Fetal Tissue Research Benefits Everyone, Even Hypocrites

August 3, 2015

If you believe in miracles, scientists’ ability to study and cure human disease by looking at microscopic cells from aborted fetuses is indeed a miracle. If you don’t believe in miracles, it’s an extraordinary human achievement. Miracle or not, this science is extending the length and quality of your life, and the lives of your loved ones. And the lives of anti-choice activists.

In order to be used, these cells have to get from an abortion clinic to a research lab, hundreds or thousands of miles away. Federal law regulates this procedure, which has been going on for decades.

Anti-choice activists recently climaxed a three-year infiltration of the commercial world of fetal tissue donation and distribution. The videos they illegally shot, dishonestly edited, and illegally distributed purport to show Planned Parenthood (PPFA) breaking the law while participating in a trade they consider evil.

While PPFA denies any wrongdoing, these activists acknowledge the various laws they broke—counterfeiting drivers’ licenses, creating a phony company (CMP) with a website and history, signing non-disclosure agreements to get private meetings that they agreed to not record, and recording them.

They also got access to the personal information (such as home addresses) of abortion providers, which of course they have now distributed on the internet. These details have predictably led to grisly death threats—which CMP says was one of their goals.

You probably wouldn’t want people sneaking into your workplace, videotaping you, claiming your work is evil, and then publicizing your kids’ names and school location. CMP Board Treasurer Troy Newman is president of Operation Rescue, which ultimately helped murder Dr. George Tiller in his church. In 2003, Newman said that the murder of abortion provider Dr. John Britton was “justifiable defensive action.”

The transfer or scientific use of fetal cells does nothing to facilitate abortion, and fuming over it is a clever propaganda ploy by anti-choice activists. Once an abortion is completed, it’s over. What’s done with the fetus at that point is totally irrelevant. Opponents are using the little-known issue of fetal cell use simply to reiterate their hostility to abortion.

And like the details of virtually every medical procedure (amputation, breaking bones to do heart surgery, installing a colostomy bag, etc.), it’s not for the untrained faint-of-heart. So a couple of Planned Parenthood staff sounded “indelicate” or “insensitive?” Isn’t that what you would sound like at work if people outside your industry heard your slang, your necessarily casual attitude about your work with frustrating customers, dangerous situations, or awful boredom?

If donating your organs for medical research after you die is honorable, why is donating your fetus’ organs less honorable? The tired old “but fetuses don’t get a vote on ending their own life” is a sophomoric distraction; neither does the victim of a car accident. A fetus is aborted (for better or worse); shall we use its cells to advance human life or not?

Anti-choice people should applaud this miraculous assist in the cycle of life, rather than hypocritically deploring it because they disagree with the choice that creates the opportunity in the first place.

To discourage clear thinking about this, anti-choice activists use grisly language, such as “cutting up babies and selling their body parts.” After a deadly car accident, no one complains “You let Harvard Medical School chop up Aunt Lucy for science experiments.”

If these people were honest, they’d distribute the UNEDITED videos they took. For example, the Planned Parenthood (PPFA) Senior Director of Medical Services told CMP ten different times that they would not profit in any way from fetal tissue—and all ten instances were cut out of the video released by CMP. Similarly, the President of the PPFA Medical Directors Council stated clearly that any tissue donation program would have to meticulously comply with federal law—which was also edited out.

CMP Board chair David Daleiden states that his and CMP’s goal is to end safe access to reproductive health services in the United States, and to discredit lawful fetal tissue donation programs. Of course, these are the same people demanding that Congress de-fund  comprehensive sex education, which is proven to reduce unintended pregnancies (and therefore abortions), and to fund only discredited abstinence-based programs. This proves that their main agenda is limiting sexual expression, not “preserving life.”

Last year, the National Institutes of Health distributed $76 million for research using fetal tissue to more than 50 universities, including Columbia, Harvard, Stanford, Yale and the University of California. Researchers say fetal tissue is a uniquely rich source of the stem cells that give rise to tissues and organs, making them crucial in finding cures for diabetes, Parkinson’s, Alzheimer’s, and leukemia.

This long-running criminal conspiracy by phony researchers must not end funding for real scientists whose work saves the lives of people who have already been born—including anti-choice activists. Planned Parenthood should stand up and proudly say yes, we do this work, whose blessings the public enjoys every day.

If anti-choice activists find this research so ghastly, they should refuse to use every medical advance it has helped develop in the last quarter-century.

What I Know About Your (Hetero) Man’s Sexuality

July 30, 2015

How do I know about male sexuality? I’ve been a sex therapist and marriage counselor for 34 years. From listening to thousands of people talk about their most intimate experiences and desires, here’s what I’ve learned about most men:

* He wants to please you.

He actually cares whether you enjoy sex with him. And his own experience is affected by yours. So if there are things that would make sex more enjoyable for you, tell him. That includes not just positions, but things like hygiene, timing, and language.

Perhaps he initiates by saying “Hey baby, let’s play hide the salami” when you’re tired and he hasn’t shaved in a week. If you like that, fine; if that’s a turn-off, he really needs—and wants—to know. Tell him—and if necessary, tell him why you’re telling him.

* Touching is a big part of sex for him.

Some people have a pretty narrow sense of what “sex” is. But most men enjoy touching and being touched as an integral part of sex. Assuming you like it, caressing you is both sensual and erotic for him, and it’s a great way to get your two bodies in synch.

So if you like to touch or be touched, do plenty of it, and don’t worry that he’s getting impatient.

If you don’t enjoy it, of course, you won’t want much of it, and so you’ll either prevent it or pull away as soon as you can. Your guy will probably find this confusing or disappointing, and you’ll undoubtedly find the whole interaction awkward. So if there’s a way you like to be touched, tell him. Be really specific. If he says he doesn’t like being told what to do, ask him if he wants the information or not. If he doesn’t, you have a much bigger problem than touching.

* Sex is about more than intercourse for him.

The behavior and bragging of teenage males (and the stupid movies they like!) has led to a common misunderstanding about adult men—that they’ll stick their penises into anyone or any place, and hardly notice the details.

Fortunately, that generally isn’t true for grownups.

Most adult men like to feel emotionally connected during sex, even if they find it hard to talk about. Most men like to kiss or hug (or both) during sex; if your guy doesn’t, there’s probably a good reason, so you might want to ask about it. And most men like for sex to involve their hands, your hands, and often their mouth and your mouth. So don’t rush to intercourse, and don’t let him, either.

If he does head toward intercourse faster than you’d like, ask what the two of you can do to make the stuff before (or even instead of) intercourse more entertaining.

* He may like to be bitten

Human eroticism includes the instinct to bite. Any woman who’s ever nursed a child remembers that.

If you don’t like being bitten, ever, you shouldn’t have to endure it. If it comes up, say “no thanks” in a friendly yet firm way, and that should be the end of it. But if you’re intrigued, or you know what you like (especially when you’re really excited), don’t be afraid to mention it. Or, at the appropriate moment, to press your shoulder, arm, breast, or other body part against you partner’s teeth. He’ll get the message pretty quickly. If he doesn’t, he’s almost certainly not interested.

* He’d love to answer your questions.

What does your guy like in bed? I’m glad you’re curious, and I encourage you to speak to the world’s expert on that—him. If you lead with the truth—“I’d like to know what you like so we can both enjoy sex more”—chances are he’ll tell you. And if he’s too shy to tell you, invite him to show you. He can, for example, put your hand on his penis or nipple, put his hand on top of yours, and move both hands the way he likes.

If he says he doesn’t know what he likes, that’s the perfect chance to suggest you explore his body together. Start with a hand or foot caress, look at and talk to each other, and move on to other body parts from there.

Nine Absolutely Untrue Myths About Porn—And One Fact We Can All Agree On

July 12, 2015

Opinions about porn are like noses—everybody has one. But varying opinions are so contradictory, they can’t all be right.

We actually do know a lot about contemporary porn’s use and effects, so let’s get some knowable facts out on the table.

* Myth: Porn is mostly violent and misogynist.
* Fact: Most porn shows happy, smiling people doing fairly ordinary things. A lot of porn shows happy, smiling (and perhaps sweaty) people doing exotic things. And some porn shows adults pretending to play dominance and submission games. Pretending? Yes. The actors and actresses are acting.

* Myth: Watching porn causes erection problems.
* Fact: (1) There has been no documented increase in erection problems, so there’s no “epidemic” for porn to cause. (2) Of course most young men with erection problems watch porn—because most young men watch porn.

* Myth: Porn destroys good intimate relationships
* Fact: (1) No one chooses to watch porn instead of being in a vibrant sexual relationship. People do back away from the chance for a good sexual relationship for many reasons, such as anger, guilt, fear of intimacy, depression, and anxiety. The fact that such people may get involved with porn is not the problem.

(2) Sexually unsatisfying relationships are caused by many things, such as misinformation, medication side effects, hormone problems, anger, childhood trauma, fear of abandonment; a refusal to discuss the sexual disconnect is common. Just because one or both partners look at porn doesn’t remotely mean that porn is the problem.

* Myth: Most men hide their porn-watching from their partner because they know they’re doing something wrong.
Fact: Most men hide their porn-watching for one or more reasons: (1) they believe their partner would be uncomfortable about it and might insist they have a right to a porn-free house; (2) like most Americans, they are uncomfortable discussing sexuality in general; (3) they don’t want to confront the reality of their partner’s or their own sexual dissatisfaction; (4) when someone tells their adult partner “I forbid you from watching that in our house,” they are really instructing, “You better keep it secret.”

* Myth: Only a man would enjoy porn; women simply don’t like it
Fact: (1) Millions of women watch internet porn—some by themselves, others with their partners. Some women watch porn specifically made for them, while others watch the same videos that men do. (2) Fifty Shades of Grey is the best-selling book in history. It’s porn. Its readers are almost exclusively women.

Myth: Watching adult porn leads to watching kiddie porn
Fact: (1) The adult porn industry doesn’t make kiddie porn, doesn’t promote kiddie porn, and doesn’t want its customers to watch kiddie porn. (2) Can you imagine any adult porn that would lead you to want to watch sexual videos of children? Kiddie porn isn’t something anyone gradually develops a taste for.

* Myth: Porn is all about men’s sexuality and men’s pleasure
* Fact: Most porn includes a focus on the pleasure of the characters portrayed by actresses. This often includes cunnilingus, typically includes a female orgasm (no matter that it may be shown unrealistically), frequently shows her enjoying fellatio, and may include domination that she finds pleasurable. These are standard features of ordinary caring and consensual heterosexual sex.

* Myth: Watching porn encourages violence against women
* Fact: (1) Since broadband brought free, high-quality porn into almost every home in America, the rate of rape in the U.S. has gone down (according to the FBI). Yes, rape is an under-reported crime—and that was true before porn, just as it is now. (2) This decrease in rape following the spread or legalization of porn has been documented in dozens of countries including Denmark, Japan, and Croatia.

* Myth: Neuroscience proves that watching porn can damage your brain and even cause porn addiction.
Fact: No it doesn’t. (1) The brain lights up during all pleasurable activities, including watching a sunset and playing with your grandchildren. Of course it lights up during sexual arousal.

(2) While there are plenty of people with unhealthy porn-watching habits, no one has actually documented “porn addiction.” Unless someone has other non-porn mental health problems (such as bipolar disorder or obsessive-compulsive disorder), almost anyone can modify their porn-viewing habits if they want to—making it quite different than addiction.

Here’s a fact we should all agree on and act on: that kids need an intelligent, caring adult to talk with them about porn. Kids need to know that:
* Porn is an adult product, showing adult themes and behaviors that will be confusing to someone without experience.
* Porn is not a documentary, and doesn’t portray sex as it really is. It’s made by actors and actresses playing characters that someone made up.
* The bodies shown in porn are not typical adult bodies. Just as the NBA, NFL, and movie studios select people for their unusual physical characteristics, so do porn producers. You don’t look like LeBron James, you don’t look like Tom Cruise, and you don’t look like Rocky Buttman, either.

* Most of all, if your kid has any questions about porn or sex in general, she or he should ask you. And they won’t be punished for their question. You do promise that, right?
Need help discussing porn with your kid? My new video “Helping young people develop porn literacy” will make it easier. It’s available as a DVD or mp4 download here.

Is Lousy Sex Better Than No Sex?

June 26, 2015

It depends on what you want from sex.

If you mostly want an orgasm, lousy sex might do the trick. If you mostly want to have someone agreeing to have sex with you whether they really want to or not, lousy sex may be your best bet. If you mostly just want to see someone naked, or briefly feel a tit or some balls in your hand, lousy sex may be good enough.

But most men and women want other stuff from sex. Maybe you do, too.

For example, you may want to see your partner smile with pleasure. You may want to feel close to someone, or a sense of acceptance, or specialness, or the experience of collaboration. You may want to feel the gentleness in your partner’s touch, or in your own. You may want to feel relaxed and carefree, and know that your partner feels that way, too. You may want a chance to explore the universe and express yourself.

These things are generally missing from lousy sex. Actually, the fact that they’re missing is what can make sex lousy.

Why do people acquiesce to sex they don’t want, or don’t think they’ll enjoy? For various people, it’s the belief that:
* if I don’t do it, my partner will yell at me, sulk, mistreat the kids, embarrass me in front of others, or even hit me.
* if I don’t do it, I’ll feel guilty
* if I don’t do it, my partner will stray, or even leave me.

This is not an ideal state of mind from which to begin sex. But many people seem surprised that when this is how sex starts, neither person is likely to find satisfaction.

When someone is relatively uninterested in sex, or they know that the sex currently available isn’t enjoyable to either partner, it’s interesting how rarely they wonder why their partner pursues that lousy sex so enthusiastically. Typically, the narrative is “my partner is over-sexed, I’m not, so he pursues me even when I’m not interested, and then he’s dissatisfied with the sex that I generously have despite my own lack of interest.”

Hardly anyone ever asks, “if my partner knows he or she is going to be sexually unsatisfied at the end, why does he or she want it so much?”

It’s really no mystery why people DON’T have sex they don’t expect to enjoy. It’s the same reason I don’t eat broccoli and you don’t listen to country music—we don’t expect to enjoy the experience.

So why do people pursue sex they don’t expect to enjoy? And why do they accept it when, grudgingly or not, it’s offered? It’s essential to get people talking about this honestly.

One reason is that they don’t want to be in one of those couples that never has sex. And it’s often true—a couple doesn’t have sex four days in a row, then five, and before you know it, it’s been seven months. At that point, initiating sex is an enormous challenge; enjoying it is even harder.

Other reasons people pursue or accept sex they assume will be lousy is because they can’t stand their sense of separation. Or they don’t want to pretend that everything is OK. Or because they yearn for touching. Or because they want to experience sexual feelings in their body, even though the feelings will soon be overtaken by frustration or sadness. Or because they clumsily imagine that THIS time their partner will be open to being pleased, despite years of evidence to the contrary.

Many low-desire people assume their partners are chasing exquisite friction and porn-worthy acrobatics. So when their partner finally says simply “It’s not the orgasm I want, it’s you,” or “yeah, getting licked is nice, but you reaching out to hold my hand is better,” the reaction frequently ranges from disbelief to confusion, sorrow and finally acceptance.

And that’s why it’s so important to challenge couples’ traditional ways. That weekly pity handjob? On the surface it may look like a sympathetic partner giving a deprived partner a gift, which is accepted gratefully. In reality, however, it may be building resentment in both partners, while reinforcing the idea that sex is troublesome, divisive, and for other lucky people. The hand-jobber feels valued for her hand, not for who she is. The hand-jobbee feels he has to trade his dignity just to get some touching, and he always notes how uninteresting his penis is to his partner.

With such couples, I encourage a moratorium on pity sex. And I encourage them to find an activity or two they can enjoy together unambiguously—playing Scrabble, walking the dog at night, reading Alice in Wonderland aloud to each other. Eventually we look for erotic activities they can share without inhibition or second-guessing—admiring each others’ hair, rubbing each others’ legs, spooning consciously for 60 seconds.

And I push them to keep talking about what they really want. When people are honest—with themselves and with each other—they almost invariably discover there’s an overlap between what they each feel, and what they each want. Not about superficial things like a favorite position or lingerie color. No, I mean the serious stuff, like “I’m afraid to get too close,” or “I’m afraid s/he won’t like the real me,” or “I dislike my body so much I can’t imagine someone else valuing it.” And “I want to feel special,” “I want to feel safe,” and “I want to laugh together.”

Sex therapy is rarely about just penises and vulvas. It’s mostly about people.

What Dads Can GIVE on Father’s Day

June 21, 2015

Two words: sex education.

Yes dads, today is your day. And one of your gifts is that you’re in a unique position to help your kids grow strong and healthy.

They need you to talk about what sex means to you, whether that involves pleasure or values or intimacy or self-expression. They need to know what was confusing or troubling for you about sex when you were their age. A story about how you coped back then may get both of you laughing together—if it doesn’t get you crying together.

They need to know that masturbation is OK. They’re going to do it whether you like it or not; your reassurance can help them do it without guilt or shame, which is a huge advantage in life.

They need to know that there are different kinds of sex. I don’t mean oral vs. anal vs. the Pirate Game. I mean sex for closeness, sex for pleasure, sex for giving a gift, sex for expressing yourself, sex for coping with a difficult day or week. And also sex for manipulating, sex for avoiding a serious relationship talk, sex because you feel that’s all you have to offer the world. When your kid’s old enough, different peers will want to have sex for various reasons. So will your kid. He or she needs to know how to tell which reasons are operating at any given time.

Your kid needs to know that contraception is an integral part of penis-vagina intercourse. This includes kids who identify as gay; the rate of unintended pregnancy among gay teens is way too high. Like using a helmet when biking (which no one did when I was young), learning the connection early helps kids take it for granted.

Kids need to know about consent—that having sex with someone who’s ambivalent or drunk or wanting revenge on an ex-boyfriend is a big mistake, possibly a huge mistake. They need to know that real consent looks like enthusiasm; bland acquiescence, or a drunken, shrugged “whatever” is not consent. Coercion? That’s when you do something with someone’s body that they don’t want you to do. There’s no possible reason that ever makes it OK.

Your kids need to know how you feel about pornography. However, no one wants their first adult-child conversation about sex to be about porn. So if you haven’t begun to talk about sexuality, start this week. And remember, “Porn is crap and if I catch you watching it I’ll kill you” doesn’t qualify as a helpful conversation. All it does is provide the instruction “When you have questions about porn, don’t ask me.”

When it comes to sex, don’t wait until they ask. Did you wait until they asked you to teach them about brushing their teeth or using a seat belt? Of course not. Dad, you have many responsibilities, and one of them is raising the subject of sex with your kids over and over. “The Sex Talk” does not exist. It’s The Ongoing Sexuality Conversation. Because what your kids need to hear (and to ask) about sex changes as they grow and change.

Traditionally, dads protects us. The question is, what does protection actually look like—withholding information, and implying that facts are dangerous, or telling us the truth and equipping us to face life?

There is no part of your kids’ lives where you are needed more than in teaching them about sexuality. And the most important lesson you can teach is that people can talk about sex the way we talk about other things—without euphemisms, baby talk, or embarrassment.

That opportunity is your gift. Enjoy it many times, starting today.

Good News About (Some) Sexual Rights

June 19, 2015

A few of our civil rights in America were reaffirmed last week. Ironically, the context, as is often the case when our basic rights are trampled, was sexuality.

* Forced ultrasound and required physician speech found unconstitutional

Like 12 other states, North Carolina forces women undergoing a legal medical procedure (abortion) to undergo an invasive procedure (uterine ultrasound) they may not want, and to listen to their doctor recite a script that the doctor may not want to recite and the woman may not want to hear.

In upholding a successful challenge to the law, a federal court concluded that the “state cannot commandeer the doctor-patient relationship to compel a physician to express its preference to the patient.”

Furthermore, “transforming the physician into the mouthpiece of the state undermines the trust that is necessary for facilitating healthy doctor-patient relationships and, through them, successful treatment outcomes.” Authored by conservative judges, the court’s decision is an elegant description of the brutal way government treats patients just because it doesn’t like their medical choices.

The Religious Right and other groups have consistently tried to regulate abortion differently than other legal medical procedures. The goal has always been to restrict people’s rights to this extremely safe medical intervention, simply because some people don’t want others to have it. When a group can mobilize our system of government so that one point of view gets more government-sponsored attention than others, we lose a little more of our democracy.

You may have read that presidential hopeful Scott Walker thinks that ultrasounds are “cool.” If he were a more sophisticated man, he might read this ruling and understand that “cool” is not a high enough standard to warrant government intrusion into people’s basic rights to medical care.

* Minnesota unlimited commitment of sex offenders found unconstitutional

In most countries around the world, governments exercise profound power over their citizens capriciously, destroying lives deliberately or carelessly.

Americans are justifiably proud of the many limits on our government’s power to do just that. Most Americans don’t realize, however, the limits on those limits—that is, the ways our government can legally target individuals and destroy them.

One way is through the radical laws regulating those convicted of sex offenses. It sounds like a punchline, but it’s true—in most states you can be punished more severely for molesting a child than for murdering one.

And that’s even true for non-molestation offenses that are considered sex crimes—possession of child pornography, voyeurism and exhibitionism, sexting, minors dating minors, certain kinds of sex work, and various activities relating to adult pornography. You can lose your children if you engage in prostitution in order to feed them. Or if you play SM games with your partner, even if the kids are blissfully unaware.

In this country, a convicted sex offender has to undergo successful “treatment” in order to be let out of prison after completing his or her sentence—a requirement imposed on no other convicted criminals. To prove the “treatment” is working, the convict must sooner or later admit his/her guilt. Punishments including denial of parole await those who refuse to “admit” their guilt.

Which makes the following fact all the more shocking: after a convicted sex offender has served his or her full sentence (often a decade or more), the state has the right to keep that person in jail permanently—based on some official’s hunch, feeling, instinct, or the phase of the goddamned moon.

Yes, even though sex offenders rarely reoffend sexually when they leave jail, the state can keep them locked up indefinitely if it guesses that they are at risk of reoffending.

In Minnesota, not one single person civilly committed after completing their sex offender prison sentence was ultimately released. The state’s involuntary detention program was challenged for equaling life imprisonment without trial. A federal court agreed. And so Minnesota will have to change the program. It can’t give anyone back their lives, of course. And the court certainly didn’t say a state couldn’t lock people up indefinitely—only that Minnesota, like other states, has to seem to do it less capriciously and more rationally.

That will be marginally better. But only marginally, because no therapist in the world can accurately predict who will NOT re-offend. Remember, most sex offenders don’t sexually re-offend. But because wardens and politicians don’t want the public to blame them on the rare occasion that a re-offense occurs, officials pretend that they can predict accurately—justifying the state’s ability to lock people up indefinitely.

Or else politicians in the prison industry’s pocket pretend that locking up people for life without a trial is the way to protect the public.

And many Americans agree. As long as the person being locked up isn’t them.

Unfortunately, there’s no guarantee that it won’t be you. You think you’re safe because you haven’t molested anyone? Tell that to the people behind bars who didn’t molest anyone, either.

So two different federal courts—in Minnesota and in North Carolina, a thousand miles apart—have reminded two different state legislatures that our civil rights include rights relating to sexuality. There’s the right to get an abortion without coercion. And the right for even half a chance to get out of jail after completing a prison sentence for a sex crime.

Of course, these two battles in America’s ongoing war on sex aren’t finished. The GOP’s obsession with preventing abortion in the most demeaning, most economically discriminatory fashion possible. And those obsessed with sex crimes, like the National Center for Missing and Exploited Children, will keep spewing phony, scary propaganda that drives citizens, juries, and legislators alike.

But every once in a while, our increasingly conservative court system notices how states and the feds break the law trying to control our sexuality. Sometimes conservatives actually conserve. They deserve our thanks.

Why Bruce/Caitlyn Jenner Matters to Straight People

June 3, 2015

Alfred Kinsey said it best in 1948: the world is not so easily divided into sheeps and goats.

In his ground-breaking surveys of Americans’ sex lives, Kinsey discovered that many “straight” people were not entirely straight. This finding has been confirmed many times by subsequent studies of both men and women.

Back then, you were either 100% hetero-erotic in behavior, fantasy, and curiosity, or you were “queer,” a bucket of miscellaneous identities at the edge of the world. But Kinsey realized that sexual orientation isn’t that simple. And so he devised the Kinsey Scale, on which sexual orientation is not a fixed binary, but is rather located on a continuum.

Suddenly, we had more ways to describe ourselves.

Now multiply that by time—who we are sexually at 40 is often slightly different than who we were at 20. Now add the uncertainty of the future—we don’t really know what opportunities, challenges, contingencies, and near-death experiences lay around the corner for us.

As people say on those dating sites, “it’s complicated.”

And that’s why the whole gay-transsexual-queer-whatever thing matters to straight people.

Because those “other” folks are paving the way for everyone else to accept themselves as they are, rather than each of us searching for a sexual category to squeeze ourselves into.

And that’s true not only of sexual orientation regarding gender, but of other sexual categories. “Kinky” and “queer” are the new non-categories, used by thoughtful and lazy people alike. No problem. Terms like “bottom” and “slut” are also getting used, twisted, and are in the process of becoming meaningless as well.

Sex is one of life’s few arenas where we really can create our own story and evolve our own truth. Except for that pesky little detail of unintended pregnancy, sex has very little objective reality. We can configure it as we wish, collaborating with a partner to create forms of expression that suit who we are, or wish to be. There’s no need to select an off-the-rack sexual identity—“bisexual,” “eco-sexual,” “vanilla,” or anything else.

And so straight men watch porn of men sucking each other’s penises. Straight women fantasize about kissing a woman when they want to climax with their husbands. People do, or imagine, sexual activities that don’t fit into “normal” categories. They’re sometimes troubled by this. As long as behavior is consensual, they needn’t be. Fantasies don’t even have to meet that requirement.

And remember, you don’t have sex with “men” or with “women,” you sleep with George or Maria (or with as many unique individuals as you do). No one sleeps with all men, so we don’t need to categorize you as “a person who sleeps with men.”

So what do you call a lesbian who has a weekend fling with a man? Sonia. What do you call a guy who likes to spank his partner one night, and be spanked the next night? Morgan. What do you call yourself? Anything you like—and you don’t need a category.

“Pink Viagra”—Not Pink, And Not Viagra

June 1, 2015

And that’s why it doesn’t exist.

But let’s back up a few steps.

On March 27, 1998 the FDA approved Viagra as the first oral treatment for erection problems. It went on sale later that year, and was soon followed by Cialis and Levitra, variants of the same drug. All three are now currently in use.

As my essay in Playboy back then predicted, the drug was hugely successful, misunderstood and misused, and expected to perform miracles. It hasn’t.

It doesn’t make angry men sweet, doesn’t make clumsy men graceful, doesn’t make weak backs strong, and doesn’t make drunk men sober. As the manufacturers themselves will tell you, these drugs aren’t aphrodisiacs, and so they don’t make bored men randy.

They make it easier for blood to hang out in the penis, facilitating erection under certain rather narrow circumstances.

Because only a small fraction of sexual frustration is caused by erection problems—and only a fraction of erection problems can be fixed with Viagra—the search has continued for other sexual enhancement products. These have ranged from vibrators to testosterone creams to porn to SM gear to shares of Apple stock. Each has advantages and drawbacks. Since none is a panacea, the search continues.

More specifically, people want a drug that can increase desire. People have wanted this for at least 3,000 years of recorded history, presumably longer. The Bible, Sophocles, Dante, Shakespeare, and the Bronte sisters have all discussed the need for such a product.

And so less than ten years ago, our very own FDA was asked to evaluate the already-existing drug Flibanserin as a “pink Viagra”—a treatment for “female sexual dysfunction,” a vague condition that variously featured low desire, low enjoyment, or genital discomfort or lack of feeling.

Exactly five years ago, after huge campaigns both promoting and denouncing the drug, the FDA rejected it, citing Flibanserin’s side effects and limited efficacy. Health activists cheered, grown men wept, venture capitalists tore their hair, and life went on.

At the time, I wrote that the process of defeating the drug had reinforced the myth that female sexuality is more complex than male sexuality, and that the “comprehensive approach” that anti-drug activists were suggesting was already being tried by mainstream sex therapy, and proving inadequate. At the same time, I was skeptical about the drug’s usefulness.

Now Flibanserin is back in the news, as the FDA is reconsidering its rejection. This is the same drug, but the conflict now has a different narrative: pro-drug activists are condemning the FDA’s alleged sexism, demanding that women have as many options as men for treating sexual difficulties.

What nonsense. There is no drug to enhance sexual desire or enjoyment in men. And the FDA’s rejection of Flibanserin for women has nothing to do with sexism. The FDA isn’t pro-men or anti-women. It’s pro-pharmaceutical corporation. It will approve every drug it possibly can, given the available clinical data and prevailing political pressure (see its handling of Emergency Contraception and at-home abortion drug RU-486).

Anti-drug activists are complaining about Big Pharma’s “disease mongering,” an oversimplification. There IS unexplained loss of desire in both women and men, along with loss of desire and physical discomfort. After we rule out the usual suspects—depression, lousy relationship, poor body image, toxic religion, medication side effects, mommy & daddy issues—neither medicine nor psychotherapy has much to offer people. And yet this problem undermines the quality of life for millions of adults.

Is the mechanism of low desire and low enjoyment different for men and women? My guess is that there are several bio-psycho-social mechanisms driving the problem, with some unique to each gender, while others are the same for both genders.

Should we take a pill for this? Should we need a pill for this? Should we demand a pill for this? Viagra was a genuinely disruptive technology, abruptly inserting erections in couples that hadn’t seen one in years. It helped some relationships, and made others way more complicated.

But that’s nothing compared to a drug which will increase desire. If that ever comes to pass, the politics of how it will be used in a given couple will make the bloody Roman Empire look like Woodstock.

Your Husband Watches Porn—Now What?

May 30, 2015

Another woman leaves my office, broken-hearted that her husband looks at porn. Or enraged that her husband looks at porn. Or terrified, confused, or ashamed.

I understand the anguish, I do. It’s all the more poignant because it’s so unnecessary. Although porn feels like the problem, focusing on that rarely brings domestic peace or more intimacy. It certainly doesn’t bring more or better sex.

Here’s what various women say they feel in this situation:
* “I hate that he keeps secrets. I feel left out.”
* “I can’t compete with those damn women who perform in porn films. I’ll never have a body like that, and I won’t do some of the fancy stuff they do. Even if I did, I’d look ridiculous.”
* “I feel ashamed that this is what he’s fallen into—a dirty little habit that I’m certainly not proud of.”
* “I think he’s probably a porn addict—and if not, I bet he will be soon.”
* “I don’t like the ideas he’s getting about sex or women. They’re not normal.”

And, sometimes, “How often does someone need to masturbate? I know men do it more than women, but once or twice a week should be plenty.”

* Let’s start with that last one. Of course, almost all porn watching is done as part of self-pleasuring. Thus, when someone objects to a partner (or teenager) looking at porn, my first question is, “what about masturbating without porn?” If they feel OK about it, we can proceed to talk about porn; if not, there’s no point in talking about porn. It would be like discussing objections to watching The Daily Show with a person who thinks that TV watching is bad.

In such a case, I ask something like “Please explain why you object to someone in a couple masturbating as part of their sense of autonomy and relationship with pleasure and their own body.” Some people feel very strongly that partners in a couple surrender their sexual autonomy—not just regarding other people, but regarding internal sources of stimulation, fantasy, or satisfaction. Few people make this explicit during courtship, so it doesn’t come up until later when one person feels resentful.

* Then there’s the sense of exclusion or secrecy, of “watching porn is his private thing, and I don’t get to be a part of it.”

Well, yes, you probably don’t.

Very few couples share porn. If you want to, you can ask, and he might agree. But most women upset about their partner’s porn watching don’t want to watch with him, they want him to stop watching.

So the question is what you make of his secrecy about it.

Some people say the porn consumer’s secrecy is proof that there’s something wrong with consuming porn. But people keep secrets primarily to avoid consequences. If someone believes he’ll get criticized or punished for disclosing porn watching (or anything else), of course he’ll hide it. So don’t expect to ban it or criticize it, and then have him talk about it openly.

Although it’s great when couples desire openness, most people believe in adult privacy. Virtually every pair of adults has a don’t-ask-don’t-tell policy covering, depending on the people, the past, the present, or even the future. Whether or not they respect this in others, most adults expect it for themselves.

* The idea that a woman has to compete with the women or activities in porn films is fascinating. Of course, some women feel they have to compete with Scarlett Johansson and Beyonce; that’s a fool’s errand that no one should attempt (they are professionals; do not attempt to do their job in your home).

If you try to compete with mega-stars of course you’ll try to compete with Rosie Cheex; but if you’re smart enough to realize you can’t match the Beyonce machine, please let go of Candye Kisses as well.

While making superficial comparisons is inevitable, most men know that porn is a fantasy, not a documentary; no one actually expects his girlfriend to pay the pizza delivery man with oral sex, and no grownup really expects his partner to look or act like a porn star.

Porn or no porn, every man and woman has to figure out how to feel OK with themselves when they don’t look as good as others, have as much money as others, or have jobs or children as prestigious as others. This is the fundamental existential task of all people who want to enjoy life, and porn didn’t invent it.

* As for the recently invented “porn addiction,” there’s simply no such thing. If you want to say your guy watches more porn than you want him to, or even that he watches more porn than he intends to, go right ahead. You may be right—lots of guys have trouble regulating their porn consumption. But we already know what overconsumption is like regarding chocolate chip cookies, Facebook, and TV football games, so let’s not invent a new clinical category just for porn. If you think your guy is out of control, just tell him. Don’t diagnose him—tell him you’re concerned.

* Finally, exactly what ideas is hubby getting from watching porn? How do you know? How do they affect his behavior or mood?

If hubby doesn’t approach you for sex as you’d like, it’s not because of porn. If you want to know why that is, you need to ask him. Most women don’t; when they do, men often lie. That’s a couples issue, not a porn or even a sex issue.

If hubby is always demanding sex, or is rough or selfish during sex, it’s not because of porn. It’s because he’s a jerk or he doesn’t like you or he’s desperate for something that he isn’t talking about. To start solving this problem, stop having sex you don’t like, and find a way to get your guy’s attention so you can discuss this.

If hubby is grumpy or depressed, it’s not because of porn. If you want to know why, you need to ask him. If you’re concerned, tell him so, rather than criticizing porn. If hubby treats you or other women disrespectfully, it’s not because of porn—it’s because he’s a jerk, or he’s in pain, or both. To find out, you need to ask.

The problems in our lives usually have more than one simple cause, and require more than a simple solution. And our problems are rarely solved by telling our mates what they’re doing wrong and what they need to do instead. Concerned about something? Don’t blame porn—talk to your partner.

What’s “Natural” About Sex?

May 3, 2015

The New York Times Magazine has a great opinion piece this week about how “natural” doesn’t have a specific legal meaning.

We now live in a world in which “natural Cheetos” and “100% all-natural chicken nuggets” are for sale. The anti-vaccination nuts deride medicines that are “unnatural,” forgetting that the goal of all medicine is to defeat nature. Anti-gay folks talk about “natural [i.e., heterosexual] marriage,” as if marriage isn’t an artificial institution like baseball—and, like baseball, is played differently in different places and subject to periodic rule changes (insert favorite rant about the Designated Hitter or former laws against interracial marriage).

One of the top questions about sex people bring to therapy relates to what’s “natural.” There are two different aspects to this.

The first is about the ecology of sexual interactions: making time for sex, the process of initiating, discussing preferences, feeling adequate, and negotiating contraception.

People want sex to be “natural.” Men and women concerned about this generally mean that they don’t want to make dates for sex, want sex to mysteriously happen without anyone actually initiating, don’t want to communicate what they like and don’t like, want to believe that their partner is deeply satisfied without actually asking or noticing, and want the need for contraception to just go away.

In other words, people who insist that sex be “natural” want it to be like it was during high school or college, when no one had a clue about what was going on. You may recall that that sex often came with physical discomfort, pregnancy scares, self-doubt, and feeling isolated or confused. What a blessing that ten or twenty or forty years later, most people forget about that.

Sex in adulthood isn’t going to be like it was in high school or college.

Of course, some adults try hard to reproduce the carefree sex of their youth. So we see some middle-aged people getting drunk to have sex, not a pretty sight. Or adult women who insist that initiating sex is “a man’s job,” or adult men who say birth control is “up to the woman.” In both cases, people seem unaware about how such demands distort relationships. Ditto for the naïve ideas of men who expect their penis to get hard without being touched, and women who expect that men will know what they like sexually without being told or shown.

That’s not how sex works. We may have an excuse for these such ideas when we’re 18, but not when we’re 40. And without making a date for it, most grownup couples don’t usually find themselves suddenly tumbling into bed together for sex—especially if they have kids.

So if your definition of “natural” sex is that it just happens, no one talks, there are no problems, and birth control just disappears—you know, a 1938 black-and-white film with Cary Grant or a modern romance with Scarlett Johansson—“natural sex” is going to be hard to create. And if you can create it, you probably won’t enjoy it.

The second concern about “natural” sex equates it with “normal.” As in “Doc, is it natural to…
…want sex three days in a row?”
…be too tired on your wedding night to have sex?”
…fantasize about threesomes—and neither guy is my husband?”
…think so much about my small penis that I have trouble enjoying sex?”
…want to be slapped the second before I orgasm?”
…fantasize about sex with the babysitter—she’s practically a kid herself!”
…like getting oral sex, but I don’t like to give it?”
…have a bigger orgasm from oral sex than from intercourse?”
…like women with really big butts?”

I think the most helpful answer is “no, these things are NOT normal—because there is no normal when it comes to sex. There are things that are statistically more common than others, but that doesn’t make them superior. Besides, with a global population of five billion adults, something done by only a tiny minority can involve a huge number of people.

Sexual medicine physician Charles Moser says human beings are kinkier than any one of us can possibly imagine. Sex researcher Mickey Diamond says that nature loves diversity; but unfortunately, society hates it. I’d add that society fears it, especially if the diversity involves sex.

My goal has never been to help people have sex that’s “natural,” referring to either the first or second meaning. My goal is to help people let go of the need to be sexually natural or normal, trusting themselves and their partner to simply create experiences that are enjoyable to the two (or more) parties involved. It’s a challenge grownups should embrace, not fear.


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