Tag Archives: Communication

What it’s like to talk to your doctor about sexual health when you’re bisexual

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There’s a misconception that bi people are just going through a phase — but what if our doctors believe it too?

“Are you sexually active?”

I’d been dreading this question since losing my virginity to a female friend a few weeks earlier, not long after my 16th birthday. Somehow, the harsh fluorescent lights in my doctor’s examination room made this query seem even more menacing.

“Yes,” I said, but there was an ellipsis in my voice. A hesitation. An unspoken “but . . . ”

“You’re using condoms, right? So you don’t get pregnant?” she prompted, and I didn’t know what to say, because we weren’t. We didn’t need to. It was the wrong question.

“Uh, I’m not having sex with a guy,” I managed to stammer.

My doctor peered at me over her wire-rim glasses, “Oh,” she replied.

There are a lot of things a teenager might be nervous to disclose to their doctor — a marijuana habit, some worrying mental health symptoms, a secret relationship their parents don’t know about. While we should all feel free to tell our doctors what’s really going on with us, it’s particularly egregious that so many of them are still in the dark about something so basic as sexual orientation, making these already-difficult situations even more challenging.

The day of my first difficult conversation about my sexual health, my doctor didn’t give me any medical advice on the sex I was having. She didn’t suggest my partner and I use dental dams or latex gloves. She didn’t suggest we get tested for sexually transmitted infections (STIs). She didn’t ask whether my partner was cis or trans. She didn’t ask what sexual orientation I identified as (bisexual, for the record). She didn’t even ask me if I had any questions for her. She just moved on to the next part of our checkup.

I didn’t recognize these as problems at the time; I was too young and nervous to question the approach of my all-knowing doctor. Everything I later learned about safer sex — with the other cis girl I was seeing at that time, and with other partners later on — I learned from the internet. And while the internet can be a great resource for such information, doctors should be a better one.

Bisexuals are told all the time — both implicitly and explicitly — that we’re not queer enough to align ourselves with queerness, or that we’re too queer to align ourselves with straightness. I still find it hard to push back against these stereotypes today, at 25.

These presumptions are particularly upsetting in medical situations, where many of us already feel nervous and unempowered and, for many queers, apprehensive. The medical system has oftentimes failed us and our queer foreparents: inequitable health care access due to poverty, doctors’ lack of knowledge about LGBT identities and sexuality and the pathologization of queerness are just a few examples.

Two years later, in a different relationship with a person of a different gender, I returned to my doctor. I was a girl on a mission.

“I’m seeing someone new and I’d like to get an IUD,” I told my doc, with all the bravery and resolve I could muster as a meek 18-year-old still coming to terms with her sexuality.

“I thought you were a lesbian?” she replied coolly, barely looking up from her computer screen.

“No, I’m bisexual,” I clarified, my voice only shaking a little.

Medically speaking, it shouldn’t actually matter what word(s) I use to define my sexual orientation; my doctor should want to know, instead, what sexual activities I am participating in. I could’ve been a lesbian having sex with a man (they do exist!). I could’ve been having sex with a trans woman or a nonbinary person who had the ability to get me pregnant. There was no reason for my doctor to assume I was a lesbian in the first place, nor that a risk of pregnancy during sex meant my existing sexual orientation was being challenged.

I was reminded of a story I had read online. An American photographer I followed, Brigid Marz, wrote on Flickr that she and her girlfriend went to a hospital to get treatment for her flu symptoms. A staff member asked Brigid if there was any chance she might be pregnant, and she laughed, indicated her girlfriend, and said no. She’d dated and had sex with men before, but not recently enough that she could be pregnant. Months later, she received a $700 medical bill, $300 of which was for a pregnancy test she’d neither authorized nor needed.

“I am so sick of being treated differently just because I have boobs,” she wrote, but I would argue she was treated differently because she is non-monosexual – she is neither completely straight nor completely gay. Our medical system seems to assume everyone is one or the other, sometimes even when we’re loudly asserting otherwise.

In the end, my doctor refused to prescribe me an IUD on the basis that I was “just casually dating” and should wait until I was “in a serious relationship” before committing to a long-term birth control method that reflected my relationship status. She prescribed me the pill instead — the hormonal content of which exacerbated my mental health conditions for years, something the non-hormonal copper IUD may not have done.

What rankled me was that I was in a serious relationship at the time. My doctor may have assumed my relationship was casual because I was now with a man and I was previously with a woman, or she may have simply thought I was too young for the IUD — but I think it was because of negative stereotypes about bisexual people.

Bi folks’ relationships and attractions are often written off as “just a phase” or “just for fun.” We’re told we don’t know what we really want or who we really like — or, worse, that we’re intentionally playing with partners’ hearts, never intending to pursue commitment or depth in our relationships.

In my experience, this is about as true for bisexual people as it is for straight or gay people — some folks are looking for serious relationships and some just aren’t — but this assumption weighs most heavily on bisexuals. Whether or not my doctor was consciously aware of the stereotypes she was affirming that day, it’s clear to me that my relationship would not have been written off as “casual” if I identified as straight or gay.

If I could go back and talk to myself when I was a shy and shaking 16-year-old in my doctor’s office, I’d tell her to advocate for herself. I’d tell her to ask the questions she wanted answered, and double-check the answers on Scarleteen later. I’d tell her it was okay if she didn’t even know what questions to ask.

I’d tell her to be unashamed of her burgeoning bisexual identity, because it’s nothing to feel shifty about. But mostly, I’d wish I didn’t have to tell her all these things. Her doctor shouldn’t have made her doubt all this in the first place.

Complete Article HERE!

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What straight couples can learn from gay couples

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By
When I embarked on the seven-year journey that would result in a trilogy of comedy shows and my first book, I had no idea what a huge part sexual orientation would play.

Yes, I’m a lesbian and that has influenced much of how I’ve socialised and dated for the 20 years or so since I came out. Yet, as I talked to more and more LGBT people – particularly those a little older than me who had experienced way more discrimination – I realised that being forced to think ‘outside the box’ around the concepts of love and family had resulted in some very self-aware, savvy and compassionate strategies for coping with the complexities of human relationships.

While I welcome the progressive legal changes that have seen a huge rise in acceptance for LGBT people, I worry that a blanket assumption that we all aspire to marry, have children and be ‘normal’ means that we might lose sight of some of the very best of these pioneering ideas.

Gwyneth Paltrow and Chris Martin used the term ‘consciously uncoupling’

Open relationships can be incredibly successful. Gay men fairly typically negotiate sexually open partnerships and have done for many decades. However, what is less widely-reported is just how good they are at remaining emotionally faithful to a primary partner. Their separation rates are the lowest of any section of society. Figures from 2013, from the Office of National Statistics, showed that civil partnership dissolution rates were twice as high for female couples as they were for male. While early divorce statistics in the UK evidence that ratio increasing further still.

So what are the relationships lessons straight couples can learn from the gay community?

1. An ex can be a best friend

Long before American author and family therapist Katherine Woodward Thomas devised the phrase ‘conscious uncoupling’ and Gwyneth Paltrow made it famous, lesbians were the godmothers of the concept of compassionate endings.

Recently, Dr Jane Traies conducted the first comprehensive study of older lesbians in the UK. She told me, “It’s not uncommon for a lesbian’s ex-partner to be her best friend.” She described one couple, now in their seventies, one of who had previously been in a straight marriage. The other had always been openly gay and had many more significant exes, who they would regularly spend time with. The central relationship seemed to be richly rewarded by having this framework of other ongoing connections supporting it.

2. ‘Living Apart Together’ can be great

Although the idea of ‘LAT’ couples is now more widely discussed, it was the LGBT community who originally piloted this idea. As my friend, the gay poet Dominic Berry, points out, “Perhaps if people are doing something widely viewed as deviant, making another deviance from the norm isn’t too big a jump.”

A lot of the automatic assumptions that are made about relationships – that you must get married, be monogamous, have children, move in together – have been cheerfully dispensed with. In many cases, an alternative romantic framework suited the individuals in the relationship much better.

Some straight couples can be reluctant to talk openly about sexuality

3. Talking about love, desire and sex is good

When I conducted a survey for my comedy show, I asked respondents if they actually  discussed sex and fidelity with a partner. One straight woman wrote, ‘Good lord no! It’s one thing to do the deed but we’re too uptight to actually talk about it. Thank goodness.’

My gay friends, by contrast, tend to have spent so many years agonising about their sexual identity that discussion of it with friends and families has been essential as part of the ‘coming out’ process. In many cases, this had lead to a readiness to air other really important questions around desires, boundaries and consent once they were in an adult relationship.

4. ‘Family’ doesn’t have to mean blood

When I arrived in London as a young student in the Nineties, the LGBT community provided me with the strongest sense of belonging I have ever experienced.

In the face of prejudice and discrimination, gay people historically partied hard together and took more care of one another within the bubble of separatism. They cultivated a concept of ‘friends as family’, something the writer Armistead Maupin refers to as ‘logical family’.

5. Love isn’t like it is in the movies

Because films depicting same-sex relationships have generally been far-removed from the sugary rom-com ideal, gay people are more pragmatic and realistic about the extreme challenges of falling in and out of love and staying together.

In 2017, we may not be facing quite as much adversity as the characters depicted in Carol or Brokeback Mountain, but we know that the ‘fairy tale’ romance is a load of old hokum.

6. Rules are made to be broken

When the activism group Gay Liberation Front formed in the early Seventies, they gleefully celebrated their difference from the oppressive, beige ‘norms’ that most of society were having to follow. This resulted in an inclusive, embracing atmosphere and a sense of fun and freedom for anyone who wanted to reinvent and rethink traditional relationships and try out different models of being together.

Complete Article HERE!

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Personal Inventory

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By Susan Deitz

Relax your body before you start this questionnaire. It’s important you start this with shoulders loose and mind clear. Don’t rush through the following questions, because chances are they’ll lead to still more probing. (For now, jot down those additional questions on a separate sheet of paper for future reference.) The best way to do these justice is to read them through in one sitting, let them “marinate” awhile and then reread them and give your answers. Some of them may trigger an immediate response; others take more thought. Please don’t give a fast pat answer; the whole point of this exercise is to search deeper for your real belief.

—How do you feel about sex outside marriage? Does your religion, upbringing or personal morality make it out of bounds? Would denying those controls upset you so much that you wouldn’t enjoy yourself if you did become sexually active?

—If you can enjoy sex outside marriage, how do you feel about sex outside caring?

—Can you imagine having sex on the first date? If you can, what sort of “ingredients” would have to be present? If not, when do you feel is a reasonable time to begin sexual involvement?

—Would you get involved with someone even if you knew it was to be for a very short time — perhaps only for one night? Under what circumstances?

—Can you imagine having a married lover? Why or why not?

—Would you consider having a sexual relationship with more than one person at the same time? (This question deals with plural ongoing relationships, not with group sex.)

—Ideally, how often would you like to have sex? How long can you go without sex?

—Do you enjoy periods of celibacy? For how long can you remain celibate? Are you ever concerned about losing your sex drive?

—What are your thoughts about giving yourself pleasure? Masturbation is still a taboo issue, but your own thoughts on the subject should be very clear because of the episodic nature of sex as a single person.

—If you are sexually active, have you settled on a safe and effective method of contraception? If you answered “no” or are unsure of your answer, are you clear about the range of options open to you and which one is best for you?

—Do you know enough about sexually transmitted diseases — such as AIDS and herpes — to protect yourself? If not, do you know how to get information about them?

—Do you/would you ask a new partner about his or her history of sexually transmitted disease before becoming intimate, even though it might be awkward?

—How do you plan to handle pressure from a date or partner to have sex when you’d rather not?

—If you’re a single parent, are you clear about having sleepover lovers when your children are home? Are you clear about separating your personal needs from your parental role? How honestly do you speak with your children about your sexual relationships?

—What do you appreciate most about sex? What makes it wonderful for you?

—Do you feel comfortable speaking with your partner about your likes and dislikes in lovemaking? Is your partner comfortable talking with you about them?

—How strongly do you feel about the answers you’ve given here?

—What, if anything, would make you change your mind about them?

—Do you have an idea about handling your sex life if you were to be unmarried for a lifetime?

—Do you feel you could adapt your sexual attitudes to make yourself, as a single person, more comfortable? If yes, how would you accomplish this?

What other questions can you ask yourself now that you’re thinking along these lines? If you’ve come up with more of them, write and answer them. Remember, please, there are no rights or wrongs here — only clear thinking on some murky issues. Best to clarify them now rather than be faced with that murkiness totally unprepared and therefore most vulnerable.

Complete Article HERE!

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How To Tell Your Partner You Have An STI

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By Cory Stieg

Early on in relationships, it can feel like you have to be careful and strategic about what information to divulge to your partner and when. This is particularly true when it comes to sexual health, because although your partner doesn’t need to know about every time you’ve had bacterial vaginosis in your lifetime, they may need to know about your STI status.

If you have an STI, it’s your responsibility to tell your partners before you have sex, says Kristen Lilla, LCSW, a sex therapist and sexuality educator. That way, your partner can make an informed decision that’s right for them. “There’s no law about discussing your STI status, but it is the ethical thing to do for your health and someone else’s,” Lilla says.

That said, no one has the right to judge you simply because of your current or previous STI status — so just because it’s important to share these health details, that doesn’t mean your partner is free to shame you. Each day, more than 1 million STIs are acquired worldwide, according to the World Health Organization, so there’s no reason to justify or apologize for your STI status, Lilla says.

There’s not necessarily a perfect time to tell your partner that you have an STI, because every relationship progresses at a different pace, but you should absolutely do it before having sex, Lilla says. “Some people prefer to have this conversation right away when they begin dating someone, and may not want to be with someone who judges them for having an STI,” she says. “Other people do not want to be judged, and may feel embarrassed or even guilty, so they might prefer to wait until they get to know someone and have established some trust before discussing it.” But if you wait to share your STI status after you’ve already had sex, then it can make your partner feel betrayed, Lilla says. Although you might be comfortable having sex and using condoms as a barrier method to reduce the risk of STI transmission, your partner might not be if they know you have a particular STI — and that’s okay, but it warrants a (sex-positive and shame-free) conversation to figure out where everyone’s boundaries are.

If someone judges you for having an STI, you deserve to be with someone else who won’t judge you.

Kristen Lilla, LCSW

So, how do you have the talk? Find a time and place that allows you and your partner to actually discuss the topic calmly — preferably out of your bedroom, Lilla says. “If you feel comfortable, it’s okay to talk about how you feel about your STI status,” Lilla says. For example, you can start by saying, I really like you, so this is difficult for me to talk about, Lilla says. Or, I know some people are freaked out by STIs, but I’m not ashamed to share my status. “It also helps to let the other person know if you are taking medications or not, and give them an opportunity to ask questions,” Lilla says. You don’t have to explain to someone how you got an STI, but you should be prepared to answer any specific questions that your partner has about the STI you have, and how that impacts their risk, she says.

Of course, the details of the conversation are dependent upon the people involved and the STI in question. If you have a bacterial STI, such as chlamydia, then your conversation will probably be different than one about a viral STI, like herpes, Lilla says. That’s because one STI is treatable, and the other isn’t. If you have an STI that’s been treated, Planned Parenthood suggests you say something like, I think it’s important to be honest, so I want to tell you that I got tested for STIs last month and found out I had chlamydia. I took medicine, and I don’t have it anymore. But it showed me how common and sneaky STIs are. Have you ever been tested? There are different implications for every type of STI, so this might not be exactly what you say. For many people, talking about getting tested can be a good jumping-off point.

This may all be easier said than done, since STIs can be a tough topic to navigate, especially if you already feel vulnerable, Lilla says. Unfortunately, many people feel embarrassed or ashamed about having STIs because of unfair societal stigma. But as long as you’re honest, you can’t go wrong — and again, nobody should shame you for having an STI. “If someone judges you for having an STI, you deserve to be with someone else who won’t judge you,” Lilla says.

Ultimately, you’re obligated to make sure your partner knows everything there is to know about your current STI status, so they can make the decision that’s right for them (and vice versa). And if you talk to your partner before becoming sexually active, then you haven’t exposed them to anything, so there’s nothing to apologize for. “What’s more important is to talk with your partner about how to move forward being sexually active in a way that feels safe and comfortable for both of you,” Lilla says.

Complete Article HERE!

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The Science of Passionate Sex

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How to have hot sex, according to science

By Scott Barry Kaufman

Our culture is obsessed with sex. Everywhere you look is another article on how to have hot sex, harder erections, mind-bending orgasms, and ejaculations that go on for days. What people seldom realize, though– and which the latest science backs up– is that this is exactly the problem.

There’s nothing wrong with desiring sex. I’m extremely sex positive. Rather, I believe it’s the obsessive focus on the pragmatics and mechanization of sex– in isolation from the rest of the person— that is making us actually less satisfied with sex. We aren’t integrating our sexual desires into the totality of our being, and our whole selves are suffering as a result.

In a series of clever studies, Frédérick PhilippeRobert Vallerand, and colleagues studied a concept they refer to as harmonious sexual passionpassion for sex that is well integrated and in harmony with other aspects of the self, creating minimal conflict with other areas of life. Harmonious integration of ones sexual desires frees one up to fully engage and enjoy sexual activity in an open, spontaneous, and nondefensive manner. Items measuring harmonious sexual passion include: “Sex is in harmony with the other things that are part of me,” “Sex is well integrated in my life,” and “Sex is in harmony with the other activities in my life.”

In contrast, those who have obsessive sexual passion have not well integrated their sexuality into the totality of their being. Their sexual desires remain detached from other areas of their self as well as other domains in life. This leads to more narrow goals, such as immediate sexual gratification (e.g., orgasm), and leads to more of an urgent feeling of sex as a goal, compelling us to perform, instead of us being in control of our sexuality. This can significantly limit the full enjoyment of sex as well as life. Items measuring obsessive sexual passion include: “I have almost an obsessive feeling for sex,” “Sex is the only thing that really turns me on,” and “I have the impression that sex controls me.”

Across a number of studies, the researchers found that these two forms of sexual passion– obsessive and harmonious– differ remarkably in the way sexual information is processed, and how sexual activities are experienced. During sexual activities, obsessive sexual passion was related to negative emotions. Outside of sexual intercourse, obsessive sexual passion was related to intrusive thoughts about sex, conflict with other goals, attention to alternative partners, and difficulty concentrating on a current goal when unconsciously viewing pictures of sexually attractive people.

Obsessive sexual passion was also related to the biased processing of information. Those scoring higher in obsessive sexual passion were more likely to perceive sexual intent in ambiguous social interactions as well as to perceive sexuality in words that don’t explicitly have a sexual connotation (e.g., “nurse”, “heels,” “uniform”). Obsessive sexual passion was also related to violent actions under threat of romantic rejection, as well as greater dissolution of romantic relationships over time.

In contrast, harmonious sexual passion showed much greater integration with more loving aspects of the self, as well as other life domains. For instance, participants were asked to list as many words as they could in 1 minute related to the word “sex”. Those scoring higher in harmonious sexual passion were still sexually passionate beings: they listed quite a number of sexually-related words. However, they had a more balanced profile of purely sexual representations (e.g., “penis”, “breasts”, “vibrator”) and sexual-relational representations (e.g., “intimate,” “caress,” “intercourse”). In fact, the magic number seemed to be a ratio of 2: once the number sexual words outweighed the number of sexual-relational words by a factor of 2, there was a substantial increase in obsessive sexual passion and a marked decrease in harmonious sexual passion.

Those scoring high in harmonious sexual passion also showed greater control over their sexual drive. Whenever a sexual stimulus was subconsciously encountered (e.g., a beautiful person), they were able remain on task (which was to identify natural vs. artificial objects). Harmonious sexual passion was also related to less sexually intrusive thoughts and was unrelated to attentiveness to alternative partners. This greater integration and absence of conflict led to higher relationship quality over time.

It’s important to note that obsessive sexual passion is not the same thing as sexual compulsivity, or even sex addiction (although it is still hotly debated whether sexual addiction really exists). Even though obsessive sexual passion was correlated with negative emotions during sexual activity, it did not lead to greater feelings of distress. Also, both harmonious and obsessive sexual passion were related to loving and enjoying sex-related activities.

In fact, both harmonious and obsessive sexual passion were equally correlated with sexual desire. This is a really important finding, because we have a tendency to stigmatize those with greater sociosexuality in our society. Those with a more unrestricted sociosexual orientation are more willing to engage in casual sex, and report greater sexual desire and frequency of fantasizing about sex. These results suggest that sociosexuality itself is not the problem; rather, it’s how your sociosexuality is integrated into your identity and other areas of your life that really matters.

Perhaps instead of our cultural obsession with sexual performance, we should shift more towards helping people accept and feel comfortable with their sexuality, embrace sexual passion, and help them harness that passion in ways that bring joy, vitality, and openness to all areas of their life.

Complete Article HERE!

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