They divided the types of harassment into two main groups: non-physical harassment and physically coercive sexual behaviour, such as unwanted kissing, groping, intimate touch, and intercourse. Physical sexual coercion is often characterized as sexual abuse in the literature.

Studies usually lump these two forms of unwanted behaviour together into the same measure. This means that a derogatory comment is included in the same category as rape.

“As far as we know, this is the first study that has distinguished between these two forms and specifically looked at the effects of non-physical sexual harassment,” says Bendixen.

Comments that for some individuals may seem innocent enough can cause significant problems for others.

Many factors accounted for

Not everyone interprets slang or slurs the same way. If someone calls you a “whore” or “gay,” you may not find it offensive. For this reason, the researchers let the adolescents decide whether they perceived a given action as offensive or not, and had them only report what they did find offensive.

The article presents data from two studies. The first study from 2007 included 1384 . The second study included 1485 students and was conducted in 2013-2014. Both studies were carried out in Sør-Trøndelag county and are comparable with regard to demographic conditions.

The results of the first study were reproduced in the second. The findings from the two studies matched each other closely.

The researchers also took into account a number of other potentially influential factors, such as having parents who had separated or were unemployed, educational programme (vocational or general studies), sexual minority status, , and whether they had experienced physical coercion in the past year or any sexual assaults previous to that.

“We’ve found that sexual minorities generally reported more psychological distress,” says Bendixen. The same applied to with parents who are unemployed. On the other hand, students with immigrant status did not report more psychological issues. Bendixen also notes that sexual minorities did not seem to be more negatively affected by sexual harassment than their heterosexual peers.

However, the researchers did find a clear negative effect of non-physical sexual harassment, over and beyond that of the risk factors above.

Uncertain as to what is an effective intervention

So what can be done to reduce behaviours that may cause such serious problems for so many?

Kennair concedes that he doesn’t know what can help.

“This has been studied for years and in numerous countries, but no studies have yet revealed any lasting effects of measures aimed at combating sexual harassment,” Bendixen says. “We know that attitude campaigns can change people’s attitudes to harassment, but it doesn’t result in any reduction in harassment behaviour.”

Bendixen and Kennair want to look into this in an upcoming study. Their goal is to develop practices that reduce all forms of and thereby improve young people’s psychological well-being.

Complete Article HERE!

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What it’s like to be a male sexual surrogate

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The Sessions looked at the work of sexual surrogates

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For most adults, sex is an activity that can bring joy, frustration, contentment or disappointment – the full range of human responses. But for a few people, the very thought of sexual contact with another human being causes such anxiety that they can never get close to the act.

For them, psychosexual therapy is usually a good choice. And in a few cases, this can involve a particular form of therapy: use of a sexual surrogate.

Sexual surrogates are trained and professional stand-in partners for men and women who have severe problems getting to an intimate/sexual relationship. Normally, the client will be undergoing counselling with a psychosexual therapist, and then, in parallel with that, will have ‘bodywork’ sessions with a surrogate partner.

Andy, 50, is a psychosexual therapist who also worked as a surrogate for a number of years. Clients tend to be aged from their mid-thirties to around fifty and most came to him through word of mouth. “Some people have never experienced sexual intimacy,” he explains. “I had one client who had never gone beyond kissing.” Others have experienced abuse and have negative connotations around sex or have physiological problems.

“I would usually do between six and ten monthly sessions of three hours each. The first sessions would be about getting comfortable being in a room with a man. So I will say, ‘So you’re in a room with a man, how does that feel for you?’ And perhaps it reminds them of being a teenager so we’ll talk about what that teenage part of them needs – to be more confident, say.”

Although the sessions would build towards penetrative sex, it would be a long way down the line. But some clients want to take things too quickly, he says. “If they want to rush into sexual intimacy or penetration then I’ll slow them down and ask them where that comes from. Most of them do need to slow down because they’re rushing into what they think is the goal of sex.”

After a few sessions, Andy would bring touch into the sessions. “I would ask them what sort of touch they would want to receive. And they might like to receive some sort of massage, fully clothed or partly unclothed. Sometimes we would sit opposite each other on the sofa and find out what happens in her system if one of us leans closer. Does she get excited? Does she want to run away? Does she want to reach out and have more contact?”

Once the client was comfortable with touching, nudity would be introduced. “I might do an undressing process where I would invite them to take off one piece of clothing and each time to name a limiting belief that stops them really enjoying and celebrating their body and allowing pleasure in it. ‘One thing that stops me is my belief that I’m unattractive and my bum’s too big.’ They would take off that piece of clothing and that belief. Then I would offer feedback about what I see, so, ‘Your breasts feel very sensual and feminine to me’.”

Sexual surrogacy has been operating in Britain for a few decades, introduced from America, where it was also the subject of the Oscar-nominated film The Sessions, based on the true story of partially paralysed polio survivor Mark O’Brien and Cheryl Cohen-Greene, the surrogate he worked with to overcome his problems.

While most surrogates are female working with male clients, there are a handful of male surrogates in Britain who work with female clients. Male surrogates tend to be mid-thirties and older.

For many men, being hired to act as an intimate partner for a woman they barely know would be a strange situation. So how did Andy feel during these sessions? “Sometimes it was quite challenging, sometimes engaging, sometimes arousing,” he recalls. “And client reactions were very varied too. Some would feel ashamed, sometimes emotional or physical discomfort. Or they would feel excitement and confidence. It was moment to moment – it’s like how you feel in a relationship, you feel many things.

“It’s an interesting line to walk. There are many clients that I have worked with who I really liked and I enjoyed the work with them both sexually and emotionally but I’m also aware that I’m not there to be in a relationship with them.”

He is glad he did the job but it did cause him difficulties, not least in relationships with his own partners, whom he always made aware of his work. “I supported many women through a very challenging and sometimes life-changing process,” he says. “But I found that ultimately it took too great a toll – energetically, physically and emotionally. I was putting myself in situations of intimacy with a client that I wouldn’t necessarily have chosen. And I found that draining. I would sometimes ask, ‘Why did I do that to myself?'”

Overall he believes they key to sexual surrogacy involves being realistic about what will come of it.

“I think surrogacy is to be entered into with as much self-awareness as the client can muster,” he says. “While it can point them in the right direction, it’s not the answer. Ultimately, they have to find confidence within themselves. It can be a step on that journey.”

Complete Article HERE!

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