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Single cells, single cells

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› andrea@altsexcolumn.com

Dear Andrea:

I read your recent article about postpregnancy changes [12/19/07]; you didn’t mention one promising new treatment for stress incontinence, stem cells. Maybe you’re not interested because it’s not a standard treatment yet, but in case you simply didn’t know, here are some links: www.medscape.com/viewarticle/494967 (requires log-in), www.medpagetoday.com/Surgery/Urology/tb/6055.

Love,

Helpful Reader

Dear Helpful:

I’m interested! My interest in urinary stress incontinence goes way back to when I was first looking into the female ejaculation thing and telling people over and over that "this is not urinary stress incontinence! Nothing to do with that! Forget you ever heard the words urinary stress incontinence." Which I promptly did. And now I’m writing and teaching about what happens to sex after you have babies and barely have time to think about female ejaculation, but guess what’s back as an issue, big-time? Of course. People talk about baby weight and boobs and tiredness and getting "touched out" by having a baby stuck to you at all hours, but how often does anyone mention the fact that peeing when you laugh, sneeze, or do anything more interesting in the way of convulsive expulsions is (a) very common postpartum (in which postpartum can mean, say, 40 years postpartum) and (b) just mortifying and deeply antierotic? (Right, yes, except to that subset — you know who you are — who do find random uncontrollable peeing erotic; you can just sit down, since we’re not talking to you.)

From the Medscape article Helpful linked:

Preliminary research suggests that stem cell therapy is a viable and efficacious treatment for stress urinary incontinence, according to results presented … at the 90th scientific assembly and annual meeting of the Radiological Society of North America.

"We believe we have developed a long-lasting and effective treatment that is especially promising because it is generated from the patient’s own body," said Ferdinand Frauscher, MD, associate professor of radiology at the Medical University of Innsbruck, Austria. In the study, women who had autologous adult stem cells implanted into the rhabdosphincter were free of incontinence for a year or longer, he said.

You caught the part where these were the women’s own stem cells, right? These are not the stem cells of controversy, drawn from the blasto-Americans whose lives are supposed to be every bit as valuable as that of an adult with a life and a family and a case of Parkinson’s or MS and no good therapies, nope. They were pulled out of the patients’ arms and injected back into the women’s urethras, where they proceeded to thicken the walls and make the sphincter more elastic and contractile. Plus, they’re smart:

"These are very intelligent cells," Dr. Frauscher said. "When they connect with other cells they stop growing." He said it takes about two weeks for the cells to complete the process. However, some women in the study reported a benefit within 24 hours of treatment. Dr. Frauscher said that was probably due to a "bulking" effect of the cells, creating pressure on the urethra.

In another, similar study, the women were still continent a year later. This is really good news, if a little early and a little techy and not likely to be appearing at a doc-in-the-box clinic near you any time soon. We can keep our fingers (and, unfortunately, our legs) crossed, though.

While we’re crossing, here’s more good news for women who, like me, did their dancing to ’80s music while the ’80s were still happening and might be wondering where their smooth skin, bouncing curls, and vaginal lubrication went: gone with the estrogen, of course. You could get whiplash keeping up with the latest on hormone-replacement therapy for menopause — it’ll give you cancer; no, it’ll protect you from heart attacks; no, it’ll give you heart attacks but protect you from cancer — but (also from Medscape, at www.medscape.com/viewarticle/568354):

The American Association of Clinical Endocrinologists (AACE) has released a statement on hormone replacement therapy (HRT) and cardiovascular risk, emphasizing that HRT does not appear harmful in younger women in early menopause and may indeed be beneficial in this group.

Younger for these purposes means under 60 (phew!) or less than 10 years after menopause. HRT isn’t going to be for everyone, and these are the same numbers (the Nurses’ Health Study) that have been crunched and crunched again while women get the above-mentioned sore necks (and sometimes much, much worse) in attempting to keep up with the latest, but right now this seems good. I’ve tried to look forward to my cronehood as a time of wisdom and serenity, but … bleah. Just whisper the words vaginal atrophy to any woman past 35 and you’ll see how eager most of us are to give up our estrogen. Given the choice, I’d rather pee my pants.

Love,

Andrea

Andrea is home with the kids and going stir-crazy. Write her a letter! Ask her a question! Send her your tedious e-mail forwards! On second thought, don’t do that. Just ask her a question.

A week late

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› andrea@altsexcolumn.com

No, not that kind of "a week late." This is my New Year’s column, a week late, but let’s not beat ourselves up over it. Barring the exceedingly rare case in which someone both recognizes the need for change and makes and keeps a promise, New Year’s resolutions mostly just hang around like any other weapon (see: Chekhov’s gun), waiting for us to use them against ourselves. Some people won’t have a gun in the house; I won’t have stupid vows lying around waiting for me to stub my toe on them. And with that, some nonresolutions, just mere suggestions, for better sex in 2008:

(1) Get the right birth control. One couple’s perfect method is another’s PMSy nightmare, chemical burn, or poor lifestyle fit, and there’s often no way to tell without experimenting. Hints: if you never remember whether you turned the stove off, I wouldn’t suggest relying on the pill, and if you cannot handle the phrase cervical mucus, you probably don’t want to handle the real thing either, so no fertility awareness method for you!

(2) If you’ve been faking it, cut that right out.

(3) Try something new. You’ll usually see this as "try a new position," but positions are hardly the alpha and omega of sexual variety. It’s still just fucking. I mean try something really new. Obviously the Web is the go-to source for somethings new, but a field trip, all hand in hand and coupley, to a nice sex shop is probably more fun. Also, you could buy something. It’s the patriotic thing to do.

(4) Learn something new, even if you don’t think you want to try it. Most of the "Ew, yuck" reactions to your supposedly kinkier sexualities come from lack of information and fear of the unknown. Of course there are depths below depths of depravity out there for the plumbing, but I’m not talking about the really dank and dangerous stuff. So much of kink and fetish turns out to be harmless and often endearingly nerdy on closer inspection. Look behind the flames-of-hell clip art on any S-M organization’s information site and you’ll find a lot of software professionals and librarians earnestly comparing notes on how not to hurt one another while playing with whips and chains.

(5) Get better at something you already do. This immediately brings to mind the sort of ridiculous gimmicks you used to find in Cosmo — shaving grapes or what have you — but you really can give better head or get in better alignment for intercourse or any number of similar improvements merely by paying attention to what you’re doing. Many people do a more mindful, conscientious job of blow-drying their hair than … well, anyway.

(6) Declutter the bedroom. (Actually, declutter the whole house.) Clutter in the bedroom is a definite buzz kill. If you’re dating, the clutter functions as another self-perceived flaw, an externalized big butt or stretch mark, another reason to want to skulk in the dark instead of letting your light shine. If you’re partnered, it’s a good excuse to harbor resentment (whose goddamn expired bus passes are those, anyway?) or let yourself get into that deeply antierotic spiral where we can’t just be all spontaneous, for God’s sake! There’s important stuff to do! And then you don’t do it (in either sense of it) anyway. What’s on my bedside table: 18 books, read, unread, and never to be read; bookmarks; crumpled sale slips; a flashlight with dead batteries; two bottles of flat seltzer water; one toddler’s sock; a pacifier; an expired bus pass; a finger puppet representing Charles Darwin; and three bottles of assorted lubes sent to me by a nice marketing rep at Babeland. What should be on my bedside table? Oh, guess.

(7) Compliment your partner on what he or she does wonderfully well. Nobody (at least nobody you want to know) feels all that overwhelming confident where it counts, not all the time, and if you could use the boost, so could they.

(8) Do the sex (or just sexy) date thing, but for God’s sake, don’t take it too seriously. I’m not talking meeting your partner at the door wrapped in festive holiday plastic wrap, but setting aside the time for reals instead of just saying you will all the time. And tell your partner it’s sexy night. There’s nothing worse than having your partner miss the point and brush past you on the way back in from your romantic dinner to find out what’s in TiVo. Give them a chance not to feel like it too. Just because it’s your sexy night doesn’t mean it’s theirs.

The big metaimprovers, in digest format:

(9) Know what you want.

(10) Share the information (not necessarily applicable to masturbation).

Have fun.

Love,

Andrea

Andrea is home with the kids and going stir-crazy. Write her a letter! Ask her a question! Send her your tedious e-mail forwards! On second thought, don’t do that. Just ask her a question.

Hamster dance

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› andrea@altsexcolumn.com

Dear Andrea:

I have a friend a few years younger than me. We were recently at a bar talking about his girlfriend and my wife. After a time, he confided to me that in the past few weeks he has been having trouble getting it up and was very concerned that he would have to take erectile dysfunction meds for the rest of his life or that he was losing his edge. We are both in our early 40s and in good shape and health.

My answer to him was that he should not panic. It seems to me that as the weather gets colder, the days become shorter, and we set the clocks back, our bodies, which are much more attuned to nature than we are generally aware, prepare for winter and slow down. I noticed that my sleep patterns changed at the visible onset of winter. I’ve been less interested in sex and other physical activities. I also remember that in the spring, when the days get longer and the sun shines, I get really horny all of the time — or at least I did last spring.

Are there any studies to support my thesis? Is any of this quantifiable?

Love,

Regular Reader

Dear Reg:

Pretty much, yes. What a great question to get on a gloomy winter day just a few days shy of the solstice. Let us thank all the little gods and goddesses for the end of the %#@&*%@ darkness, with extraspecial gratitude reserved for Flora, Persephone, Maia, and anyone else who is usually depicted wreathed in posies and scattering petals through the newly verdant forest while the little animals frolic … ahem. Why do I have spring fever when it isn’t even spring?

I’m not sure if there has been any serious research done on humans and libido fluctuation through the seasons, but because the slightest fluctuations in reproductive capacity can cost high-stakes meat producers serious money, plenty of hormone-titer and testicle measurements have been done on bulls and boars and other large horned or tusky beasts, and yes, those characteristics do fluctuate with the seasons, and by quite a bit too. Mostly, though, males get all maleish during their breeding season, whenever that may be, but one of the most striking differences between ourselves and most of our animal cousins is our lack of an estrus cycle and corresponding male big-balls cycle. However …

It’s nice that I happened to mention little animals frolicking, because have I got a frolicking animals story for you: "Sex Ends as Seasons Shift and Kisspeptin Levels Plummet" (at www.eurekalert.org/pub_releases/2006-12/iu-sea122806.php). It concerns a neuropeptide most excellently named kisspeptin. Oh, and it’s about Siberian hamsters. Kisspeptin triggers the release of the important reproductive hormones gonadotropin-releasing hormone and luteinizing hormone, without which we (and the hamsters) would not experience puberty, libido (in the hamsters at least), or conception. Hamsters placed in a winterlike environment with short days and low light immediately experience a drop in kisspeptin and with it the hamster equivalent of mojo workin’. Happily, though, the winterized hamsters were just as sensitive to kisspeptin as the summer hamsters were; as the article emphasizes,

"What is really striking is the disappearance of kisspeptin in animals experiencing winter-like days, yet the ability to respond to kisspeptin when we provide it," said Timothy Greives, lead author of the study. "These data show that the disappearance of kisspeptin in the brain is likely critical in turning off reproduction during winter."

So is kisspeptin supplementation the answer to your problem? Oh, I wish, but hormone feedback loops are way too serious and complicated to mess with when we don’t know what we’re doing, and in this case we truly haven’t the faintest. Plus, seen any kisspeptin on the supplement shelves recently? So no, of course it isn’t the answer, but I think it’s worth paying attention to the fact that we are, as you say, "much more attuned to nature than we are generally aware." We might try adapting to the season by either simply expecting less of ourselves and our partners in the depth of winter — a winter break, as it were — or bringing our opposable thumb–having, tool-using human best to bear on the problem. Try (or rather suggest to your friend that he try) light therapy, as prescribed for seasonal affective disorder. And why do you think the midwinter tropical vacation is so popular? Surely froofy umbrella drinks are available in the frozen north; there must be another, better reason for heading to summerier climes with your sweetie as the days get short and dark. Failing that, we could do what sensible large fauna (and many types of flora too, come to think of it) do when the weather gets nasty: hibernate.

Love,

Andrea

Andrea is home with the kids and going stir-crazy. Write her a letter! Ask her a question! Send her your tedious e-mail forwards! On second thought, don’t do that. Just ask her a question.

Santa’s secret

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› andrea@altsexcolumn.com

Dear Andrea:

I’m a guy with a platonic, single, straight female friend in her mid-20s who could really use her first sex toy but doesn’t seem comfortable enough with her sexuality to buy one on her own. The holidays seem like the perfect excuse to give a gift that keeps on giving. I was going to get her a gift certificate or gift from a woman-friendly online store, since she may be uncomfortable going into an adult store and a vibrating gift under the Christmas tree might make Christmas morning a little embarrassing.

She’s the first girl I’ve ever met who doesn’t have at least one toy. I don’t think it’s occurred to her female friends to get her a toy or gift certificate, and I imagine she might be uncomfortable with my telling them she could really use a sex toy. But it’s been years since the girl’s had sex. I can see how giving a toy as a gift can be awkward, because it can become associated with the visual image of the gifter. But among friends without a great deal of cash, it could also be uncomfortable for her to receive a gift certificate for $50 or $100. Is there a way around this that results in a more sexually fulfilled and less tense friend?

Love,

Secret Santa

Dear Santa:

She might be uncomfortable with you telling her friends she needs a good buzz-off? Do you think? Please, please, put down the gift certificate and back away slowly. There is no way for this to go well and too many possible bad endings to count. I mean, let’s say you’re right and she really has been utterly abstemious all these years, as opposed to uninterested in detailing the contents of her bedside drawer for you, her straight male friend. Even so, what could be more mortifying than a gift that says she’s hard up and in danger of drying out and all her friends know it? I suppose for maximum mortification you could save the gift presentation for whatever party she and all of your mutual friends will be attending, and let her do the stammering and blushing in public, but I’m confident that the moment would suck for her whether public or alone with you, the friend who suddenly seems to know too much and be thinking too deeply about what does or doesn’t go on between her sheets. You’re mean well, and it’s nice that you care and all, but just don’t.

I see one way you could ensure that she has access to what you have determined she needs, but it’s both expensive and rather ridiculous: on the Romper Room–ish principal that you shouldn’t bring any if you don’t have enough for everyone, pass out the gift certificates to your whole circle, whoever you’d normally be buying presents for, boys and girls alike. Then you’ll just be thought of as generous, if slightly pervy, instead of creepily overinvolved in the sex life of someone with whom you are not and will not be having sex. Unless you actually do want to have sex with her, in which case I still wouldn’t recommend buying her a vibrator.

Oy. This is very complicated. It makes me glad I’m Jewish and don’t have to buy Christmas presents for anyone, let alone receive any. It’s a minefield! Who knew?

Love,

Andrea

Dear Andrea:

We are trying to have a baby. After we have sex, the semen doesn’t stay in but trickles out of the vagina. Why does it happen, and what should we do to keep it in so I can conceive?

Love,

Drippy

Dear Drip:

The only connection between your letter and the one proceeding is the way they produced an involuntary and audible "Don’t do that!" from me as I read them. Don’t have a baby!

Oh, relax. You can have a baby, but you should already know the answer to this, and I can’t help wondering what else you don’t know. The semen trickles out because it’s already done its job. Only a very small part of the ejaculate is made of sperm; the rest is what would be called "inactive ingredients" if your husband were ejacuutf8g, say, toothpaste instead of semen. The carrier fluid coagulates briefly, just so it won’t run down your leg before the sperm have made their escape. Once the sperm have gone, the leftover gunk liquefies and runs down your aforementioned leg to form the "wet spot" of lore. If it didn’t, you’d be carrying the leftover goo from a lifetime of sexual encounters around with you until you scrubbed it out with a bottle brush, and that is not a nice picture.

You’re fine. If your question really does reflect your general state of knowledge about these things, please get a book. Get several. Get a library card. This baby-having business is not simple, and while there is such a thing as too much information, too little information is worse.

Love,

Andrea

Andrea’s on vacation this week; this column ran previously (12/12/06). But she’s still checking e-mail and eagerly awaiting your questions about love and lust!

Loose women

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› andrea@altsexcolumn.com

Dear Andrea:

I have a good one for you! What does being pregnant and having a baby do to your body? Is it true that birth will enlarge your vagina, or make it "loose?" Does it get worse if you have more children? Is it noticeable to men? What about if you have a C-section? Are there other postpartum changes to a woman’s body that affect how much she enjoys sex?

Love,

Trepidatious

Dear Trep:

The harsh truth is that pregnancy and childbirth usually do cause physical changes (thanks for asking!), although these are by no means always dire or even particularly notable. The change you sound most concerned about is vaginal looseness and yes, it does happen. As I am constantly repeating, the vagina is not a fixed size like a train tunnel. It is a potential space, like a sock. Even so, it’s supported by a whole complex of structures in the pelvis: not only muscles but also connective tissues of various types, all of which can get stretched out of shape, weakened, or even torn. Tone at the front of the vagina, where we feel most of the sexual sensation, can be lost due to perineal stretching, tearing, or the increasingly unfashionable but still sometimes necessary episiotomy. Nerve damage is fairly common too, and we need those nerves for more than just sensation; they also tell our muscles what to do. So while the sort of looseness that a million extremely crass jokes are built on may be rare, it’s probably not as rare as the completely pristine and unchanged postpartum vajayjay. Change happens, and yes, pregnancy itself — a.k.a. carrying a smallish medicine ball firmly lodged above your cervix for half a year — is enough to do some of the changing.

There’s an excellent if not particularly cheerful article called "Pregnancy, Childbirth, and Your Pelvic Floor: Understanding the Connections" at www.augs.org/custom/kb/answer.cfm?id=61. It’s adapted from a book called Ever Since I Had My Baby (Random House, 2003), which sounds informative if a bit dispiriting. Do we really want to know that we might lose a fair amount of the sensation we enjoy during intercourse? Do we want to know how extremely common a little bit of urinary stress incontinence — something we thought only happened to great-grandma — really is? Actually, yes, we do. Much of the potential damage can be avoided or at least mitigated by good care and careful choices, so of course we want to know about these things ahead of time.

I looked up "changes after childbirth" or some such thing on About.com yesterday and found the usual sprightly lecture on doing your Kegel exercises. Under the "Did you find this article helpful?" heading was a large, crabby "No!," which cracked me up. I’m sorry the Kegels didn’t work for Crabby Reader, but in truth they’re about all we’ve got in our looseness-mitigation and restoration of continence arsenal. There are surgeries, but surgery is expensive and risky and requires the kind of recovery time that mothers rarely have available for lolling about on the chaise longue sipping sweet tea. In truth, a lengthy course of Kegels, energetically performed, can vastly improve muscle tone and help prevent its loss in the first place. Exercising your hoo-ha can feel undignified, but being afraid to sneeze (or laugh!) for fear of leaking is damned depressing. After all the Kegels there may still be a little extra space up there, but frankly, that can be put to good — or at least entertaining — use. It’s the tonelessness toward the front that both partners can find dismaying and that inspires the jokes that end with (please forgive me, mothers everywhere): "Flashlight? Hell! Help me find my keys, and we can drive out!"

Other changes you wonder about (arousal, lubrication) are generally more of a more hormonal nature and will right themselves in time. "But what other long-term disfigurements and indignities await?" the anxious nullipara asks. Have you seen those trend pieces in the papers on the so-called mommy makeover? That’s a tummy tuck (for weakened abs and loose skin), lipo (to remove new fat deposits on hips, thighs, or belly), and breast augmentation (for deflated boobs). Not always mentioned but also available: trimming or plumping stretched or saggy labia and a little internal spiffication. Think what you like about the doctors who push such services and the women who feel they need them. Many of my own such thoughts fall on the uncharitable side, and a browse through those cosmetic surgery Web sites, which are as unappealingly (to me) slick and pink as a freshly Brazilianed mons veneris, does little to change my reaction. Still, if you need help, you need it, and we should be glad the procedures are available to those in need, even if it’s hard not to think about all of the yachts and country-club memberships some of those unwarranted labiaplasties are buying.

Love,

Andrea

PS Don’t forget my favorite girl-power Web site, Shape of a Mother (theshapeofamother.com/home.php). Consciousness raising, not boob lifting!

Andrea is home with the kids and going stir-crazy. Write her a letter! Ask her a question! Send her your tedious e-mail forwards! On second thought, don’t do that. Just ask her a question.

Sexy beast

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› andrea@altsexcolumn.com

Dear Andrea:

My ex-boyfriend won’t give me back my stuff! I’ve e-mailed him repeatedly but gotten no response. I broke up with him because he just couldn’t be bothered to show up or call. After three months of him flaking, I ended things.

He was also impotent, but couldn’t have an adult conversation about it. He was tired, or his grandmother was dying … After lots of excuses and frustration, I began to feel a little insecure, even though I’m smart and healthy, I exercise, I have a nice figure, and I make reasonable efforts on my appearance.

Anyway, pencil dick (think: roll of quarters) decides to let me know one night when we’re out drinking that he thinks my pussy smells. I am, of course, shocked and horrified (I should also mention that I’ve had nothing but compliments from other exes). But quarter dick says he’s sensitive to smell. I try to initiate an adult conversation. Is pubic hair an issue? He says yes, and that all of his girlfriends have been completely shaved.

This was difficult for me, because although I shave my legs and pits and trim my pubes, I think shaving your pussy is just masochistic. I also have some history with not-too-cool stuff that happened to me before I’d even grown any pubic hair. He’d been saying that he wanted me to open up to him more, so I told him I was having a tough week after our conversation. He said he’d come over but never showed, never called.

I left a bag with his stuff and a note tied to his front door. So maybe me not getting my stuff back is just karma for taking the easy way out. But I feel he owes me something for all of the bullshit he put me through! Because what I’m left with, more than the absence of my stuff, is this feeling that I never had before — that maybe, somehow, because I don’t shave I’ll be unattractive to future partners. What I really want back is my sense of self-confidence. I’m not afraid to be a psycho hose beast on this, so feel free to make outlandish suggestions.

Love,

Stuff Waiter

Dear Stuff:

Sorry, can’t. The giant revenge scene in which people (usually women) cut up Prada ties and throw entire bedroom suites from upper-floor windows and set fire to Cadillacs is a staple of a certain type of cozy, girlfriendy fiction, but truly, we are all better off keeping it fictional. These dramatics are, as I say, usually carried out by women (real or fictional), and all we have to do to get a clearer look at the phenomenon (is it kinda cute-when-you’re-angry or just plain psycho?) is switch the genders: what if a vengeful man took a knife to your stuff or set pictures of you on fire outside your office? Would you perhaps find his behavior a touch … threatening? I think any ex in his or her right mind would, and should. Sorry to go all your mother on you, but do you really want to be that sort of person? The sort of person others in your circle will be warning new people about ("Yeah, she’s cute, but that bitch is crazy")? Sound familiar, would-be psycho hose beast? Of course it does. Don’t do it. Enlist a mutual friend to go get your stupid stuff, or just e-mail the guy and tell him you’ll be there at X o’clock on Y day and show up without waiting for his response. And if that doesn’t work, remember: it’s just stuff. You can get some other stuff.

I have no doubt that you are nicely groomed and nicely shaped and smell nice too (most women do unless bacteria are involved somehow). What I don’t believe is that pencil dick (think of him that way, and the words "no great loss" come easily to mind and stay there, do they not?) was ever really your boyfriend or even ever all that into you. If he’d been more into you, he might have tried a little harder to have sex with you, for one thing. People who are into you also tend to return phone calls and show up for dates and comfort you when they inadvertently hurt your feelings. Oh, and nobody nice inadvertently hurts your feelings by telling you your most intimate parts smell bad.

Actually, that last part is not necessarily true. People who love us sometimes have to tell us hard and inconvenient truths. Nice people will do anything to avoid that kind of thing, and if we have to do it, we don’t do it all suddenly and brutally at the bar, for god’s sake, and we don’t then refuse to comfort or even call. Only a pig-dog would do that. Putting it that way is, I realize, unfair to pig-dogs, and nice people don’t do that either. Neither, however, need we allow pig-dogs to determine our worth or define us in any other way. We do that ourselves. Buck up now, and don’t set anything on fire.

Love,

Andrea

Andrea is home with the kids and going stir-crazy. Write her a letter! Ask her a question! Send her your tedious e-mail forwards! On second thought, don’t do that. Just ask her a question.

Sleep tight

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› andrea@altsexcolumn.com

Dear Andrea:

I am newly married and have a great, fulfilling sex life with my husband. A while ago, I told him that I’m really turned on by the thought of him rousing me out of sleep with sex. Months have passed since I told him my fantasy, and, thinking he just wasn’t interested, I recently asked him why he hadn’t tried it yet. His response was "I have, but every time I do, you mumble incoherent stuff and roll over." I’m really bummed that I don’t remember his advances, and even more bummed that my deep slumber is depriving me of potentially awesome sex! Is there anything I can do about this issue, or is this a fantasy that must remain only in the mind?

Love,

Sleepy

Dear Sleep:

I’m not sure if it’s my job to rate people’s fantasies, but hey, what the heck? Good fantasy. It just ever so gingerly starts to poke a toe into kinkier water: unconsciousness, inability to give consent, a little bit of the more wholesome sort of necrophilia — good stuff! — and yet it’s very sweet, very harmless, and very married. I give it a 9, and I’m sorry it’s been such a bust for you so far. Happily, though, you’ve hardly exhausted the possibilities. Give it here, and let’s see what we can do.

Your poor sweet husband is doing the equivalent of the would-be dom who, when the disappointed bottom complains, "You had me all tied up! You had a flogger! Why didn’t you whip me?" says, "Um, you said, ‘Please don’t!’<0x2009>" That’s why we have safe words: not so much so the top will stop as so he or she will start. The main problem, obviously, is that you have not worked out with your husband what you mean by rousing, nor have you determined just how awake you have to be in order to for him to continue his ministrations. If you’re going to push it toward my (admittedly, liberally editorialized) version above, then you hardly need be conscious at all. You’ve also apparently failed to give him explicit permission to wake you up. Which was sort of the point, wasn’t it? Your husband is simply being too considerate, and if he’s to take the role of the sort of brute who would rouse a lady from her slumbers just to satisfy his base lusts, he’d better get with the program: either he wakes you or he has his way with your somnolent self. Either way, he has to press the issue. He can’t just let you snore on! Talk about unclear on the concept. Apparently he needs express permission to pester you, so grant it and go to bed.

As I was answering this, something about it began to seem familiar, and after a while I realized I was remembering that long, deeply strange period in Alt.Sex.Column’s history (starting, I think, in 2004) when sleep sex and sleep rape simply would not go away and leave us alone. There was the guy who’d mounted his male partner in the latter’s sleep; there was the story of the woman who’d get in her car, drive to bars, and pick up strangers for sex, all in her sleep; and there was this guy who claimed he’d had accidental anal sex with his wife in her sleep and is still kind of freaking me out at several years later:

Since then I have done this again, with a growing sense of excitement. She will stir and wake up … so I always get out before she wakes. I want to do it when she’s awake but I don’t know how to tell her…. [February 2004]

He didn’t wait for my answer ("She will kill you!") before he confessed to her and then seemed a little surprised when she nearly killed him. And there was the molesting priest who had the boy sleep over repeatedly, got him drunk, took him out to bars and parties, and did who knows what to him under cover of night, then blamed it all on some sort of parasomnia. What I don’t think I ever followed up on, though, was whether those stories about sleep-driving, sleep-slutting around, and so on, were ever tied retroactively to use of Ambien and similar sleep drugs, which, it was revealed last year, can certainly have that sort of effect on the poor, hapless, really tired people who take them. If Ambien can (and it can, it can) cause people to wander down to the kitchen in the wee hours to stuff their faces, why couldn’t it make people stuff other things as well, all unawares?

None of which has anything to do with you, Nice Married Lady. You simply want to be roused by something, well, arousing. And you have every right to be, if you ask me.

Love,

Andrea

Andrea is home with the kids and going stir-crazy. Write her a letter! Ask her a question! Send her your tedious e-mail forwards! On second thought, don’t do that. Just ask her a question.

Homocision follow-up

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› andrea@altsexcolumn.com

Dear Readers:

You want to talk about homophobia! That’s cool. So do I, especially if it means we don’t have to talk about circumcision, which — really, honestly, wow. People, some perspective here. I was watching Delicatessen the other night — you know, the surreal French horror-comedy about the landlord–cum–deli owner who keeps his meat locker stocked the same way Mrs. Lovett got her mince for pies in Sweeney Todd, my all-time favorite piece of musical theater? So I was watching that, and as the evil proprietor advanced on Granny with his cleaver, I suddenly remembered that at least one of you had called me a butcher, of all things, over the circumcision issue. If I weren’t laughing so hard at the image of my husband, myself, and the sweet, rather distracted gray-bearded mohel in his greasy black hat advancing on our helpless babe with a gleaming cleaver, I might’ve been offended. Another reader suggested that we did it to appease a magical being in the sky. I will have you know, sir, that I don’t believe in an MBITS any more than you believe in my (and my partner’s) ability to make a good decision for our kid. We did it, more or less, for tradition’s sake and to help our son connect with his ancestry, and to keep him from being burdened with the only foreskin at Jew Camp when he gets there. And that’s enough of that. Here are some recent responses to the homophobia columns:

I believe homophobia is rooted in some baser instincts among animals — as you said, we are wired to notice differences. We then perceive (or install) hierarchy as a self-esteem mechanism and — even more primordially — as a method of establishing some basis of feeling superiority as a potential mate. As animals we seek, by instinct, someone to feel we are superior to, so we can enhance our perception of our viability among competitors. The next step is to communicate that notion to potential mates and competitors. From that gesture we create culture in our tribes. Although today we love to believe that (for example) sending an e-mail to a writer proves our sophistication, it has not been that long since we were clubbing one another over the head for food.

Yeah, sorta, maybe. Although I’m convinced that human culture is founded on both our need and our capacity to tell us from them (what do you think circumcision was for, anyway? Isn’t it just a primal version of "shirts versus skins?") for both good and, increasingly, ill, there’s really nothing in it for a male animal who gets all puffed up and furious over the mere existence of another male who presents no threat. What a waste of energy. I’m not quite seeing homophobia as a mating strategy. But that was interesting, so thanks. Next we have:

My theory is that it is all about warfare — does that sound crazy? Let me explain. Long ago, there were probably different peoples at war with each other. One of them needed to demonize the other in some way, as warring parties do. Perhaps one of the cultures was strictly heterosexual and the other not. Thus, the hetero rulers locked onto homosexuality as something to demonize. The winner of the war appears to have been the hetero side, which perhaps explains the heavy homophobia throughout history. A stronger war-related reason might be the necessity of military secrecy. Without the serious taboo, there would be spies literally sucking the military secrets out of people (pun intended). It may also have been a smart political tactic of the rulers. I am going to assume that people who think independently are more likely to deviate from sexual norms. Those independent thinkers are most likely the biggest threat to a controlling, ruling entity. What better way to isolate these troublemakers than with sexual taboos?

Not a chance in hell, but thanks for writing! Have you ever heard of Occam’s razor?

More seriously, there are dozens of theories attempting to explain homophobia (or, more accurately, heterosexism), most of which make more sense than the above but none of which will ever be definitive, because different people hate for different reasons and because some pervasive human beliefs are so old that they have been lost in prehistory. Basically, though, the answer’s going to be a mixture of societal discomfort with sexuality in general (heterosexual intercourse excepted, what with the carrying on of the species thing), sexism, and the need to keep categories neat and distinctions distinct. I don’t think it’s hard to understand where homophobia might come from. It’s why we can’t make it go back there that’s bothering me.

Love,

Andrea

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Dammit

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Dear Andrea:

I’m a woman, and my partner is too. We’ve agreed that for now, when we have sex outside our relationship, we’ll have safe(r) sex. Another woman I’m dating is a major squirter, as in I need goggles and a raincoat. Next time we want to use a harness. However, I’m concerned that there’s no safe way; when she comes (and she comes bucketloads), won’t her ejaculate get into me?

I’ve thought about wrapping up with Saran Wrap and making a hole for the dildo, but that still doesn’t seem like it would stop it all. Are there any studies on STDs present in female ejaculate? And even if there are none, how possible is it that her ejaculate will throw off my pH balance (I have a very sensitive system)? Also, some got in my eye. What are the possible risks involved in that?

Love,

Wearing a Raincoat

Dear Coat:

I’ve encountered the goggles-and-a-raincoat type, in close quarters, and ever since have laughed great big belly laughs whenever I see a safer-sex pamphlet or demo showing someone lightly draping a lady’s lady parts with a scrap of latex the size of a playing card (same as the recommended serving of protein in most diet plans) and daintily lapping at it as though normal people have sex without making any sudden movements or producing more than a teaspoon of fluid at a time (and very obedient fluid at that). Not only is this sort of exercise unrealistic, but it doesn’t even look fun. But there it is, having outlived its ’90s heyday, refusing to die.

Some colleagues and I were sharing some similar laughs over the sorts of tricks each of us have had to teach at some point, usually as (or to) college students. There’s the one where you cut up the glove to make a dental dam kind of thing with a teeny protuberance, like an appendix, where the thumb used to be (stick your tongue in there and wiggle it around and try not to feel like you’re involved in some kind of freaky scene with a hobbit-hole full of wee folk). Or the one where you wear a garter belt upside down or backward, using the clips to hold a dam flaccidly in place over the site whence one of your girlfriend’s deluges may be erupting soon. It’s all so absurd, and has been taught so earnestly and for so long. I don’t even think we’re ready to use the past tense here, unfortunately, as I still find those sad little crafts projects all over the Internet whenever I’m out looking for updated, useful STD information. (Check out this hilarious link: www.freepatentsonline.com/20030150463.html.)

All of which brings us to the fact that female ejaculation is still such a hotly debated topic that you can find many denials that it exists, even among supposed experts, and if it may not exist, I doubt it’s been tested for STDs. Personally, I think it’s an unlikely candidate for a disease transmitter, barring any local infections, which would cause it to be carrying a lot of white blood cells. If it were a good way to spread HIV, then the much-trumpeted "imminent" woman-to-woman epidemic of the ’90s would have arrived — and, of course, it never did. This is your health, however, and your promise to your partner that you will not expose yourself to anything (or anything avoidable, anyway). So here are my suggestions: (1) That trick where she gets herself off while squatting directly above you? Don’t do that. (2) Whatever you’re doing, have her warn you before she makes like a human bidet, so you can duck. (3) The cling-film* diaper may work better if you use a female condom (they are lubed with silicone, which is inert and unlikely to mess you up) at the same time, although you will sound like a theaterful of candy-wrapper rustlers and smell and taste like nothing at all, which many people do not consider a reasonable trade-off. (4) There are highly engineered, very expensive latex novelties that you might find useful. And last: (5) Close your eyes and avert your head. Again, I think it extremely unlikely that she could pass anything to you, but eyes are a good enough conduit. Does she have anything? Have you asked her?

Seriously, I don’t think any of this is really necessary, but again, you promised no body fluids, and those are some ways to avoid them. Another approach, of course, would be to declare fem-jack fluid not scary and renegotiate. I would.

Love,

Andrea

* If you’ve never seen or heard Nigella Lawson pronounce the phrase cling film, you won’t know why I insist on saying it even though I’m far more American than apple pie. Check it out.

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Ape-man

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Dear Andrea:

I just read your question in the Slate article (www.slate.com/id/2174411) that asks sex columnists what puzzles them. For you, it was, in short, "Why homophobia?"

I’m convinced that boys learn it from their peers. Once a person is labeled gay, that person is marked for ostracism. A boy who comes to the defense of a gay boy pretty much guarantees that he’ll be lumped in with the gay boy, so a powerful taboo is set up. If he joins in the ostracism, he’ll be rewarded with membership in the brotherhood of dudes.

I’m sure I’m just touching on the situation here, and it’s sort of a chicken-and-egg solution, because who taught the meanies homophobia in the first place? And finally, I’m from Hawaii, where folks are a tad more tolerant of gays. It’s not a Shangri-la of acceptance, but Hawaiian culture is more inclusive than mainland American culture. So I guess I can end with another question: why are some cultures more homophobia prone than others?

Love,

Island Reader

Dear Island:

Yes, I was asked come up with something that I just don’t get, and I picked homophobia, or rather, the kind of semidispassionate, delayed-gratification, frighteningly organized sort of homophobia that results in anti–gay marriage legislation, not the kind that results in broken heads. The latter I can understand, sort of. The people who break heads — with their inarticulate, reflexive need to Hulk Smash! whenever they feel their shoddily constructed senses of self crumbling at the margins — are not the people who coolly invent laws to ruin other people’s lives from a distance. Those are the ones whose motivations fail to connect with me, so every time I try explaining them to myself (they sincerely believe their gay neighbors are breaking God’s laws and must be punished; they feel very strongly that only heterosexual marriage can protect Western society from the barbarians at the gates; they want to save Ellen and Portia from sin; etc.), the brief, bright light of understanding flickers out, and I find myself wondering why those people will not go away and leave the rest of us alone.

It’s not that I’m entirely at sea as to where homophobia comes from or why people feel it. I believe quite strongly that we are wired to be exquisitely sensitive to sameness and difference and that once upon a time recognizing one’s own was a vital survival strategy on the Serengeti, as anything strange was far more likely to be foe than friend. I also believe that humans evolved with an extraordinary gift for pattern recognition and an accompanying discomfort around things, especially people, that fail to categorize neatly. Just ask any transgender person or any parent who has been subjected to the surprisingly aggressive grilling that old biddies on the street feel entitled to initiate: "Are you sure she’s a girl?" "Yes, quite." "Then why is she wearing a blue hat?" People are extremely invested in knowing who’s a what and who isn’t. This maintains order, and we are order-loving animals. Obviously how order loving varies: compare, if you will, the behavior of Israelis attempting to board a bus with that of the Swiss — those kinds of small variations probably account for the slightly less homophobic milieu of your island home, if in fact you’re not imagining it.

We know these things about our primitive behaviors, and we know that, like violent sexual jealousy and rape as a reproductive strategy — among many other unattractive behaviors from our prehistory — they’re no longer adaptive. We are now forced to live crammed into the same cage with others of all sorts, with the cheering side benefits of cultural liveliness and hybridity, but our inner ape-man will take a while longer to be bred away, if he ever goes at all. I sincerely hope that we are not someday living in off-Earth colonies, all evolved and beige and Starfleety, and still occasionally passing laws against the one group (besides fat people) it’s still OK to subject to state-sponsored discrimination.

Now check this out: back at Slate, where I went to catch up on the Human Nature column, there was this very appetizing column fodder: "Genetic brain manipulation can change sexual orientation in worms." Seriously! Of course, they were worms, and our concept of "sexual interest" can be applied to them tenuously at best, but it does seem to imply that, at least for worms, the capability to "think" like a male worm is present from the beginning, awaiting only the kiss of a genetic engineer to awaken it. Not conclusive, certainly, but hella intriguing. The story is here: www.eurekalert.org/pub_releases/2007-10/uou-sas101707.php.

Love,

Andrea

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Duck’s breath

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Dear Andrea:

I just found your column by accident, and I love it! Major props to you for being such a talented sex columnist and a mother!

My problem: Between the ages of 19 and 31, I had bulimia. I’m now 37. I love going down on my man, but I feel I gag more than I should. I’ve wondered if it has anything to do with the purging I engaged in when younger. Do you have any ideas for how I could retrain myself so that my gag reflex is not so prominent (if such a thing is even possible)?

Love,

Gag Me

Dear Gag:

Forget being a writer-mother (most female writers have accomplished that, haven’t they, without feeling the need for extraspecial acknowledgment?) — props to you for getting over your bulimia. It can be pretty intractable, as I’m sure you know, and it can leave physical and emotional scars that are hard and sometimes impossible to heal. So yay you.

While it’s true that bulimics can get good at gagging, I haven’t found anything to support the idea that they train their gag reflexes into overactivity under normal circumstances once normal circumstances resume, as yours have (and so again, yay you). Quite the opposite, actually: "loss of gag reflex" shows up on most of the symptom lists I’ve found in the literature, and that is some extensive literature, let me tell you. So I think what we have here is in fact your normal gag reflex reasserting itself. Isn’t that nice?

OK, not really. I get that. But a normal response means you can take normal, even simple measures, and my usual prescription for gagging downgoers is so simple that I’m always amazed I have to mention it — I don’t remember anyone ever teaching this one to me! — but there ya go. Wrap your hand around the base of his penis. Slide it up if there’s still too much length to take comfortably (unlikely, if you do the math); slide it down to expose the desired length. It’s like those "no sew" curtains from Ikea: just pick the length you want — and you don’t have to iron anything either.

There are exercises out there, but since they’re mostly the poking yourself in the uvula with a tongue depressor sort of thing, I rarely recommend them; in your case it’s expressly contraindicated. There are a lot of people promising good results with hypnosis as well, but frankly, that’s kind of creepy, and besides, the hand thing works perfectly, so why bother? I do think you can do a little deep breathing and imagine your throat muscles hanging out on a lovely tropical beach listening to calypso tunes and all that, and I do think it helps, but I don’t think you have to do anything more complicated or programmatic than that.

You may also find that after you’ve had enough gag-free, thoroughly (and mutually) pleasant experiences with this, you’ll simply gag less because you’re expecting to gag less. If not, though, hand trick!

Love,

Andrea

Dear Andrea:

In a previous column [3/12/03] you established that it’s safe to ejaculate inside a woman when she’s on the pill. My question is, what should be done then? Does she need to clean it out or can she just leave it in there? If the former, how would you clean it? And if the latter, wouldn’t it drip? It all seems awfully inconvenient either way.

Love,

Confused

Dear Con:

Oh, bless your heart. Whatever made you think it was supposed to be convenient? Nature is not convenient; she is messy and kind of a bitch, as has often been noted, often enough by me. Here in the column, for instance, I have covered not only duck rape and homosexual duck rape but also homosexual necrophiliac duck rape. Twice. Which reminds me that I never linked to the articles about how female ducks have begun evolving baroquely twisty and turny oviducts to confound the males (properly drakes, I guess) who have been evolving complexly twisted, outrageously outsize phalli that look like they might have been designed by Antoni Gaudí.

From World Science Net (www.world-science.net/othernews/070501_duck.htm):

"[Study lead author Patricia] Brennan hypothesizes that the female waterfowl have evolved these anatomical features to block male attempts at reproductive control. ‘Despite the fact that most waterfowl form monogamous pairs, forced copulations by other males … are common,’ said [coathor Richard] Prum. ‘In response to male attempts to force their paternity on females, female waterfowl may be able to assert their own behavioral and anatomical means of controlling who fathers their offspring.’"

I mean, how cool is that? I wish I’d known about it back when I was doing feminist street theater, because how great would those costumes have been?

Um, what? We weren’t talking about duck rape but about used-semen drippage? Ugh. No wonder I was so eager to veer off topic. As quickly as possible. No, please don’t "clean it out." Yes, it drips. No, nothing bad happens, and nobody’s the wiser — unless you rush straight from bed to nude yoga class, so I advise against that.

Love,

Andrea

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Re-re-recap

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› andrea@altsexcolumn.com

Dear Readers:

Do you remember where we left off last week? I’d wanted to write about the now semirecent research on circumcision and sensitivity, but I spent so much time patting Another Concerned Penis Owner on the, uh, head, about harboring what was probably too much bitterness about having been clipped as a kid that I ran out of space and time. I really wanted to get to the experiment results that were bouncing around the Internet back in the spring, and here’s our chance.

The article was published in the Journal of Sexual Medicine in May. You can see it at tinyurl.com/yo32c7 or I can abstract the abstract for you, like this: There has been research done on sexual sensation in circed and uncirced men, but none, the authors say, on men who were aroused at the time of measurement, which they think is pretty important. They had the subjects watch sex flicks and nonsex flicks, and they tested for pain and touch sensitivity on "the penile shaft, the glans penis, and the volar surface of the forearm." They determined levels of sexual arousal by thermal imaging, which is kind of cool and reminds me slightly of the time I bought K a remote-sensing thermometer for his birthday. It looks like a gun and has a laser sight, which are always fun things, and we took it to a bar and annoyed people all night by announcing the temperature of random beverages and body parts. From across the room! Like magic! Perhaps you had to have been there.

The results (straight from the abstract): "In response to the erotic stimulus, both groups evidenced a significant increase in penile temperature, which correlated highly with subjective reports of sexual arousal. Uncircumcised men had significantly lower penile temperature than circumcised men, and evidenced a larger increase in penile temperature with sexual arousal. No differences in genital sensitivity were found between the uncircumcised and circumcised groups. Uncircumcised men were less sensitive to touch on the forearm than circumcised men. A decrease in overall touch sensitivity was observed in both groups with exposure to the erotic film as compared with either baseline or control stimulus film conditions. No significant effect was found for pain sensitivity."

In this study at least (it was small but doesn’t, to be fair, seem to be the kind of research that requires a huge cohort to shake out the noise and find something statistically significant), there was no difference in touch sensitivity on the penis, although there was a marked one in temperature, for whatever that’s worth (the uncut men were cooler and got hotter). I don’t know what to make of the fact that the uncut group was also more sensitive to being tapped on the arm. The most interesting fact to emerge from this particular study, though, is that sensitivity decreases as arousal increases. This is the exact experience that many women report, anecdotally at least, but not something you hear men complaining about nor their partners observing. Here it is, though, straight from the lab.

So what are we to make of the study’s central finding, which would imply that the perceived loss caused by routine circumcision is possibly not worth all the Sturm und Drang and gnashing and wailing, not to mention the freaky little devices for hauling the leftovers up over the tippy-tip like a cowl-neck sweater? Well, this is just one little study, and there are others purporting to reach different conclusions (although the one that shows major loss of sensation in circed men was done following adult circumcision, which is just not at all the same thing). Anyway, an argument can be made (and agreed with, if you are me) that it doesn’t really matter how sensitive the glans (or forearm!) is later; snipping healthy parts off healthy babies for no clear reason is still pretty hard to support and is kind of a spookily primitive habit for a supposedly advanced civilization to be hanging on to. I don’t exempt myself and my peeps from this, in case you’re wondering. In fact, the nonpointless version I put my son through is, if anything, more primitive — it’s a tribal blood rite, for god’s sake — but since he literally belongs to a tribe, it seemed necessary. I do believe that this study shows what it purports to and feel faintly vindicated, since I’ve been ever unimpressed with people who blame everything that’s wrong with their bodies and their relationships on something that doesn’t remotely faze the vast majority of "survivors," and I object to the word intactivist on aesthetic grounds — but finally, again, it doesn’t matter. Routine, nonreligious, nontherapeutic circumcision was a peculiarly American, distinctly 20th-century fixation, and a fairly nasty one at that. So what if it isn’t crippling? It’s still stupid.

Love,

Andrea

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RECAP recap

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› andrea@altsexcolumn.com

Dear Readers:

Since the major anticircumcision group is called, rather cleverly, RECAP (RECover A Penis), and since the letter below refers to an exchange in the column going back years, I think a recap might be in order. Way back when, I briefly shared the militantly anticirc bench with the rest of the loons, although I must admit I did not much enjoy their company. By the time I ran the original columns I’d — oh hell, here’s the original, slightly edited:

"I have actually put a great deal of consideration into my stance on circumcision, or rather, lack of one. Growing up Jewish among Jews, plus growing up American in an era in which American boys were just sort of automatically clipped, like Dobermans, I never really gave it much thought. Then I became a sex educator and a huge advocate of consensuality in all things … and developed a fairly militant opposition to cutting healthy parts off innocent children. Then I talked and talked with men and men … plus attended my nephew’s bris, which was lovely, and by the end I was all, ‘Huh. Well, this is problematic, but I think people are making too much of a fuss.’

"There’s no question that the procedure is both unnecessary and nonconsensual, and it’s obvious that the nerve-rich, self-lubricating, and glans-protective foreskin is meant to be there. But most men get along just fine without theirs … get plenty of pleasure out what they do have, and are able to leave behind whatever grievances they might have against their parents and the medical establishment."

While I’m waxing autobiographical, I’ll add that since I wrote that, I found myself rekindling a romance with my roots, having a nearly irony-free traditional Jewish wedding, and eventually not only agreeing to circumcise my son but basically insisting on doing so. I’m still against routine, pointless medical circumcision, but I don’t think I’d be welcome on the radical anti bench anymore. Sorry! Maybe Savage will sit with you. He’s interested in penises.

Love,

Andrea

Dear Andrea:

I think it goes a lot deeper than that the sensitivity-loss issue alone. Having part of one’s sex anatomy removed without your consent can tap into some strong and perfectly valid feelings of violation. It can involve a lot more than a simple "OK, I have lost X amount of sensitivity, but hey, I can still enjoy sex, so no big deal." What does one do about feelings one is not supposed to be having and that nobody takes seriously?

I liked your statement about American boys being "automatically clipped, like Dobermans." I hope you can see how being treated like a dog can be somewhat dehumanizing. Sure, parents and doctors had the best intentions, and I suppose we can look at it as a medical mistake carried out when there was less medical information and less consideration for ethics and individual rights, but that doesn’t mean we have to take it lying down.

Sit idly by and accept that doctors continue to perform the same surgery on infants that should not have happened to me a couple decades ago without speaking up? I wish more people had spoken up then — maybe I might have escaped this needless surgery.

Love,

Another Concerned Penis Owner

PS Circumcision is apparently protective against HIV, and we all know Africans can’t possibly be educated and entrusted to use far more effective and far less invasive measures than surgery to avoid contracting the virus. I read a press release that actually listed circumcision first among a list of preventative methods: "All avenues and approaches toward prevention need to be pursued, including circumcision, condom usage and antiretroviral drugs…" I suspect that circumcision does not hold a candle to the efficacy of a condom or a sensible approach to sexual conduct. And what of education? That American doctors might start using this as yet another reason to circumcise babies (despite the fact that the United States happens to have one of the highest HIV rates in the modern world and by far the highest routine circumcision rates) is a whole other topic.

Dear Concerned:

Well, it is, and it isn’t. I think you’re having a perception problem. While you understand intellectually that routine circumcisions are in fact less common every year in the US, your intense investment in the subject is making it hard for you to see that there is no evil scalpel-wielding cabal for you to rally against. The American Association of Pediatricians is officially anticirc. Even I am on your side. You’re winning.

Africa is another question. The sad truth there is that no, education is not enough, and no, condoms are not enough. There has been no shortage of either, and still the epidemic rages. Right now circumcision looks good — very good — as an additional weapon (nobody’s arguing against education and condoms) against a disease that is wiping out villages and leaving generations of children to starve in the streets. Up against that, a foreskin really is just a few inches of expendable flesh.

Love,

Andrea

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Plus ca change

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Dear Andrea:

Why, umpteen zillion years into the AIDS era (I used to volunteer for Gay Men’s Health Crisis in the 1980s), is there still no useful data about the risks of oral sex for men? Have we really learned nothing since the first appearance of "Low risk but not no risk"? With the understanding that not letting someone come (or precome) in your mouth is a start (but also loses a lot of the appeal), is there any sensible way to assess and reduce the risks of the common American blow job?

Love,

Loyal East Coast Reader

Dear Loyal:

Actually, the relative risks of the Great American Blow Job have been much on my mind of late. I’m working on an article about whatever happened to the heterosexual AIDS epidemic and what straight, middle-class ladies should do about HIV when they start dating again after their marriages break up. (Quick answer: nothing. They’re not going to encounter any, but while they’re taking unnecessary precautions against HIV they’re incidentally protecting themselves from real menaces like human papillomavirus and herpes.) Not that this applies at all to your question or your demographic; what’s sauce for the goose, after all, is not necessarily sauce for gander and gander.

Back when you were first volunteering in New York and I was out here gearing up to become a sex educator, nobody knew nothin’, and the safest thing to do was to lump everything that might possibly be dangerous into "Thou shalt not" and try to get people to take a "100 percent safe" pledge. I suspect that then, as now, the people most likely to achieve 100 percent safety weren’t at much risk to begin with, while the hard partiers continued to party hard-ly, no matter what their T-shirts said. I know for a fact that politically aware womyn at the time would not shut up about woman-to-woman transmission, which turned out to be so much poppycock — or poppyhen, as they might have had it. Likewise, the much-ballyhooed heterosexual AIDS epidemic never made it off the cover of the news magazines and into the bedrooms and bloodstreams of straight America.

So, your question. If there were a definitive answer to that, it would be coming out of a few labs here in San Francisco. But of course, HIV being a shifty bugger and human behavior being even worse, there isn’t. There are animal studies (using simian immunodeficiency virus, which is similar but by no means identical) demonstrating that you can easily spread the virus by swabbing monkey tonsils with an infected Q-tip. Then there are the epidemiological studies like HOT, the HIV Oral Transmission study, dedicated to finding those cases in which a guy gave blow jobs but never, ever, ever had unprotected anal sex and seroconverted anyway, and that is so complicated a business I’m going to let one of the researchers explain it:

"I’m going to conclude with the HOT study, in which, again, we interview men who we screen and rescreen to ascertain that, in fact, their only risk is oral sex. So they are a special population, and they are screened and rescreened, and they get their HIV test, and eventually we do another very in-depth interview, and after three corroborating screenings, or two screenings and one interview in which they say they’ve only had oral sex, 25 percent later report a higher risk exposure — anal sex in the same time period — after we get them in another environment with a different questionnaire and a face-to-face interview, and this is after they’ve been told that, in fact, they’re negative. And so we see this working many ways, and they’re, like, ‘Whew! Well, now I can tell the truth.’ But in fact, of those 363 men, we estimate that up to a quarter of them probably weren’t having only oral sex, and so I think that we have huge problems in terms of self-reported risk behavior."

That was from a very informative experts’ roundtable discussion I found on HIV Insite (hivinsite.ucsf.edu), a UC San Francisco site I have just declared required reading for the interested. The good news is that the best work currently being done is readily available to us for free. The bad news is that, due not to bad science or lack of science but to the vagaries of human memory and human motivation, they still can’t really answer your question. How many new HIV infections are caused by fellatio to ejaculation? I’ll let the above experts answer that. It’s funny but not, you know?

JK I think we agree it’s less than 5 percent, don’t we?

SB Uh, … yes, I’d probably say it’s — it may be less than 5 percent. I’d say 5 percent or less. But I wouldn’t say 1 percent either.

JK Well, 1 percent is less than 5 percent … [Laughter]

KS Well, I wouldn’t say "5 percent or less."

SB So I don’t know that we’re going to come to consensus on that.

And what’s the best way to reduce whatever risk there is? Not going down on HIV-positive men. Easy for me to say, sure, and awfully glib, but you can’t say it ain’t so.

Love,

Andrea

Hurt!

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Dear Andrea:

I have recently discovered that I’m one of those lucky women who can ejaculate. Hooray! Except when it gets really wet and wild, I am plagued by a burning sensation. It isn’t enough to stop the action, but it’s annoying, and makes me think that I’m hurting myself. Could it be that my boyfriend’s super-rough hands are giving me microscopic little cuts? It gets pretty heavy at times. Why is too much of a good thing making me burn?

Love,

On Fire

Dear Fire:

Oh lord, I’m seeing those little wavy lines that Mike Myers used to do with his fingers on Wayne’s World right before the flashback scenes. I’d forgotten all about "Freshenup, the gum that goes … squirt!," a singularly unappealing product heavily promoted when I was in high school, but YouTube, of course, has not (www.youtube.com/watch?v=_oWF2bSZjGM). Back then my friend Ted used to wander around pretending to wince in pain and muttering, "The gum that goes … hurt!" under his breath. This was before Ted went manic and wrote 150 songs in one week and ended up on a locked ward, but … oh, sorry, wavy lines. How could you have expected that your perfectly innocent question would cause that sort of reaction in me? I can’t be the only one who’s thought of that squirty gum over the years, though, especially when the topic of female ejaculation comes up, and done some wincing herself. So gross. Squirt! What were they thinking?

Anyway. I think you’ve answered your own question with the mention of super-rough hands. I’m not sure if you meant that he tends to play pretty rough with you or that his hands are literally alligatory, but either way, how can we begin to solve this if he’s roughing you up every time you get down? If it’s really skin roughness, then we (this includes me) are going to have to get comfortable with the idea of our guy getting a little Queer Eye with the self-care products and start using an oily scrub (these can be found in manly scents like eucalyptus or menthol or, I dunno, beer) in the shower and lotion after. A manicure wouldn’t hurt, either. If it’s the former problem and he’s just very grabby or pinchy or punchy, we’re going to have to ask him to cut it out. Of course, if you like it rough (you’d have plenty of company), this is going to be a little bit harder to solve.

If he’s actually tearing you up a little, the main culprit isn’t going to be pressure, it’s going to be friction, so see what happens if you use just a ridiculous amount of lube, preferably the space-age silicone stuff which is so antifriction it’s practically antigravity. This stuff is dangerous: it has magical container-escaping properties and once it’s on your floor it kind of wants to kill you, but it will make his gnarly fingers glide over you like a little swan on a glassy pond. With lily pads. Or it might, anyway. It’s worth a try. So is teaching him how to touch nice.

OK, so that’s why you might be hurt and how to stop it. The next question is why does it sting when you ejaculate and not when you, say, whistle "Dixie"? Well, we know why but nobody wants to talk about it except me, or so it seems sometimes. It’s stinging because the fluid that’s getting in there is a mite acidic, and it’s a mite acidic because it’s pee, sort of. We’ve been over and over this, but I always feel, afresh, like I’m popping the world’s sweetest child’s most favoritest balloon.

The quick version goes something like this: the glands rumored to be responsible for the squirt, the Skene’s glands, which cluster along the outside of the urethra, are too tiny to produce or contain the truly shocking amounts of fluid that some squirters can loose upon the world or their partner’s face. That can be about half a liter of stuff, a water bottle full, so no way. The awkward but so far scientifically supported truth appears to be that the bed-soaking stuff originates in the bladder and is expelled through the urethra, very much like another, more familiar fluid that we make and discard gallons of on a regular basis without giving it anywhere near this much thought. The stuff we’re privileging by calling it ejaculate is not, in fact, identical to the pee we pee when we need to pee. It’s much diluted, basically water, and we still don’t completely understand how a woman who emptied her bladder right before coming to bed can produce so damned much of it so soon after, but it does often contain pee’s signature substances: urea and creatinine. And where there’s pee and abraded skin, there’s a stinging sensation.

Try to avoid broken skin. Get your boyfriend in on the effort. It will work, and this will work out.

Love,

Andrea

Andrea is home with the kids and going stir-crazy. Write her a letter! Ask her a question! Send her your tedious e-mail forwards! On second thought, don’t do that. Just ask her a question.

Just do it

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Dear Andrea:

That nursing column wasn’t real, right? I’m all for attachment parenting — in fact, my three-year-old is still co-sleeping, and we’re just grateful that he sleeps at all. But we have a spare bedroom. We have a couch. Hell, we have a kitchen table and the living room floor. They must be able to find a place to have sex that isn’t directly next to their sleeping child?

I’m glad the column is going to venture into the realities of sex after parenthood, even if I’m going to be squicked out all day now.

Love,

Gentle Reader

Dear Gen:

Sorry for the squickage (although it does tend to come with the Alt.Sex territory, doesn’t it?) and I’m glad somebody likes the parenting stuff! It’s not always easy for me to reconcile my print life as a (one hopes) sexily knowing know-it-all with my current real-life life as a slightly befuddled toddler wrangler in a faintly besnotted T-shirt.

The letter was, as I admitted, a work of fiction by an online friend who was squicked herself by the tendency in some quarters of the Interweb to turn enlightened parenting into a competitive sport. "Attachment parenting," for those not playing along at home, is supposed to foster in your children such a secure sense of loving support at home that they feel safe exploring the world independently. Those people happily boasting online that they obviously have to homeschool because their six-year-olds simply aren’t ready to wean yet are missing the point, probably on purpose.

And what, besides breasts, does this have to do with sex? Enough, I figured, since even those of us sensible enough to avoid getting into ridiculous babes-in-arms races feel the pressure to privilege baby above all. While wearing my sex advisor hat (and what does that look like? one wonders somewhat nervously), it’s my job to worry about the grown-ups.

So what of noncrazy parents struggling to maintain a sex life in the face of a sudden incursion of tiny, extremely demanding people into their lives and beds? Even people who started out absolutely determined that crib is crib and bed is bed often end up with a small person occupying essential real estate. What does one do? I’m glad, for instance, that you have a spare room and a coffee table and a large macramé plant holder to hang from, or whatever you listed there, but do you really use them? Do you leave the baby sleeping quietly in your queen-size and sneak off to disport yourself in the garage? Good for you if so (and no, I’m not being facetious — I mean it: good for you), but I think many people mean to and hope for the best, but end up sighing and kissing goodnight and sinking gratefully into Morpheus’s arms instead of each other’s. It’s understandable. We’re tired!

The other conventional wisdom beloved of (presumably baby-free) sex advisors is to take a weekend away just for the two of you (or, in the interest of inclusivity, the three or more of you, if that’s what you’re into). This is nice on paper, but if you have a baby, let’s face it: you’re not leaving him or her for an entire weekend to go golfing on the Lost Coast. You’re just not. If your children are old enough to understand that Mommy and Daddy, or Mommy and Mommy, or Mommy and Daddy and Mommy (enough — inclusivity makes me tired) are coming back, then maybe. But the price tag on a weekend away plus 24-7 nanny time is scarifying enough to kill Mommy and Daddy’s buzz three counties away. So mostly a "no."

If I didn’t believe so strongly that a decent sex life really is key to a decent home life, and that happy people make better parents, and that better parents make healthier babies, I’d be tempted to say, "Aw, screw it, just give up and hope you’ll get your mutual mojo back in a few years when the kid’s over needing Mommy and Daddy all night." I do, though, so I’m going to suggest sneaking him back into his own bed in the sleep-like-the-dead early dawn instead. And getting a relative (or hiring a teenager) to take the kids out on a weekend morning twice a month. And getting TiVo to record The Daily Show instead of wasting precious baby sleep time staring at the tube.

Again, more later. In the meantime, my bedside table may have held more exotic objects in its time, but it currently boasts a copy of And Baby Makes Three, by John M. Gottman and Julie Schwarz Gottman. I don’t ordinarily waste my time on self-help lit, but Gottman is the man who made a science of saving marriages, or at least accurately predicting which ones are capable of saving themselves. He’s the one who determined that rolling your eyes with contempt when your partner speaks means you might as well start dividing up the CDs. So don’t do that, people, and I’ll be back with a book report.

Love,

Andrea

Andrea is home with the kids and going stir-crazy. Write her a letter! Ask her a question! Send her your tedious e-mail forwards! On second thought, don’t do that. Just ask her a question.

A big how-to

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Dear readers:

The subject of size-discordant couples, discussed here recently, is a perennial favorite and will only get more so until such a time as we USA-ians fulfill our currently apparent destiny and become a nation of like-size giants in both height and girth. Till then, though, making a couple’s ends meet will continue to be an issue and a puzzlement. I suggested pillows, as usual, specifically the sort of ramps and wedges sold expensively as sex pillows and less appealingly but more affordably at medical device emporia, and heard from half of such a couple who eschew such artifice and stick with the basics (this is for a tall guy–short girl couple, remember; thin person–fat person follows):

His wife can kneel on the bed, crouching forward a bit and stabilizing herself with her arms, with ass towards the edge. Unless the guy is the Jolly Green Giant, he should be able to steer into her with just a little doing. She will be more comfortably positioned on the bed than bending over while standing up too. My partner is six feet one, and I’m five-three — we make it work just fine!

Then I took the discussion to one of the invisible rooms full of invisible friends I frequent out on the Interwebs. (What? You don’t have invisible friends? I couldn’t live without them, and they come in very handy at this job too. Where do you think I found you a cabaret singer who can give advice on felutf8g with abandon without causing damage to the vocal cords, for instance, or a realtor willing to comment on the thankfully now-fading fad called "house humping"?) This invisi-friend is generally rather reserved and bookish in style (I was going to say "gently reared" but thought better of it in context), unlike another longtime Web friend I might have asked to comment, the possibly altogether-too-fabulous Miss Plumcake, now busy garnering famitude over at Manolo for the Big Girl (manolobig.com). Still, still waters and all that. Here is my bookish invisi-friend, in all her surprising, not to say shocking, candor. Say thank you!

"I am very fat. My husband and I are both about the same height, and he’s slender. We both have joint problems. We also have awesome sex. So, here are some things that work for us — keeping in mind that it never hurts to stretch a little beforehand.

"The best all-around position is what we call scissors. (Possible a misnomer — it’s not the classic scissors position, almost more of a hybrid between that and spooning. Spissors.) I lie on my left side, knees slightly bent, and raise my right leg. He kneels and enters me, and we roll over, me pushing off with my left leg, so that he winds up lying on his side and I have my right leg over him. My left leg is between his two legs. I am almost, but not quite, lying on my back, and we’re at an angle to each other. This is great because it’s completely comfortable, he can reach to touch me, and we both have good access to me for hands or vibrator. A variation on this is to leave me on my side but throw my right leg over his shoulder while he remains kneeling — great penetration and good access — but it’s not as comfortable for long.

"If you have the right furniture, cowgirl can be very easy. This position blows his mind. We line up a rectangular ottoman perpendicular to the sofa, and he lies back — propped up on big pillows — with his butt on the ottoman. He’s lying near one end of the sofa so that I can use the arm to help take my weight. All I do is straddle the ottoman and him (they’re almost the same width) and lower myself. Once down, I can rest my arms on the sofa, lean forward, or sit upright. It does give my thighs a workout, but despite my weight it’s comfortable for him and much, much more comfortable for me than kneeling on a bed — my weight is either sitting down on him or on my feet. He has a fantastic view and it’s perfect for kissing. Only drawback for me is that I can’t really get to my clit.

"Three or four bed pillows also help for doggy-style, so I don’t have to rest my entire weight on my arms. The sofa and ottoman are also handy for this position; I put one knee on the sofa, one on the ottoman, and he stands behind me while I rest against the sofa arm, piled with cushions.

"Positions that don’t work so well: reverse cowgirl (who cares anyway?) and classic missionary. We can do the latter, but it’s not very comfortable, and I don’t recommend it for the big-bellied."

If more people wrote me letters like that, I wouldn’t have to get child care on writing days. I could just cut and paste and go play patty-cake. So get on that, readers, won’t you?

Love,

Andrea

Andrea is home with the kids and going stir-crazy. Write her a letter! Ask her a question! Send her your tedious e-mail forwards! On second thought, don’t do that. Just ask her a question.

Sucks to be you

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Dear Andrea:

My wife and I are the proud parents of an eight-month-old boy. While I was prepared for the postpartum lull in the bedroom, I was not at all prepared for the combination of sex and nursing.

My wife has gotten really into attachment parenting and co-sleeping and it took me a while to get comfortable with having sex with the baby in the bed, but, generally, my appreciation for the rare opportunity always ends up outweighing any discomfort. However, the last two times we’ve had sex, he has awakened in the middle of things, and rather than stopping, my wife has just put him to her breast and said to go ahead with things on my end. I’m really not comfortable sharing my wife with my son in this way. And frankly, no matter how much she moans and sighs, I just don’t think she can be that into it when her attention is divided like that!

When I’ve brought up my concerns, she accuses me of not having our son’s best interests at heart and points me to all of the attachment parenting literature about how not responding to his needs will hurt his neurological and emotional development. I don’t want to hurt my son, but I also don’t want to sleep with a vending machine. You’re a mom now — am I being a jerk?

Love,

Married to the Lunch Lady

Dear Lady:

My first response to your letter (after the admittedly rude cackling noise I made on reaching the part where she gaily calls out, "Carry on!" as though she hadn’t just grabbed the child and held him out in front of her as a human shield against any further attempted intimacies on your part) was sorrow that it was unprintable. You are not, after all, a sad, snaggy guy being slowly pushed out of the marital bed when the little one said, "Roll over!" You are a (female) online bud of mine who wrote this letter as an exercise following a discussion of what makes for good column fodder, and I bless you for it! It’s a great letter, fictional or not, and hey, lookit, I don’t even have to correct your spelling. So let’s just act as if, shall we?

Your wife has not so much adopted attachment parenting as she has, I wager, been assimilated by the Übermamas, a leaderless cult whose hive mind is headquartered at the MotheringDotCommune Internet forums. It is fashionable in that milieu not only to parent children to within an inch of their lives but to view husbands the way a lady mantis might describe her views on marriage and partnership, if asked: good for one job only, and that easily performed without thought or decision-making privileges or, indeed, a head. Dude, you must reclaim your head and put a stop to this — if not for yourself, then for your son! What sort of model of manhood is this for him?

Actually, he’ll be fine. It’s you I worry about. You must know that attachment parenting does not even require that you adopt what is optimistically known as the "family bed" (often, in practice, a "Mommy and baby while Daddy sleeps on the couch" bed), let alone the abomination that is "Oh, carry on, don’t mind him stuck on my tit here." All shock and revulsion at the actual act aside (about which more in a minute), you must realize that "go ahead with things on my end" means that there’s nothing going on on her end. I’m sure there are readers who will spaz out over the child abuse aspect, but I assure you there is none. This isn’t about sexualizing the child; it’s about desexualizing you. You will soon find yourself consigned to, at best, the couch or, at worst, someone else’s couch. If nobody’s ready to have the baby sleep in his own room yet (I am not a huge fan of banishing baby, myself) then get a side sleeper or a dresser drawer or something and let him snooze away peacefully in there while you and your wife snuggle or sleep or do other things starting with s. Speaking of which, this is serious.

Now, as for what your wife may be feeling, I confess to oversimplifying in an earlier column when I denied that suckling could ever feel anything like, well, sucking. Of course it can. Not only are the sensations superficially similar (although I don’t advise partners to do the weird rhythmic press-and-swallow thing while making a fishy-mouth face, not sexy), we have only so many physiological responses available to us. Nursing can feel good, and it releases the same hormones that sex, or rather having had sex, does. I’d even venture to say that the release of good feelings (mostly hormonal-emotional, but to some extent physical as well) is adaptive, evolutionarily speaking. Then I’d say that that’s all very well but we have evolved pretty far and we can keep these things separate and I heartily encourage us to do so. More later.

Love,

Andrea

Andrea is home with the kids and going stir-crazy. Write her a letter! Ask her a question! Send her your tedious e-mail forwards! On second thought, don’t do that. Just ask her a question.

Going topless

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Dear Andrea: My girlfriend is really into BDSM. At first I tried and played a convincing (I think) top-dom, but it just wasn’t hot for me, so I looked some stuff up to get inspired. As I was reading-watching, I would really get off on it, but the sex with my girlfriend still wasn’t hot. Then I realized that when I was masturbating to all this I was fantasizing about subbing. Oops. I am way in love with my girlfriend, but she is a bottom. Period. She might switch it around if it meant a lot to me, but I would know that it wasn’t really making her happy. I don’t know what to do. Can I become a top? Can I teach myself to like it? I’m going to do it either way but I really want to get into it, so please help! I want us to be good in bed together but two bottoms don’t make a top. Help! Love, Topless

PS We’re lesbians, if that matters.

Dear Tops: It sure doesn’t, but thanks for the info!

I was just thinking about this last night when a friend was catching me up on her latest dating adventures. She was lamenting that some potential dates seem to come equipped with a set of kinks perfectly matching her own, and though that sounds good, it is of course no use at all. As you have discovered to your frustration, one wants a date with a complementary set of kinks, not a matching one. It’s not an uncommon problem, and its most common manifestation is exactly the one that’s driving you nuts: there are too many bottoms in this world and nowhere near enough tops to keep them satisfied. Why this is (beyond the fact that topping is hard work) I couldn’t tell you for sure, but I bet any number of eager grad students are currently proposing theses on the subject to bored advisors who have read enough similar stuff already.

Here’s my theory: There are people for whom BDSM is a core part of their identity, running as deep as, say, homosexuality or monogamy. Some may always have recognized this element in themselves, even before they had the language to express it (these are the kids who always want to play pirates or whatever game involves somebody getting tied to something or intentional infliction-receiving of pain, even when the other kids are long since ready to move on). Others don’t realize it until they’re exposed to S-M in some more adult context, but then it just clicks in, key into lock, and they know. Your girlfriend sounds like one of these BDSM lifers, who tend, in my experience, to be pretty set on their preferred role even if they do switch experimentally on occasion (a good idea, if only to find out how painful-exhausting it is to experience-produce any particular sensation).

Then there are the anything-goes people, who are happy to pick up a flogger or don a dog collar, what the heck, as long as it’s fun. This type of player may not identify as an S-M person per se but may just enjoy a little power exchange on the occasional Friday night, no biggie. You may fall more on this end of the spectrum, but even what-the-heckers will usually discover some sort of preference, as you have. Most people do have a preference: Rare or well-done? Black or with milk? The perfect 50-50 switch is almost certainly as rare as the perfect 50-50 bisexual, but plenty of people find something to like in either role. I do think you can develop an appreciation for topping and get some satisfaction out of a job well done (there are resources like The New Topping Book by Dossie Easton and Janet Hardy to help you with this), but you can enjoy and get good at it without every really becoming a top the way both of you are currently bottoms. Be careful about taking on a role that isn’t really you, though. Nobody loves a martyr, and you’re still going to want to bottom sometimes. I worry about you starting to resent your girlfriend for getting to have all the fun.

I have a suggestion that might save your relationship or might strike you as all sort of wrong and make you hate me, but here goes: you guys find a willing top, maybe somewhere in your extant social circle, maybe online or by joining a BDSM social organization, and bottom together sometimes. This kind of shared adventure can be hot, hot, hot and very bonding, sort of like getting lost in the woods together and surviving through mutual trust and interreliance, but a lot more fun. I think if you do that sometimes, and play top sometimes, and stick with the vanilla sometimes, you’ll probably be OK, provided you both take care of getting your itches scratched. Love conquers … much. Love, Andrea

Andrea’s on vacation this week; this column ran previously (7/05/06). But she’s still checking e-mail and eagerly awaiting your questions about love and lust!

Eye spy

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Dear Andrea: I’ve found myself a femmy boy who’s willing — nay, enthusiastically prepared — to wear green eye shadow in public. This is delicious. However, we live in Colorado Springs, Colo., which is for its size a wealthy and well-educated town, but also headquarters for Focus on the Family, New Life Church, Will Perkins, Fort Carson, NORAD, and the Air Force Academy. One of my femmy-boy friends was recently chased down an alley downtown by some of the local military simians for the apparently gender-treacherous crime of wearing a top hat. It was lucky for him he knew the area well and wasn’t nearly as plastered as they were.

My two questions about the eye shadow thing are these: First, and I understand if you’re not able to answer because you don’t live here, if we do go on a date while he’s wearing it, what do you think our chances are of finishing the evening without getting the shit beaten out of us? And second, what’s your opinion on where one should put one’s feet while treading the fine line between keeping yourself safe and taking a stand for the right to do what you want with your body if it’s not hurting anyone else?

I guess the question is along the same lines as, how do you feel about him wearing a ball gag and leash to the local Starbucks? Eye shadow is just a less overtly sexual signal. Well. To some people. Not to me. Love, Don’t Kick Me

Dear Kick: Gotcha. And no, I surely do not live there, nor would I, but we did blow out a tire there on a cross-country trip once and got stranded for a couple days. Pretty town. Really nice park. I knew all that stuff (Air Force, antigay groups, etc.) was there, but you can’t tell by visiting — it’s not like there are giant "Fags go home" banners flying gaily over Main Street or anything. But would I, were I a guy, dress up in my gayest glad rags and sashay down the same main drag in a pair of darling red wedge espadrilles and a panty-girdle? I would not. I suspect you would not, either, were you a guy (you’re not, right?). It would be no safer for you to accompany your new girly-boy while he did it either. There is sticking up for your inalienable right to be a weirdo, and there is stupidity. I draw the line at stupidity in any other context, so why would I make an exception for this one?

There was a time in the late ’80s and early ’90s when all the cool kids were making a spectacle of themselves in the name of political action: visibility, I think we called it. All you had to do was print up some T-shirts or stickers and show up en masse where you weren’t expected and you got to feel all brave and thrillingly transgressive and challenging to heterosexual hegemony and stuff. It was great. It was also kind of fake — when you’re surrounded by a few dozen or hundred or thousand of your closest friends and you’re in San Francisco or New York or Washington, not Jakarta or Beijing or rural Rwanda, you’re pretty safe. Even if the cops get you, you’re going to be cited and set free; protesters in the United States are rarely brought to trial, let alone found bound and beheaded in a ditch. That doesn’t mean that nothing we do here is dangerous, though, and unfortunately walking certain streets in a state of visible gender ambiguity can still get you kicked in the face.

There is no set point on the continuum from safe but stifled to "Kick me" that I can recommend you find and cleave to, never again to stray. I do not think it would be very smart to dress your boy up and parade him around near the base at bar-closing time on a Saturday night; nor do I think those of us who fail to conform in every particular to local community standards for gender performance need cower at home forever for fear of attracting a disapproving glance. Somewhere between "Don’t frighten the horses" and "Fuck ’em if they can’t take a joke" lies the perfect level of public self-expression for you two as individuals of your particular place and time. Find it. Also consider finding some fellow gender traitors with whom to make your scene, even if that scene is no more trangressive than going out for fish and chips (I’m pretty sure that’s what I ate at your local brew pub while waiting for our truck to be fixed so we could get the hell out of there) and the late showing of Snakes on a Plane. I think you’ll be OK. I wouldn’t recommend the Starbucks–ball gag excursion, but that’s because it’s in bad taste, not because it could get you killed. You’ll have to use your common sense. If you haven’t got any, I really do think you’d better stay home. Love, Andrea

Andrea’s on vacation this week: this column ran previously (8/22/06). But she’s still checking e-mail and eagerly awaiting your questions about love and lust! Contact her at andrea@mail.altsexcolumn.com.

Diet plate

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› andrea@altsexcolumn.com

Dear Andrea:

I’m in my thirties. Most of my life, my sex drive has been pretty low — not during the "honeymoon" phase, but within a year, it tends to taper off to almost nothing. This significantly, negatively impacts my relationships (my last one ended due to not enough sex; my current one has same problem).

I suspect this is pretty common. What are the typical causes of low libido in women? I don’t really believe in aphrodisiacs, but are there any proven treatments?

Love,

No There There

Dear There:

Female sexual dysfunctions are, somewhat sadly, a growth industry. With the latest research indicating that something like 40 percent of women experience something dysfunctionish (most often low desire but also anorgasmia, aversion, or pain), you can see how people who develop and sell new treatments might have their eye on you. All good, to a point. We don’t want to see the same preying on the desperate but not that bright that supports the cosmetics industry. Did you know there’s already a real product called Hope in a Jar? Let’s not have another.

Male sexual dysfunction is usually easy to recognize and fairly easy to treat. Most men who think there’s something wrong down there want sex — oh, do they want it — but are hampered by lack of or loss of erection, or by coming too fast or, sometimes, too slowly (it’s always something). We women tend to keep our dysfunctions tucked neatly away out of sight, like our genitals and our vibrators, so problems are harder to quantify and harder to treat. This is especially true of the desire disorders, which occur in men but are practically epidemic in women. Causes may be hormonal, situational, or historical, and it’s tricky even to figure out if you have one, let alone to treat it. How hypo does a hypoactive sex drive have to be before it is considered a problem? And who is it a problem for? Is there a right and proper level of desire out there, and ought women who don’t meet it feel inadequate or just different? Must women’s desire match men’s in order to be considered normal? Should a woman "fix" herself to suit a partner, even if she would be pretty much satisfied with whatever amount of sex her natural inclinations tell her is enough? See what I mean?

There is, I’m afraid, nothing yet available in the way of an aphrodisiac for women (or for men either, should they need one; the history of aphrodisiacs has mostly involved men slipping random substances into women’s drinks and crossing their fingers). There are a few things in the pipeline, very close to release, or already available off label, although most are just testosterone with assorted delivery systems. Testosterone patches will be worth trying when approved, but they’re simply not going to work for everyone (most of the trials have enrolled naturally or surgically menopausal women only) and aren’t safe for everyone. Testosterone has been shown to be effective, though — it seems to be responsible in large part for the "go out and get me some" drive that most men tend to have in greater abundance than most women do, even highly sexual women, so it’s the obvious place to look for a treatment for "just don’t feel like it" complaints. Wanting to want it is probably the most common complaint going, but you still have to ask yourself why you want to want it before it’s really worth trying to want to want it, if you know what I mean. You do know what I mean, don’t you?

I do wonder if you are really even part of Hypoactive Nation or if you might have something altogether different going on. If you’re into it at the beginning, and then it tapers off, you may just be kind of a novelty freak (I’m guessing this isn’t it but you never know), or you might be — brace yourself for this one — having kind of blah sex, or sex with kind of blah people. If, for instance, you don’t have a lot orgasms because you’re not that turned on, and you’re not that turned on because you don’t have a lot of orgasms (so why bother wasting all that good pelvic engorgement?), you’ve got yourself a nasty little cycle there. Arousal disorders may not be as common as desire disorders, but they can create desire disorders. You know why some diets work, at least at first? It’s because the food isn’t appealing enough to crave or to stuff yourself with when it gets there. A few bites will suffice.

I’m wondering if perhaps the sex you are having (and have had) is of the cottage-cheese-and-tuna plate variety, and you need to work on finding your French triple-cream cheese on a fresh baguette and a pain au chocolate equivalent. Or if that doesn’t sound that appetizing either, what does, and how can you get some of that instead?

Love,

Andrea

Andrea is home with the kids and going stir-crazy. Write her a letter! Ask her a question! Send her your tedious e-mail forwards! On second thought, don’t do that. Just ask her a question.

Low T, no T

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› andrea@altsexcolumn.com

Dear Andrea:

I read your column about potential causes of a husband’s lackluster performance in the bedroom [8/8/07]. You mentioned that the letter writer’s husband should talk to his doctor about low testosterone, and I thought you might be interested in more information on that. As you said, low testosterone (low T) and diabetes are linked. In fact, a recent study found that men with diabetes are more than twice as likely to have low T than other men. To educate men about the link between low T and diabetes, the American Association of Diabetes Educators created the "Take Charge. Talk T." program, which includes a pamphlet men can take to their doctors or diabetes educators if they think they are experiencing low-T symptoms.

[List of low-T facts here: an estimated 13 million American men have low testosterone; symptoms include low sex drive, erectile dysfunction and depression; treatment is available in various forms; obesity and hypertension are also risk factors, etc. — A]

If you would like more information, please visit www.TalkLowT.org. On behalf of my client, Solvay Pharmaceuticals, which markets the testosterone therapy AndroGel, I am including fact sheets. If you plan on covering low-T or T therapy in the future, I would be happy to set up an interview with a doctor or low-T patient.

Best,

PR Lady

On behalf of Solvay Pharmaceuticals

Dear PRL (be glad I didn’t call you PharmGirl):

I have to finish poking myself in the eye with these sticks first, and then I believe I’ll have lunch, but I appreciate the offer. (Seriously, I may take you up on it at a later, less summer-vacationy date.) Unlike many people I encounter while doing vaguely progressive work in a place where more people practice Tantra than go to church on Sunday, I don’t dismiss out of hand the idea that so-called "Big Pharma" can be a source of good. How can I, after all the intensive interventions that got my kids and me through a dicey beginning, not to mention my long love affair with antidepressants and a devoted fan-girl relationship with Viagra and the gang? While dispatches from Big Ph are best taken with both a grain of salt and a diuretic for the sodium sensitive, I’ll still take them. And I do like the idea of checklists the patient can take along to the doctor. What with the research being newish and the subject being vaguely sex-related, some doctors are just going to nod and smile and pretend they never heard a request for a testosterone test, and one may be able to catch their attention by waving a few brightly-colored pages about. There are some such available on the pharma-sponsored site to which Ms. Lady linked, www.talklowt.org, and I can’t see any reason not to use them, although they do contain a few quibbleworthy statements like "A simple blood test … will determine if your testosterone levels are below normal." From everything I’ve read elsewhere, this ought to be precisely untrue: testosterone may be bound by sex hormone binding globulin, so either high or low SHBG, both common, will produce inaccurate test results. You will want to wave around some pages about how to get an accurate testosterone test done along with the others.

Speaking of hormones, the other noteworthy note I got last week came from a trans woman (I assume) incensed at my — what else? — insensitive use of language. The subject was a recent "Why does my guy look at tranny porn?" question [8/1/07], and in case the one letter I got really was standing in for a thousand equally pissed-off people too lazy to write letters, I thought I’d clear up a misunderstanding or two while I’m waiting for lunch or a poke in the eye, whichever I was going to do first while avoiding a visit from a doctor or a patient with low testosterone. My correspondent took offense at the term transsexual porn, pointing out that some transsexuals are adopting the term "Harry Benjamin’s syndrome" (Benjamin created the well-known Standards of Care for patients seeking sex reassignment surgery) to avoid just such a sexualization of their identity.

Indeed, but then I have to point out that (a) people choosing this label are a very specific subset of a large and often fractious community, and (b) you may repeat "No transsexual would be comfortable being photographed displaying her private parts. And they certainly never identify as ‘chicks with dicks.’ What you are describing is something totally unrelated to transsexuals" as often and as emphatically as you like, and it’s still not going to be any truer than, say, "No Jewish American woman would ever go out wearing her husband’s underwear because she couldn’t find any of her own." The problem with umbrella terms like transsexual is that we may have to share them with people we think smell bad. My correspondent may prefer to think that all trans women don little skirts from Talbots and disappear into the genpop, but it just ain’t so. Don’t the nonops who pay for their estrogen by running ads in the back of papers like this one deserve inclusion? Where is the love?

Love,

Andrea

Andrea is home with the kids and going stir-crazy. Write her a letter! Ask her a question! Send her your tedious e-mail forwards! On second thought, don’t do that. Just ask her a question.

Craig, list

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› andrea@altsexcolumn.com

Dear Andrea:

I am in love with a girl a few years younger than me. She’s in her early 20s, and before me she had never had a sexual partner. The fact that I’ve been around the block over and over again made me reluctant to become "that guy." That said, our relationship has become very serious as well as emotionally rewarding.

The fact that I’ve been recruited as the lab segment for a human sexuality course has not been lost on me. I’ve done my best to exemplify a quality educational experience. We still have a couple of problems, though. First, I am an audiophile: besides having a good record collection, I’m physically aroused by sound. Even now I’m contemputf8g how I can turn my nonsqueaky bed into a squeaky bed. She’s pretty quiet (not letting go?), which leads to the second problem: the elusive orgasm. I know many women never have orgasms or don’t start having them until later, but I’m doing my best to make sure that she beats the odds. She has them when she masturbates but refuses or ducks the issue if I ask to watch. Currently she and I are separated by the vastness of the Midwest, and I’ve been devising different strategies to break through her mental block on her return. Any additions to the list would be welcome.

Stratagem one: convince her that I am not real. This would involve blindfolding, earplugs, tying her to my soon-to-be squeaky bed, and a very slow and imaginative seduction. This will end up happening in any case because it is just hot.

Stratagem two: make a symbolic charm, imbued with sexual voodoo.

Stratagem three: learn hypnosis, then subconsciously encourage her to let the fuck go. (Has any research been done in this area?)

Stratagem four: relax and just let it happen.

Stratagem five: get advice from a sex columnist.

Love,

Audio Science

Dear Science:

Oh my. You sure do use a lot of words, don’t you? Just like to hear yourself talk, is it?

It’s funny — I had your letter mentally filed under "physical problem solving: bed squeaks" and had you filed under "freaks: audio," but now that I read back over it, it’s really just the same old same old with a lot of extra words and a very small element of interesting freakiness. So let’s look at that first, in the interest of keeping me awake (sorry, late night). So: bed not noisy enough? Immediately I think, "Yay, engineering question — who do I know who might make a good consultant for that, and how do you reverse-engineer a squeak, and what sort of hardware would produce the desired degree of squeakiness … ?" and then I thought, "Good grief, let’s not get silly." (Or squeaky either: at a former job my husband used to have to attend meetings that tended toward the discursive, and at some point someone would interrupt the proceedings with a loud "Squeeeeak!" which meant "You’re going down a rat hole.") Most people, lacking your rarified sensibilities, find bed squeakiness annoying and distracting or even mood killing, as fear of being overheard by roommates or neighbors or, God forbid, parents can do that to a person, and these less-rarified people are dying to get rid of their squeaky beds, aren’t they? Wouldn’t someone be happy to trade? Not to go down a rat hole here myself, but I was walking down the street a few days ago and my friend said, "That guy looks familiar," and I said, "That was Craig Newmark. He’s Craig!" And why is Craig famous? He’s famous because people have beds they don’t want, and other people want those beds, and Craig makes it happen for them. Don’t fix or, rather, unfix your bed, and don’t buy a new one. Use Craig!

Now, your list. Your list, with the exception of stratagem five, is just not going to work. If indeed the young lady is not having orgasms (perhaps she isn’t, but all you really seem sure of is that she is not vocalizing them to your satisfaction, which is not at all the same thing), I would not advocate either doing anything weird or doing nothing. If she maybe knows what she likes but is reluctant to spell it out for you, I do advocate talking, books (Lonnie Barbach’s are the classics, although there are newer and more sciency ones out now) to clarify things and establish a vocabulary, and something like the "Do what I tell you" game, in which you, well, do what she tells you. This allows for giggling and admissions of shyness, plus, it is hot. So is your scenario with the blindfolds and whatnot, although that one does not make a whole lot of sense under the circumstances. You are hot for sound? You like to listen? You wear the blindfold, silly.

Love,

Andrea

PS As for hypnosis and orgasm, there is … stuff on this. A great deal of stuff. I wouldn’t call most of it research.

Andrea is home with the kids and going stir-crazy. Write her a letter! Ask her a question! Send her your tedious e-mail forwards! On second thought, don’t do that. Just ask her a question.

Meds and mads

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› andrea@altsexcolumn.com

Dear Andrea:

Is there any hope for my husband, who is not able to launch since he’s on tons of meds (diabetes, high blood pressure, high cholesterol, etc.)? He’s too embarrassed to ask the doctor, and asking would mean yet another pill. Could he be depressed? Are you the one to speak to?

Love,

Nothing Happening Here

Dear Haps:

I can be spoken to, but your husband is going to have to speak up for himself. The doctors should ask, but they often don’t want to or just don’t. Specialists especially tend to be interested in the parts they’re assigned to and may not remember that your husband has a penis or a wife or anything unimportant like that. If you’re concerned about something that just isn’t that doctor’s pet thing, you may have to nag a bit or call them and ask if they’ve looked into that thing they said they’d look into. (Doctors enjoy looking into things.) You may have to get a new doctor.

There may be hope for your husband (and you! don’t forget you!), but it may take a while to unsnarl things. Diabetes can cause erectile dysfunction all by itself, as can blood pressure meds. There’s another intriguing possibility that may be worth at least a mention: both forms of diabetes, although they are otherwise dissimilar, can cause low testosterone in men. It can be hard to determine because they have to look for "free" — unbound by the protein that carries sex hormones around in the blood — testosterone, which requires a special test, and the whole issue is still a little controversial, but it’s worth a look, since it’s a pretty simple fix. I found about a zillion articles on this by looking up "diabetes testosterone," and so can he, if he ‘s so inclined.

And finally, you ask, could he be depressed? Oh, very likely, I say, but if it’s situational it’s at least worth a try to fix the situation, isn’t it? It’s possible that there is no combination of meds that will help, or it may be that there is help but it is irksome and invasive, like a penile implant or shots. One thing I know for sure, though, is that sitting around feeling broken and hopeless never gave anyone a hard-on. (Yeah, yeah, I know. Somebody, somewhere. Sigh.)

Love,

Andrea

Dear Andrea:

It was love at first sight for my husband, but not for me. I tried to dump him but realized that I couldn’t live without him — he was the most wonderful human I had ever met, period. I still wasn’t in love, and he was OK with that. Sex was great in the beginning but quickly became a chore. I meet other men to whom I am attracted but never have been tempted.

The sex is bad because (don’t scream!) he’s overweight, really has no clue about basic things like kissing, and comes after three minutes. We talk about feelings and dissatisfaction constantly. I give clear instructions, but he forgets them immediately (funnily, we have exactly the same problem with cleaning!). But in every other way, he is beautiful, kind, and the person I was looking for all my life.

I make no effort because he lacks skills and endurance and can’t or won’t fulfill my needs. He swears he will get fitter and will try harder to fulfill me psychologically and physically. I know I have become a bit castrating, but he expects me to pick up where his mom left off in other parts of our lives, which is not helping our sex life.

I’m not sure that I can rebuild a hot sex life that barely existed to begin with. Maybe he just isn’t right for me and I can’t accept it. We need a sex therapist but have no idea of how to find one who’s legitimate. How do we repair something like this when we both have already talked ourselves blue in the face for several years?

Love,

Bored by the Bay

Dear BBB:

Oh, ugh, you’re not bored, you’re seething with resentment. Both of you. If this were just about skills or duration of erection, I wouldn’t be hearing about how he expects you to be his mommy or how fat he is. Nor would you ever have had great sex to hold up against the current lackluster offerings. Apparently he doesn’t clean the bathroom? And then he doesn’t keep a hard-on? And you yell at him about both of them? Stop that! Sit down together and comb over your budget until you find enough free cash to hire a housecleaner and a licensed marriage and family therapist. (You find the name of someone convenient and affordable in a referral database and ask them some questions and hire them if you get good answers or call somebody else. It isn’t rocket surgery.) Neither cleaner nor therapist needs to be a sex specialist. Husband can learn technique from books, or from you, but you don’t seriously believe he forgets every time, do you? This isn’t one of those forgetting-stuff movies. He’s mad at you.

Love,

Andrea

Andrea is home with the kids and going stir-crazy. Write her a letter! Ask her a question! Send her your tedious e-mail forwards! On second thought, don’t do that. Just ask her a question.

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