Category: Sex

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Domestic Sex Trafficking: Hidden in Plain Sight

00Adverse Childhood Experiences, Child Development, Conformity, Emotional Abuse, Featured news, Sex, Trauma March, 20

Source: geralt at Pixabay, Creative Commons

When she was a young girl, Danielle (name changed) was recruited into domestic sex trafficking from her long-term foster home. She was only able to leave this life once her mother regained custody of her.

Sex trafficking, a term used to describe the phenomenon of individuals performing commercial sex through the use of force, fraud, or coercion, is an epidemic. It affects about 25 million people globally. The US-based National Human Trafficking Hotline received 6,244 calls of domestic sex trafficking cases in 2017. Because of the difficulty in obtaining precise information, it is likely that the number affected is higher.

A common misconception about sex trafficking is that it is fundamentally a trans-border phenomenon—that the victim must have been moved from one country to another for the event to be considered trafficking. This is not the case. While both domestic and international sex trafficking share the feature of forcibly relocating an individual so that the person might perform commercial sex, domestic sex trafficking occurs within the borders of the victim’s country, and sometimes within their own community.

Victims of sex trafficking are controlled by the trafficker. Victims do not choose their clients, or the locations where they work, nor do they keep the money that they receive from clients. They are monitored by the trafficker and cannot leave; their life is at risk if they try to escape. They work in prostitution, pornography, strip clubs, escort services, brothels, massage parlors, and over the internet. While there are people who work in these services by choice, and control their work and earnings, there are many who have been coerced into it and are controlled by a trafficker.

There are many ways sex traffickers lure victims into the sex trade. In many cases, sex traffickers are expert manipulators who prey on a person’s emotional or financial vulnerabilities and offer exactly what the individual needs or desires, such as love and care, lavish items, shelter, money, or a job, with the hopes of later exploiting them. The victim is initially oblivious to the trafficker’s, or their proxy’s, real identity and intentions. The relationship begins as positive but becomes abusive, with the person being forced into the sex trade, and forced to stay in it, to work for the trafficker.

Some populations are particularly vulnerable. One of the top risk factors in becoming a victim of sex trafficking is having experienced childhood trauma. In an interview with The Trauma and Mental Health Report, Megan Lundstrom, CEO of Free Our Girls (a US-serving anti-trafficking organization) and a survivor of sex trafficking herself, reports the findings from her 2017 project:

“What we found is what we’re calling ‘The Perfect Storm.’ Upwards of 90 percent of the women that we interviewed for that project had experienced some form of child abuse, primarily some form of childhood sexual abuse. When you have that high of a correlation that most women in the commercial sex trade experienced some kind of childhood sexual abuse, clearly there’s something going on there.”

Lundstrom continues by paraphrasing one of the young ladies in her study: “I almost feel like I had a sign written on my forehead that said, ‘I’m damaged goods, please exploit me,’ in that traffickers know how to single in on those vulnerabilities.”

This is also true for Ana (name changed), whose trafficker was the owner of a tattoo shop. She recalls: “He asked me a bunch of questions, clearly testing my victim potential before-hand, all under the guise of a tattoo artist apprentice. I took the bait. I had childhood trauma, so I had ‘bait’ practically written across my forehead.”

In terms of recruitment locations, the National Human Trafficking Hotline reports that 15 percent of US sex trafficking recruitment occurs at homeless and domestic violence shelters. A victim of domestic sex trafficking, Jessica, recounts her experience that relates to this finding. She had been abused by her parents as a child, and found herself homeless after being thrown out of the house at age 14. She describes the circumstances of her victimization: “One day I was at a soup kitchen having coffee and stale muffins for breakfast when I was approached by an older guy, probably late 20s. He asked me to have a real cup of coffee with him and I agreed…mostly because it was nice to have someone speak to me like I was a human being.”

She describes her trafficker using the most common recruitment tactic: posing as a romantic partner (otherwise known as a Romeo Pimp), and convincing her that he would love and take care of her: “When he asked me to be his girlfriend, I felt like the luckiest girl alive. God, I was so dumb.”

Jessica goes on to say that her lack of interpersonal supports, such as friends and family, made it more difficult to leave the life of a trafficked person.

Exposure to adverse childhood experiences has long-term consequences, and impacts potential future victimization. Lundstrom explains why this is:

“When you have been assaulted at a young age, you learn how to shut off mentally, you know how to dissociate, you know how to protect yourself but you also struggle with feelings of ‘my body is not my own, I’m not important, this is maybe the only way people care about me’. So when you have that package, that perfect storm of vulnerability starting at a very young age, traffickers go after that.”

The status quo will continue until we recognize that sex trafficking happens in our communities. We can properly identify, and thus intervene in or prevent such cases, by educating our families and friends, as well as the community. Teachers, the hotel industry, healthcare providers (who can also incorporate trauma-informed care), police, airport workers, and child-welfare workers can be further educated on how to recognize these red flags while dispelling unhealthy myths.

— Riana Fisher, Contributing Writer, The Trauma and Mental Health Report. Chief Editor: Robert T. Muller, The Trauma and Mental Health Report. Copyright Robert T. Muller

This article was originally published on Psychology Today

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Life After Sex Trafficking: Survival and Reintegration

00Anger, Depression, Featured news, Law and Crime, Post-Traumatic Growth, Sex, Sexual Abuse February, 20

Source: Richard George Davis, Used with Permission

In her Ted Talk, Barbara Amaya, a sex trafficking survivor, recounted a nightmare in which she ran away from her abusive home in Fairfax, Regina, to the streets of Washington, DC at age 12. She was recruited into sex trafficking by a young woman who had approached her, claiming to understand Barbara’s situation and saying she could help. The woman, who was a victim of sex trafficking herself, had been recruiting other runaways. They sold Barbara to a trafficker in New York who, as Barbara described, “Programmed my young mind and knew exactly how to create a commodity out of a human being.”

Domestic sex trafficking involves the use of coercive tactics to force an individual to perform commercial sex within the borders of one country. Victims of domestic sex trafficking are at risk for countless health problems, such as sexually transmitted infections, cancer, infertility, heart disease, and urinary tract infections. Victims also experience severe psychological distress, such as complex PTSD; mood, eating and personality disturbances; and addiction. The damage done by this trauma can last a lifetime.

The struggles that survivors face when reintegrating after having lived as a trafficked person are often overlooked. Megan Lundstrom, a survivor of sex trafficking, explains:

“I think a lot of people lose sight of the fact that just because you’ve received medical care and you’re no longer in jail, you can’t just pat a survivor on the head and say, ‘You’re fixed, go on with your life.’ That’s where the really hard work starts.”

Megan explains that returning after being trafficked, can lead to feelings of social alienation:

“You literally go through a period of culture shock of trying to understand, ‘How do I communicate with people? How do I work in a legitimate, legal job setting? What rights do I have and how do I put forth boundaries?’ All of those things are so new.”

This description resonates with Barbara. After escaping her trafficker at age 24, Barbara found herself lost and uncertain:

“By the time I left, one of the many rules of my trafficker was no reading, no writing to anyone. That amount of isolation made me feel like I was returning from Mars after a decade because I was trafficked from ages 12 to 24. I missed so many things that had happened in the real world. I also missed all the milestones of growing up in a loving environment… Nobody knew what to do with me and I didn’t know what to do with me. What was I supposed to do? I guess I’m supposed to get an education. Maybe I’m supposed to find a job? Maybe I’m supposed to get married and have a baby?”

The reintegration process is complex and multi-faceted, and it occurs one step at a time. For both Barbara and Megan, the road to reintegration required making meaning of their experience by helping others transform from victims to survivors. This involved ensuring people are prevented from being trafficked, that law enforcement agencies intervene and extract those who are already victims of trafficking from that life, and that survivors are supported while transitioning after having been trafficked.

Barbara was in a very dark depression:

“A newscast came on. I wasn’t really watching it; I was just lying here. They were talking about human trafficking… in northern Virginia and it was a very large case. I don’t remember ever having heard that term: Human trafficking. I had heard the term ‘drug trafficking,’ but not human trafficking. And then they started talking about the recruitment techniques that traffickers use and then I stood up and I had a true epiphany, a true “ah-ha” moment. I sat up and for the first time I self-identified as a victim and I thought, ‘What?’ They were describing what had happened to me, how traffickers were treating young women; that had happened to me, and it’s still happening to others. This caused a lot of emotions. One of them was anger, I just wanted to do something. I had a vague idea of helping women run away. I wasn’t sure what I wanted to do. But within two weeks, I was sharing my experiences on that safety channel and videos on my website, and I was just propelled forward.”

Likewise, Megan started speaking out about what was happening in her community in northern Colorado after feeling compelled to raise awareness about the hidden signs of domestic sex trafficking:

“Part of my exploitation happened up at the oil fields in North Dakota… When I moved back to Colorado in 2012, it was kind of the height of the oil boom in northern Colorado, and state-wide. I started doing my research because there was a hotel being built across the street from my home to house all of these oil field workers who were coming in temporarily. Because of my experience in North Dakota, I knew what that meant. It really started to bother me as I moved forward in my healing… And I was getting to a place where I felt I really needed to speak out in my community about what this hotel symbolizes to me, and maybe I was seeing what other people weren’t necessarily seeing because they didn’t have those experiences.”

Barbara’s epiphany led her to share her story on various news outlets, college campuses, and women’s organizations, and this exposure resulted in her being called upon by law enforcement to assist in training police officers. Barbara also wrote a book, Nobody’s Girl: A Memoir of Lost Innocence, Modern Day Slavery & Transformation, which contains a guide for teachers, health and medical personnel, law enforcement, and young men and women about this topic. She also created a graphic novel, The Destiny of Zoe Carpenter, which is a human trafficking educational resource for middle and high school students.

Like Barbara, Megan began speaking at different groups and realized that others had also had experiences like hers. She found that few agencies were aware that sex trafficking was happening in their communities. Megan also discovered that there were no services or trained individuals specifically serving this unique population. Recognizing this limitation, in 2014, she founded Free Our Girls, an American non-profit organization that has worked to create various resources, including awareness, prevention, and response training curriculums for survivors, professionals, and middle and high school level students, as well as outreach, intervention and restoration services for victims and survivors.

Of course, survivors from domestic sex trafficking need much help to reintegrate. Finding a sense of purpose after such tragic experiences can be a pivotal moment for those who want to recover from trauma.

-Riana Fisher, Contributing Writer, The Trauma and Mental Health Report

-Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

-Copyright Robert T. Muller

This article was originally published on Psychology Today

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When Male Rape Victims Are Accountable for Child Support

00Adolescence, Caregiving, Featured news, Law and Crime, Sex, Trauma February, 19

Source: Steve Halama at Unsplash, Creative Commons

When Shane Seyer was 12, he was sexually exploited by his 16-year-old babysitter Colleen Hermesmann. She became pregnant with Seyer’s child in 1989 and was charged with statutory rape shortly afterward. Instead of being convicted of rape, Hermesmann was declared a juvenile offender under the non-sexual offense of “contributing to child misconduct.” Seyer was subsequently court-ordered to pay child support.

In 1993, at the age of 15, Seyer appealed this decision to the Kansas Supreme Court, arguing he should not be liable for these payments. He maintained that his babysitter (Hermesmann) took advantage of him sexually when he was too young to give consent.

The Kansas Supreme Court ruled against him. The judgment stated that, because Seyer initially consented to the sexual encounters and never told his parents what was happening, he was responsible for supporting the child.

This court case set a precedent for male rape victims to make child-support payments. The financial needs of the children outweigh the court’s interest in deterring sexual crimes against male minors, even if statutory rape is the cause of conception.

More recently, in 2014, Nick Olivas of Arizona was forced to pay over $15,000 in back-payments to a woman who had sex with him when he was 14. She was 20 years old at the time. Commenting on the Olivas case and others like it, Mel Feit, director of the New York-based advocacy group the National Center for Men, told the Arizona Republic newspaper:

“To hold him unresponsible for the sex act, and to then turn around and say we’re going to hold him responsible for the child that resulted from that act is off-the-charts ridiculous… it makes no sense.”

Peter Pollard, co-founder of 1in6, an organization designed to help male assault survivors, explained in an interview with the Good Men Project why we downplay the severity of male sexual assault:

“We’re all raised in a culture that says boys are always supposed to initiate and enjoy a sexual experience and males are never supposed to see themselves or be seen as victims. The easiest default is to blame the victim, to say ‘he wanted it,’ ‘he must have chosen that.’”

These attitudes toward male sexual assault are apparent even in the way these men are treated during their court cases.

In 1996, the court heard the case of County of San Luis Obispo v. Nathaniel J in which a 34-year-old woman became pregnant after sexually exploiting a 15-year-old boy. He was also forced to pay child support, and then Deputy Attorney General Mary Roth alleged:

“I guess he thought he was a man then. Now, he prefers to be considered a child.”

Some professionals, such as Mary Koss from the University of Arizona who published the first national rape study in 1987, even argued that men and boys cannot be raped by women. In a radio interview, Koss stated:

“How would [a man being raped by a woman] happen… how would that happen by force or threat of force or when the victim is unable to consent? How does that happen? I would call it ‘unwanted contact.’”

Research indicates, however, that men can be stimulated and achieve an erection in times of fear and terror, despite not being aroused. Studies range from cases where men report arousal during assault, to scientific experiments that find men have erections under many non-sexual circumstances, including when they are unconscious.

In her research, Myriam Denov, a professor at McGill University who holds the Canada Research Chair in Youth, Gender and Armed Conflict, asserted:

“The professional assumption that sexual abuse by women is less harmful than similar abuse by men has potentially dangerous implications for [male] victims of sexual abuse. If professionals fail to recognize sexual abuse by women as potentially serious and harmful, child protection plans will not be made.”

She goes on to say that, as a result, the experiences of male victims who come forward to disclose sexual abuse by women may be trivialized. These misconceptions can lead to delayed referral to social services, or failure to provide victims with the care and support they require.

Until the idea that women cannot rape men and other rape myths are dispelled, cases where victims are misunderstood and mistreated, and even made to pay child support to their former abusers, are likely to continue.

– Ty LeBlanc, Contributing Writer

The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

-Copyright Robert T. Muller

This article was originally published on Psychology Today

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Using love dolls as a substitute for human intimacy

00Artificial Intelligence, Emotional Intelligence, Fantasies, Featured news, Intelligence, Relationships, Sex January, 19

Source: Joseph C. Topping at flickr, Creative Commons

Matt McMullen started his company from his garage in 1997, making movable-display mannequins. While selling them to retail and other companies, he began receiving emails from clientele looking for something a little more risqué than what he was initially offering. McMullen explained in a Reddit AMA:

“[The mannequins] weren’t originally designed for sexual use… I thought they’d be an interesting next generation of mannequin or just interactive art. The reactions I got were overwhelmingly geared towards their potential use as ‘love-dolls,’ and I decided to go with the flow.”

McMullen went on to form RealDoll, a multimillion-dollar business that claims to make “the world’s finest love-dolls, hand-crafted in the USA.” The California-based company ships more than ten dolls per week throughout the United States. But why are so many people purchasing these kinds of items?

In an interview with Vice magazine, McMullen described his customers:

“Some are very lonely and for one reason or another do not have the desire or ability to make real bonds with someone else. Some are victims of circumstance: either something happened to them or someone broke their heart, or they might have lost a loved one to a disease. They don’t want, necessarily, to start new relationships.”

DaveCat is a self-proclaimed ‘IDollator,’ a term used to describe those who form relationships with dolls. In an episode of the Love + Radio podcast, DaveCat discussed why he preferred a synthetic romantic relationship:

“The thing is with organic relationships, you’ve got two people in love and there’s going to be a perception of the person they’re attracted to. They’re attracted to that perception and not the person that they actually are. With a synthetic (doll), everything’s up front, there’s no deceit, there’s no nasty surprises; whatever you make as far as their personalities, that’s what you get.”

Stories like DaveCat’s are not unique to western countries. The desire for inorganic relationships has also permeated Japanese culture. It even has its own slang word ‘Moe’ to describe people who disengage from human interactions to form relationships—often romantic—with an animated or other two-dimensional (2D) character.

In his book ‘The Moe Manifesto’, Patrick Galbraith interviewed experts and fans to better understand the Moe phenomenon. Renowned Japanese psychiatrist Tamaki Saito said:

“Moe is quasi-love for a fictional character. [People who engage in these relationships], can fulfill their desires, which exist in the 2D world. [I used to think] that those who could not make it with women in reality projected their desires into fantasy… but that’s not the case. You can desire something in the two-dimensional world that you don’t desire in the three-dimensional world… If the object actually existed… it would ruin the fantasy.”

RealDoll is also beginning to develop Artificial Intelligence (AI) to make the dolls even more human and able to form imagined emotional bonds with their clients.

Some experts, such as Matthias Scheutz of Indiana University, argue that creating subservient AI dolls with tailored personalities that ‘love’ their masters unconditionally is damaging to both society and the users themselves. In his paper, The Inherent Dangers of Unidirectional Emotional Bonds between Humans and Social Robots, Scheutz argues:

“We will need a thorough investigation of the potential harm that social robots could cause to humans and the repercussions for society when we allow robots to engage humans in personal interactions.”

The Campaign Against Sex Robots is calling to ban love-dolls, claiming that they sexually objectify women and promote violence against them. The Campaign’s founder, Kathleen Richardson from De Montfort University in the UK, tells the Trauma and Mental Health Report:

“The commercial ‘sex’ (rape) trade that allows people to use human beings as objects has changed ‘sex’ from something two people experience together, to something where we are likely to see the growth of prostitution, trafficking, and pornography.”

Defending his robots, McMullen told Vice magazine:

“I think if [the AI] evolved to be so good that people no longer had to engage in human trafficking, that can only be a positive thing. Someone could buy a bunch of them and the robots could be the prostitutes instead of people.”

The human-robot relationship debate is only just starting, and will gain further momentum as technology develops. Julie Carpenter, an expert in human-robot interaction from the University of Washington, tells Forbes:

“The bottom line is that these human-AI/robot interactions are transactions and not reciprocal, and therefore probably not healthy for most people to rely on as a long-term means for substituting organic two-way affectionate bonds, or as a surrogate for a human-human shared relationship.”

With little research having been completed on either IDollator or Moe cultures, questions remain as to whether or not these phenomena are harmful to those who take part.

– Ty LeBlanc, Contributing Writer. The Trauma and Mental Health Report.

-Chief Editor: Robert T. MullerThe Trauma and Mental Health Report.

-Copyright Robert T. Muller.

This article was originally published on Psychology Today

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Does Pornography Impact Romantic Relationships?

00Addiction, Featured news, Porn Addiction, Pornography, Sex, Sex Addiction November, 18

Source: Davidcure at DeviantArt, Creative Commons

As pornography consumption has increased in the past few decades, so has fear surrounding its potential harm on relationships. But, does pornography have a negative impact on human intimacy?

An initial study in 1989 by researcher Douglas Kenrick claimed that men found their wives less attractive after viewing pornographic images. This finding created controversy around the health of watching pornography, and how its use might put female partners at a disadvantage.

Since then, however, concerns have arisen about the validity of the original study. The effects were present in a scientific laboratory, where men were exposed to photos of a Playboy centerfold, rather than in a real-world environment. These effects were also short-lived and disappeared quickly.

In July 2016, a group of researchers from the University of Western Ontario in Canada tried three times to replicate Kenrick’s study and failed to find similar results. This failure has prompted questions regarding the impact of pornography on men’s perceptions of their partners and on relationships as a whole.

It’s possible, though, that the replication studies may not have obtained similar findings due to sexual advertising becoming so prevalent in Western culture. The impact of viewing lewd images might be imperceptible now that under-clothed women are regularly displayed in popular media.

A March 2017 analysis by researchers from Indiana University examined the effects of pornography on sexual and relationship satisfaction in both men and women. The researchers examined results from 50 separate studies and determined that the impact on men and women is different. When women viewed pornography, their relationship satisfaction did not change. But when men viewed pornography, lower satisfaction did exist.

“…There appears to be no overall or global association between women’s pornography consumption and the elements of satisfaction studied by researchers to date… Men as a group, on the other hand, do demonstrate lower sexual and relational satisfaction as a function of their pornography consumption.”

These researchers raise the possibility that the men who experienced lower sexual and relationship satisfaction with their partner could be more likely to consume pornography because of their lower satisfaction—rather than pornography being the cause.

Another analysis conducted by researchers from the Universities of California, Copenhagen, and New York investigated whether viewing violent or non-violent pornography affected attitudes of violence towards women. The researchers found that both violent and non-violent pornography consumption was associated with attitudes that support this type of violence.

Researchers from Texas A&M and the University of Texas challenged these claims, proposing that pornography may be a means to alleviate sexual aggression. Looking at crime statistics, they point to evidence that, as access to and prevalence of pornography has increased, instances of sexual assault have not.

Clearly, finding a conclusive answer as to whether pornography use has negative effects on relationships is challenging. In addition, adverse effects on relationships may not be the direct result of pornography use, but rather caused by the motive behind viewing pornography or by underlying issues that lead to its consumption. In other words, it may be problems in a relationship that lead to viewing pornography.

Perhaps that is what it comes down to—the individual relationship.

In an opinion piece in The Guardian newspaper, one anonymous writer said about her husband’s pornography use:

“Porn ruined you. Ruined us… It was your love of porn that slowly diminished my love and respect for you and destroyed my self-confidence.”

If one partner has negative views towards pornography, that partner may feel betrayed upon discovering that the other partner consumes it. The partner consuming the pornography may feel guilt knowing that the other partner does not condone the behavior. These varying effects on different individuals may explain why some studies find that pornography is damaging to relationships, while others find the opposite.

– Andrei Nistor, Contributing Writer. The Trauma and Mental Health Report

-Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Medicating women’s sexual desire still highly controversial

00Featured news, Integrative Medicine, Low Sexual Desire, Meditation, Mental Health, Psychopharmacology, Sex November, 17

Source: Minjung Gang at flickr, Creative Commons

On August 18, 2015, the U.S. Food and Drug Administration (FDA) approved Flibanserin, a drug that treats low sexual desire in women.

With the medication’s presence on the market, you’d think that low sexual desire in women would be well understood. In fact, there is still widespread debate on the issue. Marta Meana, a psychologist at the University of Nevada, writes:

“Desire is the most subjective and acutely amorphous component of sexuality.”

And Lori A. Brotto, a Professor of Gynecology at the University of British Columbia, offers a similar view, explaining:

“There is no clear consensus on the causes of sexual dysfunction in women.”

While women experience obstacles to fulfillment, the causes are complex. According to Brotto:

“An abundance of data indicates that low sexual desire is strongly influenced by a woman’s relationship satisfaction, mood, self-esteem, and body image.”

Medication is, at best, a partial treatment for problems with desire.

There are also differing perspectives on proper terminology around the issue. In an interview with the Trauma and Mental Health Report, Kristen Mark, Director of the Sexual Health Promotion Lab at the University of Kentucky, said:

“Sexual dysfunction may not be the most accurate way to describe low sexual desire. Women may experience sexual problems, but sexual desire ebbs and flows, so people should expect that it will fluctuate.”

Deciding between the word “dysfunction” or “problem” may seem trivial. But language creates meaning, and shapes how health professionals treat clients and conduct research.

Other clinicians agree. Leonore Tiefer, Associate Professor at the New York University School of Medicine, offers two metaphors for sex. The first is digestion. In this metaphor, sex is “just there”. Like digestion, it does not require learning, but is a natural or innate action that the body is equipped for at birth.

The other metaphor is dance. There are many ways to dance. Some people are better at dancing, and some people like dancing more than others. Tiefer argues that sex, like dance, is a learned skill.

Tiefer has advocated extensively against pharmaceutical interventions for female sexual problems. In 2000, she convened The New View Campaign, a collective of clinicians and social scientists dedicated to reframing the conversation around sexuality.

In a 2006 article on disease mongering, Tiefer explains why a purely biological approach to sexual health is inadequate:

“A long history of social and political control of sexual expression created reservoirs of shame and ignorance that make it difficult for many people to understand sexual satisfaction or cope with sexual problems.”

To emphasize that sex has a social context, the New View wrote an alternative system of classification for sexual problems. The first category is “sexual problems due to socio-cultural, political, or economic factors”, and the second is, “problems relating to partner and relationship”.

These categories includes specific causative factors, such as “ignorance and anxiety due to inadequate sex education, lack of access to health services, or other social constraints.”

According to Tiefer:

“Popular culture has greatly inflated public expectations about sexual function. People are fed a myth that sex is “natural”—that is, a matter of automatic and unlearned biological function—at the same time as they expect high levels of performance and enduring pleasure, they are likely to look for simple solutions.”

The drug Flibanserin is one of these ‘simple solutions’. Its approval has been met with controversy.

According to Loes Jaspers and colleagues at Erasmus University Medical Center, the effectiveness of Flibanserin is very low. In a meta-analysis examining the effect of the medication in about 6000 women, Jaspers found that those receiving the drug experienced, on average, only 0.5 more “sexually satisfying” events per month compared to those receiving a placebo.

At the same time, it carries a black label, which the FDA assigns to drugs that include serious side effects. For Flibanserin, these include sedation and fatigue. When combined with alcohol and other common drugs, it can cause dangerously low blood pressure and fainting.

And non-medical treatments, such as mindfulness-based sex therapy, can be effective for treating low sexual desire. According to Brotto, mindfulness shifts attention away from negative, self-defeating thoughts, and towards sensation and pleasure.

Mark, however, thinks that hope should not be abandoned for a medical solution. She says:

“At this point, I would not recommend Flibanserin for most women coping with desire problems. There may be a medication in the future that meets women’s needs when used in conjunction with other approaches, but this just isn’t it.”

Whether women’s sexual problems should be medically treated is still debatable. But what is clear is that social and cultural factors shaping women’s sexual experiences should not be bypassed for a quick solution.

–Rebecca Abavi, Contributing Writer, The Trauma and Mental Health Report.

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report.

Copyright Robert T. Muller.

This article was originally published on Psychology Today

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Medicating Women's Sexual Desire Still Highly Controversial

00Featured news, Integrative Medicine, Low Sexual Desire, Meditation, Mental Health, Psychopharmacology, Sex November, 17

Source: Minjung Gang at Flickr/Creative Commons

On August 18, 2015, the U.S. Food and Drug Administration (FDA) approved Flibanserin, a drug used to treat low sexual desire in women.

With the medication’s presence on the market, you’d think that low sexual desire in women would be well understood. In fact, there is still widespread debate on the issue. Marta Meana, a psychologist at the University of Nevada, writes: “Desire is the most subjective and acutely amorphous component of sexuality.”

And Lori A. Brotto, a Professor of Gynecology at the University of British Columbia, has offered a similar view: “There is no clear consensus on the causes of sexual dysfunction in women.”

While women experience obstacles to fulfillment, the causes are complex. According to Brotto, “An abundance of data indicates that low sexual desire is strongly influenced by a woman’s relationship satisfaction, mood, self-esteem, and body image.”

Medication is, at best, a partial treatment for problems with desire.

There are also differing perspectives on proper terminology. “Sexual dysfunction may not be the most accurate way to describe low sexual desire,” says Kristen Mark, Director of the Sexual Health Promotion Lab at the University of Kentucky. “Women may experience sexual problems, but sexual desire ebbs and flows, so people should expect that it will fluctuate.”

Deciding between the terms “dysfunction” or “low desire” may seem trivial. But language creates meaning and shapes how health professionals treat clients and conduct research.

Other clinicians agree. Leonore Tiefer at the New York University School of Medicine offers two metaphors for sex. The first is digestion. In this metaphor, sex is “just there.” Like digestion, it does not require learning but is a natural or innate action that the body is equipped for at birth.

The other metaphor is dance. There are many ways to dance. Some people are better at dancing, and some people like dancing more than others. Tiefer argues that sex, like dance, is a learned skill.

Tiefer has advocated extensively against pharmaceutical interventions for female sexual problems. In 2000, she convened The New View Campaign, a collective of clinicians and social scientists dedicated to reframing the conversation around sexuality.

To emphasize that sex has a social context, the New View wrote an alternative system of classification for sexual problems. The first category is “sexual problems due to socio-cultural, political, or economic factors,” and the second is “problems relating to partner and relationship.”

These categories include specific causative factors, such as “ignorance and anxiety due to inadequate sex education, lack of access to health services, or other social constraints.”

According to Tiefer: 

“Popular culture has greatly inflated public expectations about sexual function. People fed a myth that sex is “natural”—that is, a matter of automatic and unlearned biological function—at the same time as they expect high levels of performance and enduring pleasure, they are likely to look for simple solutions.”

The drug Flibanserin is one of these “simple solutions.” Its approval has been met with controversy.

According to Loes Jaspers and colleagues at Erasmus University Medical Center, the effectiveness of Flibanserin is very low. In a meta-analysis examining the effect of the medication in about 6,000 women, Jaspers found that those receiving the drug experienced, on average, only 0.5 more “sexually satisfying” events per month compared to those receiving a placebo.

At the same time, it carries a black label, which the FDA assigns to drugs that include serious side effects. For Flibanserin, these include sedation and fatigue. When combined with alcohol and other common drugs, it can cause dangerously low blood pressure and fainting.

And non-medical treatments, such as mindfulness-based sex therapy, can be effective for treating low sexual desire. According to Brotto, mindfulness shifts attention away from negative, self-defeating thoughts, and towards sensation and pleasure.

Mark, however, thinks that hope should not be abandoned for a medical solution.

“At this point, I would not recommend Flibanserin for most women coping with desire problems,” she says. “There may be a medication in the future that meets women’s needs when used in conjunction with other approaches, but this just isn’t it.”

Whether women’s sexual problems should be medically treated is still debatable. But what is clear is that social and cultural factors shaping women’s sexual experiences should not be bypassed for a quick solution.

–Rebecca Abavi, Contributing Writer, The Trauma and Mental Health Report.

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report.

Copyright Robert T. Muller.

This article was originally published on Psychology Today

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Denmark Declassifies Transgender as Mental Illness

00Bias, Featured news, Identity, Mental Health, Sex, Sexual Orientation, Stress, Transgender June, 17

Source: Chey Rawhoof at flickr, Creative Commons

In March 2016, North Carolina passed a law that bars transgender individuals from using public restrooms that match their gender identity, and prohibits cities from passing anti-discrimination laws that protect the rights of gay and transgender people. The bill has thrust North Carolina into the centre of a national debate over equality, privacy, and religious freedom in the wake of a 2015 U.S. Supreme Court ruling to legalize same-sex marriage.

For individuals who identify as transgender, this law has caused “emotional harm, mental anguish, distress, humiliation, and indignity,” according to U.S. Attorney General Loretta Lynch. These consequences are in addition to the emotional anguish and shame that transgender people frequently experience when their identity is classified as mental illness.

The World Health Organization (WHO) categorizes transgender individuals as having a “gender identity disorder” in their “Classification of Mental and Behavioural Disorders”.

But in Denmark, the issue is being addressed very differently.

Effective January 2017, transgender will no longer be considered mental illness in the country, and the term ‘transgender’ will no longer be listed as mental illness, making Denmark the first country in the world to remove the link between mental illness and individuals who identify with a gender other than the one they were born with.

Sexual orientation has always been a contentious topic, and homosexuality and other forms of expression of same-sex orientation are often stigmatized. According to Susan Cochran, a professor of epidemiology at UCLA, this stigma is worsened when sexual orientation is pathologized.

Research by psychologist Walter Bockting of the University of Minnesota Medical School found that transgender individuals often experience sanctioned prejudice, such as job discrimination, health discrimination, verbal aggression, and barriers to substance dependency services.

In 2014, the WHO acknowledged that linking transgender people to mental illness is harmful and pledged to remove the link from their next International Statistical Classification of Diseases and Related Health Problems (ICD)—but this version isn’t slated for release until 2017.

In response, social democrat health spokesman Flemming Møller Mortensen told The Local:

“The WHO is currently working on a new system for registering diagnoses. It has been working on it for a very, very long time. Now we’ve run out of patience, and want to send out a signal saying that if the system is not changed by October, then we in Denmark will go it alone.”

Mortensen also told Danish news agency Ritzau:

“At the moment, transgender is listed as a mental illness or behavioural problem. But that is incredibly stigmatizing and in no way reflects how we see transgender people in Denmark. It should be a neutral diagnosis.”

This is not the first transgender rights legislation that Denmark has passed. It was also the front-runner in enacting a law passed in 2014 designed to allow transgender adults to change their gender status without any legal or medical interventions. In many European countries, this is still not the case, and restrictive laws requiring sterilization and divorce are still in effect.

Amnesty International, a major player in LGBTQ human rights, has praised the Danish Parliament for their decision, which comes at a time when states in the U.S., such as North Carolina, are passing more restrictive and discriminatory legislation against transgender populations.

It is likely that the North Carolina ‘bathroom law’ will spark court cases for years to come, and a number of groups, including local LGBTQ organizations and celebrities, are boycotting the state. Even within the state, the University of North Carolina is refusing to enforce the bathroom portion of the law and, in fact, holds sensitivity orientation programs regarding LGBTQ students so that non-transgender populations will see their trans peers as equal and worthy of respect.

The entire question of transgender rights promises to be a hot-button issue with underlying mental-health implications in the coming years. But for now, Denmark is taking the first step to ensure the inclusion of transgender individuals by acknowledging them as normal human beings.

–Veerpal Bambrah, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Lack of Regulation in Porn Industry Leaves Women Unprotected

00Career, Featured news, Law and Crime, Mental Health, Pornography, Sex, Trauma January, 17

The documentary film ‘Hot Girls Wanted’, produced by Rashida Jones and released in the spring of 2015, follows several young women living in a North Miami Beach home as they attempt to enter the amateur pornography industry. Since its release, the film has sparked major discussion about the experiences of female performers and the porn industry itself.

There is very little research available on the impact on performers within this poorly regulated industry. In the U.S., the government turns a blind eye to many of the issues surrounding the production of pornography, unless it involves performers under the age of 18. And despite laws prohibiting the employment of performers under the legal age, there are still issues involving consent among newly legal women in the 18-21 age range.

During an AOL BUILD discussion led by Jones, Gail Dines, a professor of sociology and women’s studies at Wheelock College in Boston, emphasized the lack of understanding that some young women seem to have:

“I meet woman after woman who went into this industry, thinking they were going through consent. They’re young. They don’t know what they’re up against.”

Jones also interviews one of the film’s main performers Rachel Bernard, who has since left the industry, and who openly speaks about her experience working in amateur pornography. She addressed the concept of consent, and how it can become even more problematic on porn sets:

“When you walk in, your agent might’ve told you what you’ll be doing or they were general about it because they don’t want you to have an opinion whether you like it or not.”

In the AOL BUILD discussion, Bernard explained how it was common for her to enter onto a set without previously being told the details of her performance and, eventually, she would be pressured to perform acts she was not comfortable with. In one instance, she was told to say a highly demeaning line. When she refused, the director responded by saying, “Well, it’s part of the script, so you have to.”

A lack of agency in young people entering into any field of work is problematic. But working in pornography can open performers to elevated health risks and uncomfortable situations. During the AOL BUILD discussion, Bernard described how sex work was not comparable to most other lines of work because it required a higher degree of vulnerability:

“Every job does have points where it’s maybe uncomfortable but, when you go to a regular job, you’re not showing every single part of your body. The fact that I am out there and I am completely open. Every part of my body, soul, and mind is having to be in that position. It’s a little bit more than uncomfortable.”

Not only can pornography be uncomfortable, but due to the lack of regulation in the industry, the work can also have a negative impact on performers’ health. Condom use is reported to be very low in heterosexual adult films, with only 17% of performers using condoms. And performers in the study reported feeling pressured to work without condoms to remain employed.

The average age of performers entering the industry could explain a hesitance to speak up about rights on set.

For over 40 years, the average age of entry for female porn performers has been approximately 22. In an interview with VICE, Jones expressed the significance of the age of performers in influencing how they experience this line of work:

“When you’re 18 and you’re making choices for yourself, you’re not thinking about the eternal effects of footage online. You’re not thinking about the external and internal costs; the psychological, emotional, physiological, physical costs of having sex for a living. You’re thinking about the fame part. And so you may not be the best candidate to make a decision for yourself but you’re allowed to because you’re 18 and that’s all you need to be.”

So what do performers say about the development of regulations for this industry?

In February 2016, California officials in charge of workplace safety rejected a proposal requiring the use of condoms, dental dams, and goggles for porn actors on set. The decision was made after six hours of testimony from almost 100 performers and producers who strongly opposed the proposal.

Performers who spoke up in protest of the proposal worried that those particular regulations would either hurt the porn industry and their job security, or drive it underground, resulting in even more dangerous conditions.

In an interview with The Guardian, Ela Darling, a porn performer who spoke at the hearing, explained how those regulations would further limit performers’ rights:

“This law denies bodily autonomy to an already marginalized population, and it denies us our voice.”

In a statement made after the February decision, Erich Paul Leue, the executive director of the Free Speech Coalition, a trade association for the adult entertainment industry, discussed industry members’ interest in being involved in deciding industry regulations.

“We’re not opposed to regulation,” he said. “We’re opposed to this regulation.”

In terms of regulation, the aim should be to provide performers with the freedom to make their own decisions without fear of risking job security or safety. Individuals working in the industry should not be required to compromise health, safety, or wellbeing. And despite the current lack of understanding about the implications of working in porn, one thing is clear: Performers who wish to enter and remain in the industry should be able to do so without having to check their rights at the door.

–Abbi Sharvendiran, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

Is Casual Sex Really So Bad?

Is Casual Sex Really So Bad?

20Anxiety, Depression, Featured news, Mental Health, Relationships, Self-Esteem, Sex December, 15

Source: John Perivolaris on Flickr

Smartphone apps like Tinder, Grindr, Down, Tingle and Snapchat have opened up a new chapter in the complicated world of dating and casual sex.  Dubbed “hookup culture,” smartphone users 18-30 years of age are said to be navigating a very different sexual landscape than their parents did.

Early research on the topic found that undergraduates who engaged in casual sex reported lower self-esteem than those who did not.  Yet, other studies reported no evidence of higher risk for depressive symptoms, suicidal ideation, or body dissatisfaction.

According to adjunct professor Zhana Vrangalova of New York University, the phenomenon of casual sex is layered with individual, interpersonal, emotional, and social factors.  Reasons for engaging in hookups are different.

Her recently published study demonstrates that casual sex is not harmful in and of itself, rather one’s motivations for engaging in casual sex is what affects psychological well-being.

Vrangalova draws upon self-determination theory:  Behaviours arise from autonomous or non-autonomous motivations.  When we do something for autonomous reasons, we are engaging in behaviours that reflect our values – the ‘right’ reasons.  When we do something for non-autonomous reasons, we are seeking reward and avoiding punishment – the ‘wrong’ reasons.

In the context of casual sex, Vrangalova and her team of researchers were able to show that those who hooked up for non-autonomous reasons (i.e. wanting to feel better about themselves, wanting to please someone else, hoping it would lead to a romantic relationship, and wanting favours or revenge) had lower self-esteem and higher levels of depression and anxiety.

But those who engaged in casual sex for autonomous reasons – fun and enjoyment, sexual exploration, learning about oneself – reported higher than normal levels of self-esteem and satisfaction, with lower levels of anxiety.

If hooking up for the right reasons, casual sex does not appear to have a negative impact.  Still it’s not so simple.  A number of issues need to be addressed.

Many studies examine “hookup culture” on college campuses, particularly the sex life of middle to upper class young adults.  Since college years are often a tumultuous time of self-discovery and changing opinions, longitudinal research on the long-term benefits (or drawbacks) of casual sex need to be carried out.  Few studies have explored how casual sex affects the mental health of individuals above age 30.

Outside the college domain, information on how different casual sex arrangements (one night stands vs. friends with benefits vs. non-monogamy) affect mental health is scarce, as is research exploring how casual sex behaviours vary between people of different ethnicities.  Preliminary research shows that non-white women report lower desire for casual sex.  How or why this is the case has not been examined.

There is little doubt that the sexual landscape has changed in the past few decades. Technologies, and more specifically social media, have altered the way we approach and engage in interpersonal relationships. But the idea that younger generations are ditching the traditional dating scene in favour of hooking up has not been supported by recent research.

Hang-outs, group dates, friends with benefits, no-strings-attached… For those emerging adults who are engaging in these behaviours with a psychologically healthy frame of mind, is it really so bad?

– Magdelena Belanger, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today