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British Columbian study reveals unique sexual healthcare needs of transgender men

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by Craig Takeuchi

While HIV studies have extensively examined issues related to gay, bisexual, and queer men, one group missing from such research has been transgender men.

Consequently, Vancouver and Victoria researchers undertook one of the first such Western Canadian studies, with the findings published on April 3 in Culture, Health, and Sexuality. This study allowed researchers to take a look at HIV risk for this population, and within the Canadian context of publicly funded universal access to healthcare and gender-related public policies that differ from the U.S.

The study states that trans men have often been absent from HIV studies due to small sample sizes, eligibility criteria, limited research design, or the misconceptions that trans men are mostly heterosexual or are not at risk for HIV. What research that has been conducted in this area has been primarily U.S.–based.

The Ontario-based Trans PULSE Study found that up to two-thirds of trans men also identify as gay, bisexual, or queer.

The researchers conducted interviews with 11 gay, bisexual, and queer transgender men in Vancouver who were enrolled in B.C. Centre for Excellence in HIV/AIDS’ Momentum Health Study.

What they found were several aspects unique to gay, bisexual, and queer transgender men that differ from gay, bisexual, and queer cisgender men and illustrate the need for trans-specific healthcare.

None of the participants in the study were HIV–positive and only two of them knew of trans men who are HIV–positive.

Participants reported a variety of sexual behaviours, including inconsistent condom use, receptive and insertive anal and genital sex, trans and cisgender male partners, and regular, casual, and anonymous sex partners.

The gender identity of the participants’ partners did influence their decisions about sexual risk-reduction strategies, such as less barrier usage during genital or oral sex with trans partners.

While trans men shared concerns about HIV and sexually transmitted infections with gay cisgender men, bacterial vaginosis and unplanned pregnancy were additional concerns.

Almost all of the participants used online means to meet male partners. They explained that by doing so, they were able to control the disclosure of their trans status as well as experiences of rejection or misperception. Online interactions also gave them greater control over negotiating safer sex and physical safety (such as arranging to meet a person in public first or in a sex-positive space where others are around).

When it came to healthcare, participants reported that regular testosterone therapy monitoring and transition-related care provided opportunities to include regular HIV– and STI–testing.

Some participants, however, experienced challenges in finding LGBT–competent healthcare services, with issues arising such as clinic staff using birth names or incorrect pronouns, insistence on unwanted pap testing, and a lack of understanding of the sexual practices of trans men.

The researchers note that these findings indicate the need for trans-inclusive services and trans-specific education, particularly within services for gay men.

Complete Article HERE!

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The charity helping disabled people with sex

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A charity in Taiwan has volunteers who provide sexual “help” for a small number of disabled people.

Complete Article HERE!

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Reality Check: Anal Sex

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First it was shocking, then it was having a cultural moment, now it’s practically standard in the modern bedroom repertoire—or so a quick scan of any media, from porn to HBO, will tell you. But the reality about anal is not, actually, that everyone’s doing it, says research psychoanalyst and author Paul Joannides, Psy.D., whose comprehensive book on sexuality, The Guide to Getting it On!, is used in college and medical school sex-ed courses across the US and Canada. The book is amazing not just for its straight-up factual information on practically any aspect of sex you can think of, but also for its easy, nonjudgmental, at-times humorous tone.

The CDC reports that the number of heterosexual men and women who’ve tried it vacillates between 30 and 40 percent (oddly, the CDC doesn’t report on how many homosexual men have tried it, except in a statistic that weirdly combines it with oral). If anal turns you on, you are definitely not alone, but its prevalence doesn’t change the fact that it’s the riskiest sexual behavior in terms of HIV and other STDs. Here, Joannides talks us through the realities of making anal both as safe and as pleasurable as possible.


A Q&A with Paul Joannides, Psy.D.

Q

When did heterosexual anal start to become a thing?

A

In the 80’s, I remember hearing from a friend that he had a videotape of anal porn. This seemed shocking at the time. (This was pre-Netflix: Everything was on videotape, from porn to Disney movies to highlights from the Olympics. Video rental stores were everywhere.) I’m not sure there are too many middle schoolers today who would be shocked or even surprised to watch anal sex on Pornhub or Xhamster.

Since porn became as easy to access as YouTube, porn producers have had to fight for clicks, and so porn has become more extreme. I’d say that by 2005, porn had totally blurred the distinction between a woman’s anus and vagina. This wasn’t because women were begging their lovers for anal, it’s because porn producers were afraid you’d click on someone else’s porn if they weren’t upping the ante in terms of shock value.


Q

Does the popularity of anal in porn reflect reality in both homosexual and heterosexual couples?

A

No. There are some couples who enjoy anal sex a lot, maybe 10 percent to 15 percent of all straight couples. But if you ask them how often they have anal vs. vaginal intercourse, they’ll say maybe they have anal one time for every five or ten times they have vaginal intercourse. We occasionally, as in once a year, hear from women who say they have anal as often as vaginal, but that’s unusual.

As for gay men, statistics vary widely, and studies aren’t always consistent in how they collect data—some might be looking at different levels of frequency, i.e. have you had anal once in the past year, or do you have it regularly? I’ve seen studies suggesting that 65 percent of men have anal sex, and others that suggest the figure is less than 50 percent. So, I don’t have exact figures for hetero or homosexual couples, but there is data suggesting that a good percentage of gay men would rather give and receive blowjobs than have anal sex.


Q

How should we modify the anal sex we see modeled in porn to best suit an in-real-life couple?

A

The way the rectum curves shortly after the opening tells us we need to make a lot of adjustments for anal to feel good. Also, the two sets of sphincter muscles that nature placed around the opening of the anus to help humans maintain their dignity when in crowded spaces (to keep poop from dropping out) mean there’s an automatic reflex if you push against them from the outside.

So one of the first things a woman or man needs to do if they want to be on the receiving end of anal sex is to teach their sphincter muscles to relax enough that a penis can get past their gates. This takes a lot of practice.

Also, unlike the vagina, the anus provides no lubrication. So in addition to teaching the sphincters to relax, and in addition to getting the angle right so you don’t poke the receiver in the wall of the rectum, you need to use lots of lube.

They show none of this in porn. Nor do they show communication, feedback, or trust. Couples who do not have excellent sexual communication, who don’t freely give and receive feedback about what feels good and what doesn’t, and who don’t have a high level of trust should not be having anal sex.


Q

What are the health risks of anal?

A

A woman has a 17-times-greater risk of getting HIV and AIDS from receiving anal intercourse than from having vaginal intercourse. So your partner needs to be wearing a condom and using lots of lube, unless both of you are true-blue monogamous, with no sexual diseases. Any sexually transmitted infection can be transmitted and received in the anus. Because of the amount of trauma the anus and rectum receive during anal intercourse, the likelihood of getting a sexually transmitted infection is higher than with vaginal intercourse.

Unprotected anal sex, regardless of whether it is practiced by straight or gay couples, is considered the riskiest activity for sexually transmitted diseases because of the physical design of the anus: It is narrow, it does not self-lubricate, and the skin is more fragile and likely to tear, allowing STDs such as HIV and hepatitis easy passage into the bloodstream.


Q

Are those risks all mitigated by the use of condoms and lube, or are there still issues, even beyond that?

A

The risks are substantially reduced by the use of condoms and lube as long as they are used correctly, but you won’t find too many condoms that say “safe for anal sex” because the FDA has not cleared condoms for use in anal sex. That said, research indicates that regular condoms hold up as well as thicker condoms for anal sex, so there’s nothing to be gained from getting heavy-duty condoms.

As for using the female condom for anal sex—studies report more slippage and more pain than with regular condoms.

Do not use numbing lube, and do not have anal sex while drunk or stoned. Pain is an important indicator that damage can occur if you don’t make the necessary adjustments, including stopping. If there is pain, perhaps try replacing a penis with a well lubed and gloved finger. The glove will help your finger glide more easily, and might be more pleasurable for the person on the receiving end. Also, this allows a woman to do anal play on a male partner. (When it comes to anal sex, what’s good for the goose should be good for the gander.)


Q

Are there known health consequences of anal practiced over the long-term? Can you do it too much?

A

One of the urology consultants for my book believes that unprotected anal sex can be a way for bacteria to get into the man’s prostate gland. He prefers the person with the penis that’s going into the other person’s butt use a condom.

Also, small chunks of fecal matter can lodge into the man’s urethra. So if the couple has vaginal intercourse following anal intercourse without a condom, the male partner should pee first in addition to washing his penis with soap and water.


Q

Do pre-anal enemas make a difference in terms of health safety? What about preventing accidents?

A

I know of no studies on the relationship between pre-anal enemas and health outcomes. As for its general wisdom, people seem as divided on that as on politics in Washington. So I would say, to each her own. Also, some people use a “short shot,” which is a quick enema with one of those bulb devices instead of using a bag and going the full nine yards. In any case, accidents are likely to happen at one time or another.


Q

What tests should people be getting if they practice anal?

A

There’s “should” and there’s reality. If I were on the receiving end of anal sex, I would want to be sure my partner did not have HIV before I’d even let him get close to my bum with his penis.


Q

Probably more people try anal today than in the past—are there ways to make a first experience a good one?

A

Both of you should read all you can about it first. Spend a few weeks helping the receiving partner train her/his anal sphincters to relax. Make sure you and your partner have great sexual communication, trust, and that you both want to do it, as opposed to one trying to pressure the other, or not wanting to do it but doing it because you are afraid your partner will find someone else who will. Do not do it drunk or stoned, and do not use lube that numbs your anus. If it doesn’t feel good when it’s happening, stop.


Q

Do people orgasm from anal stimulation? Is it common or uncommon?


A

Some women say they have amazing orgasms from anal, but usually they will be stimulating their clitoris at the same time.


Q

Does it usually take a few tries to enjoy anal? Are there positions that make it easiest?

A

It depends on how much you are willing to work on training the receptive partner’s anal sphincters to relax, how good your communication is, how much trust there is, and probably on the width or girth of the dude’s penis. Common sense would tell you it should go way better if a guy is normal-sized as opposed to porn-sized.


Q

What should we be telling our kids about anal?

A

We don’t tell them about the clitoris, about women’s orgasms, about masturbation, about the importance of exploring a partner’s body, and learning from each other. We don’t tell them that much of what they see in porn is unreal, and we don’t talk to them about the importance of mutual consent. So I don’t see anal being at the top of most parents’ “should talk to our kids about” lists. There are more important things we need to be talking about first.

Paul Joannides, Psy.D. is a psychoanalyst, researcher, and author of the acclaimed Guide to Getting it On!, which is now in its ninth edition and is used in college courses across the country. He’s also written for Psychology Today Magazine and authors his own sex-focused blog, Guide2Getting.com. Dr. Joannides has served on the editorial board of the Journal of Sexual Medicine and the American Journal of Sexuality Education, and was granted the Professional Standard of Excellence Award from The American Association of Sex Educators, Counselors and Therapists. Joannides also lectures widely about sex and sexuality on college campuses.

Complete Article HERE!

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Hookup culture is a cisgender privilege

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by Jesse Herb

Have you ever been called disgusting? What about deceitful or a liar? I have been called all three of these things, some more than once actually. I wish I could tell you that for every time I was called these names it was for a different reason but, unfortunately, the answer always boiled down to anatomy. What’s under my bra and what’s between my legs has made me fear for my life while simultaneously worrying I might let the possibility of experimentation pass me by.

Sex and gender are two very different things, and yet to most cisgender people, they are entirely the same: genitals equate sex, sex equates gender and therefore sexuality, and “badda bing badda boom we’re in business.” To be able to normalize the idea that everyone’s genitals align to their sex because that’s just how “it is” or is “science,” is enacting cisgender privilege and perpetuates transphobia. However, in actuality, “Most societies view sex as a binary concept, with two rigidly fixed options: male or female, both based on a person’s reproductive functions,” whereas gender is defined by “our internal experience and naming of our gender,” according to genderspectrum.org.

Privilege permeates in all different facets, in every community. In my own community, I have privilege, due to being white and cisgender-passing, but I also face the implementation of privilege done by cisgender people. One of the biggest examples of cisgender privilege is that of “hookup culture.” Hookup culture is defined as “one that accepts and encourages casual sexual encounters, including one-night stands and other related activity, which focus on physical pleasure without necessarily including emotional bonding or long-term commitment.” I’ve said it before, and as a trans woman, I’ll say it again: Hookup culture is a cisgender privilege.

It always has been and always will be. For most cisgender people, excluding demisexual (a person who does not experience sexual attraction unless they form a strong emotional connection with someone), asexual (someone who does not experience sexual attraction), or non-sexually active cisgender people, it can be as simple as swiping right or finding someone at a party and going home with them. For trans people, it is an explanation. Sometimes, the explanation can happen at the beginning with “Just so you know, I’m trans,” or it can happen later after the “Why can’t we have sex?” talk. No matter what, the explanation will happen, and more often than not, it is greeted with rejection, erasure of identity or repulsion.

Some trans people, myself included, often feel we have to hide our identities as if it’s some shameful secret, rather than our gender. Not to mention, being hesitant to talk about our identities only reconstitutes the belief that trans people are always out to deceive. Or trans people, again myself included, experience the converse and are fetishized for our gender. I still remember my freshman year when some cisgender man told me, “I prefer trans women because, since they used to be guys, they know exactly what we like.”

Trans people are subjected to all of these treatments and are much more likely to experience violence due to sex than cisgender people, especially trans people of color. There are so many privileges to recognize that exist within hookup culture:

Not having to lie or hide your identity to a potential partner is a cisgender privilege. Having a one-night stand is a cisgender privilege. Unwavering sex positivity is a cisgender privilege. Stigmatization of no sexual activity/being a virgin is a cisgender privilege. Not being pressured into body-altering surgery is a cisgender privilege. Never having to worry if someone won’t like you because you’re transgender is a cisgender privilege. Not ever having to feel unlovable because of your own gender is a cisgender privilege.

The previous examples are only a small few of the long list of privileges that exist from hookup culture. Not to mention countless other societal institutions that also preserve cisgender privilege.

Transgender Day of Visibility is a day for members of the gender nonconforming community to feel proud, safe and valid. The best way cisgender people can present support is by understanding privileges within social constructs like gender and virginity, and actively combatting them. For example, when someone is complaining that “it’s so hard to find people” or “hookup culture is so annoying sometimes” remind them that not everyone, although still pressured by society to do so, can participate in hookup culture, and also face adversity, dysphoria or vilification for trying to.

Complete Article HERE!

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…warts and all.

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Name: BD
Gender: Male
Age: 50
Location: ??
Hey doc,
Ok. I’m a 50 year old male homosexualist and I have apparently contracted genital warts at this late stage in the game. I have had 4 burned off so far, and think I detect other small, new ones. My understanding is that after this initial outbreak my immune system will control the virus.
My question is, I know they’re extremely contagious to others, but am I going to be spreading them around every time I masturbate? Cause that’s a lot. Thanks

Before I answer your specific questions, BD, let’s talk about genital warts. They are also known as venereal warts, anal warts and anogenital warts, don’t cha know. They are a highly contagious sexually transmitted infection (STI) caused by some sub-types of human papillomavirus (HPV). genital warts spread through direct skin-to-skin contact during oral, genital, or anal sex with an infected partner. Warts are the most easily recognized symptom of genital HPV infection.

Genital warts often occur in clusters and can be very tiny or can spread into large masses in the genital/anal area. The often have a tiny cauliflower shape. In women they occur on the outside and inside of the vagina, and sometimes on the cervix. Both women and men can get them on, around, or even inside their ass. Men may also find them on the tip of their cock, the shaft of their dick and/or on their balls. Only rarely do genital warts develop in one’s mouth or throat from oral sex with an infected partner.

The viral particles are able to penetrate the skin and mucosal surfaces through microscopic abrasions in the genital area, which occur during sexual activity. Once these cells are invaded by HPV, a latency (or quiet) period of months to years (even decades) may occur. HPV can last for several years without a symptom. Having sex with a partner whose HPV infection is latent and demonstrates no outward symptoms still leaves one vulnerable to becoming infected. If an individual has unprotected sex with an infected partner, there is a 70% chance that he or she will also become infected.

Alrighty then, to your specific questions, BD. I believe you are correct in your assumption that your immune system will control the virus. As to your other question, will you be spreading them around every time I masturbate; I’d have to say that there is some slight chance that your could spread the virus if you cum on someone’s skin and there happens to be a cut or an abrasion on the skin where you shoot. You also wouldn’t want to get your spooge in anyone’s eye, mouth or ass for the same reasons. But if you jerk off and your spunk falls on some inanimate object, like the floor, a wad of Kleenex, or your Aunt Tillie’s favorite antique comforter, then I think you’re fine.

Good luck

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