Most people will tell you about certain challenges that arise sooner or later in long-term relationships. In most cases, it is enough knowing that you are not alone and that rough patches are a completely normal part of intimate relationships.
However, there are certain times when an issue prompts you to question the very foundation of your relationship. Luckily, research in psychology can give us clues on how to answer our deepest and most unnerving relationship questions.
Here are three hallmark hurdles that you might face in a long-term relationship and some research-backed advice to help you combat them.
#1. Do you desire to change something about your partner?
An alteration in what you expect from a significant other in your relationship over time is natural. But asking them to change can be a delicate and potentially damaging process.
Being asked to change can evoke intense emotions for the changing partner. To make requests for change relatively easy and less stressful for your significant other, researcher Natalie Sisson of the University of Toronto gives a couple of tips:
Make an effective change request. A clear and direct change request — as opposed to one that is vague or implicit — communicates that there is an issue in the relationship and helps changing partners determine what they can do to meet their partner’s request.
Be supportive. A change request should also be balanced with support and validation, given that we know change requests are difficult to hear. It is also important that changing partners feel supported during the change process and that requesting partners provide feedback about how things are going.
#2. Do you feel like you’ve hit a sexual plateau in your relationship?
Any activity that is repetitive and lacks newness can feel obligatory. This is especially true in the case of sex, which is usually portrayed as an aspect of a relationship that keeps things exciting.
Psychologists suggest that couples can, and often do, engage in maintenance sex to keep their sex lives active.
Maintenance sex refers to sessions of scheduled sexual activity in a relationship wherein at least one or both partners may not desire the sexual activity they are participating in due to various reasons, including a lack of sex drive.
Researcher Cory Pedersen of Kwantlen Polytechnic University of Canada says that indulging in maintenance sex can help couples experience greater relationship satisfaction as partners begin to develop a deeper understanding of each other’s needs, which often translates into better sex.
Another solution to the ‘sexual plateau’ problem is to express more gratitude in one’s relationship. A recent study tracked 118 couples’ gratitude and sexual satisfaction level over the course of three months and found out that people were sexually satisfied to the extent that they expressed and received a high degree of gratitude with their partners.
“Maintaining sexual satisfaction is a critical, yet challenging, aspect of most romantic relationships,” says psychologist Ashlyn Brady of the University of North Carolina. “Results from our study suggest that experiencing and receiving gratitude increases the motivation to meet a partner’s sexual needs.”
#3. Is your relationship with yourself suffering?
It can’t be said enough that a poor relationship with ourselves almost always translates into a poor relationship with our partner.
One’s self-relationship could suffer for various reasons, such as low self-esteem due to a failure at work or chronic issues such as depression or an insecure attachment style.
Lifestyle medicine and positive psychology are great resources when it comes to improving or repairing your relationship with yourself. Here are some tips from both fields to help kick-start your self-love journey:
On the lifestyle medicine side, researchers recommend spending eight hours per night in bed without a device. They also recommend increasing your daily consumption of plant-based foods and doing 30 minutes of moderate exercise or walking 10,000 steps per day.
On the positive psychology side, researchers suggest going out of your way to give someone a genuine compliment every day. They also suggest spending 15 minutes a day reflecting on things that went well and taking time to forgive people who have hurt you.
Conclusion: Love and romance are usually portrayed as mysterious and elusive experiences that human beings have little to no control over. Therapists and researchers argue, however, that with effective communication, patience, and effort there are no relationship problems too big to overcome.
Zander Moricz, Florida class president of Pine View, talked about his ‘curly hair’ in a heartfelt speech and used it as an analogy for his sexuality. Zander had to adhere to restrictons because of Florida’s controversial ‘Don’t Say Gay’ laws in schools.
The curly hair metaphor that everyone loved
A college student banned from using the word ‘gay‘ at his graduation speech used a clever metaphor to speak about his sexual orientation.
Zander Moricz, Florida class president of Pine View, talked about his ‘curly hair’ in a heartfelt speech and used it as an analogy for his sexuality.
Zander had to adhere to restrictions because of Florida’s controversial ‘Don’t Say Gay’ laws in schools.
So as the high school graduate began his speech, he replaced gay with ‘curly hai’. By doing so, he left audiences in awe and also drew worldwide attention to his activism for the LGBTQIA+ community.
“I must discuss a very public part of my identity. This characteristic has probably become the first thing you think of me as a human being. As you know, I have curly hair,” said Zander, while speaking at the Van Wezel Performing Arts Hall
The clip showing his speech has now collected over 8.4 million views on Twitter.
florida high school class president zander moricz was told by his school that they would cut his microphone if he said “gay” in his grad speech, so he replaced gay with “having curly hair.” i am in awe pic.twitter.com/OqLbar5bwq
The teenager even removed his mortarboard cap and unveiled his curly hair to the audience.
“I used to hate my curls. I spent mornings and nights embarrassed of them, trying to desperately straighten this part of who I am. But the daily damage of trying to fix myself became too much to endure,” he said.
He further added: “So while having curly hair in Florida is difficult, due to the humidity, I decided to be proud of who I was and started coming to school as my authentic self.”
Staying on the metaphor, Zander went on to say the growth of his ‘hair’ was a messy process but he came out well due to the support of his friends and teachers.
He ended his speech by saying it was important for him to speak up about his curly hair and other curly-haired students who are adjusting to ‘Florida’s humidity’.
The moving speech comes a few months after the controversial ‘Do Say Gay’ bill was signed and passed by the state. The bill prevents the teaching of sexual orientation and gender identity from pre-school to third grade.
A team of researchers led by Alexandra Dubinskaya, of Cedar-Sinai Medical Center has found that the medical benefits of women using vibrators are strong enough to warrant doctors prescribing their use to female patients on a regular basis. In their paper published in The Journal of Urology, the group describes their metastudy of research into the health impacts of vibrator use by women and why they believe the time may have come for them to be considered medical therapy devices.
Prior research has suggested that frequent masturbation by women can have positive health impacts, both physical and mental. In this new effort, the researchers noted that little work has been done on the use of vibrators as a masturbation aid and whether they have positive health impacts. They reviewed research databases for studies that involved use of vibrators for medical benefits and found 558 papers, which they whittled down to 21.
In their analysis, the researchers found evidence of a host of benefits of regular vibrator use, noting that it improved the health of the pelvic floor, reduced vulvar pain and led to improvements in overall sexual health. They also found instances of regular vibrator use leading to improvements in incontinence along with pelvic floor muscle strength.
The researchers note that use of a vibrator during masturbation reduces the time it takes for a woman to achieve an orgasm, and also helps with achieving multiple orgasms. Other prior research associates experiencing regular orgasms with stress reduction and an improvement in overall sexual health. They suggest that adding a vibrator to masturbatory experiences leads to better outcomes.
The researchers conclude that vibrators can and should be considered not just sex toys, but therapeutic devices. And that, they point out, suggests that it is time that female pelvic medicine and reconstructive surgery specialists, and perhaps doctors in general, begin prescribing vibrators to their female patients. The team will be presenting their findings at this year’s Annual Scientific Meeting of the American Urological Association.
For many caregivers, the idea of talking about sex with their kids may be uncomfortable. But talking about sex with your kids (which is about more than discussing actual intercourse), is important in order for children to develop healthy sexual attitudes and safe sexual behaviors as they get older.
But when exactly should you talk to your kids about sex? What age is best? As you’ll soon see, therapists advise that the conversation evolves over time, with kids learning age-appropriate facts about sex.
If you’re curious as to what that looks like and how to navigate topics related to sex with children of any age, we have expert advice for you. We will address everything from anatomy and the answer to where babies come from to consent and what to do if a teen says that they are ready to have sex.
What Is the Sex Talk With Kids—and Why Is It Important?
If you never talked about sex with your own parents, you may be wondering why it’s important to do so with your own kids; certainly they’ll learn what they need to from their friends or the internet, right? Clinical psychologist Inna Khazan, Ph.D. says this is exactly what you don’t want to happen.
“Yes, kids will hear about sex from their friends and pick stuff up from TV, but there’s so much misinformation out there,” she says. “With small children, this can sometimes be silly. But with older children, misinformation about sex can be tragic and problematic. Having the right information is incredibly important for physical and mental health.”
Talking about sex with your kids is about more than explaining actual intercourse, according to Dr. Khazan. It also includes what to call the reproductive organs, knowing what type of touch is and isn’t okay, birth control, protection against sexually transmitted infections, pornography, masturbation and the potential emotional ramifications of having sex.
Since sex encompasses so much, the conversation works best if it happens incrementally, over time. But that doesn’t mean it won’t be awkward. “This is an uncomfortable topic for both parents and kids,” says psychiatrist Muhammad Zeshan, M.D., an assistant professor of psychiatry at Rutgers New Jersey Medical School in Newark. But he says that when parents do have these conversations with their kids, it establishes trust. “A child may be more likely to share if parents have had a conversation beforehand with them,” he says. And those conversations can start as young as the toddler years.
How Do I Talk to My Kids About Sex?
When Your Child Is a Toddler
During the toddler years is when a child learns the names of different body parts—including the reproductive organs. Instead of using phrases like “pee pee” or “down there,” both experts say that kids should be taught the proper names of the reproductive organs: penis and vulva.
“One reason to teach the proper names is if they have pain there, they need to be able to describe it and knowing the proper names helps,” says Dr. Zeshan. It also takes away a stigma of shame often associated with the reproductive organs, says Dr. Khazan. According to the non-profit Race Against Abuse of Children Everywhere (RAACE), if a child feels shameful about their anatomy, they may be hesitant to open up with their parents if they have a question or concern about it.
Toddlers may be exploring their bodies, including their genitals. If they express that touching their genitals feels good, Dr. Khazan says to relay the message that it’s okay to be curious, but it should be done in private.
When Your Child Is Ages Three to Five
Some preschool-age kids love to run around naked, which is a great opportunity to address nudity. “For little kids [younger than seven], I would communicate that it’s okay to be naked at home, but not in public. Then, when they get a little older, you can tell them that some parts of the body are meant to be private, just for you,” says Dr. Khazan. This, she says, relays information about what is and isn’t appropriate without using shameful language.
If a child continuously enjoys being in the nude, Dr. Zeshan says to ask them what they like about it, getting to the function behind the behavior. For example, is it because being naked makes them feel happy and excited? Free? Calm? Knowing the reason for the behavior makes it easier to address, he explains.
Both experts say that kindergarten to lower elementary school is a good age to teach children the difference between appropriate touch and inappropriate touch, communicating that the reproductive organs (and upper chest for girls) is not for others to touch except for a doctor, if given permission.
When Your Child Is Age Six to Eight
This tends to be the age when kids ask where babies come from. Both experts say you should tell the truth, using simple language. “You might say that two people’s bodies come together and meet each other,” says Dr. Khazan. “You can get into the sperm and egg when they get a little older and are able to understand more, but this can be too complicated for a young child.”
“So many parents get uncomfortable with this question, but just remember that the more you stay calm and address it without judgment, the better you’ll be able to answer it,” adds Dr. Zeshan. Like Dr. Khazan, he advises using simple language. “You can say that there’s a place close to mommy’s tummy where the baby grows,” he says, adding that you should encourage the child to ask questions, if they have any. There will be a chance to address the specifics of how a baby is made during puberty.
When Your Child Is Age Eight to 12
Puberty starts earlier than many parents may realize, according to Dr. Khazan: For girls, it occurs between ages eight and 13, and boys start going through puberty between ages nine and 14. “It’s important to talk to the child about certain changes they’re likely to experience, because this helps establish a foundation of what’s normal,” says Dr. Khazan. “That way, the child knows that there’s nothing to feel shameful or embarrassed about.”
This kind of open conversation will also be helpful when changes happen during puberty—like a girl’s first menstrual cycle—so that the child isn’t surprised and the parent isn’t left scrambling to explain what’s happening in the moment. Again, both experts urge parents to encourage their child to ask questions if they have any, which helps create a more open relationship.
Puberty is also a time when Dr. Zeshan says parents can get more specific about sex, explaining exactly what it is. Part of this, he says, is building upon the “where do babies come from” conversation, explaining the role of the egg and sperm. But sex isn’t just about making babies, of course. “This is the age to educate a child about how sex is done, how it can lead to pregnancy as well as how to avoid pregnancy, and also the importance of consent,” advises Dr. Zeshan. Pre-teens may also have questions about masturbation, and Dr. Khazan says that parents can reiterate the same message they taught them as toddlers: Exploration is normal, but should be done in private.
Since these conversations can be uncomfortable, Dr. Zeshan’s advice is to let the child determine the timing. “When the child is relaxed, ask them if they would like to have the conversation. If they say no, ask when a good time would be and let them know that whenever they are comfortable, you are ready,” he says.
When Your Child Is Age 13 and Older
Fifty-five percent of teens have sex before age 18, according to the Centers for Disease Control and Prevention (CDC)[1]. Dr. Khazan says that this is why even if you don’t think your child is sexually active, it’s still important to talk about sex with them during the teen years. This is when you should once again discuss consent, but this time addressing more specifically what it looks like, including when alcohol is involved, and what to do in a situation if they feel they are being pressured.
If a child comes to their parent and asks if they’re allowed to have sex or tells their parent that they are ready to have sex, Dr. Khazan says there is no one way to navigate this that will work for every parent. “This is a very personal decision for each family,” she says. While parents should feel encouraged to express any religious or personal values tied to sex, Dr. Khazan does say if a teenager is fearful of their parent finding out that they are having sex, they may be less likely to come to them if they need help.
“If a teen comes to their parent and says that they want to have sex, a parent can talk with them about the changes it may bring to their life and if they are ready for those changes,” says Dr. Zeshan. A parent can talk about the consequences sex can have—including sexually transmitted diseases and pregnancy—without labeling sex as “bad,” he says, adding that if a child develops a negative association with sex, it can lead to issues with intimacy down the road.
Pornography is another topic to address during the teen years. “Approach it in a curious way, not a judgmental way, allowing the teen to ask any questions they have,” says Dr. Zeshan. Instead of shutting down a conversation about porn completely, Dr. Khazan says what’s more effective is telling teens that what happens in pornography does not necessarily reflect reality and that some of what is in porn is demeaning and dangerous.
Even with all this information, talking about sex with your kids may still be uncomfortable. Both experts say this is expected and it’s 100% okay. What’s important is that you’re doing it, which not only creates a more open relationship with your child, but can go a long way in terms of keeping them safe and helping them develop a healthy attitude toward sex. And you didn’t even have to mention anything about birds or bees.
Sex is hotter for everyone when all parties can relax knowing they’ll stay inside their comfort zones. One way to ensure in advance that everyone will say comfy is to establish a safe word: a word that, when said, signals for the sexy activities to stop.
“A safe word is a word (or a system of words) that helps you communicate your sexual boundaries,” says sexologist Marla Renee Stewart, MA, co-author of The Ultimate Guide to Seduction & Foreplay and sexpert for Lovers. Safe words are often used in BDSM play, but can be used in other forms of sex, as well.
When someone uses a safe word, it signals to their partner(s) that they need to stop what they’re doing and check in with that person, according to Astroglide’s resident sexologist, Dr. Jess O’Reilly. Knowing that this system is in place helps people feel safer exploring kinks and fantasies that they might not otherwise.
How to Use Safe Words
Safe words are often used in scenes involving domination and submission so that the sub can let the dom know when they’re approaching their limits, says sex and intimacy coach Leah Carey.
If a scene involves pain, a safe word may indicate that you’ve reached your limits for how much pain you want to experience. It could also indicate that you’re experiencing emotional discomfort, says psychotherapist Frank Thewes—for instance, if you’re feeling triggered by something that’s happening or it just feels like it’s happening too fast.
“You can use your safe word any time you want to stop or take a break,” O’Reilly says. “Simply utter your safe word and play should stop. You can then talk about how you’re feeling, what you want, or changes you’d like to make in order to keep playing—or opt to stop playing altogether.”
Safe words are especially helpful in scenes that involve consensual non-consent play—that is, performing resistance as part of a kink when, in reality, you are consenting. In these cases, saying “stop” could be part of the scene, so someone might want another word that actually means “stop.”
“For instance, in a role-play situation where one partner is playing a dominant teacher and the other partner is playing a submissive student, the sub can act as if they’re resisting the encounter by saying, ‘No, I can’t do that! I’m not a bad girl/boy!’ as part of the scene, while the scene continues,” O’Reilly explains. “Similarly, in a scene that involves caning or flogging, the sub can whine and squirm and yell, but the dom knows that the sub is enjoying it unless they use the safe word.”
But safe words aren’t just for BDSM. “People who have an established safe word might also use it during vanilla play to signal that they have an urgent need that must be addressed,” says Carey—for instance, if you’re uncomfortable and need to change positions, if you’re feeling uneasy, or if you need to go to the bathroom.
Examples of Safe Words to Use
One system created within the BDSM community involves using three words, Stewart explains: “green” means “keep going,” “yellow” means “slow down,” and “red” means “stop the scene.”
Another approach is to pick just one word that means “stop.” It can be any word, but the key is that it’s not a word you would use otherwise; you don’t want there to be any confusion about why you’re saying the word. It should also be something that’s easy to remember and say even if your brain is a little fuzzy, says Carey. Some examples, she says, might be “pineapple” or “elephant.”
Stewart suggests using a word that’s a turn-off for the people involved so that it’ll stop everyone in their tracks, perhaps bringing humor into it. “Mine would be something like ‘all lives matter’ or ‘Trump smegma,’” she says. “It would invoke some type of disgust or emotion. The best words are the words that you and your lover decide together and may be equally emotional for you both.”
The specifics of the word aren’t too important, though. “Any word can be used as long as it is agreed upon ahead of time,” says Thewes. “The word used doesn’t matter as much as the word being respected.”
How to Establish a Safe Word
“You can establish a safe word at any time; however, typically, people establish safe words before they enter into a sexual relationship,” says Stewart. “You can bring it up to them in a casual setting, such as dinner or watching television, and frame it in the context of wanting to try something new.”
For instance, Stewart suggests, you might bring up the idea of blindfolding your partner, then say, “To make sure that we’re safe, let’s establish a safe word just in case you’re feeling uncomfortable, so that I know and we’ll stop what we’re doing. Does that feel good to you? What word would you like?”
Before throwing yourself into the action, it’s helpful to do a practice round where your goal is to say the safe word whether you actually need to stop or not, says Carey. This way, “the sub has a sense memory of having said the word, so they know they’re able to do it in the midst of play,” she says. “This is important because some people become non-verbal when they’re in sub space, so if the sub realizes they can’t verbally safe-word, they need to adjust their system.”
Doing a trial run also lets the dom see whether the sub is able to effectively communicate their boundaries, Carey adds. “If the dom doesn’t trust the sub can safe-word, they can’t trust any of the signals they get.”
In addition to establishing a safe word, it’s helpful to establish what the sub would like to see happen after they use it. Some subs, for example, will appreciate an aftercare routine, says Carey, which could include cuddling, talking about the scene, or having a drink or snack.
Alternatives to Using a Safe Word
There are some instances where safe words won’t be effective, such as when someone is deaf or hard of hearing, when someone is gagged or otherwise unable to speak, or when someone is in a mental space where they don’t feel comfortable speaking, Stewart says.
In these cases, you can instead come up with a safety gesture. “Using gestures such as tapping out, a fist, or an open hand can be helpful in conveying the message that you want,” Stewart says.
Another option is for the sub to hold a bell and ring or drop it if they want to stop, Carey says. As with a safe word, the people involved in the scene should establish the gesture in advance.
Whatever the safe word or gesture is, it’s imperative that the sub feels comfortable using it and the dom is open to hearing or seeing it. “If a sub safe-words, the dom absolutely cannot take this as a personal slight and wander away feeling resentful,” says Carey. “It is their responsibility to take care of the sub’s needs in the aftermath of safe-wording.”
As workplace protections expand for the LGBTQ+ community, transgender and non-binary employees may feel more comfortable being their authentic self at work. As a result, you should be prepared to work with transitioning employees. Consider developing a plan with your human resources department to educate the workforce and foster an inclusive work environment by creating policies that prohibit discrimination on the basis of gender identity or expression, allow for employee self-identification, address access to bathroom facilities, and make dress codes gender neutral. What should you know if an employee in your workplace is transitioning?
Understand the Meaning of ‘Transgender’
An important first step for employers is to understand what “transgender” means. “Transgender” is a broad term that may apply to a range of gender-nonconforming people. In general, a transgenderperson is someone whose gender identity or gender expression is different than their sex assigned at birth, and they may identify as male, female, or some combination of both or neither. Many people who consider themselves transgender do not undergo gender-affirmation surgery.
Additionally, while many transgender people do identify as male or female, some do not. They may refer to themselves as non-binary or prefer other terms to describe their gender identity, such as gender fluid, genderqueer, agender, or bigender.
A person’s sexuality and gender identity are separate statuses, and transgender people may identify as straight, lesbian, gay, bisexual, asexual, or another sexual orientation. In order to foster an inclusive environment, and avoid potential claims, it is important to avoid making assumptions about anyone’s sexuality based on their gender identity.
Review the Evolving Legal Landscape
While some states have provided employment protections for LGBTQ+ workers for years, the U.S. Supreme Court’s landmark 2020 decision in Bostock v. Clayton County changed the legal landscape nationwide.
Title VII of the Civil Rights Act of 1964 prohibits employers from discriminating against employees based on color, national origin, race, religion, or sex. In the Bostock case, the SCOTUS held that workplace discrimination based on sexual orientation and gender identity is unlawful “sex” discrimination under Title VII. This means employers cannot lawfully make employment decisions – such as hiring, firing, promoting, or disciplining employees – based on a job applicant’s or employee’s LGBTQ+ identification.
The Supreme Court found that “it is impossible to discriminate against a person for being homosexual or transgender without discriminating against that individual based on sex.”
The Court provided a workplace example to illustrate its point: An employer fired a woman because she is insufficiently feminine and also fired a man for being insufficiently masculine. Even if the employer treated them equally, it fired each worker because of their sex. “Instead of avoiding Title VII exposure, this employer doubles it,” according to the Court.
You should also review guidelines from the Equal Opportunity Commission (EEOC) – the federal agency that enforces Title VII – on sexual orientation and gender identity discrimination in the workplace. The EEOC updated its guidance in 2021 in light of the Bostock ruling.
Be sure to also review state and local laws, which may provide additional rights to LGBTQ+ employees in the jurisdictions where they work.
Prepare a Transition Plan
If you are approached by a transitioning employee or otherwise become aware of an employee transitioning, you should consider developing a detailed plan that broadly focuses on three areas: communication, education, and accommodation.
At the outset, the plan should designate one or more specific points of contact, so that employees — both those transitioning and their coworkers — know to who to call with concerns and questions.
Consider the following three points as you develop your plan:
Communication is Key You should create an inclusive and understanding environment to convey to your employees your acceptance and understanding. This includes distributing a written open-door policy for employees who wish to speak with management or human resources. If you invite employees with special circumstances to speak directly with someone in leadership, you may have a chance to respond to concerns before they escalate.Once you learn that an employee plans to transition, you should engage in an open dialogue with that individual. Encourage the employee to self-identify their pronouns and make name or pronoun changes easily accessible.You should also work with the employee to determine their anticipated timetable for the transition process. Discuss when and how the employee wants coworkers to become aware of the transition and when the employee wishes to switch names and use of pronouns. You should also review your dress and appearance policies, make them gender neutral by removing any standards based on gender stereotypes (such as requiring women to wear dresses and men to wear trousers), and allow transgender workers to follow standards that align with their gender identity and expression.All employees should be permitted to use bathrooms and locker rooms that correspond to their gender identity. Anyone who is uncomfortable sharing restroom facilities with other employees for any reason should be welcome to use single-person, all-gender facilities, if available. If single-person facilities are not available, you should consult your HR department and legal counsel to balance all considerations in a fair and non-discriminatory manner.Remember that coworker complaints or personal opinions do not supersede a transitioning employee’s rights to express their gender identity and to be free from discrimination and harassment for doing so.
Educate Your Workforce Once those matters are addressed, you should educate your workforce and encourage an environment of tolerance and mutual respect. As part of the education process, make sure all employees know that they should use the transitioning employee’s new name, if applicable, and use the appropriate pronouns for the employee’s gender identity.One common issue many transgender people experience is misgendering, and if done intentionally over time could create potential for hostile work environment. A simple way to demonstrate inclusivity is to encourage all employees to specify their pronouns of choice on company email signatures or other personal identifying communication.Education is a key part of the plan. Open forums may encourage the respectful exchange of concerns and suggested approaches. If a transitioning employee reports any incidents of perceived harassment or discrimination, you should take immediate steps to investigate those concerns and remediate any confirmed instances of unlawful discrimination.
Explore Reasonable Accommodations Finally, when possible, you should consider requests for reasonable accommodations from transitioning employee, such as flexibility or time off for doctor’s visits or to address the side effects of hormonal changes or gender reassignment surgery. Sometimes an accommodation has a minimal cost or burden and is well worth the effort. This is especially true if it prevents a costly discrimination claim and fosters an inclusive environment that focuses on retention of workforce talent.A good starting point is to simply ask what workplace accommodations the employee would like during the transition process. At a minimum, you should keep lines of communication open with transitioning employees and review their accommodation options. Workers are less likely to become disgruntled, and seek out counsel, if you acknowledge their concerns and work with them to find solutions.
Conclusion
You should review your policies and practices to ensure compliance with the Supreme Court’s Bostock ruling, the EEOC’s updated guidance, and applicable state and local laws.
NPR’s Sacha Pfeiffer talks with Eliot Schrefer, author of Queer Ducks (And Other Animals): The Natural World of Animal Sexuality. It’s about how “natural sex” may not be as binary as some think.
SACHA PFEIFFER, HOST:
At its worst, a nonfiction science book about animal sexuality could read like a dry biology textbook. But that’s not the kind of book Eliot Schrefer wrote. His book, called “Queer Ducks (And Other Animals): The Natural World Of Animal Sexuality,” is designed to be teenager-friendly, for one thing. It’s a young adult book filled with comics and humor and accessible science, and it’s filled with research on the diversity of sexual behavior in the animal world. Eliot Schrefer is with us to explain more. Welcome, Eliot.
ELIOT SCHREFER: Hi. I’m really happy to be here.
PFEIFFER: We’re glad to have you. I really liked the way you structured your book. It’s basically an animal per chapter, in a way. But you also have these wonderful illustrations. You have interviews with scientists. Tell us a little bit about how you decided to make it accessible because, again, you’re aiming for adolescents, as I understand it, in a nonfiction way, and they might be inclined to think nonfiction equals boring, dry textbook.
SCHREFER: Right. I sort of imagine, like, we’re kind of sitting in the science classroom, passing notes back and forth, and it even comes down to the doodles. There’s an artist, Jules Zuckerberg, who did a one-page comic for each of the animal species that we discuss. So it’s – the premise is that it’s an animal GSA.
PFEIFFER: A gender sexuality alliance meeting.
SCHREFER: That’s right. And so they’re each taking a turn introducing themselves. And so the bonobo takes a turn introducing how her family works, and then the doodlebug and the dolphin and so on.
PFEIFFER: Yeah, they’re really great. They make the book really accessible. As we said, every chapter basically tackles an animal and something about the sexuality of that animal. Do you have a favorite or one of your favorites that you could tell us about?
SCHREFER: Sure. Well, the hard part starting to write this book was figuring out which animals to focus on. The bonobos are famously promiscuous, and the majority of their sexual activity is between females. So I knew they had to be in there, is an early chapter.
PFEIFFER: What’s funny – well, what’s interesting about these animals are they – as you said, they’re very promiscuous. I mean, there’s almost this orgy-like way about how they behave sometimes.
SCHREFER: Yes, and what was so interesting in the early studies about bonobos – they’re really fairly new to science. We used to call them pygmy chimpanzees and just thought they were small chimps and that was it. And it wasn’t until the ’90s and the 2000s that we started really studying them. And sex, in particular same-sex sexual activity in bonobos, is a way to avoid conflict and to smooth over feelings after a conflict.
There was a really fascinating study where they gave honey, which is a really desirable food source, to a group of bonobos and to a group of chimpanzees and saw how they reacted differently. And chimpanzees, the strongest males grabbed the food source and handed it out to their allies. And then in the bonobos, they all circled the honey, and none of them touched it. And they all got very, very anxious about how this food was going to be split up. And then rather than starting eating, they started an orgy. They just all started having sex. And this is between males and males, males and females and females and females. And then once they were blissed out and calm, that’s when they started to eat this food. And chimps and bonobos are tied as our closest relative, so it’s a great metaphor for the two ways that we can also look at human nature.
PFEIFFER: There’s also a chapter that I found interesting about bulls. And a lot of bulls are used for breeding. They’re used to inseminate females. And sometimes, the bulls have to kind of get in the mood. The handlers help them get in the mood. And what’s interesting is they often bring in other males to do that, and it’s effective. And I thought that was very interesting. Tell us why you chose that example.
SCHREFER: Bovids are – have one of the largest percentages of same-sex sexual behavior within their populations. And it’s long been the ace card in the hand of cattle breeders to bring out a steer to get a bull excited in order to perform sexually. And in fact, there was one of the foremost sheep researchers, Valerius Geist, who studied bighorn sheep in the 1960s – he was in the wild observing these bighorns and saw that they basically live in entirely homosexual society until the age of 6 or 7. The males are off by themselves having frequent intercourse. And he didn’t publish on it. He wrote about this in his memoir years later because he couldn’t tolerate the idea that these – what he – quote, “magnificent beasts were queers.” And so he resisted publishing on that.
PFEIFFER: We mention that the book includes interviews you’ve done with scientists, these little question and answer exchanges. I really like those. They not only added to the science of the book, but it was interesting that these types of professionals exist. Could you tell us about one that you think is most noteworthy?
SCHREFER: Sure. I wanted to expand kids’ impression of who gets to do science, with gets in quotes there – that it’s not just old guys in white coats, right? There’s an upswell of young scientists who are doing some wonderful work around queer behavior and queer identities in animals.
So one person I spoke to was an ecologist who has transitioned genders, has – is still actively figuring out their place within the broader world and looked forward so much to the days when they could be just with their binoculars in the fields, mud up to their ankles, just staring at moose because at that moment, all these – the complicated navigation of all these identities just dropped away, and they were just part of nature. Like, they didn’t have to explain themselves to the animals, and the animals had no concept of judging or shaming anyone for the choices that they were making around their gender identity. And I found that so moving that there is some – there’s a peace to be found and a simplicity and an acceptance, a radical acceptance within nature.
PFEIFFER: Eliot, you’ve written in your book that you are well aware – these are your words – well aware that this book is bound to be controversial. But on the other hand, you also seem to be trying to assure young people out there that this is not controversial at all. It’s actually quite common in the animal world. Is that part of the message you’re trying to send?
SCHREFER: Yeah. I think there’s – you know, some people will say, well, there’s all sorts of things that animals do that humans oughtn’t to be doing – right? – that we shouldn’t cannibalize our partners after we have sex with them, that we shouldn’t be living on webs out in the wild, and that we can’t just cherry-pick which animal examples we choose to use. But that’s really getting the argument of the book backwards. I’m not trying to argue for human behaviors from certain – the ways that animals can behave. Instead, I’m trying to say that we can no longer argue that humans are alone in their queerness or in their LGBTQ identities – that instead, we are part of a millions of year tradition within the animal world of a varieties of approaches to sex and a ton of advantages that come around from it.
PFEIFFER: Eliot, you’ve written and you’ve said that you wished you had known this when you were younger. If you had known it, how do you think it would have changed how you felt about yourself?
SCHREFER: I think there’s a loneliness to human queerness, that there is this idea that it is something that happened recently to this species and that we are alone in it, and that queer people can find each other and find community with each other, and that that is the goal that they can – they should hope for when we are heavily integrated into the natural world. And that is the part of the message that I think is lost, and that LGBTQ behaviors and identities are absolutely natural.
PFEIFFER: That’s Eliot Schrefer. His new book is “Queer Ducks (And Other Animals).” Eliot, thank you.
When figuring out something as complex as sexuality, it might seem like there are more labels than there are in your local supermarket. You may also feel that it’s difficult to find just one that 100 percent fits you, which is totally fine, by the way.
Two of the identities that people might need more clarity on are “omnisexual” and “pansexual.”
At first glance, they may seem the same. You can define pansexuality as having a romantic, emotional, or sexual attraction to people, regardless of their genders. But omnisexuality can involve having a romantic, emotional, or sexual attraction to people of all genders. The distinction is slight, but it’s there.
Don’t worry if you didn’t spot it right away, though. We’ll explain their similarities, differences, and what they both mean in the context of relationships.
OK, before we delve into the specifics of pansexuality and omnisexuality, we need to discuss the concept of gender blindness. Try not to skip: This is what’s going to help you work out the differences!
You might’ve heard the term “gender blindness” used in a negative sense. Like “color blind” in terms of race, some people may use it as a refusal to acknowledge that some groups experience oppression or privilege because of their genders.
Some pansexuals call themselves “gender blind” in a neutral way, meaning that a person’s sex or gender doesn’t factor into their attraction for them. They can be attracted to someone whether they’re male, female, trans, intersex, nonbinary, etc. So, they use “gender blind” in the nonexclusionary sense, in that gender simply isn’t an issue.
However, other pansexuals might be uncomfortable with the term, feeling that it may invalidate someone’s identity, especially trans people who may have gone through a lot of hard work to be recognized as their genders. These pansexuals may prefer to say that they have no gender preference.
Whether you use the term “gender blindness” or not, and it’s good to be aware that some people aren’t comfy with it, you get the gist — it’s about not limiting your attractions by gender.
The prefix, “pan” means all, every, whole, and all-inclusive. The “pan” in pansexual means you’re attracted to someone without consideration for their gender, aka, you’re gender blind or have no gender preference. This doesn’t mean you’re invalidating someone’s gender in any way — but it just isn’t a factor in your level of attraction to them.
“Pansexual” is a relatively young term that didn’t really get used a whole lot until the mid-2010s, when it was put under the bisexual umbrella. But now, pansexuals proudly walk on their own, represented by a pink, yellow, and blue flag, which stands for attraction to all identities.
Sometimes, people can easily misinterpret pansexuality, which can create negative stereotypes and discourage people from owning their sexualities. Some mistakenly believe that the “all” part of the distinction means that pansexuals are up for getting down with anyone, all the time — and that simply isn’t true.
Others see pansexuality as an open invitation for sexual activity, and that it lessens any need for consent — nope, nope, a thousand times nope. Just like all forms of sexuality, pansexuality is a specific form of openness that the individual wholly owns and manages, not anyone else.
Want to show your pansexual pride? May 24 is Pansexual Visibility Day, with National Pansexual Pride Day on December 8.
The prefix “omni” means all, everywhere, or all-encompassing. Similar to “pansexual,” “omnisexual” means you can have an attraction to all genders — except, in this case, you do consider sex and gender to a certain extent, aka, you’re not gender blind.
If you’re omnisexual, you might have a slight gender preference when it comes to attraction, but not a specific gender requirement. So, the gender of the person you’re attracted to matters, but it’s not a determining factor.
“Omnisexual” is another fairly new term, which a lot of people might not be super familiar with, and that can lead to its own problems. For instance, both pansexuals and omnisexuals often might have to put up with the perception of being hypersexual and all the issues that come with that, such as erasure among others.
Because “omnisexual” isn’t yet a universally familiar term, people who do identify as such are often labelled as the more-familiar “bisexual” or “pansexual” instead, which can be hurtful.
But as time goes on, more and more people have access to the education to help them develop awareness of what the term means. There’s also an omnisexual flag, which has stripes of pink, blue-purple, and black. People recognize Omnisexual Awareness Day on March 21, and Omnisexual and Omniromantic Pride and Visibility Day is on June 6.
If you’re looking to find which identity is most true for yourself between omnisexual and pansexual, the main similarity can be straightforward: Both groups can be attracted to anyone of any gender, whether it’s in a romantic, emotional, or sexual way.
The key difference is the consideration of gender — pansexuals don’t consider it, omnisexuals do.
If it’s still a little tricky to distinguish in your head, imagine one person saying, “I love hot drinks!”, and another person saying, “I love tea, and coffee, and hot chocolate, and…” It’s not a perfect comparison, but it might help you grasp the difference a little more clearly.
And remember, everyone’s understanding of their own sexuality is just that: their own. You can define yourself however you choose, or not at all. Having a clear understanding of your feelings based on your experiences is what matters.
So, you might have a better inkling now of whether pansexuality or omnisexuality fits you better — that’s awesome! If you’re already in a relationship, or planning to be in one sometime, it’s also a good moment to think about how you’re going to be clear with them going forward.
The first thing to remember is that you don’t have to tell anyone that you’re pansexual or omnisexual if you don’t want to — you don’t owe that to anyone. But if your partner(s) is completely in the dark, or isn’t super knowledgeable about different sexualities, it can cause some issues.
Not communicating your sexual identity or preferences may cause you to become tense or unsure around your partner, which may cause them to become uncomfortable as a result. And that’s not a good foundation for any relationship.
If you do want to tell them about your sexuality, reassure them that you’re being open and honest with them because you want a stronger relationship. Explain what pansexuality or omnisexuality is, and work to clarify any misconceptions or defuse any stereotypes.
There’s no guarantee that your partner(s) will be receptive, or respond in a way that you like, but that’s on them. Being authentic and honest with yourself and with the person you care about is the priority. Care promotes authenticity, and authenticity should encourage better care.
If you don’t identify as either omnisexual or pansexual, it’s always a good thing to know what supportive language you can use. And if you’re an ally, advocate, or someone whose loved one just came out, it’s even more important!
First thing to remember is to avoid presuming anything about anyone. If someone tells you that they’re omnisexual, don’t reply with “but isn’t that just bisexual/pansexual?”. And the same goes for pansexuals — sexual identities are deeply personal, and it’s for each individual to decide which fits them best.
It’s important to avoid making jokes about being hypersexual. And for the love of pizza, almost every pansexual heard the “does this mean you’re attracted to frying pans?” joke a million times already.
Remember that being attracted to all genders doesn’t necessarily mean that a person wants to be in polyamorous relationships. Some might be in them, others might not be, same as anyone else.
As with anyone, it’s important to know pronouns, especially with pansexuals — some people will be “he/him” or “she/her,” but with gender being less of a concern, others may choose to be “they,” “ze,” or “xe.” It’s much better to ask than to keep getting it wrong.
Above all, simply respect and accept. If someone trusts you enough to share their sexual identity with you, that’s a big deal.
Although it can initially be tricky to work out the difference between pansexuality and omnisexuality, they’re both completely individual and valid forms of sexual identity, with their own acknowledgments. Gone are the days when both were simply thrown under the label “bisexual“.
What it comes down to is that omnisexuals tend to notice a potential partner’s gender more than pansexuals do. Other than that, pansexuality and omnisexuality share a love and attraction that isn’t limited by gender. Both can be truly inclusive.
Be true to yourself, and support others in their own journeys — after all, isn’t that what love is all about?
— The agony and the ecstasy of an open relationship
And then there were three: ‘If we can both let each other go for an evening every now and then, the reunion feels so much sweeter.’
When Tom Rasmussen and their partner of seven years decided to have an open relationship, they knew it would be exciting and revitalising – but the danger of losing what they had was only too real
By Tom Rasmussen
My mother will kill me for writing this article. She doesn’t get why my partner and I would want to have sex with other people; why, God why, would we want to question a structure as sacred and, let’s face it, successful as monogamy? As she said, when I first mentioned I’d been on a date with someone who wasn’t my long-term partner, “Well, what if he finds someone better than you?” Brutal. Mothers really know how to find your deepest insecurity before wringing it – and you – out like a dishcloth.
She wasn’t wrong, though. What if he does find someone better than me? That was, admittedly, the first question I had when my partner and I decided to sleep with other people a year ago. Not only that, we decided it would be fine if we went on dates with other people, too: one, two, 10 – as long as we kept, as every pop psychologist whose bestseller I’ve never read will tell you, communication streams open.
The first date with someone else was mine. It was with an incredibly hot guy who I’d met at a fashion party, because I’m glamorous like that. He flirted so hard it was essentially impossible to say no. My partner and I discussed it: “Let’s just see what happens.”
Naturally I was nervous. The guy was hot. I was sweaty. It was the first date I’d been on in way over half a decade. What on earth do you talk about? I messaged a friend who is a very chic dater: “Just ask him his most problematic opinion… Honestly, it’s the best opener.” I wore black, because I always wear black, and I unbuttoned my shirt one lower than usual. I kissed my partner and my dog, Celine Dion, goodbye. And off I went.
The date was fun, the sex was wild – not better or worse, but invigorating in its difference. Kissing was, bizarrely, harder than anything else because a kiss with a stranger these days feels more intimate, and until then that intimacy had been reserved only for my partner.
When I arrived home that night after sleeping with the first person who wasn’t my boyfriend in seven years, I felt, simply, glad to climb into bed next to him. But also, perhaps, like I was beginning to undo three decades of conditioning towards monogamy. A monogamy which, until then, I’d held on to so tightly it was as likely to suffocate me, or my partner, as the worrisome potential of finding someone better.
See, the thing about our monogamous relationship was that the desire we had for others never went away. It was simply annexed in our brain, right there next to Catholicism and the bad exes. That’s not to say it was repressed. I don’t know a single person in a monogamous relationship who doesn’t flirt, have crushes, perhaps overstep the mark in someone’s DMs. A lot of people cheat, too. It’s been this way for aeons and it will be this way for aeons to come (or until the next pesky mass extinction event hits). And annexing this desire is perfectly fine, but when you simply ask the question, “But why?”, finding a solid answer becomes difficult.
The day after I’d consummated our open relationship, we packed a bag and drove to the countryside for a friend’s baby’s christening. The atmosphere in the car as we drove out of London was one of deep, icy tension. We could not seem to find the right song to narrate the moment, for the whole 90-minute trip, until I burst and said: “OK, we fucked!”
We decided there and then, on the A419 on the way to celebrate the choices of some dear friends who had done what they were supposed to do and moved to the countryside to raise their perfect child, that this open thing was a terrible idea.
My partner is the love of my life. Something – perhaps the only thing, except that blondes really do have more fun – I feel sure of. A climate crisis brings daily anxiety, the newspapers are littered with transphobia, the government goes beyond incompetence to arrive somewhere between casual cruelty and calculated fascism. And on days where it feels as if there is very little to live for, just looking at him still reminds me that there is something so good in the world. Something with meaning.
See I am, and always have been, a sucker for love, romance and utter dedication – a paradox with my ever-intensifying queer politic. For a long time, it was me who had a desperate stake in our monogamy. I am the kind of person who people describe as “so attractive” but, because of my hairy belly and flagrant femininity, it’s often followed by: “I’m always attracted to people over bodies.” Well, good for you. But for me, attraction has always found me in spite of my body, not because of it. And plainly put, my boyfriend has both: charm, vigour – and abs.
‘Like every gay from a small town, I believed I was Carrie Bradshaw’: Tom Rasmussen.
Now I don’t want to be shallow: I wouldn’t want to say that the only reason I clung tightly to monogamy was because I’m a six and he’s a nine. It’s also a Catholic upbringing, every bit of culture I’ve consumed, the fact I believed I was, like every gay from a small town, Carrie Bradshaw. And I was looking for “can’t-live-without-each-other-love”, because, really, I’d never felt like I’d really been properly loved before. By anyone. Romantic or not. And so, when I built futures in my head they were monogamous. It was all I had ever seen. And I had made love, commitment and true romance all synonymous with monogamy.
At the christening we barely spoke. On the outside we were still the perfect gay couple: cooing over the baby, congratulating our friends, telling jokes only marginally over the edge of inappropriate for a christening. And for that day, everything appeared blissfully normal. But normality can be suffocating. On the way home, in the car, we broke: “Oh my God that was so normal we can’t cope.” So we checked ourselves into a cheap hotel that night, halfway between London and the Cotswolds, got absolutely hammered and defined the rules of our new setup. And at that point, there were no rules. Just communication. And that we can stop whenever either of us wants.
The second person I had sex with approached me in a bar and described what he wanted to do to me. I’d never felt a turn-on like it. Not that I’m not turned on by my partner – because various types of desire, of turn-on, are not mutually exclusive. Desire, as I’m learning, exists on various planes, in various spaces. Herein lay a huge learning curve: in an open relationship, you begin to experience totally varied and different types of desire to the type of desire you feel in a monogamous setup. I’ve had fast sex, slow sex, hot sex, sex I regret. I’ve made love to a stranger and had feelingless sex with a good friend.
The more people we told, the more we were asked my mother’s fated question: “How do you know he won’t find someone better than you?” After pushing back, I realised this wasn’t my friends and my mother telling me I was shit and my partner could – and perhaps should – find another, better partner. It was that everyone worries about this, too, in their own relationships. We’re all terrified that we are phonies and that if someone else came along we would be exposed and left to become the Miss Havisham type we were always destined to be.
The truth is, I don’t know he won’t find someone better than me. But can you know that in a monogamous relationship either? No. In fact, the answer, after a year of making mistakes and communicating about them in ways we never did before, is that it’s liberating to accept that. It’s freeing to see the end, because in seeing the end you have a reason to keep choosing the relationship.
And to me it has become an absurd claim that it would be possible to find someone better than him. Because a partnership, a love, a life that took seven years to build cannot be torn apart by something as new and naive as lust and, at most, momentary love. They are different emotions. They both provide rich experience, but they are in no way comparable. If anything, my tendencies towards jealousy and self-doubt have simmered away somewhat – because here was our get-out clause. And we are still in.
“It’s easier for queer couples,” a heterosexual friend told me, after I told her. And I think, for countless reasons, this is true: like the fact the centre still sees our relationships as fringe; the fact that sex for a lot of queer people is a mode of finding community, touch and family; the fact that we were kept out of normative conventions of relationships until a brutally recent seven years ago. But, at the same time, there is still the same fear, the same worry, the same risk of loss. So easier feels like too easy a word. Perhaps more accepted.
Culturally, we always think about the rush of the new: those heady days when you meet your partner and every move they make drives you to distraction. Then we do the merry dance of less sex, less communication, less fun, more bills, more plans, more stress, until we die or someone leaves.
And, yes, with every new partner I’ve been lucky enough to have an experience with over this moment in our relationship, I’ve experienced the rush of the new. But the rush of the new spills over into my primary partnership, too: new dynamics form, each scenario brings with it something for us to negotiate, and our sex is more adventurous than ever: perhaps because we learned new moves elsewhere or perhaps because we have a reinvigorated sense of desire for each other knowing that someone, elsewhere, has found this body in front of you desirable in new ways, too.
Our open relationship wasn’t born out of a lack of sex. Don’t worry, we’ve had that phase and we really did consider going open. But we decided then that if we were ever to do it, it couldn’t come from a place of trying to cure a wound, or fill a gap. That’s when the primary partnership ends. In fact, we’d only recently talked about getting married and then we decided to try the idea that non-monogamy might be an even more immense, powerful commitment to each other than a ring and a register.
How could that be possible? How could sleeping with other people be more of a commitment than marriage? Because in sleeping with others you are allowing your partner a deeper expression of their desires. Marriage is fantastic in many ways, but it is also a means of state control – one which produces couples who care for each other, and children who will become workers. But in the case of openness, I am committing to the fullness of his desires and mine, and the risks that come with expressing them. Commitment is another word I had got wrong, too. I always equated it with sacrifice, but I’m coming to learn it means a willingness to understand the changes in a person, to understand their fullness.
Of course, there are hard parts. With certain aspects – silly insecurities, double standards, needing to know every detail – you have to take on the individual responsibility of self-management of (some of) your own emotions. You have to accept that sometimes you are going to feel strange things and that your partner cannot be responsible for curing them. Or even always listening to them if they are unfair and unfounded. I’d been on multiple dates with someone, and felt deep worry when he told me he was going on a second. This was a feeling I had to– with the help of generous friends – self-manage. And lo and behold, he came home after what he described as an “impossibly average” date.
Something I’ve come to learn, something necessary for the success of truly any relationship, is that love is not control. Monogamy, too, is not control – and this is not my accusation. Because whether monogamous, open, polyamorous, the terms of the relationship should be agreed upon by each person within it, mutually, and not simply put there because it’s what – literally – the Bible says. I have radical queer friends who adore monogamy. I’ve met viscerally dull couples who are radically polyamorous. There’s no rhyme or reason for who it fits.
But the point is that non-monogamy is actually about care. It’s about seeing your partner, and yourself, as someone separate to you who has desires, feelings, emotions that they want to, and should be able to, share with other people – not just you. For us, at least, it’s created a dynamic of tantalising flux: one where sometimes you feel lonely, sometimes you feel powerful, sometimes you feel more in love than ever. But in understanding these dynamics that whirl around inside, and between, us both it feels more likely than ever that neither of us will find a better partner. Because if we can learn with empathy, compassion and selflessness to understand each other in what is deemed such a testing situation; if we can both let each other go for an evening every now and then, the reunion feels so much sweeter. Because you come home to someone who is committing to work hard to see you, to make space in their complicated emotional life for yours. And vice versa. That feels like more commitment, more love, than anything I’ve experienced before.
There are certain taboo topics that aren’t openly talked about, and masturbation — particularly, female masturbation — has certainly been one of them. But experts say that’s starting to change.
“There was a time when it wasn’t open for women to talk about it,” Dr. Leah Millheiser, director of the female sexual medicine program at Stanford University Medical Center, tells Yahoo Life. “Now patients are very open when asked. Women do it.”
While Millheiser acknowledges that “there are religions and cultures where it’s not acceptable because sexual activity is meant to be procreative” and that it’s still “more accepted that males do it even though women do it, too,” she says society has made “massive strides” in talking about masturbation. “We talk about vibrators so openly now,” she says. “Gwyneth Paltrow talks about it. We’ve normalized talking about vibrators and in [doing] that, normalized talking about masturbation, even if we don’t say it.”
Debra Herbenick, the director of the Center for Sexual Health Promotion at Indiana University in Bloomington, agrees, telling Yahoo Life that, in recent years, “more of my women college students talk openly about it.” But some women still feel embarrassed, “especially if they were raised in more traditional or conservative homes,” she says. “And some women don’t learn much about their vulva and vagina until adulthood; sexuality in schools rarely addresses masturbation, sexual pleasure, sexual exploration or orgasm.”
So here’s what you need to know about female masturbation.
#1: Masturbating is healthy
While pleasure is the most obvious benefit of masturbation, experts say the practice comes with some health benefits as well, including stress relief and a better night’s sleep. That’s because having an orgasm from masturbation releases feel-good hormones called endorphins, which create feelings of relaxation and well-being.
A 2019 study found that having an orgasm through masturbation was associated with better quality sleep and an easier time falling asleep. “It [also] helps them fall asleep if they’re stressed or anxious,” says Millheiser.
The orgasms that come with masturbation also “improve blood flow to the vagina,” says Millheiser, “and that keeps it healthy.”
But that’s not all: Masturbating with a partner is also “a form of safer sex,” says Herbenick. According to Planned Parenthood: “In fact, it’s the safest way to have sexual pleasure there is — there’s no risk of pregnancy or STDs.”
As Alix Agar, associate marriage and family therapist at the SHAPE Center, tells Yahoo Life: “Masturbation to orgasm has all the benefits of genital intercourse to orgasm, without any of the downsides!”
#2: Women masturbate more often than you might think
“The single biggest misconception about female masturbation is that women don’t,” says Agar, “and of course, that’s simply not true. Women have always touched or rubbed their genitals for pleasure, just as men have. They just talk about it less.”
Herbenick agrees, saying: “Many people don’t realize how common masturbation is among women. However, about 3 in 4 women have ever masturbated.”
A 2017 study found that more than 40% of women had masturbated in the last month the research was conducted, with only about 22% of women reporting that they have never masturbated in their lifetime. The study also found that more than 50% of women had used a vibrator or dildo.
#3: It’s a good way for women (and men) to learn about their bodies
Another benefit to masturbation is that it helps with “getting to know your body” and “getting to know what works for you” in terms of stimulation and pleasure, notes Millheiser.
Agar calls masturbation “an effective tool for women to learn about their orgasmic capabilities — how quickly or slowly, how intensely and how long they can orgasm.” She says that it’s “a huge benefit to sex with a partner as well, because it teaches a woman what types of touch, rhythms, etc., will bring her to orgasm, and she can teach her partner how to do the same.”
She also points out that there’s a “dangerous misconception” that girls and women who masturbate will become “oversexed, or sexualized too young or want too much sex.” She says, “These are all outdated, misogynistic myths. They relate to ideas that women’s sexuality belongs to her husband or male partner and can only be developed or explored by him. In fact, the more any woman knows about her own body and her own capacity to achieve sexual pleasure, the more she will be able to achieve mutual sexual satisfaction with her partner. Masturbation can be an integral part of any couple’s sex life.”
#4: Masturbating “too much” is rare
It’s rare that someone masturbates “too much,” says Herbenick. “When that occurs, a person generally knows because their masturbation is getting in the way of work, school or their family or romantic/sexual relationships,” she says. “In other rare cases, someone may be masturbating so much or in such a difficult way that it hurts their body.”
Herbenick says that “people who are struggling with their approach to masturbation, or their feelings about masturbation, may be helped by connecting with a sex therapist or sex coach.” She suggests visiting AASECT.org or SSTARnet.org to find a therapist in one’s area.
#5: Married women — and older women — do it, too
Masturbating isn’t just for the young and single. Married women and men, as well as older adults, partake as well. “Masturbation is available to people across the lifespan, including people of advanced age,” says Herbenick. “Indeed, many older individuals find it easier to masturbate alone or together rather than have intercourse, given some of the logistics with intercourse positioning and/or issues such as vaginal dryness or erectile function.”
Herbenick adds: “Solo and partnered masturbation are just two parts on a very full menu of ways to explore and connect sexually.”
#6: It can improve your sex life
A 2020 study published in the Journal of Sexual Medicine found that when women use similar techniques and stimulation that feel good during masturbation and apply them during sex with their partners, they report a better orgasmic response and less difficulty achieving orgasm during partnered sex.
Masturbation can also be helpful to women entering menopause. “When a woman goes into menopause, she has decreased blood flow,” explains Millheiser. “So women will say, ‘I can’t achieve orgasm anymore’ or ‘It’s really weak in intensity.’ Or, ‘I can’t achieve it without using a vibrator.’ That’s related to a drop in estrogen and nerve conduction. You need more of that stimulation to achieve orgasm.” And that’s where masturbation comes in.
#7: For some, it’s the only way they orgasm
“Women will say, ‘I can’t achieve orgasms,’ and what they’re really saying is, ‘I can’t have an orgasm with penile-vaginal or toy-vaginal penetration,” explains Millheiser. “But you can ask them, ‘Can you have orgasms through genital or clitoral stimulation?’ ‘Oh yeah, I can do that.’ It’s more common to have clitoral stimulated orgasms than vaginal penetration orgasms.”
Millheiser says that it’s perfectly OK if the only way you’re able to achieve orgasm is through masturbation. “Don’t be disappointed if it doesn’t happen,” she says. “Enjoy the orgasms that you do have.”
The number of people who identify as queer in the UK Census has increased over the past few years. This trend is in particular driven by the rising number of LGBT+ identities among people aged 16 to 24 years. The most popular sexual identity within this emerging group is bisexual – the romantic and/or sexual attraction to more than one gender. Data from the Office for National Statistics (ONS) shows an increase from 0.7 per cent in 2015 to 1.1 per cent in 2019. Rather than a sudden new surge of bisexual desires, increased acceptance, legal protection and visibility are likely to be the cause of this increase.
But why should we count how many people are bi, or study what their experiences are? Research is young in this field, but we’re already seeing that tossing all queer identities into one research bucket renders the unique struggles of being bisexual invisible. For a start, it’s hard to even get an accurate sense of the exact number of British people who are bisexual. Many people who are attracted to people beyond one gender, shy away from the identity label ‘bisexual’. When it comes to research, this reluctance has led scientists to come up with alternative ways to capture and categorise sexuality.
One of the most common tools used is The Kinsey Scale. First published in 1948 by biologist Dr Alfred Kinsey, it is used to place people on a spectrum of sexual attraction between entirely heterosexual and entirely homosexual, using a scale from 0 to 6. It also includes ‘X’ for those who are asexual. It was so successful that it is still the single most popular scale for classifying sexuality. It’s often what people are indirectly referring to when they say, “Aren’t we all a bit bi?”
When YouGov surveys conducted in 2019 used questions that mimicked The Kinsey Scale, researchers found at least a third of people aged 18 to 24 say that they are attracted to multiple genders. A startling figure compared to the 1 per cent reporting to the ONS. Only with research can we cut through the reluctance people have to say “I am bisexual”, and find out whether those attracted to multiple genders need more support than those who aren’t.
Since social scientists and other researchers have started to analyse the B, we have begun to understand the struggles that uniquely endanger bi people. Research shows us that bi women are hypersexualised, and stereotypes that see bi women as promiscuous sexual playthings feed into people’s existing rape myths.
Accordingly, studies have found that bisexual women are significantly more likely to be raped, repeatedly sexually assaulted, and to be the victims of intimate partner abuse than lesbian and heterosexual women. Had this research homogenised all women into one group, we might never have known that the stereotypes affecting bi women specifically place them at far greater risk of sexual victimisation.
A different cluster of toxic assumptions awaits bi men. Bisexual men are seen as lying, to themselves and others, because they are thought to be gay. And, particularly in the 1980s and 1990s, bi men were also seen as murderers in disguise, catching AIDS when having sex with men and giving it their female partners. This left many bisexual men isolated and alone, failed by educational campaigns that rarely moved beyond gay spaces.
We need to acknowledge the unique needs of bi people, including a specific focus on bi men. If we don’t, we fail a huge amount of the population. Armed with bi-specific research, we stand a better chance of winning the fight back against the societal biases and misconceptions that hold bisexual people down.
As a young researcher, I didn’t know anyone else who was bisexual in my field, or, for that matter, in any field. It was rarely mentioned, not even in lectures specifically on sex and sexuality. When I graduated with my PhD in 2012, I had no idea how useful my background in criminal psychology would come to be when I turned my gaze to studying bisexuality. For my new book, Bi: The Hidden Culture, History And Science Of Bisexuality, I have found and spoken to researchers across the globe and in various disciplines who are all fighting for change.
I want the world to be a safer place for people like me. The best way that we can achieve that is to visibly support bi people. Let’s not allow the ‘B’ slip into the shadows of its colourful siblings.
Autism can affect how a person communicates, learns, behaves, and socially interacts with others.
It does not require a cure. Being autistic can simply mean a person’s brain works in a way that is different from what society expects.
Autism is known as a spectrum disorder as it can affect people in different ways. Some autistic people require higher levels of support than others. This can mean they require assistance with daily tasks or skills such as language and behavior.
Other autistic people may need low levels of support or no support at all.
Autism frequently causes a person to have difficultyTrusted Source with social interactions. This may provide some challenges when it comes to forming relationships.
Read on to learn more about autism and sex, including how autism affects the development of sexuality and how to help an autistic person understand their sexual feelings.
If an autistic person needs help to understand their sexual feelings, a friend or family member may be able to assist. It is important for an autistic person to know that there is nothing wrong with having sexual feelings.
A person can help an autistic loved one understand that sex is natural and should be enjoyable. However, sexual behaviors are private and should only involve consenting adults.
When discussing sexual feelings with an autistic person, the following tips may be beneficial:
Let them know they are safe to discuss how they are feeling and that they can ask any questions about sex and sexuality.
Communicate openly and honestly, and without judgment.
Discuss sex education with them.
Teach them how to communicate with a sexual partner about things they do and do not enjoy.
Speak with them about boundaries and how to discuss these with a sexual partner.
Let them know they deserve to be treated with respect by any prospective partner.
Autism does not prevent a person from developing sexually. A study from 2021 found that most autistic adolescents and young adults have an interest in sex and relationships.
The study also noted that, on average, autistic adolescents and young adults had less knowledge of sex and privacy. This meant they were more likely to engage in inappropriate sexual behaviors.
Researchers think this lack of sexual knowledge may be due to factors such as:
difficulties with social interaction
insufficient sexual education
ableism that assumes autistic people do not have sexual feelings
stigmatization
exclusion from social interaction
It is important to provide sufficient sex education for autistic adolescents. This can help them learn what is and is not socially acceptable.
Additionally, sex education can prepare autistic adolescents for changes in their bodies as they go through puberty.
Planned Parenthood suggests parents and caregivers should aim to teach their children about:
puberty, before their body begins developing
reproductive health and how to reduce the risk of pregnancy and sexually transmitted infections
appropriate and inappropriate behaviors
Sometimes an autistic person may have difficulty with eye contact. In this case, it may be helpful to discuss these topics on a walk side-by-side or while preparing a meal together.
A parent or caregiver may also try having conversations using “what if” questions to develop solutions, such as “what if a period begins at school?”
They should also be aware of any crushes the child or adolescent has and talk about how to be respectful of boundaries.
The following organizations and resources may be helpful:
According to the Organization for Autism Research (OAR), some autistic people may find that intimate activities help them feel less stressed or anxious.
However, some aspects of autism may lead to challenges.
Sensory sensitivity
For some people, sensory sensitivity to the sounds and physical sensations of sex may cause a person to feel uncomfortable.
If a person is uncomfortable or does not want to do something, they should share this with their partner. No one should feel required to do anything they are not comfortable with.
Discussing their needs with a partner can make it easier to find solutions. For example, people can tie their hair up if the tickling causes discomfort, or they can wear lightweight clothes during sex if skin-to-skin contact feels uncomfortable.
Communication
When entering into a sexual relationship, communication is always important.
People may benefit from discussing their needs with their partner before engaging in sexual activity.
They may find the following tips beneficial:
Decide on a safe word or sound that indicates “stop.”
Decide on a “yes, no, or maybe” list before engaging in physical activity.
Keep a notepad near the bed to write notes they can point to if needed.
An autistic person may feel worried about disclosing their autism to a potential partner. They may fear that the person will think differently of them. An autistic person should only disclose their diagnosis if they are comfortable sharing it.
People may wish to end a sexual relationship if their partner:
ignores their communication needs
ignores their sensory needs
tries to make them feel bad
Sex can also be overwhelming. Autistic people may find it hard to communicate when they are overwhelmed. This can lead to feelings of anxiety or discomfort.
People can arrange to express gestures that indicate “yes” or “no” during sex. If people become overwhelmed during sex and cannot communicate verbally, they can tap their partner on the back to indicate that they want the activity to stop.
Picking up on verbal or nonverbal cues can be difficultTrusted Source for some autistic people.
An autistic person may benefit from letting potential partners know they need to be direct with them. This can also be helpful during sex, as an autistic person may not notice if their partner is signaling discomfort.
The best thing a person can do while in a sexual relationship is to communicate with the other person. Talking openly and honestly can make things more enjoyable.
Public vs. private
Knowing the difference between behavior that is acceptable in public and private settings is important. It can help to keep everyone safe.
The following table outlines some examples of behaviors and when they might be appropriate:
Healthy relationships
Relationships can be difficult to navigate, and there are many types. Depending on the relationship, a person’s behavior can be appropriate or inappropriate.
Romantic relationships involve people having an emotional and potentially sexual connection with each other that is consensual and reciprocal.
The OAR notes that healthy relationships include the following characteristics:
communication
trust
being emotionally respectful
being physically respectful
honesty
equality
being accepting of each other
Dating
Dating can be complex, and it is important to remember that:
Having a crush is natural, and it is possible to have a crush on more than one person.
It is fine not to have a crush on anyone.
Flirting can be fun, but respecting other people’s boundaries is important.
Being in a relationship can be challenging, and communicating is important.
Although it is difficult, ending relationships is sometimes necessary.
Online relationships and safety
The internet can be a good place to develop relationships, providing a person remains safe.
When they are online, people should remember the following rules:
A person does not have to share or post anything they do not want to.
A person should take precautions if they decide to follow an online meeting with a real-life meeting.
Assume that anyone can find the information a person posts online.
Never share any personal details, including financial information and full birth date, with anyone on the internet.
Never engage with any sexually explicit materials that include people under 18 years of age.
Sexual feelings are natural and not something a person should be ashamed of. It is also natural for a person not to have sexual feelings. People should never be made to feel shame for their sexuality.
Expressing sexuality can be healthy for an autistic person. Research from 2020Trusted Source found a link between sexual dissatisfaction and depressive symptoms and lower mental health. An autistic person may find that sexual behaviors help reduce anxiety or stress.
In a recent survey, more than one-quarter of women ages 50 to 80 said menopause symptoms were interfering with their sex lives — including one-third of those ages 50 to 64.
By Amy Norton
Many women remain sexually active into their 70s, but for others, menopause symptoms and chronic health issues get in the way.
Overall, 43% said they were sexually active, be that intercourse, foreplay and caressing, or masturbation. A similar proportion, however, were limited by health issues.
More than one-quarter of women said menopause symptoms were interfering with their sex lives — including one-third of those ages 50 to 64. Meanwhile, 17% said other health conditions were the problem.
It’s not clear what specific issues were the biggest obstacles. But experts said menopause can affect a woman’s sexual function in a number of ways.
Sometimes it’s relatively straightforward, said Dr. Daniel Morgan, a professor of obstetrics and gynecology at Michigan Medicine.
He pointed to a prime example: The hormonal changes of menopause can cause dryness and irritation of the vagina or the vulvar skin — which can make sex painful.
Fortunately, there are good treatments, Morgan said. For vaginal dryness, women can try over-the-counter lubricants, or get a prescription for vaginal products that contain low doses of estrogen. Steroid ointments can help soothe vulvar skin conditions, Morgan said.
In other cases, sexual dysfunction is more complex.
Declining estrogen levels can directly affect a woman’s libido, said Dr. Stephanie Faubion, medical director of the North American Menopause Society and director of the Mayo Clinic’s Center for Women’s Health.
As a result, women may find their desires are dialed down, and they feel less motivated to initiate sex — though, Faubion said, they may still respond to their partner’s romantic overtures.
At the same time, some women feel exhausted during this time of life, whether that’s related to menopausal night sweats keeping them awake, chronic health conditions, or having a hectic life. Women in their 50s may be caring for kids and aging parents, while balancing that with work.
“If a woman is exhausted, sex drops down the list,” Faubion said.
Mental well-being is also a big factor. Depression can interfere with sexual activity for some women, Faubion said. In the survey, of women who indicated their mental health was poor to fair, only 36% said they were “very satisfied” with their sex lives, versus 65% of women who reported good mental health — though it’s not clear whether the mental health issues caused problems with sexual activity.
When sexual desire and activities do change as a woman ages, that’s not necessarily distressing, both Faubion and Morgan emphasized. It’s only a problem if she is bothered by it, or it’s causing issues in her relationship.
And in cases where a couple is having difficulties they can’t work out, Faubion said, counseling might be the right option.
Menopause-related symptoms were highly prevalent among poll respondents, with half saying they’d suffered one to three in the past year. problems and weight gain were most common, followed by diminished libido, hot flashes/night sweats and mood swings.
Yet, of all women reporting menopause symptoms, only 44% had spoken with a healthcare provider about treatment options.
“Some women may not be aware there are treatments,” Faubion said. “Or they may think the symptoms will be temporary and are waiting them out.”
And, both she and Morgan said, healthcare providers may not be asking about menopause symptoms, or any issues with sexual activity.
But Faubion said it’s important for doctors of all specialties to have sexual health on their radar: Patients with conditions ranging from heart disease to hip replacements are going to have questions about sexual activity, she pointed out.
It is fine for women to let sexual activity go, if that’s what they want: In the poll, 52% of women who were not sexually active said they were satisfied with their sex lives. That was lower, however, than the figure among women who were sexually active, at 74%.
And women who are concerned about their sexual health, or menopause symptoms in general, should feel free to broach the topic with a healthcare provider, Morgan said. Your primary care doctor is a good place to start, he noted.
The poll was conducted online and by phone between January and March and has a margin of error between 2 and 4 percentage points.
More information
The North American Menopause Society has more on sexual health.
Sarah Brylinsky, a 34-year-old working in higher education in Ithaca, N.Y., is legally married to 36-year-old farm manager Brandon Brylinsky. Two years ago, on a camping trip a decade into their relationship, they met 35-year-old Matte Namer, the founder of a real estate firm.
The Brylinskys and Namer are polyamorous, which means they are open to romantic relationships with more than one person at a time. After meeting two years ago, they started going on dates together, and soon after, Namer moved in with the Brylinskys. Now, the three plan to have a child, and they want to make their relationship official so that they can be recognized by their community as a family.
But how do you make a relationship official when there are three people in it?
Polyamory is a form of consensual non-monogamy — when people have more than one sexual or romantic partner at once with all partners’ permission. A 2021 study in Frontiers in Psychologyfound that one in nine single American adults had engaged in polyamory.
In legal terms, polyamorous people are unable to marry all their of partners: It is illegal throughout the United States to marry more than one person at a time. Somerville, Mass., is thought to be the first U.S. city to legally recognize polyamorous domestic partnerships, which it started doing in 2020.
However, people like Namer and the Brylinskys are utilizing an option that symbolically, though not legally, binds all three of them: a commitment ceremony.
Commitment ceremonies are events that celebrate any number of people’s commitment to one another, and they can look many different ways, according to Connecticut-based marriage and family therapist Kristen C. Dew.
She’s seen some that “resemble the typical monogamous couples’ weddings,” she said, while others are parties or outdoor gatherings. She also said that “many opt for handfasting ceremonies,” or choose unique items as symbols of their love.
The ceremony that Namer and the Brylinskys are planning will be similar to a wedding. They’re discarding some traditions: They’ll have a cookie table instead of a cake, for example. But they will all make vows to one another. In addition, the Brylinskys will create a joint vow just for Namer, and vice versa, they said.
“We met Matte as a couple; there was a relationship that came before them, and it’s both important to establish that we made a family together and to acknowledge that we transitioned our existing relationship to make room for that,” Sarah said.
Ambyr D’Amato, a wedding planner based in New York, is helping to plan this ceremony. She said she has worked with several other polyamorous people on commitment ceremonies: In one of them, a couple that was already married waited at the end of the aisle, and the third person walked down the aisle to symbolically join them.
“It was important to [the third person], since they were not legally married to anybody, that they had a ceremony where they could involve their family and have things be more in the open,” D’Amato said. The event took place in Central Park, she added, replete with flowers, champagne, oysters and live music.
Another commitment ceremony D’Amato planned was between two people who were both legally married to other people, and each person’s partner was present to give their blessing. Afterward, they threw a dance party with their family and friends.
“I like that I can provide access to a heart-opening and connected time for people,” D’Amato said. “I also like that I can help them think outside of the box: You can do whatever you want. Nothing has to look a certain way.”
Many people are embracing the notion that their relationship doesn’t have to be celebrated with a traditional wedding, and opting for commitment ceremonies instead — even those whose relationships only involve two people.
Rachael, a 37-year-old writer, and Tom, a 36-year-old tech adviser — both based in Santa Barbara, Calif. — were legally married for financial and logistical reasons in 2015, but they publicly became each other’s spouses during a commitment ceremony on the lawn of the Santa Barbara courthouse six months earlier.
“We felt it was a better fit for us, being pretty nontraditional in many ways,” Rachael said. “We wanted to be very intentional about how we celebrated our commitment.”
Rachael and Tom, who spoke on the condition that only their first names be used, said they are non-monogamous and are open to committing themselves to an additional partner. Part of the reason they joined through a commitment ceremony is so that, if they do decide to hold another one with a third person, all three of them will be on the same footing, they said.
And as a genderqueer, pansexual person holding this ceremony in 2015 — before same-sex marriage was legal throughout the U.S. — Rachael wanted to stand in solidarity with queer people who couldn’t legally marry their partners, Rachael said.
To reflect the nontraditional nature of their relationship, Rachael wore blue, and instead of the gendered roles of bridesmaids and groomsmen, they designated a group they called “their people” to walk down the aisle one by one.
Jessica Fern, a Boulder-based psychotherapist who works with polyamorous people, touted the potential benefits of ceremonies like this.
“When someone experiences legal marginalization for their relationship structure or style, commitment ceremonies can go a long way to deepen a relationship, publicly acknowledge its significance, and even assuage some of the pain and injustice that being a minority can create,” she said.
Fern’s clients who have undergone commitment ceremonies have reported feeling more secure in their relationships as a result, she said: “They have more of a structure that they can rely on that’s bigger than just them. They can lean on each other in hard times, like, ‘I made this commitment.’ ”
But many non-monogamous people say they don’t feel safe holding an event as public as a commitment ceremony, because of existing stigma. And while those in polyamorous relationships can work with lawyers to secure certain legal protections (Namer and the Brylinskys are working with the Chosen Family Law Center to ensure they all have equal status as parents of their future child), a commitment ceremony does not confer the same rights as a legal wedding.
Some non-monogamous people hope that this will change in the future. “We have the right to be with our loved ones and share the resources that we would normally get to share in a monogamous context,” Fern said.
Still, Fern thinks anyone wanting to make an official commitment to a partner can learn from non-monogamous commitment ceremonies.
“There are so many traditions that we do in monogamous weddings, and we’re like, why do we do this?” she said. “Why do you throw the bouquet? … Why is the father giving the bride away? As people are questioning [these norms], they’re able to have even their own monogamous wedding that feels aligned with them and their values and their relationship.”
After reaching historic lows more than a decade ago, rates are on the rise again.
By Kim Tingley
Last month, the Centers for Disease Control and Prevention released its latest data on cases of sexually transmitted infections during the first year of the pandemic. In the early months of 2020, the number of people diagnosed with gonorrhea and syphilis declined, as you might expect — it was, after all, a time of extreme isolation for many. Subsequently, though, infection rates surged so much that by the end of the year, the case counts were 10 percent and 7 percent higher than in 2019. In total, there were some 134,000 reports of syphilis and 678,000 reports of gonorrhea. These were “stunning” increases, says Hilary Reno, an associate professor at the Washington University School of Medicine and medical director of the St. Louis County Sexual Health Clinic. “I can’t tell you how many primary-care physicians have called me recently and said, ‘I just saw my first-ever case of syphilis this year.’”
Indeed, syphilis was nearly eradicated in the United States around 2000; gonorrhea reached its lowest rates of infection in 2009. Many doctors who began practicing during that period haven’t had experience diagnosing these S.T.I.s, particularly in their female patients. According to Ina Park, a professor of family and community medicine at the University of California, San Francisco, “There’s an entire generation of physicians and clinicians who had never seen syphilis in women and babies before.”
This is a significant problem: S.T.I.s can irrevocably damage the reproductive system. At least 20,000 women are rendered infertile by untreated S.T.I.s in the United States each year. Syphilis can cause sores and rashes and, if untreated for decades, fatal damage to the brain, heart and other organs. Gonorrhea can be painful and may result in pelvic inflammatory disease in women. Each condition is caused by bacteria and can be cured with antibiotics (though drug-resistant strains of the bacterium that causes gonorrhea are on the rise). Unfortunately, they are often asymptomatic, especially in women, and for them it can be harder to see signs of infection and easier to mistake some of those signs as normal discharge or yeast infections.
The ease with which S.T.I.s spread undetected makes it crucial to screen for them regularly. Yet that is not happening. “The pandemic made S.T.I.s worse in America — for the first year, people all but stopped getting testing and treatment,” says David C. Harvey, executive director of the National Coalition of S.T.D. Directors, a trade association for state and local S.T.I. Health Department programs that collected its own data during the pandemic. (The C.D.C. data comes from a national surveillance system that includes mandatory lab reporting and sample surveys.) Moreover, contact tracers, assigned to notify sexual partners of exposure, were redeployed to focus on Covid.
Historically, the highest rates of syphilis have been among gay and bisexual men, then among heterosexual men. And while that is still true, cases among gay and bisexual men have risen more slowly in recent years and even declined slightly in 2020. Cases among heterosexual women, on the other hand, increased 30 percent from 2018 to 2019 and 21 percent from 2019 to 2020, jumps that experts attribute in part to the increasing prevalence of opioid and methamphetamine abuse, which makes risky sexual behavior — transactional sex, condomless sex — more likely among all genders.
This trend among women has fueled a corresponding surge in syphilis among newborns. In 2020, there was a nearly 15 percent increase in congenital syphilis — amounting to a 235 percent increase from 2016. Congenital syphilis can lead to severe lifelong health complications and stillbirth; of 2,148 infants who contracted syphilis in 2020, 149 did not survive. When women who are engaging in substance abuse become pregnant, they frequently avoid prenatal care for fear of being drug-tested and potentially losing custody of the child. That means many of them aren’t tested for syphilis and don’t receive the treatment that would prevent their baby from getting it. The C.D.C. recommends testing for the infection at the first prenatal visit and, for women who test positive or are at increased risk, early in the third trimester as well as at delivery. (Most states require doctors to perform the initial test, but only 19 also require screening in the third trimester.)
Perhaps the simplest explanation for the overall rise in S.T.I.s between the 2000s and now is that lawmakers reallocated funding to other problems deemed more dire. Many S.T.I. clinics that provided free or low-cost testing and treatment closed or scaled back hours. Other factors contributed to the problem. The growth of online dating expanded sexual networks. The ability to prevent H.I.V. infection with prophylactic medication reduced the inhibitions against having sex without a condom. And most states still do not provide comprehensive sex education. If they did, more people would know that it’s important to treat S.T.I.s and not wait, says Whitney Irie, a lecturer in population medicine at Harvard Medical School. As it is, a popular impression is that S.T.I.s are “essentially obsolete,” she says. “I don’t think there’s a clear understanding, especially among people with a uterus, of the long-term impact on your reproductive organs. There’s this casualness about it that lends itself to being casual about preventive measures.”
Reducing the burden of S.T.I.s will require outreach, particularly for marginalized groups, including women, people in the L.G.B.T.Q. community, Native Americans and Alaskan Natives and people of color, all of whom suffer disproportionately high rates largely because the health care system has neglected them. Black women, for example, have rates of syphilis, gonorrhea and chlamydia that are as much as seven times that of white women, and they face additional hurdles to receiving sexual health care. Black women, Irie says, must also contend with the “perceived stigma and perceived shame from their community” that receiving sexual health care means you don’t share its values, such as female monogamy. That’s a stereotype applied to women across many demographics.
To reach those who have been disenfranchised, providers need to be trained to offer sexual health care to patients who have experienced historical trauma and sexual trauma, including assault and abuse. “If they’re met with a system that doesn’t use open terminology or doesn’t recognize their trauma, their experience can be horrible,” Reno says. “We can retraumatize them, and they don’t come back ever.”
Public-health initiatives have also succeeded by partnering with local institutions people trust. In St. Louis, which has some of the nation’s highest rates of S.T.I.s, many barbershops and beauty salons offer testing information and free condoms; elsewhere, projects in partnership with churches have been able to increase mammograms and H.I.V. testing among Black women. Half of all new S.T.I. infections are among 15-to-24-year-olds, but school-based health centers that offer comprehensive health services on campus have been shown to improve attendance and graduation rates and decrease urgent-care visits.
The pandemic has interrupted countless health services. But it also generated solutions. For example, in March 2020, a program called TakeMeHome began mailing out free H.I.V. self-test kits, with a focus on reaching gay and bisexual men. Half the recipients had not been tested within the previous year, and more than a third of them had never been tested at all; after using the kit, more than 10 percent reported accessing other sexual-health services. “You have to make it as easy for people as possible,” Park says.
If you’re sexually active, you will inevitably be exposed to pathogens, just as you are by shaking hands with or breathing the same air as others. “Your clothes are off,” Park says. “That’s the only difference.” S.T.I.s “are not a personal failing,” Reno says. “This is a systemic societal challenge.” Thus, talking openly about sexual health care stands to benefit everyone. Park recommends pressing your provider for testing; ideally, S.T.I. screening would be treated like a trip to the dentist. “Put it in your routine as something you do regularly.”
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