Tag Archives: Sex Education

For Some With Intellectual Disabilities, Ending Abuse Starts With Sex Ed

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Katy Park, who runs arts and wellness programs for Momentum — a community service program for people with intellectual disabilities — starts a class on healthy sexuality by asking her students to define what they want in a relationship.

by Joseph Shapiro

In the sex education class for adults with intellectual disabilities, the material is not watered down. The dozen women and men in a large room full of windows and light in Casco, Maine, take on complex issues, such as how to break up or how you know you’re in an abusive relationship. And the most difficult of those issues is sexual assault.

Katy Park, the teacher, begins the class with a phrase they’ve memorized: “My body is my own,” Park starts as the rest join in, “and I get to decide what is right for me.”

People with intellectual disabilities are sexually assaulted at a rate more than seven times that for people without disabilities. NPR asked the U.S. Department of Justice to use data it had collected, but had not published, to calculate that rate.

At a moment when Americans are talking about sexual assault and sexual harassment, a yearlong NPR investigation finds that people with intellectual disabilities are one of the most at-risk groups in America.

“This is really an epidemic and we’re not talking about it,” says Park, a social worker who runs arts and wellness programs for Momentum, an agency based in Maine that provides activities in the community and support services for adults with intellectual disabilities. Those high rates of abuse — which have been an open secret among people with intellectual disabilities, their families and people who work with them — are why Park started this class about healthy relationships and healthy sexuality.

Because one of the best ways to stop sexual assault is to give people with intellectual disabilities the ability to identify abuse and to know how to develop the healthy relationships they want.

“Let’s talk about the positive parts of being in a relationship,” Park says, holding a marker while standing at a whiteboard, at the start of the class. “Why do we want to be in a relationship?”

“For love,” says one man. “And sexual reaction.”

“Romance,” adds a woman.

“How about support?” asks Lynne, a woman who speaks with a hushed voice and sits near the front of the class.

“Having support, right?” Park says, writing the word on the board. “We all want support.”

A participant helps Park hang the agenda on the wall at the start of class.

From working with the men and women here, Park realized they want to have relationships, love and romance. They see their parents, siblings and their friends in relationships. They see people in relationships when they watch TV or go to the movies. They want the same things as anyone else.

But it’s harder for them. When they were in school, most of the adults in this room say, they didn’t get the sex ed classes other kids got. Now, just going on a date is difficult. They probably don’t drive or have cars. They rely on public transportation. They don’t have a lot of money. They live at home with their parents or in a group home, where there’s not a lot of privacy.

And then there’s the one thing that really complicates romance for people with intellectual disabilities: those high rates of sexual abuse.

“Oftentimes, it actually is among the only sexual experience they’ve had,” says Park. “When you don’t have other healthy sexual experiences, how do you sort through that? And then the shame, and the layers upon layers upon layers.”

This class, she says, is about “breaking the chain, being empowered to say, ‘No. This stops with me.’ “

“I Think People Take Advantage”

The women and men come to Momentum during the week for different programs. They go kayaking and biking; they go to the library and do volunteer work at the local food bank. There’s a range of disability here. You can look at some of the men and women — maybe someone with Down syndrome — and see they have a disability. Others, even after you talk to them, you might not figure out they have an intellectual disability.

Like one small woman with short, choppy dark hair, streaked red.

She’s 22 now, but when she was 18, her boyfriend was several years older. She says he was controlling. He didn’t let her have a cellphone or go see her friends.

“He was strangling me and stuff like that,” says the woman. (NPR is not using her name.) “And he was, the R-word — I hate to say it, but rape.” She says he raped her eight times, hit her and kicked her. “So I don’t know how I’m alive today, actually. He choked me where I blacked out.”

She thinks she was an easy target for him, because of her mild intellectual disability. “I think people take advantage,” she says. “They like to take advantage of disabilities. I have disabilities, not as bad as theirs. But I think they like to take advantage, which is wrong. I hate that.”

A student takes notes in Park’s Relate class.

She says the class helped her better understand what she wanted, and had a right to, in a relationship. She’s got a kind and respectful boyfriend now.

Her friend Lynne listens and says she would like to find a boyfriend. But in her past, she has experienced repeated sexual abuse.

She talks about a time when she was 14 and “this older guy that knew us” forced her to have sex. She says she told people but no one believed her. The next year, when she was 15, she was sexually assaulted — this time by a boy at her school. “I was trying to scream,” she says, “but I couldn’t because he had his hand over my mouth, telling me not to say anything to anybody.”

Lynne, who is 38, says those rapes and others left her unable to develop relationships. “I couldn’t trust anyone,” she says. Lynne (NPR has agreed to identify her by her middle name) says this class has helped her realize she wants a real, romantic relationship and has taught her how to better find one.

“There’s A Lot Of Loneliness”

Katherine McLaughlin, a New Hampshire sex educator, developed the curriculum used by Momentum. She wrote it so that it uses concrete examples to describe things, to match the learning style of people with intellectual disabilities. It shows pictures and uses photographs.

McLaughlin says the main desire of adults with intellectual disabilities is to learn “how to meet people and start relationships. There’s a lot of loneliness.”

That loneliness leaves them vulnerable to getting into abusive relationships, she says, or to rape.

Sometimes, especially when they’re young, they can’t name what happened to them as a sexual assault. Because they didn’t get the education to identify it. “We don’t think of them as sexual beings. We don’t think of them as having sexual needs or desires,” McLaughlin says. “Often they’re thought of as children, even when they’re 50 years old.”

Sheryl White-Scott, a New York City internist who specializes in treating people with intellectual disabilities, estimates that at least half of her female patients are survivors of sexual assault. “In my clinical experience, it’s probably close to 50 percent, but it could be as high as 75 percent,” she says. “There’s a severe lacking in sexual education. Some people just don’t understand what is acceptable and what’s not.”

Most of the women and men at the class in Maine say they didn’t get sex ed classes, like other kids, when they were in school. Or if they did, it was the simplistic warnings, like the kind given to young children. “It’s easy to fall back on ‘good touch-bad touch’ sex ed,” says Michael Gill, the author of “Already Doing It: Intellectual Disability and Sexual Agency.” “That’s a lot of what they get.” And the usual warning about “stranger danger” can be unhelpful, because it’s not strangers but people they know and trust who are most likely to assault them.

Most rapes are committed by someone a victim knows. For women without disabilities, the person who assaults them is a stranger 24 percent of the time. NPR’s data from unpublished Justice Department numbers show the difference is stark for people with disabilities: The abuser is a stranger less than 14 percent of the time.

“Parents get this; professionals don’t,” says Nancy Nowell, a sexuality educator with a specialty in teaching people with developmental disabilities, an umbrella term that includes intellectual disability but also autism.

Park asks her students to weigh in on agreements with a thumbs up or a thumbs down during class.

Parents have significant reason to worry: Figuring out what’s a healthy relationship is difficult for any young person, and it can be even trickier if a person has an intellectual disability. People with intellectual disabilities are vulnerable to problems from rape to unwanted pregnancy. Some people with intellectual disabilities marry. A small number have children — and rely on family or others to support them as parents.

Still, says McLaughlin, parents often are reluctant to talk to their children with intellectual disabilities about sex. “Parents often feel, if I talk about it they will go and be sexual,” she says, and they fear that could make them targets for sexual assault.

But educators such as McLaughlin, Gill and Nowell argue the reverse: that comprehensive sexuality education is the best way to prevent sexual assault. “If people know what sexual assault is,” says Gill, an assistant professor of disability studies at Syracuse University, “they become empowered in what is sexuality and what they want in sexuality.”

Respect

Gill argues that a long history of prejudice and fear gets in the way. He notes early 20th century laws that required the sterilization of people with intellectual disabilities. That came out of the eugenics movement, which put faith in IQ tests as proof of the genetic superiority of white, upper-class Americans.

People with intellectual disabilities were seen as a danger to that order. “Three generations of imbeciles are enough,” Supreme Court Justice Oliver Wendell Holmes famously wrote in a 1927 opinion that ruled the state of Virginia could forcibly sterilize a young woman deemed “feebleminded.”

Carrie Buck was the daughter of a woman who lived at a state institution for people with intellectual disabilities. And when Buck became pregnant — the result of a rape — she was committed to a state institution where she gave birth and was declared mentally incompetent to raise the child. Buck was then forcibly sterilized to prevent her from getting pregnant again. There was evidence that neither Buck, nor her daughter, Vivian, was, in fact, intellectually disabled. In the first half of the 20th century, impoverished women who had children outside marriage were often ruled by courts to be “feebleminded.”

There was another myth in popular culture that people with intellectual disabilities were violent and could not control their sexual urges. Think about that staple of high school literature classes, John Steinbeck’s “Of Mice and Men.” The intellectually disabled Lennie can’t control himself when the ranch hand’s wife lets him stroke her hair. He becomes excited, holding her too tight, and accidentally strangles her.

The class in Maine aims to help these adults know what’s a healthy relationship and how to communicate how they feel about someone.

The main way this class differs from a traditional sex ed class is that — to help people with intellectual disabilities learn — the material is broken down and spread out over 10 sessions. Each class lasts for 2 1/2 hours. But the adults in the class are completely attentive for the entire session.

They do take a couple of very short breaks to get up and move around, including one break to dance. Everyone gets up when Park turns on the tape recorder and plays — just right for this group asking to be treated like adults — Aretha Franklin singing “Respect.” There is joyous dancing and shouts. And when the song is over, they go back to their seats and get back to work.

Complete Article HERE!

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STI symptom checker: Do I have gonorrhoea, chlamydia or syphilis? Signs of sex infections

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STIs – or sexually transmitted infections – can be passed on via unprotected sex. These are the symptoms of gonorrhoea – commonly misspelt gonorrhea – chlamydia and syphilis to look out for.

STI symptom checker: Unprotected sex risks sexually transmitted infections

By Lauren Clark

STIs – the common abbreviation for sexually transmitted infections – can be passed on via unprotected sex.

Common STIs include chlamydia, syphilis and gonorrhoea, and they are on the rise, according to recent figures.

In 2016 there were 420,000 diagnoses of sexually transmitted infections in England, including a 12 per cent increase nationwide in cases of syphilis.

Rates of gonorrhoea are also soaring particularly in London, which earlier this year was revealed to be the city with the highest STI levels in the UK.

Failing to get a diagnosis and treatment for an STI can cause pelvic inflammatory disease in women, and infertility in both men and women.

But do you know the symptoms of gonorrhoea, chlamydia and syphilis? The NHS has revealed the signs to look out for.

Gonorrhoea

They usually develop within two weeks of an infection, but can sometimes take months to appear. The signs vary between men and women.

Women:
– an unusual vaginal discharge, which may be thin or watery and green or yellow in colour

– pain or a burning sensation when passing urine

– pain or tenderness in the lower abdominal area (this is less common)

– bleeding between periods, heavier periods and bleeding after sex (this is less common)

Men:
– an unusual discharge from the tip of the penis, which may be white, yellow or green

– pain or a burning sensation when urinating

– inflammation (swelling) of the foreskin

– pain or tenderness in the testicles (this is rare)

Syphilis

The first signs usually develop within two to three weeks of infection, and can be split into early symptoms and later symptoms.

Early symptoms:

– the main symptom is a small, painless sore or ulcer called a chancre that you might not notice

– the sore will typically be on the penis, vagina, or around the anus, although they can sometimes appear in the mouth or on the lips, fingers or buttocks

– most people only have one sore, but some people have several

– you may also have swollen glands in your neck, groin or armpits

Later symptoms:

– a blotchy red rash that can appear anywhere on the body, but often develops on the palms of the hands or soles of the feet

– small skin growths (similar to genital warts) – on women these often appear on the vulva and for both men and women they may appear around the anus

– white patches in the mouth

– flu-like symptoms, such as tiredness, headaches, joint pains and a high temperature (fever)

– swollen glands

– occasionally, patchy hair loss

Chlamydia

This is one of the most common STIs in the UK, and, worryingly, it often doesn’t trigger any symptoms. If signs do appear, however, they may include the following.

– pain when urinating

– unusual discharge from the vagina, penis or rectum (back passage)

– in women, pain in the tummy, bleeding during or after sex, and bleeding between periods

– in men, pain and swelling in the testicles

If you think you may have an STI, you should visit your GP or local sexual health clinic. Find out more information here.

Complete Article HERE!

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Raising Sex-Positive Kids

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My daughter is 12 years old, and she has already been groped. It happened at a local water park last summer in the wave pool, the kind of swimming pool where mechanically generated waves simulate the swell of the ocean. As one wave lifted her up, she felt the hand of a teenage boy grabbing her bikinied butt. How strange, she thought. It must have been a mistake; maybe the wave had carried him into her. Yet the same thing happened to her 11-year-old friend who was swimming nearby. Then they heard two more girls remarking loudly that the boy had touched them, too. Apparently, this young man was groping every female buttock in the pool like he was testing for ripe fruit at the farmers’ market. Soon, the two lifeguards on duty were frantically blowing their whistles. The waves stopped and the red-handed boy, standing by the lifeguard station with his father, was told to leave the water park immediately.

While the news that my young daughter had been groped horrified me, I couldn’t have imagined a better outcome. She was with a friend and her friend’s mother, able to share and process the experience and even laughed about it a little. More important, the teenage offender was caught, confronted, and suffered the consequences. He was publically shamed for his stupid and intrusive acts, as he deserved to be. And yet, my girl had been groped. She had been initiated into the world of women everywhere who are plagued by men behaving badly. Or in the words of a recent “Saturday Night Live” skit, “Welcome to Hell.”

The recent spate of news stories about women (and some men) being sexually harassed in the entertainment industry and in politics may be painful to witness, but it’s also liberating. The #metoo movement has broken the code of silence and unleashed a formidable backlash against many men who have unfairly wielded their power. Women and men are talking; mothers and fathers are talking. And many of us are wondering: How did we get here, and how can we stem the tide of sexual misconduct for the generations to come? How can we do things a little more mindfully so that we can raise girls who are empowered and expressive, and boys who are enlightened and empathetic?

A True Yes and a True No

Alicia Muñoz, a psychotherapist and couples’ counselor based in Falls Church, Virginia, sees one solution in the growing trend toward raising sex-positive kids. “Sex positive” is a relatively new buzz-phrase that’s gaining traction in the therapy world and beyond. “It’s about helping your children grow up with a sense of sexuality as a natural, normal, healthy, pleasurable part of being alive, of being a human being,” says Muñoz. “That’s easier said than done, especially in a culture that is so weighted toward sex negativity and gender biases and power differentials that are unfair. It’s a tall order, but an important thing.”

One essential message of sex positivity is that any sexual activity, and any touching of body parts, should be consensual. “Taking the shame out of sexuality is part of what provides a foundation for the awareness of consent,” says Muñoz. “It’s being able to grow up in an environment where you’re not ashamed of your own sexuality, or of sexuality in general. That’s part of what empowers you to have a voice, and having a voice means you’re connected to your right to give a true yes or a true no in different situations, including sexual ones. And on the other side of it, you’re primed to respect another’s true yes or true no when you view sex as a positive, integral, normal part of being human.”

Raising kids to be sex positive is a lifestyle that begins at the onset of parenthood. Many parents worry about when to have “the talk” with their children, but, in a sense, we’re already talking about sex to our kids before they have language. “From the moment they’re born, babies and kids are receiving data related to sex and sexuality and gender—through their senses, touch, longings, hunger, their relationship to their body, and their parents’ or caregiver’s relationships to their bodies,” says Muñoz. Yet the time will come when children want to put sex into words they can understand. And the sex-positive way for parents is to start talking about sex as soon as a child starts asking about it. “When a child asks a question, even if that child is just two and a half or three, you answer it in simple, true language,” says Muñoz. “You call a vulva a vulva, a penis a penis. You don’t call it a wee-wee or a pee-pee or another nickname. You show that, even in the naming of body parts, there’s no need to hide it.”

While the goal is to remove any negativity and evasiveness from sexuality, it’s important not to take the message too far and give your child more than he or she is ready to handle. Talk about sex should be age-appropriate, keeping in mind what young brains need. “Little kids need short-sentence explanations rather than long lectures,” says Muñoz. “For a four-year-old who asks where babies come from, a short answer might be that babies are created by a man and a woman giving each other a special kind of hug.” Yet with sex positivity, the aim is to always expand the lens of sexuality and give a sense of inclusiveness beyond limited cultural norms or biases. So, parents might want to add that some babies are created by a man’s seed that’s put with the help of a doctor into a woman, and then that baby might be raised by two men, or it might be raised by two women. Then no matter which path the child takes later in terms of sexual preference or gender identity, the stage is set for a sense of normalcy and acceptance from the outset.

Following Your Child’s Lead

With so much buzz about sexual harassment and assault in the news and popular culture, parents may wonder how to talk about such heavy issues with their children—and how to protect them from the bullying and power imbalances that start as early as elementary school. “Most kids don’t pay attention to what happens in the news, so in terms of discussing something disturbing with your child, it’s best to wait until the child raises up the issue themselves,” says Stanley Goldstein, PhD, a child clinical psychologist based in Middletown and the author of several books including Troubled Children/Troubled Parents: The Way Out 2nd edition (Wyston Books, 2011). The idea is to follow the child’s lead; equally important is to speak with them rather than to them, even when you’re laying down guidelines designed to keep them safe—such as explaining to your teenage daughter why you don’t want her to walk alone at night.

“It’s crucially important not to say to a child or teenager, ‘Do this because I say so.’ If you do that, then you repress the capacity for abstract thinking. Instead, say, ‘Do it because…’ and express your concerns. Explain that the world is generally a safe place, but you have to be cautious. If you feel that they’re not ready to do certain things, tell them no and tell them why.” While many parents believe that the major influence for teenagers is their peer group, Goldstein posits that the major influence for healthy teenagers remains the parents. “They might say, ‘Joey does this, so why can’t I do it?’ They might give you a hard time, but they’ll appreciate it. There’s nothing worse for a child than feeling like their parent doesn’t care.”

In the same spirit, parents are modeling behaviors to their children all the time, without speaking. Empathy is not something that you can inculcate into a child, but they’ll develop the capacity for it through osmosis, says Goldstein. “If the child sees a healthy interaction between the parents, sees them supporting each other and talking about their feelings, they’ll grow up with these kinds of capacities. Empathy is something that really derives from the family experience.” Yet some things do need to be put into words, and in a world where sexual misconduct is rampant, therapists tend to agree about one thing to tell your kids unequivocally: “The hard and fast rule is that you don’t have the right to put your hands on someone else, period. And no one should put their hands on you. Period.”

The Power of Speaking Out

Parents are not the only influencers; cultural messaging is very powerful as well. Terrence Real, a psychotherapist who wrote I Don’t Want to Talk About It: Overcoming the Secret Legacy of Male Depression (Scribner, 1998) and other books, says that boys lose their hearts when they’re five or six, and girls lose their voices when they’re 11 or 12. “Five or six is when the socialization process starts to really impact boys as they get shamed for doing things they were allowed to do when they were younger,” says Muñoz. “They might be called weak or girly. So, when you have a boy, how do you keep him connected to his heart yet still have him belong in his circle of peers? How do you keep your girls raising their hands in class rather than becoming wallflowers? How do you keep them speaking up when the society says that if you speak up you’re a bitch, or you’re not as attractive?”

Expressiveness in girls is crucial to encourage for two main purposes: their ability to share difficult experiences, and their empowerment in speaking out and defending themselves. “Letting your child lead the conversation, or lead the play when they are younger, creates a space where your child trusts you to share things such as, ‘Oh, one of the boys grabs my behind at school’ or ‘I saw a video with naked people on the internet.'” Parents can practice not reacting in fear or letting their anxiety show, but opening a space to calmly help and guide them. In turn, some self-defense teachers have girls practice yelling on the top of their lungs and using their voice, so if they are assaulted or groped in the subway or on the street, they can call attention to the perpetrator and get help if help is needed.

To raise sex-positive kids requires some work from the parents, and not all of it is easy. If a parent has any sexual trauma or abuse in their own past, it’s essential for them to be willing to face and work through it, not only for their own sake but for their children’s sake. Otherwise, says Muñoz, “In your well-intentioned desire to protect your children, you’re going to be communicating a lot of sex-negative messages to them.” Another challenge for parents is resisting the impulse to impose their power as adults over their children in everyday interactions. “What they learn there is, ‘Oh, I have to obey somebody more powerful than me even if it doesn’t feel good,'” says Muñoz. “Not telling your child they have to obey isn’t the same thing as having the inmates run the asylum. Instead it’s telling them, ‘I’m with you. We work as a team.'”

Complete Article HERE!

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Why LGBT-inclusive relationships and sex education matters

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By Hannah Kibirige​

Today the Government launched a public consultation on what relationships and sex education should look like in England’s schools. While that might not be the first thing on your Christmas list, it’s been hanging around at the top of ours for a while, and is a vitally important step forward for all young people.

So why is it something we should all care about? Earlier this year, the Government committed to making age-appropriate relationships and sex education compulsory in all of England’s schools in 2019.

Currently, only certain secondary schools are required to teach this subject, and the guidance for teachers has sat untouched since 2000. To say that plenty has changed in those 17 years would be an understatement. Back then, Bob the Builder was Christmas number one, Facebook was just a twinkle in Mark Zuckerberg’s eye, and Section 28 – the law which banned the so-called ‘promotion’ of homosexuality – was still in force.

It was a different world – and the guidance reads that way. It makes little mention of online safety, and no mention at all of LGBT young people and their needs. We have, however, made progress. At primary level we work with hundreds of schools to help them celebrate difference. This includes talking about different families, including LGBT parents and relatives.

Teaching about the diversity that exists in the world means that children from all families feel included and helps all young people understand that LGBT people are part of everyday life. Lots of schools, including faith schools, have been doing this work for years. Different families, same love. Simple.

At secondary level, a growing number of schools are meeting the needs of their LGBT pupils. But Stonewall’s research shows that these schools are in the minority: just one in six LGBT young people have been taught about healthy same-sex relationships, and many teachers still aren’t sure whether they are allowed to talk about LGBT issues in the classroom.

Too many LGBT pupils still tell us that relationships and sex education simply doesn’t include them. As LGBT young people are left unequipped to make safe, informed decisions, most go online to find information instead. It will come as no surprise that information online can be unreliable, and sometimes unsafe.

In schools that teach about LGBT issues, LGBT young people are more likely to feel welcomed, included and accepted. When young people see themselves reflected in what they learn, it doesn’t just equip them to make safe, informed decisions, it helps them feel like they belong and that who they are isn’t wrong or defective. Providing all young people with inclusive relationships and sex education as part of PSHE is a key way to do this.

Every young person needs to feel accepted, understood and included. The Government has recognised that, and is clear that future relationships and sex education will be LGBT-inclusive. Now is our chance to have a say on what that should look like. Now is our chance to give all young people the information and support they need to be safe, happy and healthy, now and in the future.

Complete Article HERE!

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7 contraception options that won’t screw with your hormones

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Plus the pros and cons of each.

By

Hormones are what make the world go round. They play a massive part in influencing your bodily functions, your mood, your behaviour, and of course, your sex life – which is why, when yours are out of whack, it can have an enormous impact on your whole damn existence.

Hormones can also be a big factor in the type of contraception you use, and increasing numbers of women are looking for non-hormonal methods of preventing pregnancy and sexually transmitted infections (STIs). If you’re one of them, here are seven contraception methods you could consider:

1. Male condoms

What is it?
Probably the most familiar method of non-hormonal contraception, male condoms are thin latex sheaths that go over the penis during sex.


Pros and cons:

“They’re really easy to use and you only need to use them when you have sex,” says Sue Burchill, head of nursing at sexual health charity Brook. “They protect against sexually transmitted infections (STIs) as well as pregnancy. Plus, they are available for free from Brook services (for under 25s), some youth clinics, contraception and sexual health clinics and some GPs. You can also buy them at any time of day from supermarkets, vending machines in public toilets, petrol stations etc, even if you’re under 16. They also come in different shapes, sizes, textures, colours and flavours which can make sex more fun.”

Condoms are the only type of contraception that a man can use to control his own fertility, but they do also have some potential disadvantages. “Some people are allergic to the latex used in condoms. This is rare but if you or your partner is allergic, it’s possible to use latex free polyurethane condoms,” Sue adds. “Sometimes they can split or slip off – if this happens or you are worried you may need emergency contraception.”

2. Female condoms

What is it? Female condoms, sometimes known as ‘femi-doms’, are similar to male condoms, except they’re worn internally, inside the vagina, instead of going over the penis.

Pros and cons:
Like their male counterparts, female condoms also protect you against STIs and pregnancy, and are available for free within many of the same services. You can also put them in before you have sex (up to eight hours before).

If they’re not used properly, however, female condoms can slip or get pushed up into the vagina – and again, if this happens, you might need to seek emergency contraception. “You need to make sure the penis goes into the condom and not between the condom and the vagina,” advises Sue. It’s also worth noting that female condoms are not always available at every contraception and sexual health clinic and can be more expensive to buy than other condoms.

3. IUDs

What is it?
Intrauterine devices, or IUDs, are t-shaped plastic devices that contain copper, and stop an egg from implanting in your uterus. They need to be fitted by your doctor or nurse.

Pros and cons:

IUDs are often recommended for women who cannot use contraception that contains hormones, like the pill or the contraceptive patch. They provide a long-term solution that once fitted, can prevent pregnancy immediately, and for up to 10 years (depending on what type of IUD you go for). They don’t interrupt sex, or mess with your fertility, and, crucially, you don’t have to remember to pop a pill every day for it to be effective. “The IUD is not affected by vomiting, diarrhoea or other medicines like other methods of contraception,” Sue notes – in fact, it can even be fitted as a method of emergency contraception.

This is not to say that the IUD has no potential pitfalls – “it does not protect against STIs, and your periods may be heavier, more painful or last longer,” she adds. There are also several risks, although slim and unlikely, that come with fitting and using the IUD – you may get an infection when it’s inserted, it can be be pushed out or displaced, and there is very minor chance of perforation of the uterus. If you do somehow get pregnant when you’re using one, there is also a small risk of ectopic pregnancy.

4. Cervical caps or diaphragms

What is it? These are dome-shaped devices which look similar, but diaphragms fit into the vagina and over the cervix, whilst caps need to be put onto the cervix directly. They need to be fitted by a professional on the first occasion, and used in conjunction with spermicide for maximum effectiveness.

 


Pros and cons:
“They can be put in before sex so they don’t disturb the moment (you will need to add extra spermicide if you have sex more than three hours after putting it in),” says Sue. “They are not affected by any medicines that you take orally, and don’t disturb your menstrual cycle” – although it is recommended that you do not use the diaphragm/cap during your period, so you will need to use an alternative method of contraception at this time.

And the downsides? As with pretty much all methods except condoms, they don’t provide protection against STIs, and they’re also not as effective at preventing pregnancy as other methods (around 92-96%, compared with 98% for male condoms, for instance). “They can take a little getting used to before you’re confident using them,” Sue admits, “Some women can develop the bladder infection cystitis when using diaphragms or caps – check with your doctor or nurse if you need further advice. Some people may be sensitive to latex or the chemical used in spermicide.”

5. Sponges

What is it? As you might imagine from the name, the sponge is a… well, sponge, which contains spermicide to help to prevent pregnancy. They’re a single use option, and cannot be worn for more than 30 hours at a time.

Pros and cons:

Sponges provide protection from pregnancy on a two-fold basis – the spermicide slows sperm down and stops them from heading towards the egg, and the sponge itself covers your cervix, to block them if they do get there. They are easy to use, but require a little bit of prep – you have to wet the sponge to activate the spermicide, and then insert it, as far up as you find comfortable. They also need to be left in your vagina for at least six hours after having sex, so you have to remember to include this in your 30 hour calculation. It shouldn’t happen, but if the sponge breaks into pieces when you pull it out, you need to contact your doctor right away.

Once again, there’s no STI protection, and you can’t use them when you’re on your period, or have any form of vaginal bleeding, as this could increase your chances of getting toxic shock syndrome. They’re also not recommended for women who’ve had physical trauma in the area, or given birth, been through miscarriage or abortion recently. If you’re unsure, talk to a professional before making your purchase (because unlike many other options, sponges aren’t given out for free).

6. Natural family planning

What is it? Natural family planning involved monitoring your fertility signs, such as cervical secretions and basal body temperature, to find out when during the month you can have sex with a reduced risk of pregnancy.


Pros and cons:
It can be used to plan pregnancy as well as avoid pregnancy, if you’re thinking of starting and family – and if you’re not, it does not involve taking any hormones or other chemicals or using physical devices, like many other methods do. The NHS states that it’s up to 99% effective if the method is followed precisely – but you need proper teaching about the indicators, and because it can be tricky to master, mistakes happen, so it’s generally around 75% mark instead.

You’ll still need to consider protection from STIs, and use a different form of contraception if you want to have sex during your fertile times. “You need to keep daily records, and some things such as illness or stress can make results difficult to interpret,” says Sue. “It can take longer to recognise your fertility indicators if you have an irregular cycle, or have stopped using hormonal contraception. It demands a high level of commitment from both partners.”

7. Tubular occlusion

What is it? Tubular occlusion, or female sterilisation, is a surgical method of contraception that involves using clips or rings to block your fallopian tubes. It is thought to be more than 99% effective, and doesn’t effect hormone levels – you’ll still get your period if you have it done.

Pros and cons:

If you’re certain that sterilisation is the right option for you, it means that you no longer have to worry about pregnancy (although the same can’t be said for STI’s, which you’ll still need protection from). There shouldn’t be any impact on your sex drive, and rarely has any other long-term effects on your health.

However, as with any operation, there are potential complications, including internal bleeding, infection, or damage to your other organs. The chance of sterilisation failing is around in 1 in 200, but it can happen, and if it does occur, there’s a higher chance of the pregnancy being ectopic. Surgeons are generally more willing to carry out sterilisation on women who are over 30 and have already had children, but you can request it whatever your circumstances. It’s likely you’ll be referred to counselling before making your final decision, because of the permanent nature of the choice that you’re making.

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