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How to Talk to Your Younger Sibling About Sex

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Since older siblings can sometimes be the best sex-ed teachers, here are four important topics to cover and a few links about how to get the conversation started.

Positive sexuality is at the forefront of conversations being had by student activists on college campuses. Dismantling the societal constructs of traditional masculinity and femininity and redefining campus sexual scripts are priorities aiming to decrease sexual assault rates and increase discussion about what perpetuates them.

As a result, college students are in a prime position to be instigators of conversations amongst younger groups, because they are at the core of the rapidly changing dialogue prompting social changes that support young adults in expressing their sexuality and promoting safe sexual climates for everyone.

Being a mentor to the younger kiddos in your life, and more specifically the youngsters in your family, can be a tricky yet invaluable role to fill. If you decide to open up a conversation about sex with younger siblings, some awesome topics to include are consent, gender identities and expressions, contraceptives, birth control and the construct of virginity. There are certainly other categories to include, and questions will likely arise about the many nuances of sex, but starting with broad ideas essential to healthy sexuality will set up the conversation to be productive and meaningful.

1. Consent

It’s never too early to start introducing principles of consent into children’s lives, nor is it ever too late. If your siblings are elementary school-aged, having a conversation with them about consent does not have to centered around sex, because consent is applicable to any and all interactions, whether sexual intentions are present or not.

Teaching young kids to ask for permission to hug someone or to sit close to someone plants the seed for healthy habits of asking for and offering consent to grow. If younger individuals become accustomed to asking for consent in small, everyday ways, they will be more aware and respectful of others’ boundaries. As they grow into adolescents and college students, the concepts of consent will be second nature and clearly understood when they do enter into sexual contexts where consent is required.

Regardless of the age of your siblings, consent is applicable to everyone and should be a frequent, continuing conversation. For siblings that are old enough to dive deeper, unpacking the mechanics of genuine and enthusiastic consent can include information about how things such as power dynamics, substances, coercion and intimidation can all influence the improper acquisition of consent. This is also a great time to emphasize that despite the common tactics used to unfairly obtain someone’s consent, the right to enthusiastically consent to sexual activity without the influence of outside factors is omnipresent, powerful and absolute.

Consent is a quintessential component of healthy sexual encounters! For more info on consent, and the “Yes Means Yes” campaign advocating for enthusiastic consent, check out https://www.yesmeansyes.com and have your siblings take a look, too for the scoop on all things consent and respect. As quoted in an article on everydayfeminism.com “conversations about consent—especially if those conversations are with children—are not always easy to have. They are, however, necessary if we’re trying to create a society in which consent is understood and respected by adults and children alike.”

2. Gender Identities

Another frequently skipped-over chapter in the sparse book of sex education in America is the section on gender identity. Thanks to celebrity stories in recent years such as Caitlin Jenner, Jazz Jennings and many other Hollywood young adults openly identifying as gender fluid, bisexual and indicating other identities along the gender-nonconforming spectrum, gender identity and gender rights have become popular topics. While many school sex education programs are a bit behind the times and have yet to add conversations about various gender identities into their curriculum, older siblings can try to fill some of the gaps.

The biggest point to emphasize to a younger sibling is the difference between sex and gender, and that gender is a social construct that is governed by expectations and norms that align with the gender binary system. To expand on that, include notes about how gender is made up of multiple components that fall along a spectrum; there are new models, like the gender unicorn, being developed to illustrate this idea; the colorful and simple designs are engaging for young learners and a great visual representation of the spectrums in general.

Most of all, encourage youngsters to explore and contemplate their own gender identity by questioning the norms they’re conditioned to live in accordance with, and support them unconditionally in their discoveries. Your unwavering love may serve as an example for when they find themselves being a support for a friend or peer one day.

3. Contraceptives

For siblings that are approaching the age of dating and having sex, a little brush up on contraceptive options is a helpful addition to sibling sex-education sessions. This goes for all gender identities, not just the ladies! Everyone should be aware of how to protect themselves and their partner of choice, so that everyone can feel safe and focus on other matters at hand. A quick browse through the “Birth Control” tab on teenshealth.org gives an extensive explanation of the various methods of birth control and contraceptives, the intended uses of each, the effectiveness rates and some FAQs.

While talking with a healthcare provider is the best idea for beginning a birth control plan, providing kiddos with information about their options allows them to reflect on what they’re comfortable with and choose an option that suits them if and when they need it.

4. Virginity

When younger siblings are thinking about becoming sexually active, a chat about the virginity construct can help them reflect on what sex means to them. There is heavy emphasis placed on the “losing of” one’s “virginity” and how the experience is meant to be transformative, pivotal and special. For some, the giving of virginity to another person signifies an act of deep trust, intimacy and comfort. For others, the concept of virginity is merely an ancient phrase sometimes used to label the beginning of their sexual adventures.

There is no right or wrong way to think about a first sexual experience, nor is there a universal definition of what composes the official loss of virginity, which some sex beginners don’t get the chance to contemplate before diving in. The concept of virginity loss is associated with impurity and places the person taking someone’s virginity in a position of power, while the person who “lost” it is seen as sacrificing something valuable.

Contemplating the idea that virginity is not a physical state or thing, but instead a construct that can be accepted or disregarded, allows young people to decide for themselves how they want to think of sex and define it in their own terms. First times are a lot of things, ranging from spontaneous, meaningful, messy, calculated or a combination of everything. Restructuring the way young adults think about their first sexual experiences gives them the power to conceptualize their sexual debuts as they choose to.

Beyond everything, the most important thing about having a conversation with siblings about sex is just to have it (the conversation). In the era of change kids are growing up in, the taboo topic of sex is not yet a conversation of full disclosure, even as it gains traction. Being an advocate for positive sexuality development by starting dialogue can help change this, one awkward chat at a time.

The following websites are excellent resources with information on the topics above and many more! They’ve got tips for curious teens and lots of advice for how to start a conversation.

Complete Article HERE!

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Tie Me Up, Tie Me Down

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Rope play is a great way to be a bondage top when you’re five-foot-five.

By Jorge Vieto

Consensual rope bondage, specifically as a top, is one of the most intimate types of play I’ve engaged in with other human beings in the realm of kink and BDSM.

The instant shift in power is a turn-on like no other for me. (Thankfully, it’s not hard to find folks willing to be tied up in this town.) However, when the person I’m interested in getting naked with has never been tied up, has limited experience, or is hesitant to be bound in my rope, things become a bit more intriguing. It’s my job to make being tied up with rope sound approachable, safe, sexy, and fun — and generally, that’s not hard to do. The art of negotiating a bondage scene with a “rope virgin” is what I call the chase.

Rope bondage binds me to another individual. If I am “showing my ropes” to someone I’ve never tied up before and who I just met for the first time, it instantly connects us. If I am tying up someone I have played with before, it brings us even closer. The amount of trust all my willing “victims” place in me shows their confidence in my skill is immense. They trust me so deeply as to let me take some, if not most, of their mobility away. They are left in a very vulnerable state — and to me, vulnerability is sexy as fuck.

Combining the power dynamic and vulnerability that’s inherently a part of consensual rope bondage together with the contrast of different body sizes together is extremely hot to me, especially if the person that I am tying up is much larger and taller than myself. The beauty of using rope, and often blindfolds, is that — once placed on my bound prize — I become any size their imaginations make me in their blind, immobilized state. Or, if they like, they can also relish the difference in size as well.

As a rope-bondage top, it doesn’t matter to me that I’m only five-foot-five and 120 pounds — nor does it matter that most of the folks I tie up in my encounters are men who are twice my size (and sometimes more). With enough rope and know-how, I can tie them down like the six-inch-tall Lilliputians tied down Gulliver during his travels. And as a bear and a chubby-chaser who happens to be shorter and smaller than most people I know, having rope skills make it easier to have sex with men who tower over me. These skills come in handy in so many ways, especially if you want to tie them down and use them as your personal dildo or mount them without having to bring out your stepstool. I’m sure you get the picture.

Chasing down such beautifully massive “prey” is hard work. So having the ability to tie them down easily and quickly for inspection, exposing their naughty bits for me to enjoy and explore, is important. I can engineer an instant “portable fuck sling” with rope. Making their whole ride a lot more comfortable and enjoyable is key. Comfort increases the chances they’ll spend at least a few hours in captivity, being teased, tortured with pleasure, and forced to blow multiple loads. Over the years, I’ve adapted to tying up bigger bodies, learned to use thicker and longer pieces of rope, and memorized a few quick ways to extend rope and work with different levels of flexibility or lack thereof. These are all important things if you enjoy tying not only bigger folks, but also folks with different mobility and flexibility concerns. Once my prized catch is secured in whatever rope contraption I’ve decided to put him in, the real fun begins.

One quarter of the fun comes from the chase, another quarter from tying down my catch, and another from figuring out what makes them moan with pleasure the loudest. The last quarter comes from deciphering how to get them close to coming, so that I can bring them to the cusp and stop! Then, I start the process of bringing them close to climax over and over again until they have no choice to blow their load. For many, simply having my crotch buried in their face while I jack them off is good enough. For others, stimulation with an electric butt plug and conductive pads on their cock does the trick. For others, a good old-fashioned ass pounding by yours truly is just what they need. I get off on helping someone else get off, so if none of the above activities is going to get the job done, chances are, I will be able find something that will. That’s if they want to get off; if bondage snuggles or 100 gentle kisses strategically placed on their body is all they need, then I can do that, too.

As long as they’re tied up.

Once I’m done with them, I can release them unharmed. They can then go back to their natural habitats, tired, sweaty, and weak, sporting big smiles on their faces.

Complete Article HERE!

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How the Nazis destroyed the first gay rights movement

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‘Damenkneipe,’ or ‘Ladies’ Saloon,’ painted by Rudolf Schlichter in 1923. In 1937, many of his paintings were destroyed by the Nazis as ‘degenerate art.’

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Very recently, Germany’s Cabinet approved a bill that will expunge the convictions of tens of thousands of German men for “homosexual acts” under that country’s anti-gay law known as “Paragraph 175.” That law dates back to 1871, when modern Germany’s first legal code was created.

It was repealed in 1994. But there was a serious movement to repeal the law in 1929 as part of a wider LGBTQ rights movement. That was just before the Nazis came to power, magnified the anti-gay law, then sought to annihilate gay and transgender Europeans.

The story of how close Germany – and much of Europe – came to liberating its LGBTQ people before violently reversing that trend under new authoritarian regimes is an object lesson showing that the history of LGBTQ rights is not a record of constant progress.

The first LGBTQ liberation movement

In the 1920s, Berlin had nearly 100 gay and lesbian bars or cafes. Vienna had about a dozen gay cafes, clubs and bookstores. In Paris, certain quarters were renowned for open displays of gay and trans nightlife. Even Florence, Italy, had its own gay district, as did many smaller European cities.

Films began depicting sympathetic gay characters. Protests were organized against offensive depictions of LGBTQ people in print or on stage. And media entrepreneurs realized there was a middle-class gay and trans readership to whom they could cater.

Partly driving this new era of tolerance were the doctors and scientists who started looking at homosexuality and “transvestism” (a word of that era that encompassed transgender people) as a natural characteristic with which some were born, and not a “derangement.” The story of Lili Elbe and the first modern sex change, made famous in the recent film “The Danish Girl,” reflected these trends.

For example, Berlin opened its Institute for Sexual Research in 1919, the place where the word “transsexual” was coined, and where people could receive counseling and other services. Its lead doctor, Magnus Hirschfeld, also consulted on the Lili Elbe sex change.

Connected to this institute was an organization called the “Scientific-Humanitarian Committee.” With the motto “justice through science,” this group of scientists and LGBTQ people promoted equal rights, arguing that LGBTQ people were not aberrations of nature.

Most European capitals hosted a branch of the group, which sponsored talks and sought the repeal of Germany’s “Paragraph 175.” Combining with other liberal groups and politicians, it succeeded in influencing a German parliamentary committee to recommend the repeal to the wider government in 1929.

The backlash

While these developments didn’t mean the end of centuries of intolerance, the 1920s and early ‘30s certainly looked like the beginning of the end. On the other hand, the greater “out-ness” of gay and trans people provoked their opponents.

A French reporter, bemoaning the sight of uncloseted LGBTQ people in public, complained, “the contagion … is corrupting every milieu.” The Berlin police grumbled that magazines aimed at gay men – which they called “obscene press materials” – were proliferating. In Vienna, lectures of the “Scientific Humanitarian Committee” might be packed with supporters, but one was attacked by young men hurling stink bombs. A Parisian town councilor in 1933 called it “a moral crisis” that gay people, known as “inverts” at that time, could be seen in public.

“Far be it from me to want to turn to fascism,” the councilor said, “but all the same, we have to agree that in some things those regimes have sometimes done good… One day Hitler and Mussolini woke up and said, ‘Honestly, the scandal has gone on long enough’ … And … the inverts … were chased out of Germany and Italy the very next day.”

The ascent of Fascism

It’s this willingness to make a blood sacrifice of minorities in exchange for “normalcy” or prosperity that has observers drawing uncomfortable comparisons between then and now.

In the 1930s, the Depression spread economic anxiety, while political fights in European parliaments tended to spill outside into actual street fights between Left and Right. Fascist parties offered Europeans a choice of stability at the price of democracy. Tolerance of minorities was destabilizing, they said. Expanding liberties gave “undesirable” people the liberty to undermine security and threaten traditional “moral” culture. Gay and trans people were an obvious target.

What happened next shows the whiplash speed with which the progress of a generation can be thrown into reverse.

The nightmare

One day in May 1933, pristine white-shirted students marched in front of Berlin’s Institute for Sexual Research – that safe haven for LGBTQ people – calling it “Un-German.” Later, a mob hauled out its library to be burned. Later still, its acting head was arrested.

When Nazi leader Adolph Hitler needed to justify arresting and murdering former political allies in 1934, he said they were gay. This fanned anti-gay zealotry by the Gestapo, which opened a special anti-gay branch. During the following year alone, the Gestapo arrested more than 8,500 gay men, quite possibly using a list of names and addresses seized at the Institute for Sexual Research. Not only was Paragraph 175 not erased, as a parliamentary committee had recommended just a few years before, it was amended to be more expansive and punitive.

As the Gestapo spread throughout Europe, it expanded the hunt. In Vienna, it hauled in every gay man on police lists and questioned them, trying to get them to name others. The fortunate ones went to jail. The less fortunate went to Buchenwald and Dachau. In conquered France, Alsace police worked with the Gestapo to arrest at least 200 men and send them to concentration camps. Italy, with a fascist regime obsessed with virility, sent at least 300 gay men to brutal camps during the war period, declaring them “dangerous for the integrity of the race.”

The total number of Europeans arrested for being LGBTQ under fascism is impossible to know because of the lack of reliable records. But a conservative estimate is that there were many tens of thousands to one hundred thousand arrests during the war period alone.

Under these nightmare conditions, far more LGBTQ people in Europe painstakingly hid their genuine sexuality to avoid suspicion, marrying members of the opposite sex, for example. Still, if they had been prominent members of the gay and trans community before the fascists came to power, as Berlin lesbian club owner Lotte Hahm was, it was too late to hide. She was sent to a concentration camp.

In those camps, gay men were marked with a pink triangle. In these places of horror, men with pink triangles were singled out for particular abuse. They were mechanically raped, castrated, favored for medical experiments and murdered for guards’ sadistic pleasure even when they were not sentenced for “liquidation.” One gay man attributed his survival to swapping his pink triangle for a red one – indicating he was merely a Communist. They were ostracized and tormented by their fellow inmates, too.

The looming danger of a backslide

This isn’t 1930s Europe. And making superficial comparisons between then and now can only yield superficial conclusions.

But with new forms of authoritarianism entrenched and seeking to expand in Europe and beyond, it’s worth thinking about the fate of Europe’s LGBTQ community in the 1930s and ‘40s – a timely note from history as Germany approves same-sex marriage and on this first anniversary of Obergefell v. Hodges.

In 1929, Germany came close to erasing its anti-gay law, only to see it strengthened soon thereafter. Only now, after a gap of 88 years, are convictions under that law being annulled.

Complete Article HERE!

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College Students Want to Talk About Sex. They Just Don’t Know How.

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Fear of sexual assault on college campuses is twofold: Many students are afraid of being victims of assault, while others are terrified of being accused of it.

If that sounds ridiculous, consider this: Apps have popped up in recent years that allow students to sign virtual consent forms before engaging in intimate encounters. The contract on SaSie, one such app, prompts consenting parties to fill in their names and e-signatures, and add pictures of their photo IDs so as to provide “a legally binding modicum of evidence for students and adjudicators.”

Clear communication in sexual encounters is paramount and the stakes are high. Nonconsensual sex is rape. But it’s ridiculous to think that consensual sex should require a legal contract.

This is not the way for students to get clarity on healthy sex. If we are going to change a culture of normalized drunken hookups and damaging acts of sexual violence, we must get to the roots of the problem: communication and education.

Most colleges and universities require that freshmen and other new students attend orientation workshops to familiarize them with guidelines for consent, a term that is often narrowly defined to avoid confusion. Sex, our administrators and peer leaders tell us, requires verbal positive affirmation at each progressing stage of physical intimacy.

This is not a bad way to define consent, but it overlooks emotional intimacy and vulnerability entirely. When gymnasiums full of relatively inexperienced undergraduates hear an administrator explain “No means no” over a microphone, no matter how intently we pay attention or how much we agree with that statement, we are not receiving guidance on language that will help us communicate with future partners. Consent workshops can be as impersonal and utilitarian as an SAT prep book: fact-based, transactional, generalized and devoid of human emotion.

As a transfer student at Middlebury College, I sat through two such orientations and several mandatory forums about sex on campus. It was uncomfortable.

But I can see the connection between these awkward seminars and the rise of swipe-for-consent apps: Both are the outcome of a culture completely out of touch with healthy communication about sex, especially when it comes to educating young adults about it.

It’s not any school administration’s fault. There are no national guidelines for sex ed, and the curriculum for it varies greatly around the country, often from state to state. Fewer than half of the states require sexual education in public schools, and only 20 of them even require that it be medically, factually or technically accurate. Think about that.

To be clear, inaccurate sex ed isn’t to blame for all cases of sexual violence, which college-age women are three to four times more at risk of experiencing than all other women, according to a 2014 Department of Justice report.

Still, as young adults, we have no real guidance for modeling intimate behavior on anything other than the glamorized, highly choreographed sexual encounters we see on TV and in movies, music and pornography. Those media generally fail to include any language of consent at all. Nowhere are Americans exposed to the idea that talking to your partner before, during and after sex — regardless of whether you met five years or 15 minutes ago — makes sex better! Why is nobody teaching us that “great sex” happens when both partners are equally engaged in respecting and communicating their expectations?

To address this intimacy gap in our language, my peers and I started the Consent Project at Middlebury. We invite speakers to address topics like pleasure, anatomy and masculinity. On weekends we host a “Morning-After Breakfast,” where students talk about sex and relationships without judgment. Every breakfast begins with an icebreaker — a game of sex and anatomy trivia to loosen up language around taboos — and then students break into smaller groups to air out personal confusions.

The idea is to identify, through group communication and brainstorming, what defines good and healthy sex. Our goal is to develop a shared idea of consent that encompasses self-advocacy, respect and mutual fulfillment — and not to treat it like a checkbox.

In Consent Project meetings, students bring up topics that don’t necessarily come up in school-sponsored consent workshops. They talk about drinking to overcome inhibitions, only to wake up the next morning feeling unfulfilled, unsure and sometimes even regretful about their choices. Both women and men admit to feeling inadequate and a pressure to “perform.” Women more often voice frustration over not having their own sexual needs met or respected, while men express anxiety about sexual rejection. There are many elements that add to students’ confusion, but the role that drinking and recreation drug use play cannot be overstated.

It may seem like a small thing, but these conversations actually do seem to make students more comfortable. There is always a healthy amount of laughter despite the seriousness of the conversations. We get a lot of feedback from students who say they feel willing — or even excited — to start talking about sex more openly.

The miscommunication that can lead to sexual violence, on campus and off, is not unavoidable. Absent reform in the K-12 system, students can help create safe environments and learn from one another. Teachers, administrators and the media tell us only part of the story. Let’s learn to talk openly and respectfully about sex, pleasure and our boundaries, in all the ways we individually define them.

Complete Article HERE!

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What gay trans guys wish their doctors knew

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Vancouver study peers into the lives and troubles of trans MSM

Sam Larkham organizes sexual health clinics across Metro Vancouver with the Health Initiative for Men (HIM). He says he was once referred by his doctor to a trans health care clinic that had been closed for years.

By Niko Bell

Speaking to gay and bisexual trans men, the word “invisibility” comes up a lot. Invisibility in the bathhouse and on dating apps, invisibility among cisgender people, straight people, trans people and gay people. And, too often, invisibility in the doctor’s office.

“I have tried just going to walk-in clinics and stuff like that to ask questions or request tests,” one trans man recently told researchers in Vancouver. “And I just found the doctors were generally confused about me and my body. And I had to go into great detail. That made me not so comfortable talking to them about it because they were just kind of sitting there confused.”

“People have tried to talk me out of testing . . . saying I was low-risk behaviour,” another man told the researchers. “They didn’t understand my behaviour really. . . I’ve had practitioners as well say they don’t know what to do; they don’t know what to look for.”

Both men were speaking to researchers for a new study on the sexual health of trans men who have sex with men — a group social scientists know remarkably little about. Many of the men spoke about being on the margins of mainstream culture, gay culture and of the healthcare system.

It should be no surprise, then, that the study happened almost by accident. When PhD student Ashleigh Rich started work with the Momentum Health Study — a five-year, in-depth research project on the sexual health of men who have sex with men (MSM) conducted out of the BC Centre for Excellence in HIV/AIDS — she never intended to write a paper about trans MSM.

But a small group of trans men volunteered for the study, some pointing out ways the Momentum researchers could change their surveys to be more inclusive.

There were too few for quantitative research — only 14 — but Rich asked if they would sit down for an hour and talk about their experiences. Eleven agreed.

The result is a slim, 11-page paper that hints at a world of things we don’t yet know about transgender gay and bisexual men. We do know they form a large part of the trans population; nearly two thirds of trans men say they are not straight. We also know trans MSM participate in the same rich world of sexuality as other men who have sex with men — from dating apps to anonymous sex to sex work and a broad range of sexual behaviour.

We don’t know much about trans MSM risk for HIV; estimates range from much less than cisgender gay and bi men to somewhat more. We also don’t know much about how a combination of stigma, invisibility and limited healthcare options may be affecting trans men’s health.

Rich is cautious about drawing any broad conclusions from her study. Not only is it a tiny sample, but the men she spoke to are also mostly urban, white and educated. This study was less about answering questions, and more about figuring out which questions to ask.

A few themes, though, emerge clearly. One is that trans MSM often find themselves falling through the cracks when it comes to sexual health. Doctors are increasingly aware of how to talk to gay men, but don’t always see trans gay men as “real” MSM. They assume trans men are heterosexual, or fail to bring up sexual health altogether.

Some doctors give trans men information on PrEP — a preventative anti-HIV medication that can drastically reduce the risk of contracting HIV if taken every day — based on studies on cisgender men, without checking to see if different anatomy requires different doses. When trans men come in for HIV tests, they are sometimes urged to get pap smears instead.

“We come in with specific issues we want to talk about in a health care consult, and sometimes once people discover we’re trans they’ll want to do a pregnancy test or something,” says Kai Scott, a trans inclusivity consultant who collaborated on the study with Rich. “And we’re not there for that. They’re giving us things we don’t want, and not telling us the things we do need to know.”

Sam Larkham, a trans man who organizes sexual health clinics across Metro Vancouver with the Health Initiative for Men (HIM), says he was once referred by his doctor to a trans health care clinic that had been closed for years. Experiences like that make him think the best path for trans MSM is to rely on queer-focused health care providers like HIM.

“It would be ideal if it were the whole medical system, but that’s impossible,” Larkham says. “I think we have to look at what we can do, and that’s have specific places where we have nurses who are well trained to handle trans MSM. I think that’s the more doable thing. I would love to have every clinic be culturally competent, but that’s not the reality and never will be.”

Scott is more sanguine. He points to Trans Care BC, a provincial health program that has pushed for more education for doctors. Education needs to happen on both fronts, Scott says, among MSM organizations and in the health care system at large.

Lauren Goldman is a nurse educator for Trans Care BC. Since she was hired last fall, she’s been giving workshops to healthcare providers on how to treat trans patients. For now, though, the workshops are aimed at small groups of sexual health professionals, such as at the BC Centre for Disease Control or HIM. Goldman wants the program to expand to include everyone.

“We know trans patients are accessing care through a number of places all across the province,” she says. “We want everyone to have access to this information as soon as possible.”

Goldman says Trans Care is designing an online course that could bring trans cultural competency to primary care doctors everywhere as part of mandatory continuing education. Trans Care has also designed a primary care “toolkit” for doctors, and is in talks with UBC’s medical school about including trans-focused sexual health education for doctors in training.

Without specialized knowledge, Goldman says, there’s a lot doctors can miss. Testosterone can make vaginal tissue more sensitive and inflexible, for example, meaning trans men might have special difficulties with genital sex. Bacterial vaginosis is more common, and the usual antibiotics given to cis women may not solve the problem. Vaginal and rectal tissue may need different doses of PrEP to be effective.

And, most importantly, doctors need trans patients to know they will be heard.

“We need to be providing really obvious cues that show people that our services are trans inclusive,” Goldman says. “Including how we design our services, how we market our services, how we educate our clinicians, what signs we hang up, letting people know that our clinicians have a greater understanding of gender diversity.”

While Goldman is educating doctors, the trans men Rich studied were already very well educated about their own sexual health. They told Rich about careful risk assessments they make around sex, sharing information with other men, and advocating for STI screening to their reluctant doctors.

One man described slipping in HIV tests while getting regular testosterone-level screening: “Yeah, oh, I’m already getting blood drawn. I probably need to get tested, let’s just draw two more vials for HIV and syphilis.”

It’s not surprising that many trans men are so health-conscious, Scott says. “We’ve had to be champions of our own bodies for a while, and so that ethos carries through when it comes to health information.”

But it would be a mistake to overstate how safe trans MSM are, he adds. For one, the urban, white and well-educated men in Rich’s study may be more likely to have access to resources and care than less wealthy or more rural trans people. Also, the very reason trans MSM seem so safe might be because they aren’t getting the opportunities for sex they want.

“To some extent, we’re still on the sidelines,” Scott says. “I don’t think that systemic rejection should be the means of HIV prevention for trans and nonbinary people. We’re dealing with a lot of rejection, and so I don’t think we’ve really had the opportunity to be exposed to that risk.”

The theme of rejection is echoed frequently by the study subjects.

“I remember meeting this one guy at a friend’s party and we were flirting the whole time,” one participant recounted. “He was like, ‘Oh we should totally go for a beer’ and so we connected and then I told him I was trans and he was like, ‘Oh I’m not looking for anything.’”

“Cis men often shut down immediately, out of a sort of fear of the unknown, and being unaware of what can and can’t happen,” Scott says. “They can assume all trans guys are bottoms, which isn’t true.”

Constant rejection can wear trans men down, Larkham says. Not only does it damage mental health, but constant rejection can weaken trans men’s resolve to negotiate sexual safety.

Many trans men, the study notes, rely on online hookup sites, where they can be upfront about being trans, and avoid rejection by anyone who isn’t interested.

The burden of rejection is one reason trans MSM need better mental health services too, Larkham says. Too many men show up to sexual health clinics after being exposed to sexual risks. Mental health support, he thinks, could reach people earlier.

But again, Scott strikes a positive note. “It’s a source of celebration to me that despite huge barriers we’re still having the sex that we want,” he says.

In the end, the clearest message to emerge from Rich’s study is that there’s a lot more to learn. She hopes to get more answers from the next stage of the Momentum study, which will recruit a larger sample of MSM from across Canada. That study, she hopes, will be large enough to deliver the kind of precise, quantitative answers that this one couldn’t.

Scott is also eager to move forward.

“There’s so much you want to pack in and so much you want to report on,” he says. “There’s such a dire need to research these issues. People are really hurting, and I really feel that. But you’ve got to take it one step at a time.”

Complete Article HERE!

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