STI 101

Recently, I have been having quite a few conversations with people about how various STIs are transmitted. Consequently, I have become interested in discordant partners, meaning partners who have different statuses (e.g. one is HIV positive and the other is not). Now, I am a believer in being risk-aware. Life is all about taking risks. If someone is aware of all the risks in a given situation and makes an educated decision as a result, I have nothing but respect for the person, regardless of the decision made. That all being said, this STI 101 post will place a bit more emphasis on how to avoid contracting and spreading an STI in a situation where partners have differing statuses.

The STIs I will discuss in this post are chlamydia, gonorrhea, hepatitis B, herpes, human papillomavirus (HPV) and syphilis. If you are looking for HIV, here is my HIV 101 post. For each STI, I will discuss what is it, how it is transmitted, symptoms, basic testing information, treatment and how to protect yourself and/or how to not spread it to your partners.

Note: Similar to my HIV 101 post, I will not cite my sources throughout my post. I will link my sources at the end.

Chlamydia

What is it?

Chlamydia is a sexually transmitted infection caused by the bacterium Chlamydia trachomatis.

Transmission

Chlamydia is mainly transmitted through vaginal and anal sex. It can also be transmitted from a pregnant mother to her child during birth. The child is most likely to be exposed to chlamydia if the mother contracts it during her pregnancy. Although rare, chlamydia can also be transmitted through oral sex and by touching your eye with your hand that has the bacteria on it. It is estimated that about 2.8 million new infections occur every year. Apparently, people under the age of 25 are the most susceptible to contracting chlamydia.

Symptoms

Most people who contract chlamydia will not experience symptoms. When someone does experience symptoms, they will usually appear about five to ten days after they contracted the STI. Some common symptoms are: abdominal pain, bleeding between periods, abnormal discharge coming from the genitals, painful urination, and genital and anal swelling. If chlamydia has infected the throat, the individual may experience a sore throat and if it has infected the eyes, the individual may experience eye redness, itching and fluid discharge.

If chlamydia is not treated for a long period of time, it can cause pelvic inflammatory disease (PID), which infects the fallopian tubes, ovaries and uterus, and epididymitis, which infects the urethra and testicles. Both of these diseases can lead to infertility.

Testing

A health care provider can determine whether or not someone has chlamydia by taking cell samples from the cervix (Pap Smear), penis, urethra or anus. Also urine can be tested. 

Since most people who have chlamydia will not experience symptoms, the only certain way to know if one has contracted chlamydia is to get tested regularly.

Treatment

Chlamydia is treated with antibiotics. If someone has contracted chlamydia, their sex partners should be tested and subsequently treated if they also have chlamydia. Individuals should not have sex (all forms of sex. Yes, oral counts.) until 7 days have passed if they took a single dose antibiotic or after they have finished taking their 7-day course of antibiotics. This is important because not having sex for 7 days will prevent the spread of the STI. Also the CDC (Center for Disease Control) recommends that people should be retested three months after they were treated just to be on the safe side.

Ok, so about sex…

Since chlamydia is mainly spread through unprotected sex, one should use condoms and dental dams to protect oneself from potential infection. I would also suggest using gloves while engaging in manual stimulation (i.e. fingering the vagina and/or anus) to avoid a situation in which a person could infect their eyes by touching it with a potentially contaminated hand.

Gonorrhea

What is it?

Gonorrhea is a sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. It is also known as “the clap” or “the drip”.

Transmission

 Gonorrhea is transmitted though oral, vaginal and anal sex. Gonorrhea can also be passed from a pregnant woman to her child during childbirth. It is estimated that over 700,000 people become infected with gonorrhea every year.

Symptoms

Like chlamydia, individuals with gonorrhea usually do not experience symptoms. If someone does experience symptoms, they tend to occur one to fourteen days after the initial infection. Some common symptoms include: abdominal pain, bleeding between periods, painful urination, abnormal pain, genital discharge, urinating more than usual, anal discharge and genital swelling. If the throat is infected, one can experience an itchy, sore throat or trouble swallowing.

If a child contracts gonorrhea through the pregnant mother, it can lead to premature birth, stillbirth and infections of the blood, joints and eyes.

If gonorrhea remains untreated it can also cause pelvic inflammatory disease and epididymitis.

Testing

To test for gonorrhea, a health care provider could collect samples of abnormal discharges, cell samples from the cervix, penis, urethra, anus or throat and urine.

Treatment

Gonorrhea can be treated with antibiotics. However, recently, drug-resistant strains are evolving around the world, making treating gonorrhea very difficult. The CDC recommends treating gonorrhea with dual therapy with the use of two drugs to treat the infection. Please make sure to take all the prescribed antibiotics to ensure the infection is gone. Not sticking with the antibiotic regimen for the entire period of time can create more drug-resistant strains.

Ok, so about sex…

Since gonorrhea is spread through unprotected sex, one should use condoms and dental dams to protect themselves.

Hepatitis B

What is it?

Hepatitis is an infection of the liver. 

Transmission

The type of hepatitis virus that is most likely to be sexually transmitted is hepatitis B (HBV). HBV is transmitted through vaginal fluids, semen (cum and precum), blood and urine. Infected fluids must come in contact with cuts and tears in the skin and/or through mucous membranes, like the ones in the vagina, anus and mouth. HBV can be spread through unprotected oral, vaginal and anal sex. The friction created in unprotected vaginal and anal sex can cause the canals to tear, giving the virus a way to enter the body. HBV can also be passed from pregnant woman to her child during birth.

HBV can also be spread by sharing intravenous drug needles or using contaminated needles in piercing or tattooing.

Symptoms

Individuals who contract HBV usually do not experience symptoms. When someone does experience symptoms, they usually appear between six weeks and six months after the initial infection. Some common symptoms include: extreme tiredness, abdominal pain/tenderness, loss of appetite, nausea, joint pain, headaches, fever, hives, dark urine, and jaundice.

Testing

A health care provider can conduct a blood test in order to diagnose someone with HBV.

Treatment

A cure for hepatitis does not exist. In most cases, hepatitis B goes away on it’s own in four to eight weeks. However, in some cases, people become carriers and suffer from chronic HBV infection. Carriers can be contagious for the rest of their lives. There are drugs that can help treat chronic HBV, but again, a cure does not exist.

The HBV vaccine is given to prevent an infection, not to cure an already existing one. The vaccine causes the immune system to create antibodies that will fight off the virus.

Ok, so about sex…

One can protect themselves by using condoms and dental dams while having vaginal, anal and oral sex.

Herpes

What is it?

Herpes is an STI caused by two viruses: herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). Both types can infect the oral and genital areas. However, oral herpes is mostly caused by HSV-1 and genital herpes is mostly caused by HSV-2.

Eight out of ten people in the US have oral herpes and one out of four have genital herpes.

Transmission

Herpes can be spread by touching, kissing and vaginal, anal and oral sex. A pregnant woman can pass herpes to her child during birth. Herpes is the most contagious while the individual has open sores. Cuts in the mouth, cuts in the skin and internal tears due to unprotected sex can make a person more susceptible to contracting herpes.

Symptoms

In many cases, someone with herpes may not experience symptoms for years. Or the symptoms can be so mild that they are not noticed or are not taken seriously.

With oral herpes, cold sores can appear on the lips/mouth and can last for a few weeks and then disappear. Symptoms can reappear weeks, months, or years later. Recurring outbreaks could be caused by: stress, menstruation, other infections, sunburn, sex and skin irritation.

With genital herpes, some symptoms include: clusters of sores on the vagina, cervix, vulva, penis or anus, itching and genital swelling. No one is sure what causes recurring outbreaks in genital herpes.

Initial herpes outbreak symptoms can also include: fever, headache, chills and flu-like symptoms.

Initial symptoms usually go away after two to four weeks and recurring symptoms usually go away after ten to fourteen days.

Testing

A health care provider can conduct a blood test to determine whether or not someone has contracted herpes.

Treatment

A cure for herpes does not exist. However, there are antiviral medications that can suppress recurrent outbreaks while the person takes the medication. Daily suppressive therapy for those who experience symptoms is available in order to reduce the likelihood of transmission to partners.

Ok, so about sex…

During an outbreak, an individual should refrain from having sex and/or kissing (oral herpes). However, it should be noted that even when symptoms are not present, a person could still potentially spread herpes with unprotected sex. Wait until seven days have passed and the outbreak has fully ended before having sex again.

Condoms and dental dams reduce the risk of transmission, but not completely. Contact with sores or fluids, not completely covered by condoms and dental dams, can transmit the virus.

If you are having sex with someone who has herpes, be sure to get tested regularly.

Human Papillomavirus 

What is it?

There are over one hundred types of human papillomavirus (HPV). Forty of those can infect the genital area. Genital HPV is very common. Many people have had HPV at one point and many do not know currently they have it.

Transmission

Genital HPV is transmitted through skin-to-skin contact during vaginal, anal and oral sex.

Symptoms

Most people who contract HPV do not experience symptoms. 

In many cases, the immune system clears up the virus on its own and the infection will disappear in eight to thirteen months.

However, in the cases, in which the body does not successfully fight off the virus completely, it can cause the body to change. These changes include genital warts and cancer. The strains of HPV that cause genital warts are considered low-risk. High-risk strains of genital herpes can cause cervical, vaginal, anal, penile and throat cancer.

Testing

A common way for someone to find out they have HPV is after receiving abnormal test results from a pap smear. During a pap smear, cell samples are taken from the cervix and tested for abnormalities. Other than a pap smear, there are no other tests for HPV.

Treatment

There is no cure for HPV itself. However, there are treatments for the genital warts and cancers that HPV causes. It is best to diagnose and treat a HPV-related cancer early while it is easily treatable.

There are two vaccines (Cervarix and Gardasil) that help to protect against the strains of HPV that are most responsible for causing cervical cancer. Gardasil also helps to protect against genital warts and other types of HPV-related cancers. Both vaccines are recommended by the CDC to young women between the ages of 11 and 26. Recently, the CDC has recommended that Gardasil should be made available to young men between the ages of 11 and 21. Gardasil is licensed for young men between the ages of 9 and 26.

Ok, so about sex…

Use condoms and dental dams to lower the chances of HPV infection. Barriers (condoms and dental dams) do not completely protect against HPV, but they are much safer than unprotected sex.

Syphilis

What is it?

Syphilis is an STI caused by the bacterium Treponema pallidum. 

Transmission

Syphilis is transmitted by contact with open syphilis sores. Contact can happen during vaginal, anal and oral sex. Rarely, syphilis can be spread through kissing if there are sores on the person’s mouth. It can infect the vagina, anus, urethra, penis, lips and mouth. About 36,000 people in the US contract syphilis each year.

Symptoms

Most of the time, a person who has contracted syphilis will either not experience symptoms or the symptoms will be so mild that the person would not really pay attention to them.

There are three stages of syphilis infection:

• Primary Stage – In this stage, painless open sores (known as chancres) appear on the genitals, in the vagina, on the cervix, lips, mouth, breasts, or anus. The sores usually appear about three weeks after infection, but may take up to 90 days. Without treatment, they last 3–6 weeks. Syphilis is especially contagious when sores are present. The liquid that oozes from them is very infectious.

• Secondary Stage – After three to six weeks, other symptoms may appear. These symptoms can disappear and reappear repeatedly for up to two years. These symptoms include: body rashes, mild fever, fatigue, sore throat, hair and weight loss, swollen glands, headache, and muscle pains.

• Late Stage – Long-term untreated syphilis can cause serious damage to the nervous system, heart, brain and other organs and even death.

Syphilis is not usually contagious during the latent stages (hiding period) in the first four years. Untreated syphilis can remain latent for many years or a lifetime. It can still be transmitted from a pregnant woman to her child.

Testing

Like many other STIs, a person who has syphilis will not usually experience symptoms. Regular STI testing will ensure that a syphilis infection is caught early and treated.

Treatment

Syphilis is treated with antibiotics and, in the early stages, syphilis is very easy to treat. Although syphilis is easy to treat, the effects of long-term untreated syphilis are not. A health care provider will test blood or fluid from sores to diagnose someone with syphilis.

Ok, so about sex…

Using condoms and dental dams will reduce the risk of contracting/spreading syphilis.

If there is anything you would like to see added or removed from this post, please let me know (along with the reasons for your request, of course).

CDC and HPV vaccine 

CDC STI main page

Planned Parenthood STI main page 

The Medicalization of Childbirth

Yeah, I know, I’m talking about medicalization again. Seriously though, it’s a process that influences so many aspects of our society and I dislike it so much! That all being said, I promise this is my last medicalization post for a little while so bear with me.

So what do I mean by “the medicalization of childbirth”? I would define it as the process in which the phenomenon of childbirth is seen as something that requires medical interventions in order to be successful. The female body alone is not seen as sufficient and, without these medical interventions, not only would the birthing process be unsuccessful, it would also be dangerous. This medicalization process did not happen overnight. According to Kristi Williams and Debra Umberson in their article, “Medical Technology and Childbirth: Experiences of Expectant Mothers and Fathers,” before the nineteenth century, “childbirth was treated largely as a natural process requiring little or no medical intervention. In the mid- to late-1800s, however, a number of social and cultural factors converged to open the door for medical involvement in the birth process…A central component of this effort was the medicalization of pregnancy and childbirth and the elimination of the competition of midwives” (149). The medicalization of childbirth was born out of competition and a need to make money. The Industrial Revolution also began at around this time and its themes seeped from the factory floor into the birthing room. The body, namely the female body, came to be seen as a machine that can break down and the doctor came to be seen as the mechanic. The doctor becomes the only person who can fix the flaws inherent in the female body. As a result, “the woman becomes the recipient rather than the producer of the child” (149-150). She loses her reproductive power as she is reduced to a potentially dangerous vessel from which the doctor must procure the child.

These themes are still present today. How many times have you heard a woman mention receiving and/or desperately needing epidurals or other forms of pain medication the moment someone brings up the topic of childbirth? And in this country, most births take place in a hospital under the guidance of doctors and nurses. But hospitals are places for the sick. Why should a perfectly healthy pregnant woman automatically be expected to have her baby in a hospital? Because women are made to be afraid. Women are scared of a process that they (and other mammals) have been doing for ages. As Kiki Zeldes and Judy Norsigian declare in their article, “Encouraging Women to Consider a Less Medicalized Approach to Childbirth Without Turning Them Off: Challenges to Producing Our Bodies, Ourselves: Pregnancy and Birth,” “Highly medicalized birth is now the norm for most women, and the perception is that they should fear birth—or at least worry about it incessantly. Many women believe labor and birth will involve insurmountable pain and suffering that can be controlled only with an epidural, and that a medicalized, high-tech birth is the best and safest option for them and their babies” (246). When you hear women talk about giving birth, all they can talk about is how painful and horrible it will be/was and how they will demand medication the moment they set foot in the hospital. You really can’t blame women too much when all their information about childbirth is gained from the medical system and the media. Have you ever seen a TV show or a movie that did not depict childbirth as a horrible apocalyptic event? I haven’t. Women are being primed from the start to have certain beliefs about childbirth. It seems as if giving birth is this horrible life or death situation that one can barely survive, which is interesting when one realizes that women and animals have been able to continue their species for all this time. How were women in the past able to bear it if it was so terrible? And don’t animals feel this pain too? If giving birth was so terrible, why haven’t mammals evolved to make this process completely painless? You would think (if we are analyzing this from an evolutionary standpoint) that since this horrible process could potentially affect the reproductive success of numerous species, a mechanism would have evolved to ease this process. But it hasn’t. Animals are usually able to bear it just fine. What makes humans so different? Are we weaker than animals?

Apparently, we are if all these medical interventions are anything to go by. The medical interventions I will be discussing in this post are elective inductions and caesarian sections (aka c-sections). 

• Inductions are measures taken to speed up the birth of a child. Inductions are appropriate if the continuation of the labor would negatively affect the health of the mother or the child. Inductions become ‘elective inductions’ when the labor is sped up for reasons other than the health of the mother or child. In a labor without complications and a healthy mother, there is no need whatsoever for inductions. And inductions in low-risk pregnancies come with risks. In the article, “Elective Induction of Labor as a Risk Factor for Cesarean Delivery Among Low-Risk Women at Term,” Arthur S. Maslow and Amy L. Sweeny discuss some of the risks and costs of having an induced vaginal birth. They reveal that inducing labor in an otherwise healthy pregnancy “significantly increased the risk of cesarean delivery for nulliparas [women who have never given birth before], and increased hospital predelivery time and costs” (917). Complications that arise from interventions can result in more interventions, which could result in more complications. This cascade effect could then put the mother and/or child at risk, necessitating an emergency c-section that was previously unneeded. Maslow et al. brings up another point: Not only are electively induced vaginal births correlated with an increased risk for an unplanned c-section, they also cost more money than a non-induced birth. Maslow et al. calculated the cost to be an “additional $273 per elective induction” (921). With an additional predelivery time of four hours (an extra four hours before the baby is actually born), the actual induction procedure and an increased chance of epidural use (probably due to the extra four hours of labor), it is not hard to see why an induced birth would cost more money (917, 921).
• Cesarean sections, also known as c-sections, are becoming a disturbing trend in childbirth in this country. Silver et al. discloses this alarming fact in their article,  “Maternal Morbidity Associated With Multiple Repeat Cesarean Deliveries:” In 2006, the c-section rate in the US reached over 29%. Much higher than the World Health Organization’s maximum recommended rate of 15% (1231). Although the Maternity Center Association in New York has declared that vaginal births are safer than c-sections, the American College of Obstetricians and Gynecologists “has determined that it is ethically permissible to accede to a request for an elective cesarean section from an informed woman (Klein 161). However, are women being properly informed? They are already being primed to believe that non-induced vaginal births are one of the most dangerous and/or painful events they can possibly experience. On top of that, many doctors in this country tend to tout c-sections as a much safer and much more convenient alternative. But is that really the case? Zeldes et al. do not think so. They disagree saying, “Most women are not aware that the pain of a cesarean birth may extend well beyond the postpartum period. A recent Birth article on postpartum problems showed that 18 percent of women who had a cesarean section reported pain at the site of the incision 6 months after surgery” (247). A cesarean section is a surgery with all of the risks and complications that come with it. The hospital stay is extended in order for the mother to recover from the surgery and Silver et al, lists other risks and complications that one has to think about before undergoing a c-section: “Serious maternal morbidity [illness] increases with increasing number of cesarean deliveries. The majority of this risk is attributable to that associated with placenta accreta [when the placenta attaches too deeply to the uterus] and/or the need for hysterectomy [removal of the uterus]. Placenta postoperative ventilation, intensive care unit admission, operative time, and days of hospitalization, also was increased with increasing number of cesarean deliveries”(1229-1230). All of these risks are not considered when perfectly healthy women decide to go under the knife.

 So as a result of a lack of knowledge and fear of pain, women allow these unnecessary medical interventions to occur, putting themselves at potential physical risk. However, a woman’s physical health is not the only thing that suffers. Williams et al. declare, “research on women’ s pregnancy and childbirth experiences suggests that the use of medical technology alienates many women by minimizing the importance of their roles and their level of control over their bodies and birth experiences” (147). Apparently, medical interventions have a tendency to decrease a woman’s birthing self-efficacy, meaning they negatively affect a woman’s belief that she is strong enough to give birth on her own.  N.K. Lowe further examines the birthing self-efficacy of pregnant women in their article, “Self-efficacy for labor and childbirth fears in nulliparous pregnant women”. Lowe states, “If a woman does not believe that she is capable of the tasks or effort required to cope with labor, she is unlikely to be motivated even to try. Avoidance of, or withdrawal from, the experience through anesthesial analgesia or even Cesarean section becomes an attractive alternative. Likewise, her thoughts about labor, including her affective state, are influenced so that labor becomes an insurmountable task generating great anxiety and fear” (223). Women are then encouraged to give up their control to medical “experts” and to medical interventions that are unneeded and potentially dangerous.

There is another school of thought, unrelated to fear and the “dangers” of vaginal birth, that support full elective medical interventions during childbirth: convenience. William F. Rayburn and Jun Zhang discuss the appeal of convenience in their article, “Rising Rates of Labor Induction: Present Concerns and Future Strategies”. They admit: “Scheduling an induction rather than waiting for spontaneous labor offers many advantages: easing domestic arrangements, ensuring attendance of the patient’s physician, and avoiding journeys during labor either from distant places or in severe climatic conditions” (166). Planning the birth of one’s child the same way one would plan a business meeting does seem appealing. And many women see it as exercising their right to choose and the ability to medically control the frightening birthing process. Being able to plan one’s labor also sounds like a dream to doctors. They could schedule deliveries to the days and times that are the most convenient for them. Also, according to Klein, elective c-sections and other medical interventions are supported by many in the medical community because the interventions make the birthing process something they can totally control (163). This is true for c-sections, especially. Instead of relying on the workings of a woman’s body and giving it the time and/or space needed for it to do what it has evolved to do, doctors can just perform the surgery, deliver the baby and move on with their day.

Despite the conveniences, as stated previously, there are a lot of health risks associated with elective c-sections and inductions that women are not being made aware of. Klein bemoans the fact that “women rarely receive the time (which should be at least an hour) that a full discussion of the complexities of birth alternatives deserves. Moreover, the person providing the counseling is often in a conflict of interest” (162-163). Women are not being properly informed of all the possible risks of medical interventions in part because these interventions tend to be more convenient for the doctor. The issue of choice and consent in regards to elective medical interventions is a gray one because how can someone make an informed decision without accurate information? Women are made to believe that vaginal births are terrifying and that c-sections, epidurals and inductions are the safest ways to give birth when that is not necessarily the case. Instead women should be made aware of the power and magnificence of their bodies. They should be aware that it is possible to give birth without heaps of medication and they do not need medical interventions in low-risk pregnancies. If after receiving accurate and detailed information, a woman still wants some medical intervention than that is her decision, but without being properly informed, it seems as if women are being trapped into believing that their bodies are once again not good enough.

Monogamy as Mandatory?

Our society is enraptured by monogamy. So much so that other forms of intimate relationships never cross the minds of most people. It’s talked about in nearly every movie and nearly every song: finding one’s soul mate, getting married and being extremely jealous because another individual is stepping on their romantic territory. Even the scientific community is participating in this love affair with monogamy. Animals and genes are being observed and analyzed to discover the roots of the one and only true way to be in a relationship. Now, as you should know by now from reading my other blog posts, I am not a fan of being told I only have one option. Life is never that simple and when someone tries to claim that life is that simple, something is very wrong. So what is monogamy? Why does society love it so much? And are there other options?

Monogamy is a type of relationship in which two individuals decide to have sex/be intimate only with one another. One recurring idea that I have come across in life and while researching for this post is the idea that monogamy is pure and natural. When I typed in the word “monogamy” or the phrase “monogamy in humans” in Google Scholar I was pretty shocked by all of these articles enthusiastically supporting the naturalness of monogamy. I could not help but wonder why was it so important to find examples of monogamy in the animal kingdom? Would discovering that monogamy exists in animals and even in animals closely related to humans really prove that monogamy is the only natural way? First of all, I have never understood the argument that something that is natural is automatically good. Obviously, that is not the case. Poison, diseases and hurricanes are natural, but they certainly are not things that people tend to want more of. Secondly, there are also many instances of non-monogamy in the animal kingdom. In their article, “The Benefit and the Doubt: Why Monogamy?,” G. A. Schuiling states, “The fact that humans can be monogamic is exceptional for an Ape: of the Apes, only the gibbons are [solely] monogamic” (56). They go on to say, “Chimpanzees live in relatively large, promiscuous groups (although there is a strict hierarchy with an ‘alpha male’ at the top, who mates with the majority of females). Male gorillas, on the other hand, have a harem of several females, while orangutans are polygamic” (56-57). Schuiling argues from an evolutionary theory perspective which I tend to dislike in discussions of sexuality, but I do find it amusing that nature readily challenges the “naturalness” of monogamy.

That being said, I should explain why I tend to dislike evolutionary theory in discussions of sexuality. In evolutionary theory (and in everyday life) monogamy automatically refers to a heteronormative couple. Also monogamy is described as the pinnacle of evolution and as absolutely necessary because how else will females obtain resources in order to care for their offspring without a male present? In evolutionary theory, males are on the hunt for young fertile females to impregnate so their genes will be passed to future generations and females are on the hunt for a big, strong male who has lots of resources and who seems healthy enough to provide them with offspring (Schuiling 57). Well what about individuals who are not straight? What does evolutionary theory have to say about them? Pretty much nothing. People who are not heteronormative are seen as failures evolutionarily speaking because they will not procreate and spread their genes (which is obviously the only thing we live for), but at least, they can help care for the children of their heteronormative relatives in order to be evolutionarily useful according to the kin selection theory (this theory, by the way, is incorrect). Now, one could argue that these evolutionary theories only reference the past and obviously have no bearing in our modern world. I would disagree. These theories still influence the ideas and beliefs held by our society today. When society proclaims the naturalness of monogamy, they are also proclaiming the naturalness of heterosexuality and ‘traditional’ gender roles. This is evident in how ridiculously difficult it is for non-heterosexual people to gain equal marriage rights in this country. It is evident in the idea that in order for homosexuality to be seen as acceptable, a gene has to be discovered or examples in nature have to be found in order to prove its “naturalness” and by proxy, its goodness. It is evident in the idea that virginity (and the virginity of women, in particular) is still prized in this society. What better way to control women and their sexuality than to demonize them if they do not keep themselves ‘pure’ so they can be worthy of their future husbands who will provide them with resources? And it is evident in the idea that young (barely legal) women are the sexual ideal in this society. Obviously, one has to make sure they are fertile enough to spread a man’s genetic material.

If monogamy is the only true and natural way, then why is divorce so common and necessary? Shouldn’t it be extremely easy to stay with the first person one falls in love with for the rest of their life? But it isn’t. People break up, divorce and cheat on their partners every day. Monogamy also has this connotation of being the more moral option because no one wants to be “promiscuous”. That is just not what good people do. Christian Klesse in their article, “Polyamory and its ‘Others’: Contesting the Terms of Non-Monogamy,” states, “The derogatory term ‘promiscuity’ implies that a person has ‘unreasonable’ numbers of sexual partners. It is frequently associated with immaturity, character-deficiency, shallowness, narcissism, egocentrism, relational incapacity, lack of responsibility, and worthlessness” (573). This reminds me of a theme I constantly bring up: Normal vs. Abnormal. When I see a phenomenon described as abnormal or “unreasonable,” I cannot help but take a critical look at the argument being made. What exactly is an unreasonable amount of partners? Is it any partners other than the person one intends on marrying (if that’s even an option)? And is everyone capable of being promiscuous? I would postulate that only women have that dubious honor. I rarely hear teenage boys being told to be careful not to become “one of those boys”. So if having an “unreasonable” amount of partners makes a person an immature and worthless individual with a character deficiency, it is no wonder why many people do not even consider anything beyond monogamy (and lie about how many partners they’ve had). Interestingly enough, Schuiling comes to the same conclusion I do, using evolutionary theory in all of its essentialism. They conclude, “Culture, with its temptations but also with its system of bans and commandments, may strongly frustrate urges deeply rooted in the human mind” (Schuiling 59). Schuiling believes that although men and women desperately want to find that one perfect mate, they also want to mate with as many people as possible in order to ensure genetic security and survival. Schuiling thinks that cultural institutions, like religion and marriage, evolved to control these other urges as much as possible. As a result, according to Schuiling, compulsory monogamy is not natural for humans and flies in the face of other urges, which has the potential for conflict.

Now that I have discussed the ‘natural origins’ of monogamy, I want to discuss social influences and pressures. One idea that seems to be very powerful in this society is the idea of the “soul mate”. A soul mate is said to be the one and only person out there for everyone. No one else in this entire world will ever be better suited. This soul mate will have everything a person ever needed and will be everything they could possibly ever want. All someone has to do is find them. And if a person is in a relationship with someone who doesn’t have everything they want, the person either must deal with it and accept that they will not be completely fulfilled in this relationship or leave and find someone else because clearly that original person wasn’t their soul mate. This could lead to serial monogamy and eventual frustration because that one person who solves all of their romantic problems seems so elusive. Can one person really fulfill all of a person’s needs? Should there only be one person in one’s life to fulfill all of their needs? Society does not have this expectation for friendships. No one is forced to have only one best friend who MUST be able to handle all of their friendship needs. If there is enough room in one’s heart to love all of our friends and family in various ways and capacities, then why can’t there be enough room for multiple romantic/sexual/intimate relationships?

This brings the discussion to the topic of polyamory and other types of non-monogamy. There are many different types of non-monogamy, but three common types are: Swinging (being in a relationship with one person, but being able to have sex with others with the consent of the partner), casual sex (sex with multiple people without building committed relationships), and polyamory (building various types of relationships with multiple people). I should state that all 3 forms of non-monogamy are valid and none of them are better than others. For the purpose of this post, I will talk a bit more about polyamory. Jin Haritaworn, Chin-ju Lin and Christian Klesse, in their article, “Poly/logue: A Critical Introduction to Polyamory,” assert that polyamory “tries to provide languages and ethical guidelines for alternative lifestyles and sexual and intimate relationships beyond the culture of ‘compulsory monogamy’ (518).” In essence, it is about options and providing people with other ways to love or relate with others if monogamy does not make them happy. Two common reactions that I receive when I bring up the topic of polyamory with someone new are “Oh no, I would get too jealous” and “Isn’t that just cheating?” The role of jealousy in a relationship is very fascinating to me. It almost seems as if jealousy is a required part of a monogamous relationship. Jealousy is a horrible emotion. It is based out of insecurity (regarding one’s self and the relationship) and the idea that another person might pose a threat to the relationship. I am sure most people would agree that it is not a pleasant experience, but for some reason, it is still seen as something that just happens, just another aspect of being in a relationship. But honestly it does not have to be this way in any relationship, monogamous or non-monogamous. A successful relationship, whether it is monogamous or non-monogamous, requires communication and honesty. Without these things, relationships are doomed to fail. Being honest to partners about one’s feelings and encouraging open discussion about them will assuage negative feelings. Jealousy is a powerful emotion, but that does not mean people should let it get the best of them. Acknowledging one’s own jealousy and then discussing it with your partner(s) is a healthier and more positive way of dealing with it without damaging the relationship in question. And as for cheating: No, being poly is not synonymous with cheating. Cheating involves hiding/lying to your partner(s). As long as you are honest with your partners and communicate with them clearly about your needs and desires then no, it is not cheating. And being poly, just like any other form of relationship, requires honesty and communication to make it work.

As I said before, for me, it is all about giving people the ability to choose what is best for them. Polyamory is not for everyone just like monogamy isn’t for everyone. People deserve options and shouldn’t be forced into one type of relationship. One type of relationship is not more “natural” or better than another. Monogamy is not mandatory and no one should feel ashamed for living a life that fulfills them.

Neonatal Male Circumcision: Harmless Tradition or Child Abuse?

For the purposes of this blog post, I am defining ‘neonatal male circumcision’ as the ‘nonreligious tradition of surgically removing the foreskin from a male newborn baby’s penis as practiced in American hospitals’. Let me just say that I firmly believe that circumcising a male infant is wrong. Period. It’s really an issue of consent for me. The infant cannot consent to having a piece of their penis cut off. I really cannot think of any significant reason why infants should be circumcised. I think it’s just another way for medical practitioners to make a little money and just another tradition that most people follow without truly thinking of the their reasons for doing so. In this post, I am going to list three of the most common arguments for male circumcision that I have heard personally and then I will pick them apart. Enjoy.

Common Arguments for Neonatal Male Circumcision:

• Protection Against Future STIs

In their meta-analysis of multiple research studies, “How Does Male Circumcision Protect Against HIV Infection?,” Robert Szabo and Roger V. Short state that “…circumcised males are two to eight times less likely to become infected with HIV. Futhermore, circumcision also protects against other sexually transmitted infections, such as syphilis and gonorrhea…” (1593). HIV is thought to initially attach to CD4 and CCR5 receptors found in genital and rectal mucosa and much of these receptors are found in the foreskin of the penis. So the assertion that circumcision has the potential to act as protection against STIs is valid. However, there are confounds to this research. Most of the research that focuses on male circumcision and HIV are conducted in Africa with adult men. As Robert S. Van Howe asserts in his article, “A Cost-Utility Analysis of Neonatal Circumcision,” “The HIV pandemic in Africa demonstrates distinct epidemiological differences from the outbreaks in North America or Europe. For example, most infections in Europe and North America are transmitted by nonheteroexual means” (591). Stephen Moses et al agrees, “It has been pointed out that different sexual practices or hygienic behaviors can confound the association between circumcision status and HIV infection…different risks of becoming infected may be due to behavioral factors, not circumcision status” (369). In short, it would be inaccurate to take research conducted in Africa and try to apply it in America. The cultures, traditions and sexual practices differ. For example, in Africa, HIV is mostly transmitted though heterosexual PV intercourse. In contrast, MSM (men who have sex with men) are one of the main high-risk groups in the US. Also many of these studies conducted in Africa are with adult males who are already deeply embedded in a widespread HIV pandemic, not currently seen in the US. One major thing easily overlooked in this research is the role of condom-use. Although, in the studies conducted in Africa, condoms are readily available to the participants, it is admitted that most of the men “never used condoms, and condom use did not seem to influence the rate of transmission of HIV” (Szabo and Short 1592)”. Of course, condom-use did not influence the rate of HIV transmission. They were not being used! According to the CDC (Center for Disease Control and Prevention), “Laboratory studies have demonstrated that latex condoms provide an essentially impermeable barrier to particles the size of HIV... [and] particles the size of STD pathogens”. Condoms protect against HIV and other STIs. Is surgery really necessary? Those who support neonatal circumcision as a preventative mechanism against HIV in America are basically using the argument: ‘Circumcising a male infant will probably protect males from possible future transmission of STIs if your son decides to have unprotected sex’. Neonatal male circumcision costs, on average, between $200 and $400. Condoms are given out freely at any healthcare facility and college. How is it in any way preferable as a parent to spend at least $200 on a painful surgical procedure to protect your son from possible future STIs when the same protection could be given for much cheaper with a condom and a lesson in proper bodily and sexual hygiene? And, for that matter, how can one ever be certain that one act in infancy will really protect adult men against anything in the future? The individual has an entire life’s worth of behaviors to confound any kind of neonatal protection. And let me restate, the baby is being put through a painful procedure that they cannot consent to. If it is not ok to cut off a piece of an adult’s anatomy without their permission, why is doing it to an infant perfectly fine? If an adult male wants to be circumcised to lower his present risk for HIV by undergoing this procedure, than that’s fine. That’s his decision. However, putting a male infant through a painful (and costly) procedure that may or may not protect him for possible future STI transmission is sick in my opinion. Also there is a risk of complications, like accidental (further) mutilation of the genitals, infections and, rarely, death. The risks, at least in my opinion, outweigh the benefits of possible future protection.

• Aesthetics

People seem to be concerned about whether or not a penis is circumcised for aesthetic reasons, i.e. circumcised penises are believed to look better. Let me tell you a secret: All erect penises look the same. Problem solved. Cutting off part of your infant’s genitals just because you think they will be more sexually appealing in the future is disturbing. Please stop thinking the aesthetic appeal of your infant’s genitals.

• “Oh, they won’t feel/remember the pain.”

Really? Although at first glance, their status is questionable, newborns are definitely humans. Therefore, they have nerves and they can feel. In their article, “Circumcision Practice Patterns in the United States,” Howard J. Stang and Leonard W. Snellman reveal, “all too frequently, the physician performing the circumcision denies the infant the benefits of anesthesia because of inaccurate perceptions of the risks of anesthesia or denial that the procedure warrants such amelioration of pain” (3). The idea that infants are denied anesthesia just because it is assumed that they probably won’t feel the pain is troubling. And as for the belief that circumcision is ok because the infants will not remember the pain: So I can hurt anyone I want as long as they forget about it later?

Males should be allowed to make the decision of whether or not to be circumcised on their own when they are adults. At the point of adulthood, they will be able to assess their own risk for STIs and will make the decision of whether or not to be circumcised. In an area facing an HIV pandemic, like Africa, where condoms are simply not being used, than it is easy to see why circumcision could be a viable option for adult men who want to lower their risk while still having unprotected PV sex. However, in the United States, where condom-use is mostly encouraged and there is better access to sexual health education materials, neonatal circumcision is unnecessary. Also it is extremely interesting to compare Western views regarding male and female circumcision, also known as Female Genital Mutilation, (I’ll make a post about this at some point in the near future). Nearly everyone in the US will agree that FSM is wrong. Most people will say it’s a nonconsensual act that causes physical and psychological scarring to innocent young girls. However, these same people will argue that male circumcision is perfectly normal and safe ‘in the right hands’. So what’s the difference? At the end of the day, a child is still getting parts of their genitals chopped off without their consent. Is it just because it has become a tradition in Western society? And are parents being properly informed of the extent of the benefits and risks of circumcision? Doctors should inform them of current research and give them the information needed to make educated decisions. And parents should not take every single thing their doctor says as law. Do some research. Weigh the pros and cons and make an educated decision. An infant should not have to suffer just because of possible future STI transmission and shallow societal aesthetics.

A Quick Thought: The F-Up Agreement

So as I’m sure I’ve mentioned once or twice, I do psychology/sexuality research at an internship in NYC. In my internship, I work with and interview the participants in the studies. The other day, I called in one of my supervisors to do her part in the interview and, during her segment, she brought up something that I just have to share with you.

So the concept that my supervisor (let’s call her Sally) brought up is called, “The F-up Agreement”. This agreement applies to individuals in committed relationships who decide that they do not want to use protection (condoms, dental dams, etc) in their relationship anymore and want to become “fluid-bonded” (i.e. have sex without condoms, dental dams, etc). “The F-up Agreement” has two parts. Part one is the agreement that they won’t use protection in their relationship, but if and/or when they have sex with people outside of the relationship, they will use protection. Part two of the agreement states that if one partner “f’s up” and has sex outside of the relationship without protection, they can ask to use protection in the relationship with their primary partner(s) with no questions asked.

Now, I love this agreement. Sexuality researchers and therapists are realistic. As awesome as it would be for everyone to use protection all the time for the rest of their lives, we all know that’s not going to happen. And realistically, no one in a committed relationship wants to use protection for the rest of their lives. It’s understandable. I just want people to be as healthy and safe as possible and to understand/be aware of the risks. This theory is both realistic and risk-aware. One thing I’ve noticed over and over again in sexuality research is how hard it is for people to talk about safe sex and STIs in relationships, both committed and casual. Lots of assumptions are made, but, in many cases, no actual conversations are had. For instance, I know of one man who contracted HIV, but did not do intravenous drugs and was in one committed relationship for years. How did he get HIV? His partner had contracted HIV and never told him because the partner was afraid that he would leave him. It’s easy to judge the partner, but everyone who has been in sexual relationship knows how difficult and “unsexy” it is to bring up STIs. I think this agreement allows for sexual safety without the 'awkwardness' that everyone is afraid of. Now, I know “The F-up Agreement” involves a lot of trust and maturity. I’m sure the temptation to ask your partner exactly why they suddenly want to use protection would be very strong. However, you have to respect the fact that your partner cares enough about you that they would ask to use protection in the first place. And interrogating your partner would put a strain on the relationship and, if a “f-up” happens again in the future, the partner might not say anything anymore. This agreement is about the greater good of the relationship and the sexual health of everyone involved. It’s about trust and responsibility. And honestly, if you don’t trust someone enough to take care of their own sexual health and, indirectly, yours, then maybe you shouldn’t be in a relationship with them. Just a thought.

Sex Addiction Part 2

I recently had a mini-debate with someone in regards to whether or not the word “addiction” was an appropriate word to describe the phenomenon of “sex addiction”. In this section, I will discuss why I think “addiction” is not a suitable word, the other party’s counterargument and my following counterarguments. Please read "Sex Addiction Part 1” first. It explains what the phenomenon of “sex addiction” is, its relation to medicalization, how it reinforces sexual scripts and gender stereotypes, etc.

So I think a great way to start would be to define the word “addiction”. Now, when most people think of an addiction, they think about withdrawal symptoms and trying to quit and being unable to, but that’s not the whole story. Nick Heather, in his article, “A Conceptual Framework for Explaining Drug Addiction,” describes addiction in three parts: “(1) the level of neuroadaptation, (2) the level of desire for drugs and (3) the level of ‘akrasia’ or failures of resolve” (3). To clarify, an individual becomes addicted to a something when they resolve to stop, but fail many times, when they build up a tolerance and suffer from withdrawal symptoms upon trying to stop, and experience neuroadaption, which is when their brain changes permanently as a result of taking the drug. Common examples of permanent changes to the brain would be a decrease in dopamine production or a decrease in gray matter as a result of using the substance, that causes your body to need the substance in order to maintain a state of 'normal' (for lack of a better word at the moment) that non-substance users experience. My argument is that becoming “addicted” to sex is impossible because one cannot become addicted to behaviors. Behaviors do not cause neuroadaption and there has been no empirical evidence that the desire for lots of sex or having lots of sex causes physical changes in the brain. Two counterarguments I have seen for this were “Well, sex releases dopamine so can’t someone become addicted to that release?” and “I stopped having sex for a while and I suffered from withdrawal symptoms. I felt terrible.” To counter the first argument: Yes, sex results in a release in dopamine, many daily activities do. Dopamine is a neurotransmitter that is essential in learning and in making sure we continue to do things that are beneficial to our survival, like eating and having sex. Dopamine is related to feelings of pleasure and its release serves as a reward to the body for performing essential tasks so the individual will continue to do it in the future. However, the release of dopamine does not automatically result in addiction. The release of dopamine in the brain experienced through daily activities is a normal dosage that the body is naturally used to. However, the amount of dopamine released into the system when taking something like cocaine is well over and beyond the amount the body is used to. Cocaine inhibits the reuptake of dopamine, allowing the neurotransmitter to flood the brain. As a result of this unnatural flood of dopamine, the brain decides that it does not need to produce its own dopamine anymore. Now the brain is changed permanently and the user’s dopamine levels are below the norm without the drug. The individual no longer feels naturally rewarded without the drug. This is why many drug users say they need the drug to feel normal. In regards to the second argument, the difference between the experiences one might have after not having sex for awhile versus not taking a drug is that one can actually potentially die from the latter. In their article, “Myth of Sexual Compulsivity,” Martin P. Levine and Richard R. Trioden  agree with me stating: “First sex is not a form of addiction…Sex is an experience, not a substance. Although sexual experiences may be “mood altering,” abrupt withdrawal from sexual behavior does not lead to forms of physiological distress such as diarrhea, delirium, convulsions or death. Vomiting induced by fear of giving up a learned pattern for dealing with anxiety (such as having sex) is not the same thing as vomiting induced by physiological withdrawal from a physically addicting substance” (357). In light of these facts, the word “addiction” is not appropriate and the phenomenon does not fulfill all the necessary requirements to be referred to as such.

Moving away from the biological to more cultural/social perspectives, I want to discuss the main counterargument of the individual with whom I had the mini-debate with. His argument was that discounting the appropriateness of the disease model of addiction in regards to this phenomenon creates a stigma against those who suffer from it. He also specifically mentioned a moral stigma being directed to these individuals as well. My argument is that the term “sex addiction” and all of the connotations and meanings surrounding it create and reaffirm stigmas and stereotypes rather than erasing them. In “Sex Addiction Part 1,” I discussed how individuals who label themselves as ‘sex addicts’ tend to believe that medicalizing this phenomenon removes all the moral judgment and stigma that they otherwise might suffer as if medicine is somehow immune to social influences and morals. I further argued that this is not the case (see post for more). The diagnosis for “sex addiction” actually creates distinctions between “good” sexual behaviors/fantasies and “bad” sexual behaviors/fantasies. “Good” sexual behaviors/fantasies usually exist within the context of heterosexual sex in a heterosexual marriage or committed relationship. Anything else is usually labeled “bad”. Levine et al continues this train of thought, saying, “In addition, as conceptualized professionally, sexual addiction is currently the only type of ‘addiction’ in which the addict is not expected to give up [their] ‘drug’ of choice as a part of the ‘treatment’. As long as sex is ‘used’ in appropriate contexts (such as marriage, a committed relationship), the addict has been ‘cured’. Note that sexual expression is condoned when it occurs in the social contexts that affirm the traditional sexual order, but medicalized as an “addiction” when it falls outside existing norms” (357). Not only does “sex addiction” stigmatize certain sexual behaviors, but it also reaffirms gender stereotypes (see part 1). Another thing to think about is the connotations behind the word “addiction”. Calling this phenomenon/construction an addiction, even amongst lay people in daily life, is not beneficial to those who suffer from it. The word “addiction” is associated with drugs, especially hard drugs that have no real beneficial qualities, due in part to their addictive aspects. It can be implied from this comparison that sex is also inherently bad. We all know this isn’t the case. Sex is generally good. It’s just that when a person feels like that they HAVE to have sex all the time or find themselves constantly thinking about it and it causes them distress or inhibits other aspects of their life, sex becomes negative to them in that situation. In that specific case, the individual should go see a sex-positive therapist as I stated in Part 1. However, we should be careful of the words we use. Words are important. They hold ideas behind them and the words that become commonly used are extremely powerful and we should take care to use words that do not have serious negative effects on the issues we care so dearly about. The term “sex addiction” may be comforting to some on an individual level, but it strengthens societal anxieties about sex by painting different aspects of sexuality in a negative light.

A quick note (more of a P.S.): So I used to subscribe to the term “sexual compulsion” as a substitute for “sex addiction”. After doing the research for and thinking about this blog post, I realized that I was focusing too much on terminology without looking at the bigger picture. Although the term “sex compulsion” fixes the addiction definition issue, it is just as guilty for painting sex in a negative light. Now, I think that giving this phenomenon a special medical name individualizes it and ignores the social issues. I’d rather it not be named and believe that, in therapy, societal factors should be taken into account along with the person’s individual experiences.

Sex Addiction Part 1

This post is part one in a two-part post regarding sex addiction. This part will focus on the phenomenon of sex addiction, its presentation in men and women and how it influences/is influenced by societal norms. Part two will discuss terminology: whether or not the word “addiction” should be used to describe this phenomenon and discusses other terms that have been put forth by mental health professionals.

Ok so, what is sex addiction? According to Martin P. Levine and Richard R. Troiden, it is the phenomenon in which individuals “feel driven to engage frequently in nonnormative sex, often with destructive consequences for their intimate relationships (e.g. marriages) and occupational roles” (349). Diagnosed sex addicts report a sense of being unable to control their sexual behavior and fantasies and feel distress as a result. In my opinion, the phenomenon of sex addiction is another form of medicalization (See previous blog for an in-depth explanation of medicalization). Medicalization is the process in which various phenomena are perceived in the realm of the individual and as an appropriate area for medical and pharmaceutical intervention. In short, medicalization believes that any problem and solution is solely found within the individual person. I’m not a fan of medicalization because it tends give short-term (individual) solutions to long-term (societal) problems. Medicalization tends to believe that giving an individual a pill will solve all their problems without giving any consideration to the environment (societal and otherwise) the person lives in. According to Janice M. Irvine, in her article, “Reinventing Perversion: Sex Addiction and Cultural Anxieties,” many individuals label themselves as  “sex addicts” because “it has the alleged moral neutrality of disease; they feel relieved…to attribute their sexual problems to the disease of addiction” (433).  They believe the use of medical terms and medical intervention erases stigma and social judgment. However, medicine is not immune to cultural and social influences. For example, the first edition of The Diagnostic and Statistical Manual of Mental Disorders, published in 1952, “defined masturbation, fellatio, cunnilingus, homosexuality and sexual promiscuity as forms of mental illness” (Levine et al, 353). However, now, masturbation, oral sex and homosexuality are no longer seen as disorders. The boundaries of what is considered normal and abnormal changes within time and space. Levine agrees saying, “In any given society, sexual scripts provide the standards determining erotic control and normalcy. What one society regards as being sexually “out of control” or deviant, may or may not be viewed as such in another” (351). Medicine is just as susceptible to the changing whims of a given society as anything else. It is not immune and it is not objective, although it would love to be.

The socially constructed phenomenon of sex addiction is influenced by and strengthens sexual scripts and gender stereotypes as well as reinforces cultural anxieties about sex. Men who are diagnosed with sex addiction are said to “exhibit repetitive and extreme forms of behavior. Often they are prone to violence, or engage in fetishistic behavior” (Irvine, 446). These behaviors include “uncontrollable promiscuity, autoeroticism, transvestism, homosexuality, exhibitionism, voyeurism, fetishism, incest, child molestation and rape” (Levine et al, 349). In contrast, women who are diagnosed with sex addiction are said to engage in “frequent dangerous sexual encounters with strangers” (Levine et al, 350) in which they are either “risking victimization or using sex to feel vicariously powerful” (Irving, 446). Men are described as violent, yet powerful in a frenzied animalistic way as a result of uncontrollable lust. However, women are either helpless victims or as desperately trying to seize the power that only men have (Can anyone say Freud?). Irving declares “the concept of sex addiction is also antithetical to feminism in that it shapes ideas about ‘appropriate’ women’s sexuality into static imperatives” (449).  For something that is supposed to erase stigma, it affirms old ones: of men as animals and women as weak.

The concept of sex addiction also attacks sex as a behavior and as an identity/orientation. Many sex addiction self-help groups condemn “pornography, sex without love, and multiple partners” (Irving, 446). An individual is considered cured from their sex addiction when they are engaging in sexual behavior that is normative and condoned by mainstream society, i.e. heterosexual sex within the confines of heterosexual marriage or a committed relationship. Also individuals who participant in sexual behavior that is not considered normative (people who are polyamorous, not straight, and/or enjoy casual sex) are, by definition, labeled as disordered. It does make me wonder if the guilt and distress diagnosed sex addicts feel is, at least in part, linked to societal condemnation of their sexual behavior. Maybe if society were more accepting of non-normative sexual behaviors and fantasies, there be would be less guilt and distress?

Sex addiction is more than a term and much more than a “disease”. It is a powerful construction used to label people, to sway minds and to control the public. It individualizes societal issues and problems instead of solving them and reinforces gender stereotypes. That all being said, if someone feels that they are experiencing sexual urges that are causing them distress and impairs their daily functioning, then they should go see an open-minded, sex-positive therapist. Whether it results from negative societal views of sex or an individual issue or both can hopefully be determined with therapy.