Advice: The Part-time Lover

Q: My husband and I are very happy together, but he will only have sex with me every three days. When I ask him what the problem is, he tells me that it takes three days for a man's sex glands to recover, and that having sex more frequently may cause his organs permanent damage. I've never heard this before; I wonder, is he telling me the truth, or could he be hiding some other issue?
A: Here are some basic facts. The time it takes after orgasm for bodies to return to normal levels of functioning is known as the refractory period. Heart rate, breathing and blood pressure return to normal levels. It may take a few minutes for sexual responsiveness and the capacity for erection to be restored. It certainly takes time to restore the capacity for orgasm.
As men age, the refractory period generally gets longer. It can vary from a few minutes to a day or more. There is no invariable rule, as the refractory period normally varies with any one man and varies from man to man. In general, with age it takes a longer period of stimulation to produce erection and ejaculation. Direct stimulation of the penis is helpful and often necessary,
Also as men age, the amount of semen ejaculated may be reduced. Semen consists of sperm and secretions produced by the prostate and other glands.

At the very least, your husband is operating on a misconception. It would be helpful to provide him with information. There are many authoritative websites that provide information.
But he may be operating on a deliberate lie. He may be saving his sexual energy for another partner.
You can tell a lot from the sex you now have. Is your husband open to an extended period of lovemaking that satisfies you both, both emotionally and physically, and that may involve multiple orgasms, or is sex a very perfunctory event?
If you have great sex and your husband is warm and responsive for as long as you both want or need, then it sounds as if you indeed have a lot to be happy about.
But if your every-three-days sex is an act engaged in not so much to exchange affection but to release a single orgasm, then you have cause for concern.
For starters, why don’t you try approaching your husband more often in bed?

Who Says Pills Kill Sexual Thrills?

What's good for the goose isn't good for the gander, at least when it comes to sex and some types of antidepressants.
Prozac and its pharmaceutical peers—officially known as selective serotonin reuptake inhibitors, or SSRIs—have been gaining a reputation for inhibiting sexual desire. So when Lisa Piazza, M.D., of Cornell University Medical College, placed a group of 25 depressed people on SSRls, the surprise was not that the sexual functioning of the men got significantly worse—but that of the women significantly improved.


After six weeks of treatment, Piazza found that sexual desire, psychological arousal, and overall sexual functioning improved for the women, while ease of orgasm, satisfaction from orgasm, and overall sexual functioning deteriorated for the men.

Side effects from SSRI treatment may simply be less common in women, says Piazza. She also points out that the women had greater sexual impairment compared to the men at the beginning of the study, as a result of their chronic depression. Their low starting point left ample room for improvement.

Masturbation Is Sexual Health

Here we are again in May, which was dubbed as “Masturbation Month” in the 1990s by a clever purveyor of sex toys. And yet here we are in 2020 and talking about masturbation is still taboo in most of society. And that’s a shame, literally and figuratively, because masturbation is still widely considered shameful, and because for most people it’s a healthy and normal activity. There is actually a term these days for those who prefer masturbation over other forms of sex: solosexual.
Gold standard of sex
Many people have the idea that in order to call something “sex,” it must meet the “gold standard,” that is, penetration that probably ends with an orgasm. We downplay and devalue the idea that having sex with oneself is normal—even though nearly everyone does it—and is somehow shameful. We rarely talk with our children about it, and various preachers, both religious and secular, tell us that touching oneself is either a sin or something to avoid. From my point of view, we’re in need of expanding the definition of sex, not restricting it to the “gold standard.”
Couples and masturbation
Even after 35 years of being a therapist, I’m still surprised when I ask couples if they have ever talked about masturbation, and they look uncomfortable and tell me “no.” This is particularly true of mixed-sex couples, whereas I more often hear a “yes” from same-sex couples who have negotiated, talked about what is and isn’t okay, and agreed to respect those boundaries.
In therapy with mixed-sex couples, I sometimes hear, “You shouldn’t have to masturbate, you have me!” However, my sense is that most people in relationships do masturbate, whether or not they share that information with their partner. They shouldn’t assume that because their partner masturbates, it’s taking something away from them. It’s not, necessarily. We are perfectly capable of having sex with our partner and with ourselves. I would say, however, that having a candid conversation about masturbation—how often we do it, what turns us on, what type of porn that turns us on when we masturbate, and so on—is a healthy and liberating thing. I’ve had couples tell me that they had no idea about their partner’s erotic fantasies, and that it really turned them on to talk about them. 
There are definitely times where a partner prefers masturbation over partnered sex. This is normal. Masturbation is quick and easy, whereas partnered sex demands more negotiation and time. If either partner feels that their masturbatory habits do interfere with the relationship, this invites a sexual health conversation with the couple.
Understanding yourself

When I ask clients about their sex drive, inevitably someone tells me that they have a low sex drive and consequently aren’t having sex, or as much sex, with their partner, and yet are masturbating twice a day. This indicates that they have a higher sex drive than they think they do, but that having partnered sex is desired at a different frequency. This suggests a discussion around the fact that their regular masturbation indicates a higher interest in sex with themselves, or could be related to problems in the relationship. Especially in such a case, dialogue around interest in solosex in a relationship needs to be openly explored. I discourage partners from keeping it secret. That said, both partners can agree that their own masturbatory habits are private. This is an explicit contract that is agreed upon by both.
Orthodox religion has taught unorthodox ways
I’ve had deeply religious clients who were instructed to never touch themselves. But it's difficult to suppress something so deeply a part of being human. So, they’ve resorted to putting their penis between two pillows and getting off. Forbidden to touch themselves, they find a way—like rubbing up against a mattress or the floor. The problem for some of these individuals who have come to my office for help is that having masturbated in this way has made it more difficult for them to be sexual with others. As a sex therapist, I guide these clients through talk therapy on how to move to sex with partners. There is no right or wrong way to masturbate, and one is only limited by their imagination. However, if it limits you in ways you do not want to be limited, then seeking help is the right thing to do.
Solosex is healthy and okay
If you’re not in a relationship at the moment—or even if you are—don’t let anyone tell you there’s something wrong with pleasuring yourself. In fact, make it an event, a date with yourself! Light candles, pour yourself a glass of wine and crawl into a bubble bath with romantic music playing in the background. Try a new sex toy. Read an erotic story. Spend a couple of hours turning yourself on.
One client said that his spiritual teacher told his students, “If you’re feeling ungrounded or confused, lie down and touch yourself. Your body is as sacred as every other thing in this world.”  
Things to consider:
    Masturbation is sex
    Masturbation is okay
    Not masturbating is okay
    Masturbation with a partner is sex
    Self-pleasure is okay
    Masturbation without orgasm is okay
    Masturbation with orgasm is okay
    Masturbation in and of itself doesn’t take away from sex with a partner
    Masturbation can be a way to self-soothe
    Masturbation can include sexual fantasies
    Masturbation can include no sexual fantasies
    Masturbation with a Fleshlight, vibrator, or any sex toy is okay
    Masturbating while watching porn and reading erotica is okay
    Masturbation can be your entire sex life
There’s no right or wrong way to masturbate unless it begins to interfere in other ways you wish to be sexual. For example, getting used to a certain grip for males can interfere with sensation during penetration. Some women get used to a vibrator and are not sensitized to oral or manual touch exciting their clitoris. These are correctable simply by taking breaks from masturbation or using a vibrator, and changing your grip. 
Sex educator, author, and artist Bette Dodson calls masturbation “erotic meditation” and says that you are your safest sex partner. I couldn’t agree more.

Freeing Ourselves From Valentine’s Day

I don't expect to have sex on Valentine's Day. Neither should you.
It's OK if it happens, of course; I just don't expect it.
My patients have shown me over and over that expectations like that create problems. It's even worse when you don't tell your partner what you're assuming.
But say you're like many people. You look forward to sex on Valentines Day, or your birthday, anniversary, weekend away, or the day that the kids are with their uncle. You buy a bottle of champagne, or frilly underwear, or flavored condoms. Maybe you drop a few hints. Maybe your partner gets the hint, maybe not. You aren't quite sure.

You tell your best friend what you hope will happen. Maybe you say it better happen--after all, you two don't do it as much as you used to. And you get plenty of support from the usual suspects: Cosmo, Maxim, every sex advice website on the planet. They tell you to make the sex a big deal, prepare for a special night, make this the first day of the rest of your sex life.

Or let's say you don't expect (or want) sex on Valentine's Day, but you think your mate probably does. And it better be great, right--you figure that's probably what your partner's thinking. Are you up to the challenge? Can you lose 6 pounds in 3 days so you feel sexy? Are you prepared to "give" your partner the best orgasm in history, knowing that you'll be bored or self-conscious or a little sore by the time the big moment happens--if it does?

Is it possible to load more pressure on our sexuality?
Is it possible to invite more disappointment, more misunderstanding, more frustration? I don't think so.
It's bad enough that there's a special holiday on which people are supposed to drop the everyday, truly meaningful ways they expression affection (like changing the catbox when it's not your turn) in favor of made-up stuff like chocolates, flowers, and limo rides. It's worse when people imagine they "should" have sex on this day (often in the middle of the week!), disrespecting all the reasons they don't have or don't enjoy sex as much as they used to.

Sex on Valentine's Day? If you want it, let your partner know--and don't expect it. If your partner says no, don't take it personally. Just like having sex means different things to different people, so does not having sex. And if your partner wants sex but you don't, be friendly and say no thank you. Do not have sex if you don't want to. People who do that give sex a bad name.

Valentine's Day: the day of erotic pressure. Don't blame Hallmark--we do it to ourselves.
So don't!

Child.ol'.a.try

Frank and Gina* were the couple friends admired most—intellectual, funny, professors who taught on the same campus. They seemed perfectly matched. But after the birth of their first child, their sex life dropped out, they bickered incessantly, and both started taking antidepressants. Twenty years later, they're still married, with thriving careers and successful children, but privately they have been unhappy for a long time. "I used to feel that I was the light of her life, and now I feel as though she's annoyed that I'm still here," says Frank, who perpetually contemplates separating.
Close to half of today's marriages end in divorce, but that doesn't mean that couples who stay together are happy. "Even those marriages that remain intact have generally become less satisfying," says Eli Finkel, a professor of social psychology at Northwestern University.
Many couples carry on dutifully with the task of raising a family, showing a brave face to the world while secretly stuck in a mild but chronic depressive state I call "depressively married." Modern marriage, I believe, has hit a perfect storm—a collision between our biology and our contemporary values regarding marriage and child-raising.
Most unhappy marriages seem to founder on the same rocks: children. Noted marital researchers John and Julie Gottman, cofounders of the Gottman Institute in Seattle, conducted a long-term study of 130 newlywed couples. "The data shocked us," John says. Two-thirds of the new parents self-reported that they were "very unhappy after the birth of their first child."
More than a hundred studies show that marital satisfaction falls off a cliff after the birth of the first child and doesn't get much better until the last child leaves for college.
Couples have been having children since the beginning of time; why have they become such relationship-killers only now? According to Stephanie Coontz, author of Marriage, a History and professor of history at Evergreen State University, until the 19th century, marriage served the purposes of reproduction, economic security, and the creation of alliances between families. No one would have dreamed of resting such a cornerstone of society on something as fickle as love. There was little room for feelings of disappointment.
By the 1950s, people married predominantly for love, although divorce was still rare. In the Leave It to Beaver marriage, men and women had separate roles, separate sets of friends, and separate leisure activities. Children were told to go out and play (and no one felt guilty about it). As long as women performed their "marital duty" (whether they enjoyed it or not), sexual adjustment in marriage was deemed good enough. And if either partner had an affair, it seemed easier to keep the fact secret than threaten the relationship.
In the 1970s, with the sexual revolution and the birth of modern feminism, marriage underwent a second transformation: Simultaneously, the bar of our expectations was raised while the resources we gave to our relationships were diminished.
In the contemporary era, couples expect to be best friends, to have complete equality in all spheres of life, and to sustain an ongoing romance with mutual sexual satisfaction—and an exclusive relationship at that.
At the same time, modern marriage is accompanied by ever more dedication of time and resources to children.

These are Olympian expectations, but you'd have a better chance of winning the actual Olympics. The new marital ideal is, observes Coontz, "like the little girl with the curl; when it works, it's really, really good. And when it doesn't, we feel deeply betrayed."
Orgasms for All
By the 1970s, Americans had discovered the female orgasm, and sex became an equal opportunity enterprise. While the shift has expanded human potential and produced richer sex lives for men and women, it has also made postbaby adjustment a more shocking disappointment and a recipe for depressive marriage. Sexual satisfaction is one of the best predictors of overall happiness. Yet in one study, only 12 percent of couples reported not having "serious sexual problems" after having children.
It's no one's fault. The abrupt change in sexual connection between partners is hormonally influenced. Throughout the nursing years, prolactin production depresses the sex hormones estrogen and testosterone, biologically encouraging women to de-emphasize mating and focus energy on keeping their newborn alive. Further, as breastfeeding stimulates the bonding hormone oxytocin, it prompts a shift in attention toward baby and away from husband.
A sexual chasm opens between partners that wasn't there before. The Gottmans found that a full three years after childbirth, women report feeling "not very sexual" and want sex no more than "every week or every other week," while men report feeling "extremely sexual," wanting sex "every day." And when couples do have sex, there is a great discrepancy in their enjoyment of it. Men have orgasms six times more often than their partners.
Many men suddenly feel undesired and unloved. "Something inside them just breaks," says Julie Gottman. The dramatic switch in women's attention from mate to baby, guided by oxytocin, may be "evolution at its best, but it is detrimental to intimacy between the partners." What's good for reproductive success is bad for 21st-century marital success.
Some couples survive the transition to parenthood happily. Those who do, the Gottmans find, put the brakes on being child-centered. Studies show that couples who do more things alone together are happier. Yet today's parents, by substantial margins, spend less time alone together, less time entertaining friends, and less time in leisure activity than their parents did—primarily because of an increase in time spent intensively parenting their children.
Here's the paradox: We expect more from our marriages but feed them less. As Maryland attorney and divorce mediator Nancy Caplan puts it, "The end of the 'go out and play, and don't come home till dinner' era has sucked the life out of our marriages."
Perhaps it's time to consider taking a page from our parents' book on this: Take vacations without the kids and play tennis or golf—or anything—with our spouses instead of standing on the sidelines watching a pack of 8-year-olds swarm around a soccer ball.
Only in the past two decades have we developed the idea that children need an audience for their play. Are they really better off with hovering parents, or are we creating what PT Editor at Large Hara Estroff Marano calls "a nation of wimps"? Is it a coincidence that this generation of children, who have had to do almost nothing on their own, are returning home from college incapable of earning a living? Instead of blaming the economy, perhaps we adults should blame ourselves. Our overprotected children are like domesticated animals, incapable of surviving in the wild.To survive happily as couples, we need to put a higher priority on sex and erect boundaries to protect our intimacy. Parents might consider making it a ritual to lock their bedroom door after 10 p.m. so they can sleep naked without fear of exposing their children to the primal scene. The offspring of one longtime happily married couple reports, "In our family we learned that you'd better be bleeding badly before you knocked on our parents' bedroom door on the weekends. We thought it was because they needed their sleep. Only as we got older did it dawn on us, Ohhhh, they needed their sex."
If we require a more child-centered reason to attend to adult needs, consider that a happy marriage is win-win. "The love between the couple is the real cradle that holds the baby," says Julie Gottman. In the Gottmans' studies, couples who made a priority of rituals of romance and didn't focus 100 percent of their attention on the baby were happier—and so were their babies. The infants smiled more, laughed more, played more, cried less, and showed an increased capacity to self-soothe, as measured by their heart rate.
The alternative—depressive marriage—is grim for both adults and children. Children with a depressed parent are, on average, less socially competent, have lower self-esteem, are more likely to have behavioral and academic problems (even lower IQs!), and they are two to five times more likely to develop a psychological disorder.
Nobody tells you what to really expect when you're expecting. But in the 21st century, childbirth, predictably, prompts a mental health and relational crisis. On airplanes, in the event of an emergency, we are instructed to put the oxygen mask on our own faces first, and then on the children. Perhaps we need to do the same with our marriages.

The 2012 Best & Worst Sex List

Alexandra Katehakis and Center for Healthy Sex (CHS) have released their Annual Best/Worst Sex List for 2012. While there were not as many spectacular sexual implosions this year (remember 2011's Charlie Sheen, Dominique Strauss-Kahn, Herman Cain, Schwarzenegger and Weiner,) still there were significant political and social developments that will have healthy sexual implications for years to come.
Why do these stories matter, and why do we care how sexuality affects society? Because eroticism is a fundamental, connective energy that can fulfill all our most heartfelt desires. Relational sex is more than a symbol of whether we play well with others, it's literally how we relate. Most of us lack adequate sexual education, which has become politicized to the point of incompetence. We sexually develop in the shadows. So by exploring our erotic values together we transport this personal, powerful, wholehearted, carnal energy into the light.
At Center for Healthy Sex, we believe that Healthy Sex is consensual sex between adults and yields pleasure and personal growth. Everyone has the right to experience healthy sex free from trauma, abuse, violence, crime, lies, secrets, judgment, shame, guilt and regrets. Sexual rehabilitation begins with stopping problem behaviors and leads to a meaningful life of emotional and sexual intimacy over time.
With that in mind, here are the top stories of 2012, and why they matter. We hope you find these picks provocative and ideally even erotically enlightening for the 10 best sex stories, the 10 worst sex stories, and 5 honorable mentions for good measure!
THE BEST
1. Obama Wins the 2012 Election
It was a long and contentious election, but in the end the critical mass of voters' conscience tipped toward social progress preventing a major rollback of civil (sexual) rights. The Republican party profess support for less government except when it comes to definitions of rape, LGBT rights, reproductive rights and sexual healthcare - all which they'd seek to legislatively limit or deny with assuredly devastating consequences. Instead, 2012 ushered in four more years of progressive sexuality during which there will likely be all-important Supreme Court vacancies to fill that are sure to have an impact on sexual freedoms. In related news, the 2012 election gave us 20 female U.S. senators in 2013, the highest number ever. Wisconsin's Tammy Baldwin became the first openly gay person elected to the U.S. Senate. Gay rights legislation prevailed at the polls (more on that next.)
Why this matters: Perhaps an unexpected pick for best sex of the year, but the revelations and ensuing results of this election cycle caused the single greatest contribution to healthy sex for the entire world to contemplate this year. You don't see many therapists (like my colleagues and myself) sounding off on politics. We accept and honor multiple points of view to treat people of all beliefs and faiths. The two political parties in our country are increasingly polarized, and when one of those parties clearly attempts to oppress the sexual health of its people, we need to speak up.
2. U.S. President Supports Marriage Equality
Unless you were living under a rock, you have to know 2012 was a banner year for gay marriage. For the first time, a sitting president came out in support of marriage equality as Democratic leaders voted to include a gay marriage plank in the national convention's party platform, another first. Also Homeland Security set new deportation guidelines defining same-sex couples as families; voters supported marriage equality bills in Maine, Maryland, Minnesota and Washington; and DOMA was ruled unconstitutional by a federal appeals court. The Supreme Court announced the decision to weigh in on that ruling along with the constitutionality of Prop 8 in 2013. Barney Frank became the first sitting congressman in a same-sex marriage, the DADT repeal occasioned the first gay civil union ceremony on a military base, the White House hosted multiple same-sex marriage proposals, X-Men comic book characters got gay married, and Jet magazine featured their first same-sex couple. Wow, what a year!

Why this matters: The more our society moves toward acceptance of homosexuality and the less acceptable it becomes to marginalize homosexuality, the greater the opportunity for all relationships to develop a more authentic and healthy sexuality beyond social programming. Marriage equality is more than a civil right, it's an acceptance of reality. People really are homosexual. The righteousness of homosexual orientation and expression is as real whether by birth or choice (but we say "born that way.") People have many different beliefs, gods, principles, and values. Mature relational development requires accepting others for who they are, as well as for what they believe, without trying to force ideological values through harmful, prejudicial rules unfairly applied.
3. California Voters Ban Ex-Gay Therapy
California voters became the first in the nation to block caretakers from forcing minors into reparative therapy, the harmful treatments that sometimes include shock therapy in attempts to change the sexual orientation of LGBT children. In a widely contested move, California also voted to mandate condom use in porno shoots in an effort to curb the spread of HIV and STDs for both performers and viewers. Although both votes likely will be revisited by the courts, the results were historic. In another first, the California state assembly passed a bill to allow the recognition of multiple parents per child to accommodate unique family structures, which was vetoed by the governor who objected to possible implications due to poor wording and insufficient foresight.
Why this matters: There's a saying that as goes California, so goes the nation. These bills have many legal hurdles ahead of them, but the ripples they send across the country and even around the globe will surely inspire some interesting legislation to confront challenging sexual health issues in years to come. Reparative therapy in particular has never been less popular. The World Health Organization released a report this year calling reparative therapy "a serious threat to the health and well-being - even the lives - of affected people." We've known for too long that the lives of LGBT teens are at great risk, as they face bullies in their schools, neighborhoods, and community leaders. With legislation like this, California stands up to the bullies.
4. First Transgender Testimony Before Senate Committee
In June, the first openly transgender person was invited to testify before a Senate committee. Kylar Broadus, founder of the Trans People of Color Coalition, testified in support of the Employment Non-Discrimination Act (ENDA) seeking to end workplace discrimination on the basis of sexual orientation and gender identity. Gender identity protections were added to ENDA in 2007, which has been introduced in every Congress but one since 1994, but has yet to pass both the House and Senate. In related news, the U.S. Equal Employment Opportunity Commission ruled to protect transgender employees from discrimination. The APA removed Gender Identity Disorder as a mental illness diagnosis, now redefined as Gender Dysphoria, or stress attending gender identity. There were also many visible transgender personalities this year, including Matrix director Lana Wachowski who received Human Rights Campaign's Visibility Award, and beauty contestant Jenna Talackova who, after a controversial disqualification, was allowed to compete for Miss Universe.
Why this matters: Gender identity issues affect everyone from the moment we're born until our last breath. Gender expectations, good and bad, play a huge role in childhood development and adult psychological health. Many children now enjoy greater freedoms to explore and experience life beyond assigned roles thanks to progressive parents and educators; and today, transgender children have more resources and support than ever. Transgender rights are human rights, and we all personally and publicly benefit from honoring and defending the diversity of gender identity and expression.

5. Health: FDA Approves Home HIV Test
In July, the FDA approved the OraQuick In-Home HIV Test, and in October the $40 tests were available in convenience stores and online for over-the-counter purchase. OraQuick is the first rapid home HIV test - results appear in 10 minutes. The test includes a 24-hour help line and resources for dealing with a positive result. In other health news, a nasal spray to increase sexual arousal for women called the "Female Viagra" started clinical trials. The drug is called Tefina and its intended to treat Female Orgasmic Disorder (FOD.)
Why this matters: Approximately 50,000 people become infected with HIV each year, and one in five living with HIV is unaware of their infection. Like home pregnancy tests, a home HIV test will make it easier for people to privately manage their sexual health. Already there are reports of people asking partners to take these tests before becoming sexually intimate. Female sexual dysfunction also affects many women; it's estimated up to 43 percent of women suffer from some form of sexual dysfunction. These two advances are game-changers in the field of sexual health.
6. Rep. Gwen Moore Reveals Rape in House Speech
Before Republicans blocked the reauthorization of the Violence Against Women Act, Wisconsin Congresswoman Gwen Moore courageously revealed her history of being sexual assaulted as a child and raped as a young woman in a powerfully moving speech. Multiple campaigns this year raised awareness of rape including the gay/straight-themed "Men Can Stop Rape" campaign in January, the "Real Men Get Raped" campaign on London billboards in February, and the "We Believe You" campaign in March. As the year went on, there was a groundswell of public outrage over multiple unthinkable comments from Republicans like Todd "Legitimate Rape" Akin, Richard "Rape Pregnancy is a Gift from God" Mourdock, and Roger "Some Girls Rape Easy" Rivard; who, with other key "Rape-ublicans" referred to as "Team Rape," lost almost all their elections and may even have swayed the public against their party in the general election.
Why this matters: Sexual assault affects men and women of all sexualities, but still too often the victim is blamed, and the tragedy of male rape is denied. There is far too much sexual violence around the world, such as the India gang rape victim who died this week, and for any public official to politicize the issue by parsing definitions only contributes further to global resignation toward rape. Language affect Laws affect Lives. When brave people like Gwen Moore speak up about the reality of rape, or whenever real people share their personal stories of rape, it mobilizes citizens to reflect, to defend, and to act.
7. Coming Out: Orlando Cruz First Openly Gay Professional Boxer
The coming out stories keep on coming. Orlando Cruz, currently ranked as the 4th top featherweight in the world, became the first openly gay professional boxer when he came out in October. Athletes in particular had a revelatory year as former NFL player Wade Davis came out in June, and an unprecedented 23 openly gay athletes competed in the summer Olympics. LGBT allies like Minnesota Vikings punter Chris Kluwe memorably came out in support of gay marriage, and many professional sports teams joined the "It Gets Better" anti-bullying project including the San Francisco 49ers, the Pittsburgh Pirates and the Oakland A's. Other momentous coming out stories included newsman Anderson Cooper, actor Matt Bomer, chef Anne Burrell, and musician Frank Ocean who made waves as the first mainstream hip-hop artist out of the closet.
Why this matters: Quite simply, the more out and about LGBTQA personalities, the better it gets. As prominent people become empowered to stop hiding and live authentic lives in the public eye, others are empowered to join the party. Assumptions are reassessed. Stereotypes are shattered. The rapidly increasing public support for LGBT issues doesn't happen in a vacuum - it's on the backs of these courageous personalities who risk everything for truth and honor. There really needs to develop some kind of celebratory event or commemorative medal for coming out, because it always marks such a hard-won, transformational inner process. You have to wonder what fields are still left to have their first gay outings in 2013?
8. Science & Technology: Embryos Created from Two Women, One Man
This year, American scientists successfully created embryos from two women and one man for the first time. While so-called "designer babies" are as yet an impossibility, the advance of a three-way embryo finally promises a cure for certain genetic conditions, pending a complete study of potential side effects. Other interesting sex-tech advances include computerized vibrators for long-distance lovers called LovePalz, which give a whole new meaning to the term "hooking up." The vibrators come in pairs for straight, gay or lesbian mutual masturbation action -- synchronized over an Internet connection so the device mirrors your partner's actual movement. Also TrueCompanion apparently released Rocky the sex robot this year, a male counterpart to Roxxxy who was released in 2010. Rocky costs around $1500 (an extra $100 for pubic hair) and is programmed to provide indiscriminating men or women with cold, synthetic pleasure.

Why this matters: Innovation often precedes generational trends in sexual health. Science and technology find discoveries in the grey areas beyond the black and white thinking of fundamental morality, and function like sex therapy in this regard. If a person is attracted to a unique style of consensual sex, there is almost always someone willing to fulfill that need. Similarly as there is a demand for healthy embryos, or long-distance vibrators, or sex robots, then there are scientists and developers willing to fulfill these needs. Regardless of the number of people who might object to such innovation on moral grounds, it only takes one inventor to change the course of history.
9. Legal Issues: Court Settlement for Gay Sex Addict
A married father of two was awarded $255,824 in compensation after a prescribed drug turned him into a compulsive "gay sex and gambling addict." In his claim against a British pharmaceutical company, Didier Jambart of France revealed he started taking Requip to treat Parkinson's disease and within two years had developed an "uncontrollable passion" for gay sex and gambling. During this period, he attempted suicide eight times. When he discovered a website that linked the drug with hypersexuality, he stopped the medication and apparently this stopped his uncharacteristic compulsions. In other legal news, former Penn State assistant football coach Jerry Sandusky was sentenced to at least 30 years for child sex abuse. While sexual assault charges were dropped against Dominique Strauss-Kahn last year, this year he came under investigation for "aggravated pimping" and alleged involvement in a prostitution ring.
Why this matters: More and more, the terminology of sex addiction is gaining legitimacy in the courtroom. For a court to recognize gay sex addiction as a potential side effect of a medication has certain ramifications and raises many questions. To what degree does brain chemistry account for behavior? Under what circumstances might a person be absolved for their behavior? This is a core argument with sex addiction -- such as, is a sex addict responsible for sexual acting out? In treatment, the answer is usually yes, any addict must take responsibility for their behavior, and also yes, they are powerless over the addiction that drives that behavior, and require medical, therapeutic, or 12-Step intervention to recover. What do you think drives sexually compulsive behavior, what's the difference between a sex addict and a sex offender, and is any of this treatable?
10: Media: The Sessions, The New Normal, 50 Shades of Grey
Sex in the media is nothing new, but there were several important works that explored sexual issues, advanced sexual freedoms, and stimulated sexual frenzy this year. In film, The Sessions showed us naked therapy sessions between a paraplegic and a sex surrogate, drawn from a moving real life story. In television, The New Normal broke new ground for prime-time broadcast TV with a gay couple at the forefront who invite the surrogate mother of their child and her family into their home. And in books, 50 Shades of Grey presented explicit BDSM erotica between a student and a wealthy entrepreneur, while setting the record as the fastest-selling paperback of all time.
Why this matters: Many decry sex in the media as the cause of loose morals but truthfully, many people rely on entertainment as their primary source of sexual education. How else would most people learn about sex surrogacy, or show people that anyone and everyone is deserving and capable of sexual intimacy and expression as in The Sessions? We've referred clients to sex surrogates here in Los Angeles, and while the therapeutic process is more involved than presented in the film, still the scenes of careful sexual exploration captured glimpses of the healing process, albeit in Hollywood style. And where else might Middle America watch two attractive daddies kiss and cuddle in bed reciting dialogue at turns cutting, clichéd, eye-rolling, or hilarious - just like their straight counterparts - but on The New Normal? LGBT characters are steadily becoming more visible and familiar, and two male leads in bed might be the final frontier. Finally sales don't lie - many, many people are sexually curious and titillated by erotic exploration as evidenced by the popularity of 50 Shades of Grey, irrespective of the writing quality. Apparently rope sales, as well as libidos, were on the rise this year.
THE WORST
1. Resistant Strain of Gonorrhea
The World Health Organization (WHO) and the Center for Disease Control (CDC) announced early this summer that gonorrhea outside the U.S. had become resistant to all but one class of antibiotics, raising concerns of potential mutation into an untreatable "superbug." Gonorrhea is the second most commonly reported infectious disease in the U.S., infecting an estimated 700,000 Americans a year and 106 million people worldwide.
Why this matters: Could this become the epidemic of the 21st century? Men and women infected with gonorrhea often show no symptoms, and are unaware of transmitting the disease. If left untreated, gonorrhea can cause infertility and infections that spread to other areas of the body, including the brain and heart. Gonorrhea increases susceptibility to HIV infection. People can protect themselves by being monogamous and practicing safe sex using condoms for vaginal and anal intercourse, as well as for oral intercourse (the first known case of this superbug involved pharyngeal or throat gonorrhea.) If you haven't got the memo by now, condoms aren't just a precaution against pregnancy and HIV. By absolute necessity, safe sex and the awareness of personal and partner sexual health must be a way of life.

2. Boy Scouts Child Sex Abuse Scandal
The Oregon Supreme Court ordered the release of 20 years worth of secret documents kept by the Boy Scouts of America, known internally as the "perversion files." 14,5000 pages of records were opened in October revealing a widespread, systematic effort by organization officials to cover up allegations of child sexual abuse against 1,800 scout leaders. Records show that about one third of the sexual abuse cases weren't ever reported to local law enforcement. While most of the reported offenders were barred from the Boy Scouts, there were still many pedophiles to continue in their position at the request of community leaders or Scout officials. Tellingly, there's scant information about any care shown toward children molested, the primary focus in the files concerns saving the face of the Boy Scouts of America.
Why this matters: This was the year the Boy Scouts reaffirmed their gay ban blocking "open and avowed homosexuals" from membership, leadership, or employment. 300 Eagle Scouts returned their badges in protest. It seems the Boy Scouts ban doesn't apply to their secret pedophiles and enablers. First the Catholic Church, then Penn State, now the Boy Scouts. There's an increasingly evident correlation when the leaders who perpetuate institutional homophobia are the same leaders covering up sex crimes. This brings to mind the gay bully trying to ward off his own homosexual tendencies with every outward attack, but on a massive scale. It's a societal sickness, the terrible consequences from denying the integrity and inclusion of LGBT sexuality.
3. Binders Full of Women
Mitt Romney made waves when he referred to "binders of women" describing his efforts to find qualified women for posts. In another year, the casual remark may have slipped unnoticed but too many sexist cases had amassed. The Komen controversy set the tone as the world's largest breast cancer charity announced in January it would no longer fund breast cancer screenings by Planned Parenthood. Pundits and public opinion asserted Komen had bowed to political pressure in the so-called "war on women," with Planned Parenthood a key target. Komen reversed course purging many top staff, but not before permanently damaging their mission and reputation. In related news, Wisconsin governor Scott Walker repealed his state's Equal Pay Enforcement Act and signed into law a bill forcing doctors to meet three times with patients before prescribing the medical abortion pill or be subject to felony charges. Congress voted on the Blunt amendment to allow exemptions for employers to refuse contraception coverage for their female employees. The amendment was defeated, but not before Republican Congressman Darrell Issa convened a memorably stacked all-male panel to discuss female sexual health coverage, disallowing the inclusion of the sole proposed female, Sandra Fluke, a law student whom Rush Limbaugh infamously called a "slut" and "prostitute." In 2012, fierce opposition by conservative Republicans contributed to Congress' failure to renew the Violence Against Women Act of 1994.
Why this matters: We look around the world and witness so much violence against women. One in four women has experienced domestic violence in her lifetime. The human race isn't made up of men and women, we're a people. Most of us wouldn't define ourselves by genitals or chromosomes, so why the war on women? The trauma of misogyny is an inherited and inbred trait, and who knows if it first emerges from within the individual or from without via the culture. Relational dysfunction affects us all as individuals, and it's no wonder our personal relationships often lack balance and reciprocity when our leaders can be so divisive and punishing in their legislative tactics and power plays.
4. APA Rejects Hypersexual Disorder
Hypersexual Disorder was rejected this year by the American Psychiatric Association (APA) for their "bible" of mental health, the fifth version of the Diagnostic and Statistical Manual (DSM-5). The deciding board cited the inability to make uniform assessments, while critics of Hypersexual Disorder have falsely accused supporters of creating a fake condition for profit or to enforce sex-negative morality. It's hard to know what role the fierce politics played in the APA's decision, but the lack of diagnostic inclusion will have ramifications for decades. The APA is no stranger to flawed decisions -- in fact, homosexuality was listed as a mental disorder as late as 1974 when it was controversially modified to "ego dystonic homosexuality" or unwanted homosexual arousal until 1986 when the diagnosis was removed entirely. "Shell Shock," known today as PTSD, was dismissed as cowardice in 1915 and took 65 years to gain legitimacy in the DSM-3.
Why this matters: The exclusion of Hypersexual Disorder or any comparable diagnosis in the DSM-5 not only prevents insurance coverage to treat sexually compulsive behavior, but also crucial funding for further research leaving therapists without tools for improved assessments. In stark contrast, sex addiction continues to proliferate due to ever-evolving technological accessibility, while the psychological health of our culture has also evolved so that sexually addicted behaviors are no longer as emotionally tolerable to addicts and partners as times past, irrespective of morality. Certified Sex Addiction Therapy (CSAT) or Advanced Training in Problematic Sexual Behavior (ATPSB) are specialized fields, and all bona-fide sex addiction therapists could have lucrative careers at the identical pay rate as non-sex addiction therapists (as their detractors often do.) A sex addiction therapist continues to pay for education, even after certification. Unlike other therapies, sex addiction treatment is typically short term or else it's not working. The idea that financial opportunism or moralistic ideology created the field of sex addiction flies in the face of the real state of affairs, and ignores the devastating effects on those who are most suffering.
5. John Travolta Sued for Sexual Assault
Several men filed lawsuits against actor John Travolta alleging sexual assault and similar crimes. In May, separate lawsuits were filed by a masseur in Beverly Hills and a masseur in Atlanta claiming in explicit detail how he exposed himself and inappropriately touched them. According to one claim, Travolta had been banned from a Los Angeles spa for similar behavior. Both men dropped their lawsuits later that month. In June, a third man filed an assault-and-battery claim against the actor for a 2009 alleged incident on a cruise ship where Travolta purportedly dropped his bathrobe, propositioned the man, and rubbed up against him. A masseur in New York and a gym employee made similar claims to the press. And in December, his former personal pilot filed a lawsuit claiming he was threatened by John Travolta's representatives after disclosing details in August of an alleged 6-year romantic relationship with the actor. Travolta's attorney dismissed every single one of these claims as opportunistic attempts "to get 15 minutes of fame."
Why this matters: Who can know the truth behind closed doors in Hollywood? Exhibitionism is certainly not a victimless crime. Sex addiction is a progressive disease, which many times involves greater and greater risk-taking that may bring shame and ruin on the individual and their family. People in power too often use sexuality as a form of intimidation, perhaps as an unconscious method to process their own feelings of debilitation. The all-too-common desperation of almost getting caught and covering up sexual compulsion prevents recovery for a very treatable condition, and can even become a ritualized aspect of the addictive cycle.
6. Woman Suffering from 100 Orgasms per day Commits Suicide
Tragically the day after the Tampa Bay Times published Gretchen Molannen's personal account of living with Persistent Genital Arousal Disorder (PGAD), she committed suicide. Multiple stories broke this year about women who suffer from PGAD, which can result in hundreds of orgasms each day caused by the slightest friction. In August, Kim Ramsey from New Jersey spoke out to The Sun about her condition. The documentary 100 Orgasms a Day aired in the UK in September, featuring Rachel from Atlanta who revealed at times experiencing orgasms every 30 seconds for up to eight hours.

Why this matters: Thousands of women are estimated to suffer from this condition, an offshoot of Vulvodynia or chronic pelvic pain. Chronic sexual pain affects men and women of all sexualities and backgrounds. Like many sexual afflictions, PGAD is not recognized currently as an official condition by the medical community, but should be included in the DSM-5 (see above.) Any sexual dysfunction, disorder or condition has real physical or psychological causes that can be treatable but many people lack comprehensive healthcare or are too fearful, embarrassed, or repressed to seek out professional help, and so suffer the sometimes uncomfortable, sometimes heartbreaking, sometimes deadly consequences.
7. Germany's Animal Brothels Prompt Bestiality Laws
In December, Germany's lower court passed a ban on bestiality - making sex with animals, the "pimping" of animals, or training animals for sex with humans a punishable crime with a $31,000 fine. Why would this even be necessary? Apparently since the Animal Welfare Act of 1969, bestiality laws have been off the books and recently so-called "erotic zoos" or "animal brothels" have been setting up shop where "people can visit to abuse animals ranging from llamas to goats" according to The Daily Telegraph. A bestiality group called Zoophile Engagement for Tolerance and Information (ZETA) announced plans to mount a legal challenge. According to the group Veterinarians Against Zoophilia, thousands of Germans exchange information online about sex with animals.
Why this matters: People who have sex with animals are psychologically disturbed individuals. Typically attachment disorders or relational trauma are involved, the arousal template may involve replaying the emotions of traumatic events at crucial stages in sexual development. Like pedophilia, bestiality (or "zoophilia") is always non-consensual because a child or an animal does not have the comprehension, capacity, or foresight to make informed choices involving sexual activity. That various conservatives compare homosexuality to pedophilia or bestiality indicates they do not have a moral or legal concept of a "consensual relationship," which must be somewhat unsettling on some level for their companions.
8. Political Sex Scandals: Hypocrisy of a Pro-Life Congressman
In political sex scandals, Tennessee Republican Congressman Scott DesJarlais was re-elected this year on a pro-life and "traditional marriage" platform, despite a woman's claims that he pressured her into having an abortion as the result of an extramarital affair. The week after his victory, a judge ordered the release of his divorce transcript revealing the fact that he had multiple affairs with patients and co-workers at his medical practice, as well, he supported his wife to have two abortions. In a recent radio interview, DesJarlais disclosed that "God has forgiven me." This was the year of the Secret Service scandal involving prostitutes in Colombia, multiple sex scandals in China, and the Jimmy Savile scandal in the UK involving a vast conspiracy from government officials (allegedly including a former prime minister) to BBC network execs who covered up possibly hundreds of cases of child sexual abuse committed by the popular children's entertainer who died in 2011. The Petreaus scandal, which dominated the airwaves in November and effected the resignation of the CIA director after the revelation of an extra-marital affair, seemed tame by comparison.
Why this matters: There are always political sex scandals. These sex scandals too often involve conservative politicians acting against professed values, sometimes directly counter to their political platform. For whatever reason, it seems liberal politicians are forced from office, while conservative politicians find "forgiveness from God" and continue to enforce policies that belie their increasingly hypocritical positions. Hypocrisy is a societal affliction that begins as a familial complex. When caretakers practice double standards ("do as I say not as I do") this creates confusion and resentment in children, who often struggle to reconcile the rules with the reality. In extreme case, these children will grow up to either perpetrate or tolerate extreme acts of hypocrisy.
9. Smalltown Scandals: Gay Deportation Threats in Arizona
In small-town sex scandals, Paul Babue is the conservative, anti-immigrant Republican Sheriff of Pinal County, Arizona. He's the youngest sheriff in Arizona, and last year was named the National Sheriff of the Year by the National Sheriff's Association. In 2011, he formed an exploratory committee to run for Congress, but those plans were dashed when his undocumented Mexican immigrant boyfriend of ten years publicly outed him during a bad breakup, accusing Babeu of threatening him with deportation. This November, he was re-elected Sheriff for a second term. In another small-town scandal, the City Commissioner of Boynton Beach, Florida, a Democrat named Marlene Ross, resigned from office when an investigation became public after she alleged a lobbyist had blackmailed her to change her votes or he'd reveal her sexual relationship with a first cousin, a convicted felon.
Why this matters: The issues that play out in small towns are the same issues that plague the national stage. Most of us will never know what it's like to be embroiled in public controversy, but we all have work to do around defining and living up to our true values. There's a common saying in recovery that "if you spot it, you got it." From the outside, these stories seem so unthinkably corrupt, almost clichéd. A leading anti-immigration sheriff is having a gay affair with an undocumented immigrant? Wha- ? Rather than pointing fingers, these examples are opportunities to recognize the way we all play by different rules and make exceptions that may compromise our professed values in order to get what we want. Personal sexual health doesn't involve wagging fingers to shame others. The more we identify with others in thoughtful empathy, the more we will heal what's blocked in our own sexual energy.

10. Sex Expert's Son Arrested for Public Indecency
William H. Masters III, the son of famous sex researcher Dr. William H. Masters of Masters & Johnson, in May was arrested for masturbating in Central Park, and again for indecent exposure in September. His neighbors described him as a "warm, sensitive, compassionate person." In similar news, Jason Russell of Invisible Children and KONY 2012 was arrested for public indecency in March, actor Fred Willard was arrested for masturbating in an adult theater in July, and actor Nick Stahl was arrested for investigation of lewd conduct in a private booth at a porno store this past week. Less-prominent cases included a man arrested for breaking and entering in order to masturbate to online porn, a woman arrested for masturbating at a Starbucks, and a man arrested after caught hiding beneath a trailer for a week masturbating while secretly videotaping a mother and her children as they undressed. Of course, there are many stories of this nature every year.
Why this matters: These sexual perpetrators include well-known, well-liked personalities -- the son of one of the top sex experts in history! If convicted, most crimes of this nature require registering as a sex offender for life. Why do these people risk their livelihood, families and reputations for sexual gratification, and not exactly erotic-sounding sexual gratification at that? How do we help anyone recover from clear signs of sexual addiction, when there is so much denial that it even exists?
HONORABLE MENTION
1. Genital Feast
In April, Mao Sugiyama auctioned off his severed genitals, which he cooked and served at a banquet for $250 a plate in Tokyo. A self-described "asexual," Sugiyama underwent elective genital-removal surgery in March and kept the body parts on ice. He announced the auction in a tweet: "... I am offering my male genitals (full penis, testes, scrotum) as a meal for 100,000 yen ...Will prepare and cook as the buyer requests, at his chosen location." Although Sugiyama carefully followed all laws, there was even a licensed food preparer in the kitchen, he has been charged by authorities with indecent exposure.
Why this matters: Many people identify as asexual or agender (respectively the lack of sexual interest/orientation or gender identity.) Although perfectly valid, this is not a sexual realm that is easily understood, and it's possible this feast of amputated sex organs plays into a certain shock and horror about the sexuality. Sugiyama has referred to his event as a performance intended to raise awareness about "sexual minorities, x-gender, asexual people." But many people might not see past the cannibalism.
2. Sexual Worth
A Hong Kong tycoon offered $65 million to the man who could successfully woo and marry his daughter. Sounds almost like a common fairy tale plot, right? Except that his daughter, a lesbian, already eloped with her wife to France this year. In a similar story of financial exploitation, a documentary filmmaker paid over $20,000 to two young adults to auction off their virginity online. The first, a Brazilian 20-year-old woman, sold her viriginity for $780,000, while her 23-year-old male counterpart from Russia sold his virginity for $3000.
Why this matters: To objectify and sexualize people, particularly women or young adults, cannot help but result in relational disconnection. Although Gigi Chao, the lesbian bride, publicly supported her father's actions referring to them as "sweet," the outdated offer of a marriage dowry comes with complications, especially as a manipulative attempt to change a daughter's sexual orientation. Marriage bounties are a widespread problem in many countries where women have little rights or recourse. The dream of amassing money in exchange for something as simple as sex, love or marriage reveals how little value sex, love or marriage have to offer many people whose early models may have thwarted worthy ideals.
3. CreepShots
So there are people who post so-called "creepshots" to the Internet as a hobby. They take voyeurisitic photos, mostly of women unaware. There was a forum on Reddit called CreepShots devoted to images of women uploaded without their knowledge or consent. Reddit has banned CreepShots and similar subReddits called CreepyShots and CreepSquad. On Tumblr, a blog called Predditors was created that started posting personal information about CreepShot contributors. As a result, a financial services employee was fired from his job within 24 hours after being exposed as a CreepShot troll. A teacher was fired from his job for posting CreepShots of his underage students.
Why this matters: According to the FBI, voyeurs are likely to demonstrate some characteristics that are common among serious sexual offenders. Certain voyeuristic fantasies, urges and behaviors are listed in the Diagnostic and Statistical Manual of Mental Disorders as a paraphilia. Like exhibitionism, voyeurism isn't a victimless crime. In the U.S., voyeurism laws are related to invasion of privacy laws, but can be difficult to prosecute. Video voyeurism, secretly filming sexual acts or nudity with a hidden camera, is an offense in nine states and may require the convicted person to register as a sex offender. It's possible a correlation exists between the availability of hardcore online porn and the increase in voyeuristic activities that objectify women.
4. Notable Breakups
Hollywood couples who called it splitsville in 2012 included Kristen Stewart and Robert Pattinson, Rhea Perlman and Danny DeVito, Will Arnett and Amy Poehler, Heidi Klum and Seal, Katy Perry and Russel Brand, and Glee's fictional gay couple Klaine, which sent tweens spinning.
Why this matters: Relationships are challenging. They require work, attention, and care. But all the right action in the world is no guarantee for matrimonial bliss. Of these notable breakups, the reaction of Twilight star Kristen Stewart was most remarkable. US Weekly photographed the 26-year-old actress in a secret rendezvous with a 41-year-old married man, her Snow White and the Huntsman director. Within hours Steward issued a public apology confessing to the affair, causing a predictable media frenzy. According to current statistics, 60 percent of men and 40 percent of women become involved in extra marital affairs. Healthy intimacy requires transparency. In this age of denial patterns playing out with every scandal, it's a little surprising to witness anyone on the public stage accept responsibility for their actions.
5. Public Nudity
The so-called "Buff Stop" park in the Castro District of San Francisco started attracting public nudity activists soon after its creation in 2010, becoming the first non-beach, urban clothing optional park in America. As a result of increased complaints, the city's Board of Supervisors voted for a city-wide public nudity ban (prompting a "nude-in" as demonstrators stripped in the board chambers at City Hall.) The mayor is expected to sign the ordinance, which doesn't apply to street fairs, parades or other permitted public events. In somewhat related news, grainy snaps surfaced of a naked Prince Harry playing strip billiards in Las Vegas, soon followed by topless photos of Kate Middleton sunbathing at a French chateau. Royal controversies ensued.
Why this matters: Nudity is a most basic attribute. We love our bodies, we hate our bodies. We adorn, expose, bind, flaunt, and hide our naked bodies. It might seem impossible to separate nudity with sexuality, but they are different aspects of our humanity worth exploring. It's true, the immature attitude toward nudity in our culture is easily evidenced. And it's understandable not everyone wants to share a subway seat with a sweaty ass. What's your own nude 'tude?

 
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Dr. Oz, Orgasms, and Health

Somehow I wound up in a dispute with Dr. Oz. And about orgasms and health, of all things. So, this needs clarification.
Dr. Mehmet Oz, in case you do not know, is a sometime surgeon and a media empire, with a TV show, a radio show, best-selling books, and much more. His shows are criticized by some as being sensational and going beyond the evidence, but I think it is a good idea to bring a focus on health and well-being to a mass market. Let’s face it, his viewers would not be reading The New England Journal of Medicine if the Oz shows went off the airwaves.
One of the Dr. Oz recommendations that has drawn a lot of attention is to have plenty of orgasms to stay healthy. I was drawn into talking about this issue because of a finding on this matter in our research on The Longevity Project.  In our work on the Longevity Project, we have been studying over 1,500 bright American men and women who were first examined as children in the 1920s. They were followed for their whole lives, and we have evaluated how well they aged and how long they lived. We ask: who lives long, healthy, and thriving lives, and why? Many of the participants do indeed live very long, happy, healthy lives. One really intriguing finding concerns the women’s frequency of orgasm during sex.
“Patricia” was so sensible and conscientious throughout her life that we nicknamed her Prudent Pat. In 1941, Patricia and the others answered questions about their sex lives. Patricia was prudent but not prudish. When asked, “How well mated are you and your husband, from the strictly sexual point of view?” Patricia’s response was that she was extremely well-mated. She and the other women also reported frequency of orgasm during intercourse, on a scale from “never” to “always.” The average was above the midpoint, revealing a generally good but not outstanding sexual satisfaction. But Patricia was again near the top.

The answers allowed us to create a predictor measuring what the originator of the study, Dr. Terman, called orgasm adequacy. We also spent many years tracking down and gathering the death certificates of the participants, so we would know exactly how long each one lived. Finally, we looked to see if sexual satisfaction would be related to a longer life, even after taking the women’s personalities into account. The startling result was very clear: Women who had a higher frequency of achieving orgasm during intercourse tended to live longer than their less fulfilled peers.
Many women (and men) wish we knew precisely why. The limited sexual information available from several other studies does also suggest an association between sexual activity and health, in both men and women, but the links are hazy. This is not really so surprising when one imagines trying to do a controlled study in which half of the people are randomly assigned to have more sex (or better sex). Not possible. Nevertheless, although it is true that correlation does not mean causation, it is dumb to ignore sets of correlations, that is, pieces of the puzzle, that bear on this issue.

Here’s what we do know. Sexual satisfaction tends to play a role in a happier marriage, and happier marriages play a role in greater sexual satisfaction. And we know that people in stable, fulfilling marriages tend to be healthier and live longer. Further, good health allows more sexual activity, and good sexual activity encourages many people in satisfying relationships to stay in shape and maintain their health. What is causing what? We won’t know until the completion of many other long-term studies of intimacy, personality, behavior, and health. At the moment, we can simply say that a sexually satisfying and happy marriage is one of the good predictors of future health and long life.
In our book on The Longevity Project, Dr. Leslie Martin and I advise readers to “throw away your lists.” This means that there is no single element that is a key to happiness, thriving, health, and long life. There are clusters of behaviors and healthy life patterns that are markers of thriving for most people. There are likely underlying biological predispositions in common toward good health, intimacy, and sexual activity, and also feedback loops toward better biological homeostasis. But there are also many, many bacteria and viruses that are easily transmitted through sexual intimacy and cause diseases ranging from herpes and hepatitis to syphilis and AIDS. And there are also numerous well-documented destructive psychosexual disorders, including hypersexuality (sexual addition).
So, getting back to Dr. Oz, I have been recently quoted in the news as taking issue with Oz’s recommendations to have lots of sex to stay young. But that is not really my gripe at all. Rather, the results of our years of research on well-being and health clearly document that it is your long-term patterns of health behaviors, activities, and social relations that matter most. We do not recommend obsessing about whether this week has brought you a cup of blueberries, two servings of fish, 8.5 hours of daily sleep, 10,000 steps, two hours of yoga, and the Oz-recommended number of orgasms.
 If you are interested, The Longevity Project, which explains the long-term pathways to thriving, was published in paperback edition by Plume (see http://www.howardsfriedman.com/longevityproject/ ) and is also available on Kindle and Nook. The book also contains self-assessment quizzes to help you figure your current trajectory.
Photo of Dr. Oz at the Time 100 Gala by David Shankbone; creative commons licenses-2.0), via Wikimedia Commons
Copyright © 2014 Howard S. Friedman, all rights reserved.

Men Fake Orgasms, Too

Over the past 40 years, many surveys have asked women if they've ever faked an orgasm, and consistently, half to two-thirds (53 percent to 65 percent) have said yes they have at least once.
But men faking orgasm? That's unheard of. Well, no, not exactly. Many sex therapists offer anecdotal reports, and a 1981 study of 280 college students (185 women and 95 men) showed the familiar rate among women (60 percent)—and faking by 36 percent of the men. But that was the only real study, until recently.
In 2010, researchers at the University of Kansas asked 281 undergraduates (180 men and 101 women) to complete an anonymous sex survey that included questions about faking orgasm. Consistent with previous findings, two-thirds of the women (67 percent) said they'd pretended at least once—and 28 percent of the men said the same.
While not a nationally representative sample, the participants included a reasonable demographic cross-section of college students: largely white, but some Asian, Hispanic, and African-American, and largely heterosexual, but some gay/lesbian or bi. Pretenders and non-pretenders reported generally similar sexual experience, but the fakers were more experienced, so they'd had more opportunities to pretend. Fakers were also sexually more adventurous, reporting more masturbation, oral sex, and anal play.
Most faking took place in established relationships (78 percent of the women, 53 percent of the men), but it also occurred among dating couples (2 percent of women, 16 percent of men), friends with benefits (10 percent and 9 percent), and casual hook-ups (10 percent, 16 percent).
No women faked it with men they'd just met, but 7 percent of the men did with new women acquaintances.
Most faking took place during vaginal intercourse (55 percent of the women, 80 percent of the men), but some occurred during oral sex (8 percent, 11 percent), or other unspecified sexual play (37 percent, 8 percent).

Women's pretending was rarely linked to alcohol, but men's was. Two percent of the women had some alcohol before faking orgasm and 6 percent said they were drunk. Meanwhile, 11 percent of the men had been drinking and 24 percent claimed they were drunk.
Faked orgasms typically involved acting—moaning, hip thrusting, and thrashing about in an effort to fool the partner. Young women's acting often tricks young men because guys with limited sexual experience may not recognize the pelvic muscle contractions of real female orgasms.
But men's orgasms produce visible evidence, semen, so how can men fake it? Condoms are often the key. Men thrust and moan, and then deftly discard the condom before the women notice there's nothing in it. But the men who'd pretended didn't always use condoms, so it seems that some college-age women are as clueless about men's orgasms as men can be about women's. As one man recalled about faking it: "She was like, well, did you get off? And I was like, yeah."
Men and women fake orgasms for similar reasons:
Orgasm was taking too long or wasn't going to happen: women, 71 percent; men, 84 percent.
They wanted the sex to end:  61 percent and 82 percent.
They wanted to avoid hurting the partner's feelings: 69 percent and 47 percent.
They felt bored, or tired, or sleepy, or no longer in the mood for sex: 56 percent and 72 percent.
This study confirms the previous research that a majority of women have faked orgasm at least once, and it corroborates the one previous study that men also fake it. Based on these two studies, it seems somewhere between one-quarter and one-third of college-age men have faked it, meaning that men pretend to have orgasms about half as much as women.
Have YOU ever faked orgasm? I'm especially hoping for comments from men. Why? And how did you explain the lack of semen? Or did you? I'm also interested in reports of faking by people older than college age. Is anything about faking different for older lovers?
The study: Muehlenhard, C. and S.K. Shippee. "Men's and Women's Reports of Pretending Orgasm," Journal of Sex Research (2010) 47:552.

How do you define the "best sex ever"?

Ltry to think back on the best, or even worst, sex advice I’ve ever received. I flip through my memories like an overstuffed Rolodex, but each card I pull is blank. There are no names, no numbers, no recollections of anyone ever giving me any advice about sex.
Growing up, I knew sex meant you could get pregnant and that was scary. I knew sex meant you could catch itchy, red, or even deathly diseases, which was also scary. I knew that sex was something people wanted from me and were willing to hurt me to try to get, which was something so far beyond the realm of scary that I did everything I could to be invisible so that it would stop, although it never did. The consequences of being sexual and having sex were the only aspects of sex that were ever brought up to me. No one ever told me pleasure, self-exploration, and orgasms could be outcomes too, and no one ever told me I could give all of these things to myself.
Growing up, sex meant a penis belonging to a man being inserted into a vagina belonging to a woman. Sex was over when the penis was dispensed of the lumpy yellow-gray fluid that lived inside it, like a hand pumping soap in an effort to clean itself, except, as a woman, you were never clean after sex — you were dirty and dispensable.
Sex was what people who loved each other did, and sex was what people who didn’t love each other did behind each other’s backs. Sex was sin, and sex was salvation. Sex was what men wanted, and the ability to give them what they wanted was the only power women had over men. Sex always confused me.
The pink-spined magazines my friends read after school were filled with endless articles about oral techniques and how to act on a first date, but where were the pieces instructing men to kiss our thighs and communicate? Our youths were relegated to summers-long rituals of hair masks and being hungry so that boys would think we were pretty, while our anxieties exclusively centered around how to pleasure their bodies and fulfill their desires, never once thinking that maybe we deserved to feel good too. I cried the first time I touched myself, and all the times after. I thought there must be something horribly perverted about me, something wrong with me, if I could make myself feel so good. I was ashamed of my own pleasure, and although I can identify them now, those feelings still exist within me.

Growing up, sex was exclusively centered around the penis: Gay men had sex, gay women had something akin to arts and crafts. Anyone else doing anything else didn’t exist, except in pornos or in foreplay — which never counted, of course, because that wasn’t sex. It isn’t until recently that I understood that what we were taught has everything to do with the way religion interprets biology. The penis sends its soldiers off to deliverance inside the womb, and without that, babies can’t be made — which, according to the old books, is the only reason to have sex anyway. Any pleasure a woman derives is irrelevant to baby-making — all one really needs is the hole in which to be injected. A man must be pleasured enough to make him explode inside a woman, and that became what sex is.
When I was 21, I fell in love with a woman. I was living out of the country, and couldn’t fathom “losing my virginity” (I’ll tell you right now that this is a made-up concept, and one we’ll eventually unpack) to a woman before I had slept with a man. The week I moved back to the States, I had sex with my high school boyfriend, so that I could finally get “sex” out of the way. While I was, for the first time, truly peeling back and exploring the layers of my identity and desires, I ended up stuck at the misnomered basics.
Even today, I don’t have very much “sex,” and not just for someone whose career has been primarily centered around sex. In the last year, I’ve had a penis in my vagina approximately twice — the most recent a few weeks ago, for which I got a yeast infection right after, like an uncomfortably itchy prize.
Sex, as society defines it, is constructed, just like everything else, and so it can be deconstructed. There are many people who don’t have sex — not because they can’t get laid, but because they don’t have a desire to. There are many people who never involve a penis in their sex, and there are those that involve multiple penises. There are sex scenarios where a partner is tied up, flogged, released — and a penis is never touched. There are ways to explore sexual intimacy and desire without having ever even met another — chat rooms, sexting, or playing out a fantasy in one’s mind.
Does sex equal genitalia, or does sex equal pleasure? And what if you want pain with your sex, or you really don’t want pain, but that’s what you experience when you have sex? What is sex?
In this column, I’m not going to answer questions with tips and tricks on how to find your G-spot, the best tongue techniques, or which positions you have to “master” next, because there endless answers to these questions from all perspectives on the internet — not to mention professional sex workers you can work with — and you don’t need me for that. I’m here to deconstruct all the trash that we were brainwashed with, and dance with you on the edge — whatever that edge is for you, because it’s different for everyone. I’m here to explore with you, ask questions with you, and remind you to look in the mirror and hold yourself accountable to the types of intimacy and relationships you want — and I promise none of these things have to do with how deep you can stick anything down your throat (although it’s also totally cool if that’s what you’re interested in learning).

The best sex ever has nothing at all to do with flexible positions, looking a certain way, or how loudly you moan — good sex has to do with communication, trust and feeling safe to explore. It’s about being able to say what you feel and what you want, knowing that your boundaries will be respected, and being open to going places you’ve never been before because you know you’ll be OK. Amazing sex has to do with everyone involved feeling seen, respected and prioritized.
This space, along with having the best sex ever, is for all genders, all expressions, and all identities, and I will do my best to hold space for anyone that wishes to enter it. Our identities play such a big role in how we move through the world and create connections with others, and we fool ourselves when we ignore them. One person’s fantasy is another’s trigger, and there’s room for all of it to exist next to each other.
My experience is the only true lens through which I can speak honestly, and as we get to know each other, I will continue peeling back the layers that make me who I am. I identify as a woman, although sometimes I feel a lot more like a person. I am Jewish Latinx born to immigrant parents, and I know what it is to have yachts and ski houses, and I know what it is to come home to an empty fridge. I also know that I have Abuela’s couch to crash on should my career in writing about sex not yield any lucrative results, and that is enough privilege to know that I have a lot of it. I’m queer, and it's taken me a long time to wear that word comfortably — it sits like a prickly wool shawl across my shoulders, warm, comforting, and still quite itchy. I’ve been hyperbolically sexualized since I was eleven years old, and it made me disinterested in sex for a long time. I experienced various assaults, a rape, and was molested by an uncle as an adult, an experience that still impacts every space of my life today. My career is mostly a reclamation of power that I felt I had lost, and a way to create something new when I felt destroyed.

I do not know everything, but I am deeply committed to knowing myself. I carry guilt, shame and fear, like we all do, and I know the only way to move through it is to recognize these parts of myself and make a safe space for them to exist. I love myself passionately, and this love is hard work to maintain. I do not know more than you or have all the answers for you, but I can listen and offer my advice if you want it. Ultimately, it is you who will choose what to do with it.
Whether your questions concern your relationship to yourself, or to someone else — or even to multiple partners! — send them to me at Arielle@Salon.com.
It’s lovely to meet you, dear reader, and I do hope to hear from you soon.