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A new way to think about dementia and sex

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There’s an urgent need for a new ethic of dementia care that supports the facilitation of sexual expression.

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Persons living with dementia don’t have sex. Or they have weird sex. Or they have dangerous sex, in need of containment.

When it comes to dementia and sexuality, negative language and apocalyptic warnings abound. The aging population has been described in the media as a “rape case time-bomb.” Health practitioners often respond in punishing ways to sexual activity in residential care. And the sexual rights of persons living with dementia are largely ignored within residential care policy, professional training and clinical guidelines.

As critical social researchers, we argue that a new ethic of dementia care is urgently needed, one that supports the facilitation of sexual expression.

Practitioners and administrators often hold negative and judgmental attitudes about dementia and aged sexuality

Our research at the University of Toronto and the Toronto Rehabilitation Institute-University Health Network investigates embodiment, relationality, ethics and dementia. We are motivated by a shared concern about the reductive focus of dementia care on basic physical needs, and our desire to foster a more humane and life-enriching culture of care. We have explored how the sexualities of persons living with dementia are poorly supported in long-term residential care settings such as nursing homes.

Sex and dementia in the media

When we see persons living with dementia and sex linked in the media, it tends to be in high profile cases of

Institutional policies, structures and practices must support sexual expression.

alleged abuse. One example is the legal trial of Henry Rayhons, an Iowa lawmaker found not guilty of sexually abusing his wife who at the time was living with dementia in a nursing home. Another example is the wider investigation into sexual assaults in nursing homes in Ontario.

Vital as such investigations are to the safety of residents in long-term care, we rarely see sexual expression valued or as fundamental to human flourishing.

Our research has explored how these negative representations of the sexualities of persons living with dementia are also found within long-term residential care settings such as nursing homes.

Practitioners and administrators often hold negative and judgmental attitudes about dementia and aged sexuality. When faced with sexual activity, they can intervene in threatening and punishing ways. And long-term care policies, professional training and clinical guidelines tend to ignore the sexual rights of persons with dementia.

The problem with biomedical ethics

The sexualities of persons living with dementia are considered troubling partly because long-term care polices are shaped by biomedical ethics. This ethical approach relies on four core principles: autonomy, beneficence, non-maleficence and justice. These principles support intervening in residents’ sexual expression if it will cause harm to themselves or cause harm or offence to others.

However, this approach sets the bar for practitioners’ interference excessively high. It can restrict voluntary sexual expression by residents living with dementia in nursing homes.

Biomedical ethics also ignore the performative, embodied and relational aspects of ethical reasoning. It assumes that people are rational autonomous beings. It also assumes that self-expression, including sexuality, results only from cognitive and reflective decision making. Given that dementia involves progressive cognitive impairment, persons living with dementia may be unfairly discriminated against by this approach to sexual decision making.

A duty to support sexual expression

We use a model of relational citizenship to create an alternative ethic in which sexuality is seen as embodied self-expression. It is an ethic that recognizes human beings as embodied and embedded in a lifeworld. And one that views sexuality as an important part of being human.

Social and leisure activities supportive of the development of intimate relationships are essential within nursing homes.

This new ethic broadens the goals of dementia care. No longer do health professionals just have the duty to protect persons with dementia from harm. There is also a duty to support their right to sexual expression.

We argue that institutional policies, structures and practices must also support sexual expression. These should facilitate sexual rights. We must also introduce education for health professionals and the broader public — and policy initiatives to counteract the stigma associated with sexuality and dementia.

Social and leisure activities that are supportive of sexual expression and the development of intimate relationships are also essential within nursing homes.

Of course, protection from unwanted contact or sexual harm is still important. However, freedom of sexual expression should only be restricted when necessary to protect the health and safety of the individuals involved.

Complete Article HERE!

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In defense of opposite-sex friendships

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By Heidi Stevens

My friend Jeff does not want to impregnate me.

And thank God for that, since his wife is expecting their third child this summer.

“Let me be clear,” he told me Thursday morning. “I have two, almost three children. I don’t want to impregnate anyone.”

I called him to check, since Lutheran pastor Hans Fiene put me and my fellow females on notice earlier this week.

“You don’t have any guy friends,” Fiene wrote in The Federalist on Tuesday. “In fact, you can’t have any guy friends.”

“Quite simply, men can’t be at peace being just friends,” Fiene wrote. “And there’s nothing you can do to change that. Platonic chilling won’t stop your inner (and outer) beauty from pulling a man towards romantic love. Telling him he’s like a brother to you won’t stop his brain from shouting ‘Marry that woman and impregnate her now’ when he encounters your femininity.”

Maybe Fiene didn’t mean my femininity, since I already have a husband. Maybe he didn’t mean Jeff’s brain, since Jeff already has a wife. But between his essay and Vice President Mike Pence’s no-dining-with-women rule, it’s a tricky time for opposite-sex friendships.

I’m here to defend them.

Jeff and I are friends because we work in similar industries, we live in the same neighborhood, our kids get along and we make each other laugh. I adore his wife. He likes my husband. Sometimes we meet for coffee. Sometimes we get together with our kids — with and without our spouses.

My husband, meanwhile, has a handful of female friends. He sometimes shares meals with them. With alcohol. Without me. I can’t overstate how much I prefer this setup over a husband who views all women as potential vessels to grow his babies. His female friends give him a greater understanding of half the world’s population. My male friendships do the same for me.

“It helps un-bro me,” Jeff said of his friendship with women. “I don’t know how bro-tastic I ever was, but certainly more so when I was younger and had exclusively male friends.”

Now his female friendships lend valuable insight and awareness to his home and work life. (He works in media relations.) “I haven’t had a male boss in 15 years or so,” he told me.

Friendships give us a different lens through which to see the world. They help us walk in someone else’s shoes. They give us people to care about, protect, laugh with, cry on, learn from, respectfully disagree with, cherish.

Friendships with people who don’t look and live just like us can open our minds and alter our behavior in ways that are immeasurable and invaluable.

And we should turn a skeptical eye — or avoid altogether — people whose reproductive parts don’t match ours?

I don’t think so.

We can acknowledge that some men are sometimes attracted to their female friends, and some women are sometimes attracted to their male friends. (And some men are sometimes attracted to their male friends, some women to their female friends, while we’re on the topic.)

We can also recognize that mature adults go through life, every single day, not acting on all our impulses. We don’t eat the whole pan of brownies. We don’t tell our bosses to take a flying leap. We don’t order martinis at lunch. We don’t sleep with our friends.

We don’t do the things, in other words, that sabotage our goals and our lives, even if they sound sort of fun at the time.

You can be friends with the opposite sex. You should, I would argue, be friends with the opposite sex.

The benefits of opposite-sex friendships far outweigh the possible, occasional risks, especially since we’re perfectly capable of mitigating those risks.

Men and women have far more to offer each other than our bodies, in bed. It’s insulting and, frankly, a little sad to suggest otherwise.

Complete Article HERE!

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How Straight Men Who Have Sex With Men Explain Their Encounters

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The subject of straight-identifying men who have sex with other men is a fascinating one, in that it shines a light on some extremely potent, personal concepts pertaining to identity and sexuality and one’s place in society. That’s why some sociologists and other researchers have been very eager to seek out such men and hear them explain how they fit same-sex sexual activity into their conception of heterosexuality.

The latest such research comes in the journal Sexualities, from Héctor Carrillo and Amanda Hoffman of Northwestern University. They conducted 100 interviews, with men who identified as straight but sought out casual sex with men online, hoping to better understand this population. A big chunk of the article consists of snippets from those interviews, which were primarily conducted online by three female researchers, and at the end Carillo and Hoffman sum up what they found:

They interpret that they are exclusively or primarily attracted to women, and many also conclude that they have no sexual attraction to men in spite of their desire to have sex with men. They define sexual attraction as a combination of physical and emotional attraction, and they assess that their interest in women includes both, while their interest in men is purely or mainly sexual, not romantic or emotional. Moreover, some perceive that they are not drawn toward male bodies in the same way as they are drawn to female bodies, and some observe that the only physical part of a man that interests them is his penis. Men in the latter group do not find men handsome or attractive, but they do find penises attractive, and they thus see penises as ‘living dildos’ or, in other words, disembodied objects of desire that provide a source of sexual pleasure. Finally, as a management strategy for judging that their sexual interest in women is greater and more intense than their interest in men, they sometimes limit their repertoires of same-sex sexual practices or interpret them as less important than their sexual practices with women. That way, they can tell themselves that their sexual interest in women is unbounded, while their sexual interest in men is not.

All this contributes to their sense that they qualify as being called straight or heterosexual, even when some also recognize that their sexualities do indeed differ from exclusive heterosexuality, which in turn leads them to adopt secondary descriptors of their sexual identities. As indicated by the variety of terms that they used, those descriptors often reinforce a perception that, as a sexual orientation category, heterosexuality is elastic instead of rigid — that some degree of samesex desire and behaviour need not automatically push an individual out of the heterosexual category. And while some men are willing to recognize that their sexual behaviours might qualify their being called bisexual — and they may privately identify with that label — they feel that there is no contradiction between holding a private awareness of being bisexual and a public persona as straight or heterosexual. Again, this conclusion is strengthened by a lack of social incentives to adopt bisexual identities.

It’s interesting to keep that interpretation in mind as you read the interview snippets. Take, for example, the men who sought to make it very clear that while they sometimes got with men, they really liked women:

I know what I like. I like pussy. I like women … the more the merrier … I would kiss a woman. ANYWHERE. I can barely hug a man … I do have a healthy sexual imagination and wonder about other things in the sexual realm I’ve never done … Sometimes I get naughty and explore … That’s how I see it. [Reggie, 28]

Women are hot … I can see a beautiful woman walk down the street and I instantly can become hard and get horny. I don’t think I’ve ever seen a guy walking by and got a boner. Also, I would not want to kiss or make out with them or love them. They would be more like a sexual experience. [Charlie, 32]

Some of the men did think that their behavior possibly qualified them as bisexual, but didn’t quite want to take the step of identifying as such:

I think everybody is a little bi. Isn’t that what this research is about? There’s the Kinsey scale … It’s not like Bush saying you’re either with us or with the terrorists. I think I’m probably bi but what I present to the world is a heterosexual man. Internally I’m bi, but that’s not something most people know. I’m not ashamed, but the majority of people are ignorant and close-minded. [Simon, 27]

I am not openly bisexual to society except in sexual situations … I don’t have relationships with men; I am in a relationship with my wife and only love her. [I’m bisexual] only with men behind closed doors. [Dustin, 28]

In addition to being perhaps the first instance in recorded history of someone comparing their sexual orientation to George W. Bush’s counterterrorism doctrine, Simon’s statement contains an important point: Carrillo and Hoffman note that many of their respondents simply “see no real personal or social advantages that would stem from publicly adopting an identity as bisexual or gay.” In many cases, it may not be in their interests to do so — hence the compartmentalization of their same-sex encounters.

Another reason for such compartmentalization is that it allows some men the opportunity to explore parts of their identities they feel they couldn’t safely in heterosexual settings:

For most of my sex life I’m in control of things. I’m not a boss at work anymore but I’ve been in situations where I’ve managed a hundred people at a time. I take care of my family. I take care of my kids. I’m a good father. I’m a good husband in providing material things for my wife … I’m in charge in a lot of places … There’s times when I don’t want to be in charge and I want someone to be in charge of me … that’s what brings me over [to] the bisexuals … it’s kind of submitting to another guy or being used by another guy. [Russell, 54]

“Interestingly,” write Carrillo and Hoffman, “being dominated by a man seemed to them less threatening than being dominated by a steady female partner, perhaps because it could be construed as a temporary fantasy, instead of meaning a permanent change in the gender balance.”

This same dynamic popped up the last study on this subject I covered — the idea that men “get” something about sex that women don’t, and that because there’s a fully mutual understanding that what’s going on is just sex, same-sex experiences can be set off safely away from the rest of one’s (heterosexual) identity. You can be a “good father,” which many men imply to mean being a strong, straight man, while still messing around with men on the side. From these men’s perspective, they can have it both ways — the privileges of identifying as straight and the pleasure and excitement of same-sex relationships on the side — without their identity being threatened.

Complete Article HERE!

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Not all men who have sex with men are gay…

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Ever heard of the term gay-for-pay? What about MSM?

People are slowly coming to terms with the fact that straight is not the only sexual orientation there is out there, and sexuality while often conflated with gender is not the same thing. It has taken public marches and private protests and the lives of many black female activists (it is the same everywhere, even Nigeria) to get us here; what we currently have is at best a rudimentary, stereotyped understanding of other sexuality is. Especially homosexuality, which is often visible and vilified because of the far-reaching consequences of patriarchy.

In 2016 an American boxer named Yusuf Mack found himself at the centre of a media furore when a video of him being paid to have sex with two other men surfaced on a porn company’s website. He quickly denied that it was him in the video, then amended his statement after the production company threatened to sue him, to say that he was under the influence of drugs and wasn’t aware of the things he did. After even more pressure and social media furore he released a statement coming out as gay, apologizing to his wife and ex-wife and the 10 children he’d sired with them. In reality, Mack probably considered himself gay-for-pay, a term for men who are in long-term relationships with women but work in the homosexual adult entertainment industry. Many argue that Mack was forced to ‘choose a side’ so to speak, after being forcefully outed to his friends and family. It is a slippery slope.

Not all men who have sex with men themselves gay. Not all men who have sexual and or emotional attraction to other men consider themselves gay. Donnie McClurkin, the American singer and pastor has openly admitted to being sexually attracted to men but has affirmed that he hasn’t acted on these attractions. He doesn’t consider himself gay.

What makes a man gay?

It would be presumptuous to say for sure. But here are three places that are as good as any to start.

Attraction
If a man feels repeated or consistent sexual or emotional attraction to other men then he falls under the spectrum of other-sexuality.  He might not be gay or bisexual, but he is definitely not heterosexual.

Action
Repeated acts of sexual intercourse with other men is a good benchmark for other sexuality. Like attraction, this isn’t enough to label a man as gay, but it is more than enough to open the conversation for the spectrum of sexuality and where our hypothetical man falls under this spectrum.

Acknowledgement
Acknowledgment is the best way to tell a man is gay/bisexual. When a man affirms for himself that he is either attracted to other men or enjoys repeated acts of sexual intercourse with other men.

Complete Article HERE!

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For Veterans, Trauma Of War Can Persist In Struggles With Sexual Intimacy

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U.S. Marines march in the annual Veterans Day Parade along Fifth Avenue in 2014 in New York City.

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Much has been said about the physical and psychological injuries of war, like traumatic brain injury or post-traumatic stress disorder. But what we talk about less is how these conditions affect the sexual relationships of service members after they return from combat.

Since 2000, service members who were deployed received at least 138,000 diagnoses of PTSD. More than 350,000 have been diagnosed with traumatic brain injury since 2000. Evidence suggests the numbers are actually higher because many don’t seek treatment.

These conditions cause their own sexual side effects, such as emotional numbness, loss of libido and erectile dysfunction. And the long list of medications used to treat PTSD, TBI and other medical conditions can worsen those side effects.

‘He would sleep for days’

Chuck and Liz Rotenberry of Baltimore struggled with their own challenges when Chuck returned from Afghanistan in 2011. He’s a former Marine gunnery sergeant who trained military working dogs. He left active duty in 2012.

For Liz and Chuck, sex had never been a problem. They’ve been married for 14 years and they’re still very much in love. Liz says she fell for Chuck in high school. He was that guy who could always make her laugh, who always had a one-liner ready and never seemed sad.

But when Chuck returned from Afghanistan, their relationship would soon face its greatest challenge. Baby No. 4 was just two weeks away; for sure, it was a chaotic time. But Liz noticed pretty quickly, something was terribly wrong with her husband.

“I wouldn’t be able to find him in the house and he wouldn’t be outside, and I’d find him in a separate bedroom just crying,” Liz says. “He would sleep for days. He would have a hoodie on and be just tucked away in the bed, and he wouldn’t be able to get out of bed. He would have migraines that were so debilitating that it kept him in the bed.”

When Chuck was in Afghanistan, an IED — improvised explosive device — exploded 3 feet behind him. Shrapnel lodged into his neck and back.

It would take three years for someone at the Department of Veterans Affairs to explicitly lay out for Liz that Chuck had developed severe post-traumatic stress and suffered a traumatic brain injury — and that she would need to be his caregiver.

The Marine self-image

During that three-year period, there were times Chuck estimates he was taking 15 to 16 different medications twice a day.

Sex was usually the furthest thing from his mind.

“I didn’t think about it. I wanted to be with Liz, I wanted to be near her,” he says. “When the desire was there, it was unique. It was rare, as opposed to the way it was before. And a lot of times, with the mountains of medication I was on, you know, in my head [it was] all systems go, but that message didn’t go anywhere else.”

Liz noticed that Chuck stopped initiating physical affection.

“The thought of him reaching out to me to give me a hug wasn’t existent. It was like I had to give him the hug. I now had to step in and show him love,” she says.

Sometimes months would go by before they would have sex.

“It started off as being pretty embarrassing, pretty emasculating,” Chuck says. “It was like, ‘Really? This too doesn’t work?’ You blame it on, ‘Oh, it’s just the medication,’ or ‘You’re tired,’ or whatever initially, and you don’t realize it’s stress or my brain just doesn’t work like it used to.”

Liz and Chuck had never really talked about sex in any serious way before. So they kept avoiding the conversation — until this year. That’s when Chuck finally asked his primary care provider for help. The doctor prescribed four doses of Viagra a month. Liz and Chuck say the medication has improved things substantially — though they joke about how few doses the VA allots them every month.

But asking for just those four doses took Chuck three or four visits to the doctor before he could work up the nerve. He says it can be especially hard for a Marine to admit he’s having problems with sex because it contradicts a self-image so many Marines have.

“You know, as a Marine, you can do anything. You believe you can do anything, you’ve been trained to do nearly anything,” he says. “You’re physically fit. You’re mentally sound. Those are just the basics about being a Marine.”

If he has any advice for a Marine going through the same thing he and his wife are facing, he says you need to talk about it. Bring it up with your spouse. Bring it up with your doctors.

“Marines always jokingly hand out straws. You got to suck it up. You got to do what you need to do to get it done,” Chuck says. “It’s just a different mission. … Don’t let your pride ruin what you worked so hard for.”

 Complete Article HERE!

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