Spring 2021 Sexuality Media Recommendations

June 17th, 2021

It’s almost summer, which means I better get a move on if I want to post a list of recommendations for podcasts, books, and videos about sex if I want to do it while it’s still spring. Because I’ve moved to a seasonal-ish schedule, this list is long. But that means there’s plenty to listen to during your commutes, doctor-office-waits, and long walks through the cemetery!

I didn’t read many books about sex, so my recommendations are more general. Similarly, I didn’t watch any standout video content about sex, so I’ve focused on podcasts, instead. However, you’ll definitely find plenty of them listed below!

Read

I’m going to post my review of Erato: Flash Fiction shortly. In the meantime, you don’t want to miss this collection of skillfully written and inclusive erotic shorts.

It’s not about sex but I really loved reading My Favorite Thing Is Monsters for class and can’t wait for the second. Part of the reason the book speaks to me is the way it addresses sexism and sex work. If you like graphic novels that are literature, horror, and unique art, this is a must-read.

Another non-sex recommendation is Susan Cain’s Quiet: The Power of Introverts in a World That Can’t Stop Talking. This book really got me thinking about how my brain works and how I can help–or hinder–it in the process.

Listen

I’ve been wanting to read Ace: What Asexuality Reveals About Desire, Society, and the Meaning of Sex by Angela Chen for a while. In this interview on Out in the Bay, she reads excerpts from her book, offers new ways to understand sexuality, and discusses moving from science journalism to a book inspire by her own sexuality.

I’d never heard of Man Up before I came across this episode about healthy porn habits. The hosts, who are average guys and not necessarily sexperts, feminists, or super “woke,” discuss healthy ways to use porn in such an honest way.

Researcher Justin Lehmiller invited Dr. Michael Moreno on his podcast in an episode about talking to your doctor about sex. It’s such an important issue because sex impacts our physical and mental health. Yet, doctors don’t always receive a lot of sex education or may avoid these subjects. Advice like that in this podcast is important for patients to advocate for themselves.

Although it’s an older episode, Unladylike re-aired How to Free the Vibrator, a discussion with Polly from Unbound Babes. It dives into creating a feminist, friendly sex store that people aren’t ashamed to shop at or talk about. It’s something that I can sometimes–but shouldn’t–take for granted.

If you’re into learning, then you might like This Podcast Will Kill You. The topics span a broad range, so I only tune in now and then. Of course, I couldn’t resist an episode about HPV. In fact, this episode is one of the most educational and straightforward information sources I’ve ever encountered when it comes to HPV. And I’ve been diagnosed with it. Twice.

While I’m not normally into astrology, this discussion between Nicole and Danny Santos on Sluts and Scholars was an interesting listen that made me appreciate its meaning to people a bit more.

Sex educator Jennifer Litner joins Nicole on Sluts and Scholars to discuss how parents can give proper sex education, pleasure’s role in our lives, and desire discrepancies in long-term relationships.

In an honest and casual discussion, Kitty Stryker and Sunny Megatron discuss the definition of manipulation and the various forms it takes, including those that aren’t inherently negative.

If you haven’t heard about all the censorship of sex happening on social media, this American Sex episode will blow your mind.

Anyone who has wanted to try rope bondage but finds it intimidating will love this interview with Midori American Sex. She tackles the issue in such a no-nonsense way that makes it super accessible while showinga how simplicity can still be powerful and creative.

Sunny absolutely smashed it in her breakdown of the history of sex and porn censorship on the Internet. She discusses how it has been an issue for literal decades, long before SESTA/FOSTA, and how stars, creators, and websites have dealt with increasing restrictions. This episode is so ridiculously eye-opening!

Catie Osborn relates how having ADHD impacts her sex life in an episode of American sex that’s just as helpful for those with ADHD as it is their partners.. and potentially everyone else!

I’ve been looking forward to reading Dr. Ina Park’s book about the science and history of STIs since I first heard of it. Her interview with Tristan Taormino only made me want to read it more (I’m sure I’ll eventually write a review about it)!

Academic and feminist Dr. Heather Berg literally wrote the book about porn as work, and she talks all about it with Tristan Taormino.

I love when someone just pulls back the curtain to reveal fuckery that’s been going on under our noses, and that’s precisely what Kaytlin Bailey when she appeared on Sex Out Loud Radio to discuss the history of sex work. I’m looking forward to checking out more of her work!

I hadn’t heard of Richelle Frabotta before stumbling on this podcast from Miami University, but I love her take on sex education so much that I followed her on Twitter, listened to other podcasts, and am seriously considering receiving training through the Sexual Training Institute, at which she is an instructor.

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HPV, Pre-cancerous Cells, and Me

August 8th, 2019

Two and a half months ago, I scheduled an appointment at the reproductive health clinic to have an overdue pap done. I also was excited to get my first HPV vaccine thanks to the CDC’s age limit changes last winter, and I needed a pap, also overdue by half a year. I was worried they wouldn’t let me do it all at once or that it would be overwhelming to do all of that at once but nothing else.

The appointment went as well as it could have save for switching to Kyleena (they no longer keep Mirena in stock), and my cervix being more sensitive than ever before. My first two IUDs were a breeze, but I practically levitated off of the table this time around.

I left feeling accomplished and with instructions to come back in 5 weeks later for IUD check and my second vaccine. I was honestly a little surprised to receive a phone call and already anxious as I listened to my voice mail. People who have gone through paps understand why: no news is good news. The news? My pap came back normal (false negatives are apparently common enough, however), and positive for HPV-16, one of the high-risk cancer-causing strains.

Honestly? I didn’t take it well. This year has already been so difficult with my sick cats, my dramatic family, my tight money, my bodily injuries. It all so consistently kept coming. The day after the bad news, I got a cold sore. Stress: 1, immune system: 0.

They wanted me to come back in for a colposcopy and biopsy, procedures I’d had done over a decade prior when I was first diagnosed with HPV. Knowing that the virus can resurface in time of stress, I wondered if that meant it was the same one. I made a few phone calls and contacted my ex-husband for the first in years to try to get information from the military clinic that had last treated me. As it turned out, they didn’t have any answers, so I needn’t have contacted him.

This all brought all the feelings I had after my first diagnosis. My ex had cheated on me and an abnormal pap indicated HPV. Except.. the doctors didn’t say that initially. They just told me to come back for monitoring. It was at a subsequent appointment when they mentioned me having HPV in passing. I was so shocked because this was the first I had heard of it. I kept a straight face but cried as I left and walked to the bus stop.

Two months ago I was dealing with the same thing and possibly still for the same reason. I resigned myself to not knowing, however, and went to the biopsy, which I scheduled for the next week to get it over with. Fortunately the terrible cramping and bloating I’d experienced after the IUD insertion had stopped on the morning of my biopsy. I am not sure I would have been able to handle both and was shocked; my first two were relatively easy!

The nurse practitioner who handles those was different from the gentle provider I’d had before. She’s rough in technique and demeanor. She’s a bit older and perhaps understands how much women can take, but I’ve heard from friends who have left her office in tears. When she later gave me my second Gardasil injection, she didn’t so much insert the needle as she did punch me with it.

My cervical discomfort remained despite taking more ibuprofen than I ever had before — so much, in fact, that I got home and developed a temporary case of tinnitus. HPV and hearing loss? Great!

I had to sign a waiver that they wouldn’t replace my IUD if it came out during the procedure, knowing that I wouldn’t be able to afford a new one if that happened. During the biopsy, the NP noted three places she wanted to sample and did so. She commented that the cell abnormalities were mild, and my fears were somewhat assuaged. I thought I could perhaps just get away with monitoring and not need additional procedures.

I can be a bit of a bleeder, and she struggled to staunch the bleeding with Monsel’s Solution. When it finally stopped, I was provided a pantyliner and free to leave.

While biopsies aren’t fun, I was more annoyed by the tinnitus than anything else. Over the next week or so, I experienced discharge from the Monsel’s Solution. After the bulk of it was discharged, I began spotting and didn’t stop until last week.  But because it was generally light and I didn’t have any other negative side effects (fever, etc), I waited to mention it until my IUD checkup.

After two weeks, I went back in for my results: moderate dysplasia, not mild. Not cancer but pre-cancerous. Not healthy enough to simply monitor. Not the best-case scenario.

I had to be referred to a different provider to receive treatment, and the NP recommended a Loop Electrosurgical Excision Procedure. A LEEP is essentially electrical cauterization of the cervix. I called up the OBGYN clinic at one of the hospitals and scheduled an appointment, but it was quite far out.

During this time, I went back for my IUD check and second HPV vaccine. Ironically, the medical student who performed that was much gentler than the nurse practitioner. Of course, I wasn’t spotting that day so they couldn’t check where the blood came from. But IUD looked okay, and I received the second shot. Fortunately, there were no symptoms — the first one caused a bit of discomfort at the injection site. Once that appointment was done, I simply had to wait for my LEEP.

I had initially been nervous. There have been so many appointments this summer. I went in to see the dentist in June because of some jaw pain I’d been having for about a month only to be told that I’m clenching because of stress. Knowing that I didn’t have some terrible infection eating away at my teeth was a relief, and I’ve made a concerted effort to relax my jaw since then. I also started therapy last week. I have followup appointments for both over the next week. While I am hopeful that therapy will help, just having so many appointments makes me anxious.

But by the time my LEEP appointment rolled around, I was more annoyed at filling out so much intake paperwork than I was anxious. I strode into the hospital, asked for directions, and took the elevator to the OBGYN department. I’ve never before been called as fast as I was. Yet after taking down information and instruction me to strip from the waist down, the nurse left me alone for what must have been thirty minutes. My appointment was only scheduled for thirty minutes, and the friend who drove me was waiting on me the entire time.

The doctor entered, explained the procedure and Monsel’s solution and got to work, first fiddling with a painfully ill-fitting speculum before swapping it out for another. A grounding pad stuck to my leg, I listened to the machine turn on. They applied a numbing gel that the nurse had informed me would make my heart race, and it started almost immediately. It’s difficult to remain relaxed when your heart is beating a mile a minute. Talk about a way to trigger anxiety.

On top of that, it made my legs shake, so keeping them in the stirrups was hard enough let alone being relaxed. I found out later that the gel was a mixture of numbing agent and epinephrine to prevent too much bleeding. Aside from the racing heart, epinephrine made my mouth taste awful for several days, a side effect that I had to search.

Unfortunately, I was not completely numb when the doctor turned on the LEEP machine and started cauterizing my cervix. I was on the way but definitely felt the first touches and seized up. As the numbing agent kicked it, it became easier, but the doctor still had to remind me to relax every thirty seconds.

LEEPs are short, much shorter than the time I’d spent waiting for the doctor to even make an appearance. Even though she had to apply extra Monsel’s to stop the bleeding, which hopefully means less spotting this time around (I’ve yet to start bleeding, so who knows).

I walked out frazzled because of the epinephrine and feeling discouraged that the sample would indicate I needed to go in for another procedure. I cannot stress enough how anxious this all has made me. My sleep has been terrible, and I’ve felt all the worse knowing that stress will limit my immune system, which I need to kick into overdrive to suppress this strain of HPV so I can maybe stop worrying about getting cancer.

This whole thing has had me thinking so much about my mortality. My healthiest years are likely behind me. Injuries will be more common. Sicknesses will last longer. This was all a very real reminder of that. I couldn’t remain ignorant. But sometimes ignorance really is bliss.

The shitty thing is knowing I may be okay for now but that this all could happen again someday. I could become sick or stressed, and the virus could pop back up, wreak havoc on my body.

Like it’s already wreaked havoc on my sex life. It took weeks for me to want to masturbate after my biopsy and similarly after my LEEP. Of course, penetration was off the table, but I didn’t want to touch my clitoris. I felt betrayed by my body, dysphoric. It was alien.

On top of that, I wouldn’t want to have sex with any new partner while HPV is still active in my system. While someone who has received the vaccine wouldn’t be at risk, I don’t even want to get my hopes up only to find that a potential partner isn’t vaccinated. I don’t want to think that I could transmit a virus that can give someone cancer. That’s heavy.

All of this has led me to do a lot of mesearch — research pertaining to things about myself. I’ve actually avoided looking up things this year. I wanted to remain blissfully ignorant. It didn’t work.

What may help is knowing that my LEEP results came back good. I don’t need to go in for another procedure. I will need to schedule an exam a year after my last (next May), but I can breathe a little easier for now. I hope that my anxiety can abate, my immune system can suppress this virus, and I can get on with my life. But it’s hard not to worry, to wait for the shoe to drop. 2019 has thrown me more than a few curveballs, and while I wish I was more resilient, I keep finding myself on the lookout for more danger.

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Science of Sex: Paps Vs HPV Testing for Cervical Cancer Screening

August 1st, 2019

Pap Smears Vs HPV Testing for Cervical Cancer Screening

This month’s Science of Sex was inspired by research I was doing myself based on my own health, so this post will be a bit more anecdotal/personal than usual.

I’ve been getting Pap smears since I was 18. If I had to get, I’ve had about a dozen or so — one every year until a positive HPV result when the exams became twice yearly. After things returned to normal, I went back to annual paps. Seven years ago, the American Cancer Society changed recommendations official to three years, so my visits became less frequent. As an American, I went according to the suggested schedule because I thought it was helpful; although, I realize other countries have different recommendations. I imagine that many women, trans men, and nonbinary folks have followed a similar schedule.

I don’t know if the HPV test has always accompanied my paps, but it has a good portion of them. Combination testing is recommended for anyone over 30 as it’s believed that people in their 20s may have transitory strains of HPV that will be suppressed by the younger person’s immune system. The HPV test can now detect the very strain of HPV (13 of the highest-risk strains), which is helpful to prevent cervical cancer and benefits treating HPV itself.

Read more about HPV and the vaccine.

Imagine my surprise several months ago when my pap came back clear, but I was positive for HPV 16. For those who may not be familiar, the pap smear is a collection of cells using a swab. The swab can miss areas of the cervix where cells may be abnormal, so false negatives are possible. On top of that, false positives are also possible. Because samples are sent away to a lab where a person must identify if cells are abnormal are not, there’s a pretty high margin of error.

According to one 1996 article,

Pap smears, which can detect cancer of the cervix, are now said to have a false negative rate of 20 to 40 percent.

Things may be looking up; however. Modern paps experience false negatives been 10% and 20% of the time.

A false negative could allow abnormal cells to spread and potentially turn pre-cancerous or cancerous. However, a false positive can result in unnecessary, invasive procedures. My HPV results have led to biopsies colposcopies, which enabled doctors to examins the cells of my cervix to locate and sample abnormal cells. After finding moderately abnormal cells this time around, I was referred for a procedure known as a LEEP that involves cauterization of the cervix.

Considering that abnormal cervical cells are not uncommon and not always caused by HPV and can clear up by themselves, which could make any followup procedure unnecessary.

This leads me to the crux of this post: HPV tests alone are more accurate and better predictors of cervical cancer than paps. In fact, people have questioned how useful paps are as a tool for over two decades. Clearly, co-testing (combining both HPV testing and pap smears) is effective, but it may be effective enough to simply perform HPV testing.

However, for those people who may not routinely undergo STI screenings, the recommendation that paps should be performed less frequently may mean less frequent HPV testing as well. Because HPV testing can indicate when a person’s immune system is no longer suppressing the virus in addition to new viruses, it might be helpful to increase the recommendation for HPV testing even as paps become less frequent especially considering that the CDC now states virtually everyone who is sexually active will have HPV, and it may have gone unnoticed because of a faulty pap, or may reappear during times of a weakened immune system.

Further Reading

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Science of Sex: HPV and the HPV Vaccines

June 17th, 2017

Welcome to the fourth installment in a new feature on Of Sex and Love: Science of Sex. In this feature, I plan to discuss the science of sexuality in an easy-to-digest format that’s accessible to the casual reader. I will also follow up with some extended reading material for people who want to know more about the subject of each post.

Enjoy!

Science of Sex HPV

Human Papilloma Virus in a Nutshell

HPV is the virus that causes genital warts, but just because you don’t have any symptoms doesn’t mean you don’t have HPV. It’s one of the most common sexually-transmitted infections with over 200 strains (strains 16 and 18 cause over two-thirds of all cervical cancer while low-risk strains 6 and 11 cause most warts). Over 80 million people or about 1 in 4 people have it. It’s easy to transmit through skin-to-skin contact, so even using condoms may not prevent HPV. The CDC advises that ‘nearly all’ men and women will contract HPV in your life, and it’s likely that many people don’t even know they have it.

HPV doesn’t just cause warts. It can lead to irregular PAP smear results for women and cause cervical cancer (HPV can also be the culprit for other cancers, including that of the throat and anus). Those results can lead to a woman getting tested for HPV, but there is currently no test for HPV in men who have an asymptomatic strain (some sources indicate that a test does exist but it’s expensive and invasive).

Treatment of HPV may mean doing nothing at all. Most cases clear up within two years, but this isn’t always the case.

The HPV Vaccine

A vaccine for several of the most common strains of HPV, including some that cause cervical cancer, Gardasil, became available about 10 years ago. There are now three different vaccines for HPV available (Cervarix, quadrivalent Gardasil, and 9-valent Gardasil-9), the latter of which cover more strains of HPV than the original. One study concludes that HPV vaccines can prevent “most” invasive cervical cancers (around 70% of cervical cancer for the 9-valent vaccine and 66% for original Gardasil) as well as some oral cavity, penile, laryngeal and vulvar cancers. These vaccines are at least 90% effective at blocking those strains.

The vaccines consist of two or three doses, which can depend on schedule or your age.  Even if you can’t take all shots within this time frame, you’ll still benefit from at least one dose. Similarly, the vaccine is still beneficial if you’ve already become sexually active, but it’s more beneficial if administered before sexual activity. In this case, the younger the better.

Note: While the HPV vaccine was previously approved for young adults up to 27 years, the CDC has approved it for use in adults up to 45 years old.

Although at first recommended for girls, HPV vaccines are beneficial for boys who can contract and transmit HPV. But it’s less likely that a male will no if he’s HPV-positive, which means he’s more likely to transmit it to a partner.

Still, fewer boys than girls are being vaccinated (12% of boys had received all three doses compared to 36% of girls in 2013), and vaccination occurs at a later age. Fortunately, vaccination rates have increased through the years, perhaps as no serious side effects have arisen over the years and the efficacy of the vaccines have been proven. For girls, infections by strains of HPV that the vaccine prevents has dropped 64% since 2006.

Let’s hope that vaccination rates rise, gaps close and strides can be made to cover more strains of HPV in future vaccines!

Further Reading

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