Tag Archives: Intimacy

Don’t Be Afraid of Your Vagina

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By Nell Frizzel

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Lying across a turquoise rubber plinth, my legs in stirrups, a large blue sheet of paper draped across my pubes (for “modesty”), a doctor slowly pushes a clear plastic duck puppet up my vagina and, precisely at that moment, Total Eclipse of the Heart comes on over the radio and it’s hard not to love the genitourinary medicine, or GUM, clinic.

I mean that most sincerely: I love the GUM clinic. It is wonderful beyond orgasm that in the UK anyone can walk into a sexual health clinic—without registering with a doctor, without an appointment, without any money, without a chaperone—and get seen within a few hours at most. It brings me to the point of climax just thinking about the doctors and health professionals who dedicate their life to the nation’s ovaries, cervixes, vaginas, and wombs.

And yet, not all women are apparently so comfortable discussing their clitoral hall of fame with a doctor. According to a recent report commissioned by Ovarian Cancer Action, almost half of the women surveyed between the ages of 18 and 24 said they feared “intimate examinations,” while 44 percent are too embarrassed to talk about sexual health issues with a GP. What’s more, two thirds of those women said they would be afraid to say the word “vagina” in front of their doctor. Their doctor. That is desperately, disappointingly, dangerously sad.

In 2001, I went to see a sexual health nurse called Ms. Cuthbert who kindly, patiently and sympathetically explained to me that I wasn’t pregnant—in fact could not be pregnant—I was just doing my A-Levels. The reason I was feeling sick, light-headed, and had vaginal discharge that looked like a smear of cream cheese was because I was stressed about my simultaneous equations and whether I could remember the order of British prime ministers between 1902 to 1924. My body was simply doing its best to deal with an overload of adrenaline.

Back then, my GUM clinic was in a small health center opposite a deli that would sell Czechoslovakian beer to anyone old enough to stand unaided, and a nail bar that smelled of fast food. I have never felt more grown up than when I first walked out of that building, holding a striped paper bag of free condoms and enough packets of Microgynon to give a fish tits. My blood pressure, cervix, heartrate, and emotional landscape had all been gently and unobtrusively checked over by my new friend Ms. Cuthbert. I had been given the time and space to discuss my hopes and anxieties and was ready to launch myself, legs akimbo, into a world of love and lust—all without handing over a penny, having to tell my parents, pretending that I was married or worry that I was being judged.

My local sexual health clinic today is, if anything, even more wonderful. In a neighborhood as scratched, scored, and ripped apart by the twin fiends of poverty and gentrification as Hackney, the GUM clinic is the last great social leveler. It is one of our last few collective spaces. Sitting in reception, staring at the enormous pictures of sand dunes and tree canopies it is clear that, for once, we’re all in this together. The man in a blue plastic moulded chair wishing his mum a happy birthday on the phone, the two girls in perfect parallel torn jeans scrolling through WhatsApp, the guy with the Nike logo tattoo on his neck getting a glass of water for his girlfriend, the red-headed hipster in Birkenstocks reading about witchcraft in the waiting room, the mother and daughter with matching vacuum-sized plastic handbags talking about sofas, the fake flowers, Magic FM playing on the wall-mounted TV, the little kids running around trying to say hello to everyone while the rest of us desperately avoided eye contact—the whole gang was there. And that’s the point: you may be a working mum, you may be a teenager, you may be a social media intern at a digital startup, you may be a primary school teacher, you may be married, single, a sex worker, unemployed, wealthy, religious, terrified, or defiant but whatever your background, wherever you’ve come from and whoever you slept with last night, you’ll end up down at the GUM clinic.

Which is why it seems such a vulvic shame that so many women feel scared to discuss their own bodies with the person most dedicated to making sure that body is OK. “No doctor will judge you when you say you have had multiple sexual partners, or for anything that comes up in your sexual history,” Dr. Tracie Miles, the President of the National Forum of Gynecological Oncology Nurses tells me on the phone. “We don’t judge—we’re real human beings ourselves. If we hadn’t done it we probably wish we had and if we have done it then we will probably be celebrating that you have too.”

Doctors are not horrified by women who have sex. Doctors are not grossed out by vaginas. So to shy away from discussing discharge, pain after sex, bloating, a change in color, odor, itching, and bleeding not only renders the doctor patient conversation unhelpful, it also puts doctors at a disadvantage, hinders them from being able to do their job properly, saves nobody’s blushes and could result in putting you and your body at risk.

According to The Eve Appeal—a women’s cancer charity that is campaigning this September to fight the stigma around women’s health, one in five women associate gynecological cancer with promiscuity. That means one in five, somewhere in a damp and dusty corner of their minds, are worried that a doctor will open up her legs, look up at her cervix and think “well you deserve this, you slut.” Which is awful, because they won’t. They never, ever would. Not just because they’re doctors and therefore have spent several years training to view the human body with a mix of human sympathy and professional dispassion, but more importantly, because being promiscuous doesn’t give you cancer.

“There is no causal link between promiscuity and cancer,” says Dr. Miles. “The only sexually transmitted disease is the fear and embarrassment of talking about sex; that’s what can stop us going. If you go to your GP and get checked out, then you’re fine. And you don’t have to know all the anatomical words—if you talk about a wee hole, a bum hole, the hole where you put your Tampax, then that is absolutely fine too.”

Although there is some evidence of a causal link between certain gynecological cancers and High Risk Human Papilloma Virus (HRHPV), that particular virus is so common that, ‘it can be considered a normal consequence of sexual activity’ according to The Eve Appeal. Eighty percent of us will pick up some form of the HPV virus in our lifetime, even if we stick with a single, trustworthy, matching-socks-and-vest-takes-out-the-garbage-talks-to-your-mother-on-the-phone-can’t-find-your-clitoris partner your entire life. In short, HRHPV may lead to cancer, but having different sexual partners doesn’t. Of course, unprotected sex can lead to an orgy of other sexually transmitted infections, not to mention the occasional baby, but promiscuity and safe sex are not mutually exclusive. And medical professionals are unlikely to be shocked by either.

We are incredibly lucky in the UK that any woman can stroll into a sexual health clinic, throw her legs open like a cowboy and receive some of the best medical care the world has ever known. We can Wikipedia diagrams of our vaginas to learn the difference between our frenulum and prepuce (look it up, gals). We can receive free condoms any day of the (working week) from our doctor or friendly neighborhood GUM clinic. We can YouTube how to perform a self-examination, learn to spot the symptoms of STIs, read online accounts by women with various health conditions, and choose from a military-grade arsenal of different contraception methods, entirely free.

A third of women surveyed by The Eve Appeal said that they would feel more comfortable discussing their vaginas and wombs if the stigma around gynecological health and sex was reduced. But a large part of removing that stigma is up to us. We have to own that conversation and use it to our advantage. We need to bite the bullet and start talking about our pudenda. We have to learn to value and accept our genitals as much as any other part of our miraculous, hilarious bodies.

So come on, don’t be a cunt. Open up about your vagina.

Complete Article HERE!

Life as a sex worker for people with disabilities

By Vanessa Brown

WHEN Fleur first started working in the sex industry, receiving a phone call from a parent or guardian on behalf of a potential client was “unusual”.

“It’s not an experience that many people have to go through, arranging a sexual experience on the behalf of someone else,” she told news.com.au.

Miss Fleur, as she calls herself, became a sex worker at 18. Ten years later, she’s built up a diverse client base, including many people with disabilities.

“In a lot of ways, there’s no difference,” Fleur said of her clients. “I’m dealing with adults who have a fantasy that they haven’t been able to explore. The main thing that’s different is that sometimes, but not always, appointments are facilitated through parents or carers.

“Carers listen to their clients and take their needs seriously. But it’s not that these people are arranging appointments without consent. They are doing it on the instruction of the person with the disability.”

Rachel Wotton

Rachel Wotton is a sex worker who works with people with disabilities.

About 4 million Australians, or one in five people, are living with a disability. More than million of these people are aged between 15 and 64.

In Australia and overseas, disability advocacy groups are trying to raise awareness about disabled people and sex.

Veteran sex worker Rachel Wotton is one of the co-founders of Touching Base, an organisation that allows people with disabilities to connect with sex workers.

She says the stigma surrounding the sex lives of people with disabilities is disheartening.

“It’s ridiculous. Just because someone can’t walk the same way as others, or doesn’t have the same technique to use their voice, doesn’t mean they haven’t got the same sexual desires as other people,” Ms Wotton told news.com.au.

“We are sexual human beings. How dare someone tell another person how they should or should not feel. The most beautiful thing about skin to skin contact is the idea of being.

“People need to move away from the idea that sex is intercourse. Our sexuality is expressed in many different ways,” said Ms Wotton, who has worked in the industry for more than 20 years and was featured in the documentary Scarlet Road.

achel’s client John died in November 2011. They both appeared in the documentary Scarlet Road.

Rachel’s client John died in November 2011. They both appeared in the documentary Scarlet Road.

Her clients live with a wide range of disabilities. One of her regulars, 61-year-old Colin Wright, came from a family that didn’t talk about sex. In the SBS documentary I Have Cerebral Palsy and I Enjoy Having Sex, Colin revealed that he found his first sexual partner through a carer.

“There was a lady who I felt close to so, one day, while we were alone, I asked Kerry if she would organise for me to visit a lady,” he told SBS. “To my surprise, straight away, she said ‘yes’.”

Ms Wotton says this is common in her line of work.

“Imagine if you had to ring your mother or carer and say ‘this is what I’d like to do, can you help me?’” Ms Wotton said.

“Imagine the fear of opening up about your sexual desires, as a middle-aged man or woman, to your family. Some of the parents have been amazing, and really work through this stigma. It’s very brave of them.”

Colin Wright is a client of Rachel Wotton.

Colin Wright is a client of Rachel Wotton.

When a carer or parent contacts a sex worker or sex work organization, they must provide the worker with complete consent from the client before the appointment can be scheduled.

“If someone’s father organises for me to see their adult son, I don’t care if he has paid me money. I’m going to make sure my client is consenting to the services,” she said.

“The only person who can give consent is the very person themselves. No one can give consent on their behalf.

“Some clients will contact me directly. Otherwise it’s parents or carers or support workers contacting on behalf of someone.”

Ms Wotton says the same protocols apply to any other service.

“It’s like any other appointment. The client is asking for available times, payment options, letting them know if it’s a home appointment and we discuss the disability of the client.

“The appointment is set up exactly the same as if they were ringing up for a dental appointment, hairdressing appointment or a tattoo,” she said.

“Of course people are nervous, because they have to speak with a sex worker and because of the myths around the industry. But once they talk to us, they see that we are general members of society like anyone else.”

Rachel 2

Rachel Wotton has been a sex worker for over 20 years.

Ms Wotton and her colleagues will spend a good percentage of the discussion talking about what they can and can’t do with their clients.

“There is a stigma around sex work that we will do anything. That’s not true. We are negotiating, it’s a mutually consensual adult activity,” she said.

“People often think that if they can’t verbalise yes or no, they can’t give consent. That’s just ridiculous because there are so many ways that people can communicate. There’s boards, eye movement, nodding heads, hand signals, apps and even iPads.

“We know how people consent when they understand what services and experiences they are consenting to. They have the right to withdraw consent, and that’s for the sex worker as well.

“The sexual desires of those with a disability are in line with the rest of society. It’s as far as their imaginations go.”

Fleur says more education is needed about the sex lives of disabled people.

“Adults with disabilities have all the same needs and desires as anyone else,” she said.

“I think people should take a moment to think about their own lives, and if their needs and desires would change if they became disabled. We are only a car accident away from it.”

Rachel uses a board with her late client, Mark.

Rachel uses a board with her late client, Mark.

Touching Base is a charitable organisation that requires support from the public to continue their work. More information can be found here.

Complete Article HERE!

Sexual Frustration Reigns

Hello Dr. Dick

First time question to you. I’m sure you’ve probably heard this one a million times, but I could use some advice 🙂

I married my best friend. Sex has never been frequent or great. Most of the time he finishes in less than five minutes of penetration and I rarely if ever get to orgasm. The first and last time I think I did have an orgasm I think was the day we conceived our little girl.

He’s a great guy in all other aspects, but when it comes to the bedroom, it doesn’t happen. I’ve tried seducing him (which he responds to eagerly, finishes and then rolls over and goes to sleep), tried asking if we could try different things (different has ended up being one of two positions – missionary and woman on top – he does not like and will not do anything else). He also does not want to and won’t do stimulation with his hands or anything else for that matter. He also does not like or want toys in the bedroom, for him or me.

Any ideas on how I can convert him into a wife pleaser? I’m at my wits end. Last time I seduced him to get some “cock” in me was two months ago and needless to say I didn’t get any satisfaction. For the first time though I took care of things myself and at least I slept without really resenting him 🙂

I’ve been trying to not care, but I’ve found out I’m a very passionate woman who only gets more passionate with time… and with those needs not being met, I’m wondering if it’s the end? Can people be happy without sex? I haven’t found a way to yet but if you know of something, please let me know.

Anyway, if you have a chance to respond to my ramblings it would be appreciated… even if you have some insight into his actions/non-actions it would be greatly appreciated.

Coral

You’re right; I have heard this a million times.

sexual frustrationI’m gonna spare you the niceties and get right t the point, Coral. Your husband is clearly not up to the task of being your lover. His behaviors and his disinterest in finding a solution to the problem you have together tells me that he is a selfish lout. And how in the world can he be your best friend. Best friends don’t behave like this.

Let me put it to you another way. If you were writing to me to tell me that your husband hordes all the food in the house to himself. That he has you feed him till he is satisfied, but offers you only crumbs to sustain you. And that he won’t even negotiate you getting the food you need to survive and sustain yourself. What do you think I would say about that?

I suppose you see where I’m going with that, right? Listen, you oughtn’t be beggin’ for shit that is rightfully yours.

I have one real simple premise that I live by. And that is, each of us has a right to a happy, healthy, integrated sex life. If there is something that is getting in the way of achieving that, whatever it might be, it is a problem that needs to be addressed immediately.

As far as relationships go, I am of the mind that we ought, first and foremost, work to honor our commitments of fidelity and mutual support. Are there ways that these two moral principles — a right to a healthy sex life and one’s relationship commitments — can coexist when one’s relationship excludes the possibility of happy sexual expression? Yes, I believe there are. And many couples achieve this balance, because they have an overriding love and concern for one another.

Now the facts — not all loving relationship have a sexual component. Many, for one reason or another, simply don’t. But if a partner is unwilling to provide sexual satisfaction to his/her partner and he won’t even begin negotiate an amicable solution or other accommodations then, I believe, this a form of sexual abuse.factors-of-sexual-dissatisfaction

If what you report about your husband’s distaste for anything sexually adventurous is accurate, then you have a very hard row to hoe. (BTW,are mutually enjoyed sex toys in the bedroom all that adventurous these days?) Trying to negotiate a satisfactory solution to a problem is all the more difficult when your partner is opposed to even discussing the issue. Here’s what I suggest. Have a frank talk with the bonehead. Tell him, in no uncertain terms, that he has first right of refusal to you and your long-suffering naughty bits. If he isn’t interested in keeping you sexually satisfied, that means the door is open for you to get your groove on elsewhere. If he balks at that, stand your ground. Insist that he has just the two options of taking it or leaving it.

If this means the end of this relationship, as I suspect it might. Then have the spine to make a clean break of it. Because, if you don’t, then you are complicit in the abuse you are suffering.

Good luck

Sexuality and Illness – Breaking the Silence

(This is a Companion piece to yesterday’s posting. You’ll find yesterday’s posting HERE!)

By: Anne Katz PhD

Sexuality is much more than having sex even though many people think only about sexual intercourse when they hear the word. Sexuality is sometimes equated with intimacy, but in reality, sexuality is just one way that we connect with a spouse or partner we love (the true meaning of intimacy). Our sexuality encompasses how we see ourselves as men and women, who we are attracted to emotionally and physically, what turns us on (eroticism), our thoughts and fantasies, and yes, also what we do when we are sexually active, either alone or with a partner. Our sexuality is connected to our image of ourselves and it changes over the years as we age and face threats from illness and disability and, eventually, the end of life.seniors_men

Am I still a sexual being?

Illness can affect our sexuality in many different ways. The side effects of treatments for many diseases, including cancer, can cause fatigue. This is often identified as the number one obstacle to sexual activity. Other symptoms of illness such as pain can also affect our interest in being sexually active. But there are other perhaps more subtle issues that impact how we feel about ourselves and, in turn, our desire to be sexual with a partner or alone, or if we even see ourselves as sexual beings. Think about surgery that removes a part of the body that identifies us as female or male. Many women state that after breast cancer and removal of a breast (mastectomy), they no longer feel like a woman; this affects their willingness to appear naked in front of a partner. Medications taken to control advanced prostate cancer can decrease a man’s sexual desire. Men in this situation often forget to express their love for their partner in a physical way, no longer touching them, kissing them, or even holding hands. This loss of physical contact often results in two lonely people.  Humans have a basic need for touch; without that connection, we can end up feeling very lonely.

Just talk about it!

seniors_in_bedCommunication lies at the heart of sexuality. Talk to your partner about what you are feeling, how you feel about your body, and what you want in terms of touch. Ask how you can meet your partner’s needs for touch and affection. The most important thing you can do is to express yourself in words. Non-verbal communication and not talking are open to misinterpretation and can lead to hurt feelings. Our sexuality changes with age and time and illness; we may not feel the same way about our bodies or our partner’s body that we did 20, 30 or more years ago. That does not mean we feel worse – with age comes acceptance for many of us – but we do need to let go of what was, and look at what is and what is possible.

The role of health care providers

Health care providers should be asking about changes to sexuality because of illness or treatment, but they often don’t. They may be reluctant to bring up what they see as a sensitive topic and think that if it’s important to the patient, then he or she will ask about it. This is not good. Patients often wait to see if their health care provider asks about something and if they don’t, they think that it’s not important. This results in a silence and leaves the impression that sexuality is a taboo topic.senior intimacy02

Some health care providers are afraid that they won’t know the answer to a question about sexuality because nursing and medical schools don’t provide much in the way of education on this topic. And some health care providers appear to be too busy to talk about the more emotional aspects of living with illness. This is a great pity as sexuality is important to all of us – patients, partners, health care providers. It’s an important aspect of quality of life from adolescence to old age, in health and at the end of life when touch and love are so important.

Ask for a referral

If you want to talk about this, just do it! Tell your health care provider that you want to talk about changes in your body or your relationship or your sex life! Ask for a referral to a counselor or sexuality counselor or therapist or social worker. It may take a bit of work to get the help you need, but there is help.

Complete Article HERE!

Sexuality at the End of Life

By Anne Katz RN, PhD

In the terminal stages of the cancer trajectory, sexuality is often regarded as not important by health care providers. The need or ability to participate in sexual activity may wane in the terminal stages of illness, but the need for touch, intimacy, and how one views oneself don’t necessarily wane in tandem. Individuals may in fact suffer from the absence of loving and intimate touch in the final months, weeks, or days of life.head:heart

It is often assumed that when life nears its end, individuals and couples are not concerned about sexual issues and so this is not talked about. This attitude is borne out by the paucity of information about this topic.

Communicating About Sexuality with the Terminally Ill

Attitudes of health care professionals may act as a barrier to the discussion and assessment of sexuality at the end of life.

  • We bring to our practice a set of attitudes, beliefs and knowledge that we assume applies equally to our patients.
  • We may also be uncomfortable with talking about sexuality with patients or with the idea that very ill patients and/or their partners may have sexual needs at this time.
  • Our experience during our training and practice may lead us to believe that patients at the end of life are not interested in what we commonly perceive as sexual. How often do we see a patient and their partner in bed together or in an intimate embrace?
  • We may never have seen this because the circumstances of hospitals and even hospice may be such that privacy for the couple can never be assured and so couples do not attempt to lie together.

intimacy-320x320For the patient who remains at home during the final stages of illness the scenario is not that different. Often the patient is moved to a central location, such as a family or living room in the house and no longer has privacy.

  • While this may be more convenient for providing care, it precludes the expression of sexuality, as the patient is always in view.
  • Professional and volunteer helpers are frequently in the house and there may never be a time when the patient is alone or alone with his/her partner, and so is not afforded an opportunity for sexual expression.

Health care providers may not ever talk about sexual functioning at the end of life, assuming that this does not matter at this stage of the illness trajectory.

  • This sends a very clear message to the patient and his/her partner that this is something that is either taboo or of no importance. This in turn makes it more difficult for the patient and/or partner to ask questions or bring up the topic if they think that the subject is not to be talked about.

Sexual Functioning At The End Of Life

Factors affecting sexual functioning at the end of life are essentially the same as those affecting the individual with cancer at any stage of the disease trajectory. These include:go deeper

  • Psychosocial issues such as change in roles, changes in body- and self-image, depression, anxiety, and poor communication.
  • Side effects of treatment may also alter sexual functioning; fatigue, nausea, pain, edema and scarring all play a role in how the patient feels and sees him/herself and how the partner views the patient.
  • Fear of pain may be a major factor in the cessation of sexual activity; the partner may be equally fearful of hurting the patient.

The needs of the couple

Couples may find that in the final stages of illness, emotional connection to the loved one becomes an important part of sexual expression. Verbal communication and physical touching that is non-genital may take the place of previous sexual activity.

  • Many people note that the cessation of sexual activity is one of the many losses that result from the illness, and this has a negative impact on quality of life.
  • Some partners may find it difficult to be sexual when they have taken on much of the day-to-day care of the patient and see their role as caregiver rather than lover.
  • The physical and emotional toll of providing care may be exhausting and may impact on the desire for sexual contact.
  • In addition, some partners find that as the end nears for the ill partner, they need to begin to distance themselves. Part of this may be to avoid intimate touch. This is not wrong but can make the partner feel guilty and more liable to avoid physical interactions.

Addressing sexual needs

senior intimacyCouples may need to be given permission to touch each other at this stage of the illness and health care providers may need to consciously address the physical and attitudinal barriers that prevent this from happening.

  • Privacy issues need to be dealt with. This includes encouraging patients to close their door when private time is desired and having all levels of staff respect this. A sign on the door indicating that the patient is not to be disturbed should be enough to prevent staff from walking in and all staff and visitors should abide by this.
  • Partners should be given explicit permission to lie with the patient in the bed. In an ideal world, double beds could be provided but there are obvious challenges to this in terms of moving beds into and out of rooms, and challenges also for staff who may need to move or turn patients. Kissing, stroking, massaging, and holding the patient is unlikely to cause physical harm and may actually facilitate relaxation and decrease pain.
  • The partner may also be encouraged to participate in the routine care of the patient. Assisting in bathing and applying body lotion may be a non-threatening way of encouraging touch when there is fear of hurting the patient.

Specific strategies for couples who want to continue their usual sexual activities can be suggested depending on what physical or emotional barriers exist. Giving a patient permission to think about their self as sexual in the face of terminal illness is the first step. Offering the patient/couple the opportunity to discuss sexual concerns or needs validates their feelings and may normalize their experience, which in itself may bring comfort.

More specific strategies for symptoms include the following suggestions. senior lesbians

  • Timing of analgesia may need to altered to maximize pain relief and avoid sedation when the couple wants to be sexual. Narcotics, however, can interfere with arousal which may be counterproductive.
  • Fatigue is a common experience in the end stages of cancer and couples/individuals can be encouraged to set realistic goals for what is possible, and to try to use the time of day when they are most rested to be sexual either alone or with their partner.
  • Using a bronchodilator or inhaler before sexual activity may be helpful for patients who are short of breath. Using additional pillows or wedges will allow the patient to be more upright and make breathing easier.
  • Couples may find information about alternative positions for sexual activity very useful.
  • Incontinence or the presence of an indwelling catheter may represent a loss of control and dignity and may be seen as an insurmountable barrier to genital touching.

footprints-leftIt is important to emphasize that there is no right or wrong way of being sexual in the face of terminal illness; whatever the couple or individual chooses to do is appropriate and right for them. It is also not uncommon for couples to find that impending death draws them much closer and they are able to express themselves in ways that they had not for many years.

Complete Article HERE!