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kmaherali
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Post by kmaherali »

Coronavirus and Sex: Questions and Answers

Some of us are mating in actual captivity. Some of us not at all. The pandemic raises lots of issues around safe intimate physical contact, and what it may look like in the future.


These are not sexy times.

As an obstetrician and gynecologist in the Bay Area, I’ve been caring for my patients via telemedicine for the past three weeks because of the new coronavirus pandemic. When I ask patients about new sex partners — a standard question for me — the answer is a universal “no.” They are taking California’s shelter-in-place very seriously.

In fact, many of my patients are more interested in updates about the virus than the medical (and often sexual) problem for which they were referred.

The pandemic has most of the world practicing exceptional hand hygiene and social distancing. This coronavirus is so new that we don’t know what we don’t know, and while fresh information is coming at an incredible pace, one medical recommendation has remained constant: the need for social distancing.

This time has been an exercise in prioritizing needs from wants. So where does sex fall on that spectrum?

More....

https://www.nytimes.com/2020/03/30/styl ... n=Trending
kmaherali
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Post by kmaherali »

What Single People Are Starting to Realize

What will the first post-pandemic kiss be like?


In recent months, singles have fielded dating advice from unusual sources. Mayor Bill de Blasio of New York suggested it’s wise to skip a kiss. Health officials across the country reminded us, “you are your safest sex partner.” And Anthony Fauci outlined a PG evening in which those looking for love “put a mask on and, you know, chat a bit.”

Despite this chaste advice, people are dating. One Saturday, I dined with a funny Brit. The following Thursday, I met a handsome cinematographer for a gym session. All of it happened, awkwardly, on Zoom.

The dating scene is booming — it has just gone virtual. The League’s video speed-dating feature saw attendance double in the first week of social distancing. Messaging on Hinge surged 30 percent. And since March, the number of OKCupid users who have been on a video date has quadrupled.

Being single in a pandemic prompts an extreme reaction to that status. Early research from the Kinsey Institute suggests that while everyone is lonelier now, single people are the loneliest. The psychotherapist Esther Perel explained to me this is because crisis is a “relationship accelerator.” Unhappy marriages lurch to divorce. Young lovers rush to cohabitate on a third date. And single people realize: I don’t want to die alone.

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https://www.nytimes.com/2020/05/18/opin ... 778d3e6de3
kmaherali
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Post by kmaherali »

BIRTH CONTROL IS NO LONGER PROTECTED

Karim,

As many as 126,400 women.

That, per Ruth Bader Ginsburg, is the estimated number of women who will lose access to insurance-covered birth control as a result of today’s devastating Supreme Court decision in Little Sisters of the Poor v. Pennsylvania.

We’ve spent so much of the last few months—as a result of both COVID-19 and the Black Lives Matter movement—talking about health-care disparities and inequities. Today’s ruling is not only another setback in the ongoing fight for bodily autonomy, but also a new blow to underserved communities seeking reproductive justice.

What’s particularly alarming is that Justices Stephen Breyer and Elena Kagan joined the conservative faction of the Court to issue a landslide 7-2 decision that now allows any employer to deny birth control coverage by claiming a moral or religious exemption.

Done rolling your eyes yet? Us, neither. But fear not, as our dynamic legal duo, Jessica Mason Pieklo and Imani Gandy, are back with a rapid reaction podcast that will have you laughing and crying about the madness of it all.

What happened today is a direct attack on reproductive freedom—and the nuns’ victory is likely only to embolden those seeking to diminish reproductive rights. But as we’ve always done, Rewire.News will continue to provide the timeliest, most informative coverage on these efforts, ensuring that fair, accurate conversations about reproductive and sexual health issues stay front-of-mind.

Best,

Galina Espinoza
President and Editor in Chief

P.S.: Keep up with legal news and the courts by subscribing to the Rewire.News Weekly newsletter.
kmaherali
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Post by kmaherali »

Sexual Morality by C.S. Lewis Doodle (BBC Talk 14, Mere Christianity, Bk 3, Chapter 5)

Video:

https://www.youtube.com/watch?v=-RkZXZx ... ex=13&t=0s
kmaherali
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Post by kmaherali »

Dating Means Fear. Again.

I never imagined I’d live to witness another viral threat.


Bob and I stood on his deck of his San Francisco flat, with the bright lights of the city behind us and the first wisps of the summer fog creeping in. The attraction was palpable. His finger traced the outline of my nose — and then we kissed. It was our first — romantic and passionate. And more: fraught with the unknown. The year was 1988, still early in the AIDS epidemic, when about one in two gay men in the city had been infected with H.I.V. We had not yet had the talk (“Do you know your status?”).

There was still so much we didn’t know then. A scant two years before, the surgeon general had ruled out “casual” modes of transmission — like mosquito bites, toilet seats, swimming pools and kissing. But fears lingered, especially with no vaccine or treatment, and a frighteningly high death rate. And then there was the stigma: gay men with H.I.V. were ostracized, fired from our jobs and abandoned by our families. Intimacy became woven with fear, kiss by kiss.

And now here we are again.

I never imagined I’d live to witness another such viral threat. At the time I met Bob, I was young and on a quest for my first big love; today I am divorced and again seeking connection. Looking for love by definition means taking chances, but pandemics are terrible times to take them.

By the time Bob and I became bedmates and boyfriends, he’d disclosed that he was H.I.V. positive (and I was not). We engaged in what was first known as “safe” sex but later became known as “safer” sex because nothing is absolute. Still, every sexual encounter required some degree of vigilance. I remember our anxiety-ridden conversations. “How safe is oral sex?” “What do we do if the condom breaks?” For me, then 31, the plague slowed my coming out; it reinforced notions that homosexuality was “bad”; and it bred a firestorm of fear about sex and intimacy that took years, and much therapy in my case, to work through.

Later on I learned how fearful Bob had been to reveal his H.I.V. status to me. “I told some women friends of mine, and they broke off all contact with me,” I remember him saying as he began to cry. “It was very painful.” He also worried that my fear about becoming infected would drive me to stop dating him, which in the end turned out to be true, and which I came to regret.

“We do not know if Covid-19 can be spread though vaginal or anal sex,” reads the New York City Department of Health’s “Safer Sex and Covid-19” guidelines (although the department acknowledges that other coronaviruses aren’t easily spread through sex). But kissing — not intercourse — is considered the riskiest sexual activity this time around. “Contact with saliva from kissing is a potential mode of transmission but is not well documented,” Dr. William Marshall III, an infectious disease specialist at the Mayo Clinic, told me in an interview. In Dr. Marshall’s words, I recognized my previous fear of the unknown, the ill-defined risk lurking in the shadow of intimate human connection.

Many of my friends are starved for affection and intimacy these days. We can’t even hug, much less smooch, without taking a risk. Not surprisingly, dating and sex are frequent pandemic topics. “Even those coffee dates aren’t a good idea,” a female friend messaged me, noting that masking and distancing “don’t make for much intimacy.” A recent journal article about sexual behavior during the pandemic concluded “nearly half of the sample reported a decline in their sex life.”

What to do? Celibacy is the safest option but not a reasonable one considering the nature of human beings. Still, there are adherents. A friend in his 60s told me in September: “This is the longest I’ve gone without sex since I was about 16. That is no joke.” A profile I saw on a dating app reads: “Available to chat/meet. Covid-19 got me into forced celibacy.”

My own experience on the matchmaking apps reveals many who claim they’re “only chatting now” to plenty who are still “looking.” Curious, I asked one fellow how he chose “safe” partners. “If they have a good job and are well-dressed, I’m more comfortable,” he replied. He then blocked me before I could tell him that his filters are proxies of privilege, which viruses do not respec

Others have made different adaptations, seeking companionship over intimacy. Braden Toan, another friend in his 60s, changed his dating profile in May to declare sex “off limits.” “That being said,” his updated profile reads, “a six-foot-apart walk in the park or a bike ride with an attractive and interesting man would make my day …. It’s gotta be better than sitting in your apartment waiting for a vaccine.” Mr. Toan now has a boyfriend. “I credit the virus for slowing down the process of dating, causing us to approach with a new set of needs that were more rewarding to satisfy,” he told me recently.

I joined what I call the “celibacy club” during the first week of March. No vaccine. No treatment. Too many unknowns.

Then, three months into the pandemic I felt I needed a “safe-ish” way out of my celibate state. And so early this summer, I agreed to let a friend set me up with a colleague of hers. He lived in another city, making it easier to keep our distance at first. We had video dates but no “sexy ‘Zoom parties’” of the sort recommended by New York’s Health Department. We chatted about our coronavirus exposure (minimal) and both agreed to get tested before we met in person a few weeks later. (We each tested negative.) When we met we had dinner at a restaurant with an outdoor patio, without masks and not six feet apart. After dinner we took a walk, and I could feel that familiar electricity building. Before the evening ended we embraced, then kissed. It had much of the sweetness and excitement — and some of the fear — of being with Bob all those years ago.

Maneuvering through these uncertain times, I’ve thought a lot about Bob, who died in 2015, at age 64. Condoms became lifesavers, allowing us to be intimate. What now — dental dams for kissing?

Because for now, at least, there’s still no vaccine and not much treatment. Intimacy remains woven with fear, kiss by kiss.

https://www.nytimes.com/2020/10/18/opin ... 778d3e6de3
kmaherali
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Post by kmaherali »

You Were Duped Into Saying Yes. Is That Still Consent?

Legal scholars have long debated this question. Recent psychological studies shed new light.


Imagine the following hypothetical situation: Frank and Ellen meet at a night course and end up getting drinks together after class several times. The drinks start to feel like dates, so Ellen asks Frank if he is married, making it clear that adultery is a deal-breaker for her. Frank is married, but he lies and says he is single. The two go to bed. Is Frank guilty of rape?

To most people, even those who consider Frank a dishonorable creep, the answer is clearly no. The law agrees: In most American jurisdictions, Frank is not liable for any tort or crime, let alone something as serious as sexual assault.

But why? This question has been a source of contention among legal experts for decades, ever since the law professor Susan Estrich argued that the law of rape should prohibit fraud to procure sex, just as the law of theft prohibits fraud to secure money. Ellen did not consent to have sex with a married man, the argument goes, so the sex she had with Frank was not consensual.

To many feminist legal scholars, the law’s failure to regard sexual fraud as a crime — when fraud elsewhere, such as fraud in business transactions, is taken to invalidate legal consent — shows that we are still beholden to an antiquated notion that rape is primarily a crime of force committed against a chaste, protesting victim, rather than primarily a violation of the right to control access to one’s body on one’s own terms.

It’s a powerful argument. Still, to many people, even those concerned about accountability for sexual misconduct, the notion that Frank has committed sexual assault remains deeply counterintuitive. How are we to reconcile these competing considerations?

I recently conducted a series of psychological studies that shed light on this debate. My research suggests that the reason people think Frank is not guilty of rape has less to do with their treating rape differently from other offenses and more to do with how they understand consent. Many people, it turns out, believe that an individual can give consent even though she was lied to by the person seeking her consent.

I asked hundreds of research participants to evaluate hypothetical situations in which a person is tricked into agreeing to something he would otherwise refuse. In one situation, a patient agrees to a medical procedure as a result of a doctor’s false representations. In another, a civilian allows police officers into his home because they lie about what they are searching for. In another, a research participant agrees to enroll in a study after the researcher lies about its purpose.

Surprisingly, I found that most people say that the victims in all these cases have “consented.” I also found that most people agree with the moral and legal implications of that view: For instance, they say that a doctor who performs a surgery after obtaining consent by lying deserves less punishment for medical battery than a doctor who simply performs the surgery without asking permission.

These findings fly in the face of the standard scholarly understanding of consent, which is that it is an expression of an individual’s autonomous will — controlling one’s life as one would like. Interestingly, my participants agreed with this standard legal understanding when presented with situations in which coercion or threats were used to achieve the same ends, such as when someone agreed to sex as a result of blackmail. It was only when the situations involved deception that respondents thought the victim’s “yes” counted as consent.

So it seems that the reason many people have a strong intuition that Frank didn’t rape Ellen is that they think it’s fair to say she consented, not because they think rape must involve physical force.

Of course, my empirical discovery does not resolve the question of whether our laws should criminalize sex-by-deception. It merely shows that if you have conflicted feelings about the case of Frank and Ellen, it may be because you think that his deception does not fully invalidate her consent. Whether lawmakers ought to disregard that intuition and insist on treating such cases as nonconsensual remains an open question. There might be good reasons, after all, for the law to discipline us against following our gut instincts.

https://www.nytimes.com/2021/03/05/opin ... 778d3e6de3
kmaherali
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Post by kmaherali »

What Will Happen When Americans Start Having Sex Again?

As we creep back toward normal, we have to figure out how to deal with sexually transmitted infections.


Dr. Hilary Reno’s eyes widened as she scanned the waiting room at the St. Louis County Sexual Health Clinic in Missouri, where she’s the medical director. She was used to seeing a swath of humanity parked in those plastic chairs: middle-aged men secretly screening after a tryst; college students making a post-hookup pit stop; teenagers, fresh in love, testing together before taking the next step. But now, in the spring of 2019, every seat was filled, with more patients leaning up against the walls. “How,” she thought to herself, “can we possibly keep up?”

This week, in its annual S.T.D. Surveillance Report, the Centers for Disease Control and Prevention confirmed what physicians like Dr. Reno already suspected: that 2019, the most recent year for which data was collected, would set a record for reported cases of sexually transmitted infections. In 2018, an estimated one in five Americans had an S.T.I.; that’s about 68 million people. At least 26 million new infections were contracted during 2019 alone. Chlamydia hit an all-time peak — St. Louis, as it happens, has historically led U.S. cities in cases — while gonorrhea and syphilis, along with congenital infections and newborn deaths, were at their highest rates since the early 1990s. The trends for syphilis are particularly striking, given that two decades ago, it was close to elimination.

For a while, it appeared that the pandemic lockdown might unintentionally ease the surging S.T.I. epidemic. While a few holdouts chose to manage their anxiety through sex with strangers rather than stress baking, most people hunkered down, socially and sexually distancing. And it wasn’t just Americans. Studies from Britain, Asia and Australia also found that Covid-19 dampened people’s sexual ardor: About 40 to 60 percent of adults reduced their number of partners; a similar percentage reduced the frequency of sex or abstained altogether. Instead, like everything from cocktail hours to corporate meetings, hookups went online. Tinder saw a record 3 billion swipes on a single day last March. Likewise, from March through May, OkCupid recorded a 700 percent increase in virtual dates.

But fear of contagion and death will depress libido for only so long. Just when quarantine fatigue began eroding sexual restraint, the urgent needs of Covid-19 gutted the country’s fragile infrastructure for S.T.I. control. Two-thirds of public sexual health clinics were forced to cut back their services or shut their doors in 2020, their staffs redeployed to the Covid-19 response — only one of New York City’s eight clinics remained open during the early months of the pandemic. Screenings were eliminated, follow-up of patients and their sex partners reduced.

Contract tracers, too, were reassigned to track coronavirus transmission, so attempts to reconstruct sexual networks — a major tool in reducing the spread of S.T.I.s — plummeted. The result? Delays in diagnosis, scarce access to treatment and the likelihood that we’ll keep racking up those astronomical transmission records, albeit without the same ability to document that it’s happening.

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https://www.nytimes.com/2021/04/17/opin ... 778d3e6de3
swamidada
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Post by swamidada »

Mormon sex therapist ousted from faith for critiques
Associated Press Thu, April 22, 2021, 1:43 PM
SALT LAKE CITY (AP) — A sex therapist in Utah who has publicly challenged her faith's policies on sexuality has been kicked out of The Church of Jesus Christ of Latter-day Saints following a disciplinary hearing.

Natasha Helfer received a letter Wednesday from a regional church official explaining the reasons for her removal from the Salt Lake City-based church, The Salt Lake Tribune reported. Helfer was disciplined by church leaders in Kansas, where she lived before moving to Utah in 2019.

“After carefully and prayerfully considering this matter,” the letter states, “it was the decision of the council to withdraw your church membership in response to conduct contrary to the law and order of the church.”

Helfer shared the letter on Facebook. Church spokesman Eric Hawkins said that, based on the letter, regional church leaders' decision was not related to her private practice as a therapist.

“As the letter shared by Ms. Helfer indicates, the decision of the local leaders was based on her public, repeated opposition to the church, church leaders and the doctrine of the church, including our doctrine on the nature of the family and on moral issues,” Hawkins said in a statement.

Helfer has been outspoken on sexual issues and supports same-sex marriage, counsels that masturbation is not a sin and says pornography should not be treated as an addiction. She had said that she hoped to remain in the church.

The story was originally reported by The Washington Post.

Helfer told the Tribune that she was asked to leave her disciplinary hearing before it began on Sunday because she refused to turn off her phone, which contained her notes.

“It is common for participants to be asked to turn off technology (including cell phones) or leave it outside the room, as was the case with this council,” Hawksins said. “All but one of the participants complied with that request and had brought their statements in writing.”

Church members are taught not to have sex before marriage, engage in passionate kissing, touch another person’s private parts or arouse “emotions in your own body” that are supposed to be reserved for marriage. Homosexual relations also are forbidden even if a person is married or in a relationship.

Helfer did not immediately respond to The Associated Press' request for comment.

Her ouster means she’ll be leaving a religion she’s been a member of since she was 5 years old.

While not a lifelong ban, the withdrawal of a person's membership by church leaders amounts to the harshest punishment available for a member of the faith. These ousters used to be called excommunication before the faith changed the terminology last year to “withdrawal of church membership.”

People in this category can’t go inside temples where members are married and other ordinances such as baptisms for dead relatives are performed.

Sam Young, a man who led a campaign criticizing the church’s practice of allowing one-on-one interviews of youth by lay leaders that sometimes included sexual questions, was kicked out of the church in 2018. Kate Kelly, founder of a group pushing for women to be allowed in the religion’s lay clergy, was excommunicated in 2014.

https://currently.att.yahoo.com/news/mo ... 21431.html
kmaherali
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Post by kmaherali »

Should You Always Pee After Sex? Here’s What Gynecologists Say

Some people like to cuddle after sex. Some want to shower or fall right asleep. Others may even cry. But one thing all women should do is pee after sex ... right? You've probably heard the recommendation before. But is this a crucial vagina health tip or just an old wive's tale? We spoke with doctors to get the lowdown.

What does peeing after sex do?

The main benefit is potentially cleansing any bacteria away. While there are some possible benefits to a post-sex pee, there are definitely some myths surrounding the practice.

Does it prevent UTIs?

Women who are prone to urinary tract infections (UTIs) may believe that the practice can help. Uncomfortable UTI symptoms include burning or pain while peeing, frequent or urgent urination, cloudy urine, and leaks. Bottom line: you want to avoid them. Gynecologist Alyssa Dweck, MD, co-author of V is for Vagina, and Mary Jane Minkin, MD, clinical professor of obstetrics and gynecology at Yale School of Medicine, say it's all related to anatomy. A woman's urethra, vagina, and anal area are within close proximity to each other. "The urethra, which is the tube from the bladder to the outside in women, is very short and sits right next to the vagina, which is loaded with bacteria," Dr. Minkin says.

The urethra, the place where you urinate, is also close to the anal area, which is normally colonized with tons of bacteria, according to Dr. Dweck. During intercourse and all types of sexual play, bacteria can get near the urethra and increase the chance of infection. "Lots of different activities, including sex, can facilitate bacteria from the anal area towards the urethra and cause an infection," Dr. Dweck says. "And that's why women, in general, are more prone to UTIs than men."

Another reason some experts associate sex with UTIs is because penetration may put pressure on the urethra. This irritation may force bacteria into the urethra towards the bladder, raising the likelihood of infection. In fact, people who go on their honeymoon and have lots of intercourse sometimes get sexually associated UTIs or "honeymoon cystitis," inflammation of the bladder. Taking a pee may mechanically cleanse the bacteria away. So for women who are prone to UTIs, it's a good habit and an easy effort that'll help prevent infection, says Dr. Dweck.

(Related: How Bad It Is to Wait Too Long to Use the Bathroom)

What does the research say?

One study in the Eastern Mediterranean Health Journal found that pregnant women who usually urinated within 15 minutes of sex had a lower likelihood of developing a UTI than women who did not urinate afterward. Dr. Minkin notes, that other studies have found no such connection. However, no research indicates that it raises the risk of UTIs, so consider it potentially protective: If hitting the bathroom helps you avoid UTIs, great; if it doesn't, no harm done.

Reoccurring UTIs

If you have reoccurring UTIs, get in touch with your doctor—don't expect peeing after sex to address your problem. There are medical measures that can help.

(Related: 9 Totally Not Weird Questions You Should Ask Your Gynecologist)

What about men?

Men who sleep with men are often engaging in anal sex, so they may have some bacterial exposure to the tip of the penis. That can potentially raise the risk of UTIs, but it's not the rule, according to Dr. Dweck. "The distance of the urethra and the length of the urethra—from the bladder to the outside world—is really long and scopes the length of the penis," she says. "So that's why this is not usually an issue for men."

Does peeing after sex prevent pregnancy?

"That is 1,000 percent false," Dr. Dweck says. It's among the worst pieces of health advice gynecologists have heard. "When you urinate, your urine comes out of your urethra," she says. "The vagina is where sperm gets deposited to create a pregnancy. These are two completely separate holes, and urinating is not going to flush out sperm from the internal vagina."

(Related: Samantha Bitty Knows Good Sex (and Wants You to Know It, Too))

Does peeing after sex prevent STIs?

Again, absolutely not: This isn't a solution or a recommended way to prevent sexually transmitted infections (STIs) or other infections, Dr. Dweck says. If you're sexually active, use protection, get tested regularly, and follow the instructions and recommendations of your doctor.

If you don't normally pee after sex, should you start?

Although the habit could be helpful, it's not an urgent medical recommendation for everybody. "We're not trying to mechanicalize sex into this overwhelming medical experience," Dr. Dweck says. Dr. Minkin agrees, saying that at the very least it can't hurt. Again, if you have reoccurring UTIs, talk to your doctor—peeing after sex is not the first line of defense.

Dr. Dweck says once someone has a bad UTI, they often remember to pee after sex because the infection is so uncomfortable, they'll take easy, preventive measures over an infection any day. And, no, you don't need to make a beeline for the bathroom the minute sex ends. Just pee in a reasonable time frame before you go to sleep.

https://www.msn.com/en-ca/health/wellne ... li=AAggNb9
kmaherali
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Post by kmaherali »

The Pill Helped Start the Sexual Revolution. What Will Phexxi Do?

Saundra Pelletier is marketing a new form of birth control to women wary of hormones.


SAN DIEGO — If you’re a woman aged 18 to 34, you may have seen a Phexxi ad during a commercial break on Hulu. Or you could have come across the product — a non-hormonal contraceptive gel that women can use within an hour before having sex — while scrolling through Instagram, somewhere between a recipe for Paleo bagels and an ode to body positivity.

Phexxi went on sale in September in the United States, after receiving approval from the Food and Drug Administration. Prescriptions for Phexxi are in the low thousands, according to its publicly traded parent company, Evofem — about 17,280. This is puny compared to the estimated 8.6 million women who have undergone female sterilization or the 6.6 million women on the Pill.

But Saundra Pelletier, the chief executive officer of Evofem, is hoping to reach a generation that, unlike their foremothers, who were “liberated” by the Pill, then schooled to insist on condoms, have grown up with hormones as the default birth control option.

“I think it’s insane that women have not had an option like this before now,” she said in May.

The conference rooms in Evofem’s offices are all named after women who left a mark on the world: Ruth Bader Ginsburg, Rosa Parks, Marie Curie. A stylized Joan of Arc, in hot pink, looms on a screen in the “war room.” In the cafeteria, “feminism” is written on a plaque, along with a definition of the word.

The messaging in Ms. Pelletier’s personal office is even fiercer. In the bathroom, a cup holding a toothbrush and toothpaste on the sink reads: “Tears of My Enemies.” A shower curtain (yes, there’s a shower in her office) proclaims in bold, uppercase letters, “Here’s to strong women/May we know them/May we be them/May we raise them.”

The shower is there because Ms. Pelletier, 51, works a lot. When she was diagnosed with cancer in 2018, she sought doctors who would accept that she had no intention of taking a break while undergoing treatment.

“If I stop working, I’m going to take pain meds all day, watch ‘The Price Is Right’ and end up in the fetal position in the corner,” she said. So through six months of chemotherapy and through a double mastectomy, a hysterectomy and an oophorectomy, she continued working, even appearing at conferences around the country.

Phexxi is intended not only for women questioning whether they want to take hormones, an increasingly vocal contingent during a boom of wellness culture; it is also for women who are told not to take them. Women with breast cancer, for example.

Phexxi’s mechanism is simple: the gel alters the pH of the vagina to make it more acidic and inhospitable to sperm. The product is about 93 percent effective with perfect use in clinical trials reviewed by the F.D.A., and 86 percent effective with typical use.

That rate falls somewhere between the rates for condoms and diaphragms. (Condoms prevent pregnancy 87 percent of the time with typical use and diaphragms do so 83 percent of the time with typical use, according to the Centers for Disease Control and Prevention. The Pill has a 93 percent typical-use effectiveness rate.)

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https://www.nytimes.com/2021/06/10/styl ... 778d3e6de3
kmaherali
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Post by kmaherali »

If You Ignore Porn, You Aren’t Teaching Sex Ed

Parents often say that if they try to have the sex talk with their teens, the kids plug their ears and hum or run screaming from the room. But late last month, those roles were reversed: After a workshop for high school juniors at the Columbia Grammar & Preparatory School promoting critical thinking about online pornography, it was parents who flipped out. Some took to the media — The New York Post, Fox News, The Federalist and other like-minded outlets jumped on the story — accusing the school of indoctrinating children.

While I don’t know the precise content of that presentation, I can say this: Refusing to discuss sexually explicit media, which is more accessible to minors than at any other time in history, won’t make it go away. As far back as 2008 — basically the Pleistocene era in internet terms — a study found that more than 90 percent of boys and close to two-thirds of girls had viewed online pornography before turning 18, whether intentionally or involuntarily.

I’ve been interviewing teenagers about their attitudes and expectations of sex for over a decade. When talking to boys, in particular, I’ve never asked whether they’ve watched porn — that would shoot my credibility to hell. Instead, I ask when they first saw it. Most say right around the onset of puberty. They not only learned to masturbate in tandem with its images but also can’t conceive of doing it any other way. “I have a friend who was a legend among the crew team,” a high school senior told me. “He said that he’d stopped using porn completely. He said, ‘I just close my eyes and use my imagination.’ We were like, ‘Whoa! How does he do that?’”

Curiosity about sex and masturbation is natural: good for girls, boys and everyone beyond those designations. And I am talking about children here, many of whom have yet to have a first kiss; adult porn use is a different conversation. One could also debate the potential for sexual liberation of ethically produced porn, queer porn or feminist porn, but those sites are typically behind a pay wall, and most teenagers don’t have their own credit cards.

The free content most readily available to minors tends to show sex as something men do to rather than with women. It often portrays female pleasure as a performance for male satisfaction, shows wildly unrealistic bodies, is indifferent to consent (sometimes in its actual production) and flirts with incest

The clips can also skew toward the hostile. In a 2020 analysis of more than 4,000 heterosexual scenes on Pornhub and Xvideos, 45 percent and 35 percent, respectively, contained aggression, almost exclusively directed at women. Black women have been found to be the targets of such aggression more frequently than white women, and Black men are more likely than white men to be depicted as aggressors. In other words, teens are being served a heaping helping of racism with their eroticized misogyny.

Boys I interview typically assure me that they know the difference between fantasy and reality. Maybe. But that’s the response people give to any suggestion of media influence. You don’t need a Ph.D. in psych to know that what we consume shapes our thoughts and behavior even — maybe especially — when we believe it doesn’t. Any troll with a Facebook account could tell you that.

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Post by kmaherali »

Can the Left Regulate Sex?

There is a harrowing story in The New Yorker that everyone should grit their teeth and read. Written by Rachel Aviv, it tells the story of how a respected German psychologist named Helmut Kentler decided to foster neglected children with pedophiles, how he ran this experiment with government support for decades after the 1960s, and how it created exactly the kind of hells you would expect.

It seems almost impossible that this really happened. But the past is another country, and Aviv explains with bracing clarity how the context of the 1960s and 1970s made the experiment entirely plausible. The psychological theory of the Sexual Revolution, in which strict sexual rules imposed neurosis while liberation offered wholeness, was embraced with particular fervor in Germany, because the old order was associated not just with prudery but with fascism and Auschwitz.

If traditional sexual taboos had molded the men who built the gas chambers, then no taboos could be permitted to endure. If the old human nature had ended in fascism, then the answer was a new human nature — embodied, in Aviv’s account, by “experimental day-care centers, where children were encouraged to be naked and to explore one another’s bodies,” or appeals from Germany’s Green Party to end the “oppression of children’s sexuality,” or Kentler’s bold idea that sex with one’s foster children could be a form of love and care.

All this was part of a wider Western mood, distilled in the slogan of May 1968: It is forbidden to forbid. In those years famous French intellectuals petitioned to decriminalize pedophilia, while America had its own squalid forms of predation, whether in rock-groupie culture or Roman Polanski’s Hollywood. But Aviv’s story suggests that the Germans, never a culture for half-measures, took these ideas toward a particular extreme.

That today the readers of an impeccably progressive magazine recoil in horror from that extreme is, among other things, proof that revolutions don’t move in one direction — you can climb back up a slippery slope, you can break a taboo and partially rebuild it.

But in its retreat from the Polanski era, its concession that sometimes it’s OK to forbid, cultural progressivism entered into a long internal struggle over what its goal ought to be — to maximize permissiveness with some minimalist taboos (no rape, no sex with children) or to devise a broader set of sexual regulations that would reflect egalitarian and feminist values rather than religious ones.

This tension is visible all over recent history. The mood in which liberals defended Bill Clinton’s philandering was an example of the more permissive option. The mood of the #MeToo era, which condemned cads as well as rapists, is an example of the more regulatory approach.

The temporary alliance between anti-porn feminists and social conservatives in the 1980s was regulatory, while the rise of “sex-positive” feminism was permissive. The way that same-sex marriage was championed as a conservative and bourgeois reform was more regulatory; the shift toward emphasizing the fluidity and individuality of sexual identity was more permissive.

But if the tensions are longstanding, how they’re worked out is becoming more important, as social conservatism ebbs and progressivism’s cultural dominance expands. Progressives are not quite in the cultural position that Christian churches once occupied in this country, but they are close enough that the question “how should the left regulate sex?” increasingly implicates our whole society.

In general the recent trend has been toward more regulation: The sexual-assault tribunals on college campuses, the changing rules of workplace harassment, the new politesse surrounding pronouns and sexual identity. Part of this reflects a pattern often observed by conservatives, in which certain forms of sexual liberation seem to require more micromanagement than the old “thou shalt nots” — like the rigor required to distinguish supposedly empowering “sex work” from the exploitative variety, or purportedly egalitarian pornography from the misogynist or pedophilic sort.

But this regulatory mood is contested and unstable. Last month there was an internal progressive debate about whether, now that Pride parades are essentially part of a new civic religion, their kinky side should be sanitized for kids, or whether encountering B.D.S.M. is a healthy part of a queer-affirming childhood. In New York’s mayoral race, the allegations of sexual misconduct against Scott Stringer helped derail his campaign but also exposed progressive discomfort with the stricter forms of #MeToo orthodoxy.

I don’t know how long the current period of progressive cultural power can last. But so long as it does, these debates will continue, because the regulation of sex is an inescapable obligation of power.

So progressives will continue to teeter between two anxieties. On the one hand, the fear of turning into the very Puritans and Comstocks they brag of having toppled. On the other, the fear of Helmut Kentler’s legacy, and liberation as a path into the abyss.

https://www.nytimes.com/2021/07/24/opin ... 778d3e6de3
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Post by swamidada »

‘Teaching in the middle of a pandemic is HARD’: Jamaican teachers’ conference on Zoom turns into 18+ live sex broadcast
21 Aug, 2021

Professional hardships became a highlight at a Jamaica teachers’ conference, as one of its members was caught getting intimate with a partner while her colleague was talking about “necessary connections” during a public Zoom call.
A recorded multi-member Zoom meeting from the 57th Annual Conference of the Jamaica Teachers’ Association (JTA) has gone viral. In an almost two-minute-long video circulating on Twitter, one of the call member’s windows showed sexual intercourse recorded by another conference participant.

Two people can be seen apparently having sex in a bedroom while a female voice is delivering a speech, saying: “Teaching in the middle of the pandemic was hard.” She keeps on talking about “how important this profession is” and distant teaching “challenges” – “I’ve never taught online and didn’t know what it was” – while her unaware colleague continues getting intimate with a partner in front of the camera.

A computer voice notification ‘Recording in progress’ can then be heard, with a different conference member screaming out loud “What the hell” and calling out to someone to “stop it.”

“We need necessary connections to keep afloat,” the speaker keeps on talking, as a woman can be seen leaning forward to a naked partner. Interrupting the unintended home video, a strict face of a woman, apparently a conference host from what looks like an official venue, then appears in the window.

The Jamaican teacher is not the first to embarrass herself during a Zoom call which has become a new reality for many amid Covid-related distant meetings. Accidentally revealing more than was intended, a teacher in Colombia was caught lifting his wife’s top and kissing her breast during an online physics class with students. Last year, an Argentinian MP was captured sucking on a woman’s breast amid a virtual parliamentary session. In another instance, a government official in the Philippines lost his job after having sex with a secretary during a Zoom meeting.

https://www.rt.com/news/532716-jamaica- ... -zoom-sex/

Note: Parents be careful about your children on ZOOM teaching, be watchful.
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Post by kmaherali »

OnlyFans Is Not a Safe Platform for ‘Sex Work.’ It’s a Pimp.

We are living in the world pornography has made. For more than three decades, researchers have documented that it desensitizes consumers to violence and spreads rape myths and other lies about women’s sexuality. In doing so, it normalizes itself, becoming ever more pervasive, intrusive and dangerous, surrounding us ever more intimately, grooming the culture so that it becomes hard even to recognize its harms.

One measure of this success is the media’s increasing insistence on referring to people used in prostitution and pornography as “sex workers.” What is being done to them is neither sex, in the sense of intimacy and mutuality, nor work, in the sense of productivity and dignity. Survivors of prostitution consider it “serial rape,” so they regard the term “sex work” as gaslighting. “When “the ‘job’ of prostitution is exposed, any similarity to legitimate work is shattered,” write two survivors, Evelina Giobbe and Vednita Carter. “Put simply, whether you’re a ‘high-class’ call girl or a street walkin’ ho, when you’re on a ‘date’ you gotta get on your knees or lay on your back and let that man use your body any way he wants to. That’s what he pays for. Pretending prostitution is a job like any other job would be laughable if it weren’t so serious.”

“Sex work” implies that prostituted people really want to do what they have virtually no choice in doing. That their poverty, homelessness, prior sexual abuse as children, subjection to racism, exclusion from gainful occupations or unequal pay plays no role. That they are who the pornography says they are, valuable only for use in it.

Pornography’s power became clear once again last month, when OnlyFans, the London-based subscription service, announced that it would ban the “sexually explicit” from its platform, before abruptly reversing course amid criticism. “OnlyFans has been celebrated for giving adult entertainers and sex workers a safe place to do their jobs,” Bloomberg News observed. According to the A.C.L.U., a longtime defender of pornography, “When tech platforms like OnlyFans see themselves as arbiters of acceptable cyber speech and activity, they stigmatize sex work, making workers less safe.” On the contrary, it is the sex industry that makes women unsafe. Legitimizing sexual abuse as a job makes webcamming sites like OnlyFans particularly seductive to the economically strapped.

OnlyFans became a household name during the pandemic, when demand for pornography skyrocketed. People started living their lives online, domestic violence exploded, women lost their means of economic survival even more than men, and inequalities increased. OnlyFans, niche pornography as mediated soft prostitution, was positioned to take advantage of these dynamics.

OnlyFans has been to conventional pornography what stripping has been to prostitution: a gateway activity, sexual display with seeming insulation from skin-on-skin exploitation, temporary employment for those with their financial backs against the wall and few if any alternatives. It offers the illusion of safety and deniability for producer and consumer alike. But the outcry over the proposed ban made clear that only explicit sex — mostly, the sexual consumption of feminized bodies, usually female, gay or trans — sells well in pornography’s world. As Dannii Harwood, the first so-called content creator on OnlyFans, told The New York Times, “Once subscribers have seen everything, they move on to the next creator.” Empirical research has also documented that dynamic.

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Post by kmaherali »

California Moves to Outlaw ‘Stealthing,’ or Removing Condom Without Consent

The bill, which the Legislature approved unanimously and which awaits the governor’s signature, would make it a civil offense to remove a condom during intercourse without a partner’s consent.


The California State Legislature this week approved a measure that would make the state the first to outlaw stealthing, the act of removing a condom during sex without a partner’s consent.

The bill, which was approved unanimously on Tuesday, awaits the signature of Gov. Gavin Newsom, a Democrat, who has until Oct. 10 to sign it into law. A spokesman for the governor said his office did not comment on pending bills.

If approved, the measure would amend the state’s civil definition of sexual battery and make stealthing a civil offense, meaning victims could sue their assailants for damages.

Assemblywoman Cristina Garcia of California, who sponsored the bill, said the measure would give victims another resource to hold assailants accountable. “It would also make it clear that this is not just amoral, but also illegal,” she said in an interview on Thursday.

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kmaherali
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Post by kmaherali »

Age of Consent in Classical Islamic Law
Justin Parrott, New York University Abu Dhabi

The age of consent to sexual relations is not firrmly established in classical Islamic law like it is in many Muslim and non-Muslim countries today. The appropriate age of sexual relations was set in traditional pre-modern societies by either individual families or local custom,often linked to signs of physical puberty like menarche and pubic hair.[1] The lack of consistency in this area of law is because societies throughout time and place widely vary in their circumstances, resources, concerns, and priorities.There are many instances in history for which the age of consent and marriage is in apparent disagreement with modern norms and laws. The 12th century Decretum Gratiani,for instance, mandates consent at an undefined “age of discretion”[2] and acknowledges that sexual relations and marriage might occur as early as seven years.[3] Some Christian sources state that Mary was to be given in marriage to the ninety year-old St. Joseph when she was only twelve or fourteen.[4] As late as the mid-19th century, the United Kingdom’s Offences against the Person Act legally allowed sexual relations with twelve year-olds.[5] Around the same time in the United States, each state determined its own criminal law with age of consent ranging from ten to twelve years of age. It is only at the beginning of the late 19th century, spurred on by the Industrial Revolution’s rapid economic growth and technological development, that attitudes shifted toward setting the age higher and higher.[6] Therefore, it should not be surprising that the development of classical Islamic law into centralized state systems followed a similar trajectory as other societies.

Why is this issue important today?

Sexual relations are religiously unlawful in Islam in the absence of a contract of marriage or concubinage. Concubinage disappeared when the Muslim world martialed
legal arguments to abolish slavery,[7] so consent is now only relevant to marriage. The question of consent to marriage is important to the modern context from at least two perspectives:

First, there is an ongoing controversy in regards to the practice of child marriage in some places in the Muslim world.[8] Classical Islamic jurists generally allowed a marriage to be contracted with a child, but not consummated through sexual intercourse until the child gained puberty or was physically ready to do so.[9] While the classical law theoretically upheld the right of children to consent to their marriage upon reaching adulthood, external factors such as cultural and familial pressure can easily violate the spirit of these protections, if not the letter of the law itself. The Prophet decreed that such a child must consent to the marriage before it can be consummated.[10] Therefore, forced marriages are out of the question altogether, butthe question still remains of what norms related to younger marriages that Muslims are most appropriate for them to adopt locally at the state-level in each country.

Second, the age of consent is brought up in anti-Islam polemics to allegedly demonstrate the backwards and ‘evil’ nature of Islam. Modern norms, at least in the West, have placed a stigma on sexual relations between “adults” (usually 18 years and above) and “adolescents”(usually 17 years and below). Voluntary sexual intercourse with a post-pubescent minor who is younger than the legal age of consent is legally punished as “statutory rape.” Such boundaries are appropriate for highly developed modern societies, but the rule in most of the world throughout time was based on local customs for good reason. As such, polemicists will cite the rulings of some classical Islamic jurists who allowed, or appeared to allow, sexual relations with girls as young as nine, which they claim is evidence that Islam promotes child abuse or ‘groominggangs.’ Attacks of this nature permeate the internet, anti-Islamliterature, and some political discourse, despite being based entirely on misinformed historical anachronisms.

No consensus age in Islamic law

There is no consensus in Islamic law around the age of consent to marriage or sexual relations,for the same reasons there was no consensus in the West or elsewhere. The Hanafi jurist Zaynal-Dīn ibn Nujaym (d. 1563) writes:[The scholars] differed as to the time when one could consummate with a young girl. It is said that it is not permissible to consummate with her as long as she has not reached puberty,it is said he may consummate with her when she reaches nine years, and it is said he may consummate with her if her body is large enough to handle intercourse, otherwise he may not.[11] Islamic laws related to human-human interaction(as opposed to human-divine interaction)tend to be governed by social custom rather than explicit statutes from divine revelation.[12]

Juristic and moral reasoning on the basis of general principles are often the determining factor in judging social customs to be right or wrong, appropriate or inappropriate. This flexible legal device was derived from the statement of the Prophet’s well-known companion ʿAbd Allāhibn Masʿūd (d. 653), “Whatever the Muslims view as good is good to Allah, and whatever they view as evil is evil to Allah.”[13] That is, a society of Muslims has been delegated some authority to regulate their own social customs. For this reason, it is a valid opinion in Islamic law for a fixed age of consent to be set, or for it to be set by natural signs like puberty or physical development. Today, the majority of Muslim countries have opted to set the age of consent between fourteen and eighteen, although Bahrain is an outlier with a minimum age of twenty-one.[14]

Operative principle: no harm or returning harm

Regardless of one’s opinion on the age of consent, all classical jurists accepted in principle the illegality of causing harm to another person without a legitimate reason.[15] The Prophet had issued a decree, “Do not cause harm or return harm.”[16] The jurists explicitly applied this principle to sexual relationships. Yaḥyá ibn Sharaf al-Nawawī (d. 1277), representing the Sha’i school, states this as a necessary condition when discussing the rights of wives to living and maintenance, “If it is possible to have intercourse with her without harming her, he may do that. If it is not possible for him to have intercourse with her except by harming her,he does not have permission to have intercourse with her.”[17] There is no valid interpretation of Islamic law, in any school of thought, that allows children to be abused in any way, sexually or otherwise. The Prophet said, “He is not one of us who is not merciful to our young.”[18]

Looking ahead

Islam was revealed to be relevant to all peoples in every time and place. The twin legal principles of permitting social customs in general, restricted by the imperative not to cause harm, allow some flexibility for Muslim societies to place appropriate boundaries to sexual relations as they continue to develop. It is not a coherent Islamic legal argument to claim that because the Prophet married his youngest wife Aisha at age nine, that it is permissible or beneficial for Muslims to do so while they live in greatly different social circumstances. There are other considerations in the divine law that cannot be ignored. The issue of child marriage leading to abuse is of dire importance for Muslims to address and through consultation achieve some stable legal parameters appropriate to each region’s context

At the same time, it is ignorant or disingenuous for anti-Islam polemicists to cite historical facts and classical juristic rulings out of context to vilify Islam and Muslims today. Many of these polemicists attempt to draw a straight line between these facts and the criminal behavior of some Muslims today, though no such direct connection exists in reality. The gross stereo-types born of this misinformation contribute to the ‘othering’ of IslamandMuslims, as well as unfair demands for collective responsibility or even hate crimes.[19] A wider contextual analysis of classical texts, as attempted in this article, in tandem with appreciating modern realities should demonstrate that any proposed connection between classical Islam and contemporary criminality is simply tenuous at best.

References

[1] Paula S Fass
, Encyclopedia of Children and Childhood: In History and Society
(NewYork, N.Y: Macmillan Reference USA, 2004), 45. Available from
Gale eBooks
.[2] John T. Noonan and Augustine Thompson,
Marriage Canons from the Decretum of Gra-tian and the Decretals, Sext, Clementines and Extravagantes
(n.p., 1993), C. 30 q. 2.http://legalhistorysources.com/Canon%20 ... ELAW.htm[3] Ibid., Decretals of Gregory IX, book four, C. 3.[4] Charles G. Herbermann, “St. Joseph,” in
The Catholic Encyclopedia: an InternationalWork of Reference on the Constitution, Doctrine, Discipline, and History of the CatholicChurch
(KnightsofColumbusCatholicTruthCommittee, 1913). https://www.newadvent.org/cathen/08504a.htm[5] Matthew Waites,
The Age of Consent: Young People, Sexuality, and Citizenship
(Hamp-shire: Palgrave Macmillan, 2005), 63.[6] Stephen Robertson, “Age of Consent Laws,” in
Children and Youth in History
, Item #230.https://chnm.gmu.edu/cyh/items/show/230[7] William G. Clarence-Smith,
Islam and the Abolition of Slavery
(New York: Oxford Uni-versity Press, 2006), 19.[8] See for example: Kasjim Salenda, “Abuse of Islamic Law and Child Marriage in South-Sulawesi Indonesia,”
Al-Jami’ah: Journal of Islamic Studies
. 54.1 (2016): 95-121.[9]‘AlīibnKhalafibnBaṭṭāl,
SharḥṢaḥīḥal-Bukhārī
(al-Riyāḍ: Maktabatal-RushdNāshirūn,
Academia Letters, June 2021
Corresponding Author:
Justin Parrott, justin.parrott@nyu.edu
Citation:
Parrott, J. (2021). Age of Consent in Classical Islamic Law.
Academia Letters
, Article 1148.
https://doi.org/10.20935/AL1148
.
4
©2021 by the author — Open Access — Distributed under CC BY 4.0


2003), 7:127. Ibn Baṭṭāl (d. 1057) writes, “The scholars agreed that it is permissible forfathers to marry o their young daughters even if they are in the cradle, except it is not per-missible for their husbands to consummate the marriage with them until they are preparedto safely have intercourse.”[10] Muḥammad ibn Ismā īl al-Bukhārī,
Ṣaḥīḥ al-Bukhārī
(Bayrūt: Dār Ṭawq al-Najjāh,2002), 9:21 #6946. The ḥadīth is recorded under the chapter heading, “The forced mar-riage is not permissible.” See also: https://sunnah.com/bukhari:6946[11]Zayn ... mibnNujaym,
Al-Baḥral-Rā’iq: SharḥKanzal-Daqā’iq
(Bayrūt:Dār al-Kitāb al-Islāmī, 1970), 3:128.[12] Taqī al-Dīn ibn Taymīyah,
Majmū’ al-Fatāwà
(al-Madīnah al-Munawwarah: Majma al-Malik Fahd li-Ṭibā at al-Muṣḥaf al-Sharīf, 1995), 29:17. Ibn Taymīyah (d. 1328) askes,“As long as social customs are not armed to be prohibited, how can they be judgedto be forbidden? … The default principle of customs is permission, such that none aredisallowed but what is forbidden.”[13]AḥmadIbnḤanbal,
Musnadal-ImāmAḥmadibnḤanbal
(Bayrūt: Mu’assasatal-Risālah,2001), 6:84 #3600. The chain of authorities is considered “fair” by Shu’ayb al-Arnā’ūṭ.[14]“AgeOfConsentByCountry2021,”
WorldPopulationReview
. AccessedJune14, 2021.https://worldpopulationreview.com/count ... country[15] Jalāl al-Dīn al-Suyūṭī,
Al-Ashbāh wal-Naẓā ir fī Qawā’id wa Furū Fiqh al-Shāīyah
(Bayrūt: Dar al-Kutub al-’Ilmiyah, 1990), 1:7-8.[16] Ibn Mājah,
Sunan Ibn Mājah
(Bayrūt: Dār Iḥyā’ al-Turāth al-’Arabī, 1975), 2:784 #2340.[17] Yaḥyá ibn Sharaf al-Nawawī and Taqī al-Dīn Subkī,
Al-Majmū’ Sharḥ al-Muhadhab
([Bayrūt]: Dār al-Fikr, 1991), 16:409.[18] Muḥammad ibn Īsá al-Tirmidhī,
Sunan al-Tirmidhī
(Bayrūt: Dār al-Ġarb al-Islāmī,1998), 3:386 #1921.[19] Ella Cockbain and Waqas Tufail, “Failing victims, fuelling hate: challenging the harmsof the ‘Muslim grooming gangs’ narrative,”
Race & Class
. 61.3 (2020):3-32.
Academia Letters, June 2021
Corresponding Author:
Justin Parrott, justin.parrott@nyu.edu
Citation:
Parrott, J. (2021). Age of Consent in Classical Islamic Law.
Academia Letters
, Article 1148.
https://doi.org/10.20935/AL1148
.
5
©2021 by the author — Open Access — Distributed under CC BY 4.0

https://www.academia.edu/49877685/Age_o ... view-paper
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Post by kmaherali »

KIRK DURSTON ON SEXUAL MORALITY & THE COLLAPSE OF CIVILISATION

Video:

https://gript.ie/kirk-durston-on-sexual ... ilisation/

Kirk Durston speaks about sexual morality & what could be the impending collapse of western civilisation.

Canadian Kirk Durston is a biophysicist, philosopher, speaker, and writer. He speaks with Ben Scallan in this latest issue of Big Talk.

Read the article which they discuss here: https://www.kirkdurston.com/blog/unwin
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Re: Solutions to Sexual Problems.

Post by kmaherali »

Straight People Need Better Rules for Sex

By Christine Emba

Ms, Emba is an opinion columnist at The Washington Post and the author of “Rethinking Sex: A Provocation,” from which this essay is adapted.

If you talk to young people about sex, you may sense an unsettling malaise.

Nearly half of American adults — and a majority of women — say that dating has gotten harder for most people over the past 10 years. According to the Pew Research Center, fully half of single adults have given up on looking for a relationship or dating at all. Rates of sexual activity, partnership and marriage have reached a 30-year low, with young adults leading the retreat.

“I don’t think older generations realize how TERRIFYING dating is for the current generation,” fumed one young Twitter user, to the tune of 18,000 likes. “Absolutely chaotic out here.” When I interviewed dozens of people for my book on sex and relationships, I found that women, in particular, discussed their sexual experiences in visceral terms: encounters that end in unexpected and alarming acts — a choking, say, or other porn-inspired violence — that they go along with out of surprise or resignation. After all, if consent is given (and it often is), there are no grounds left for protest.

Navigating our love lives has always been difficult. But today, the general outlook among heterosexual daters has come to take on a less playful, more depressive tone — manifesting in what the writer Asa Seresin calls “heteropessimism,” a mode of feeling “usually expressed in the form of regret, embarrassment and hopelessness about the straight experience.” (Queer relationships, being less beholden to male-female gender dynamics, may present fewer issues — but they aren’t perfect either.) It’s an anesthetic posture, one that young people use to avoid fully feeling a sense of sorrow for their lack of control and repeated disappointment or fully acknowledging the pervasive awfulness of a sexual culture that’s not suited to their happiness.

This pessimism comes at a moment when we might expect the opposite. After all, one could say that we’re living in a golden age of sexual freedom. The average age of first marriage is rising; it’s more acceptable than ever to remain single or pursue a wide variety of relationship styles. A majority of the public finds premarital sex acceptable; birth control for women is widely available and, with health insurance, often free. Sex positivity is celebrated in progressive circles, with sexual adventurousness championed and inhibition often looked down on. We have breached the ramparts of repression, and the wall of silence that prevented us from expressing our sexuality has, for the most part, fallen.

Getting rid of the old rules and replacing them with the norm of consent was supposed to make us happy. Instead, many people today feel a bit … lost.

“One of the most important pleasures of sexual intimacy,” the Washington University professor and ethicist Fannie Bialek told me when I asked why this might be the case, is “feeling like you have the possibility of the unexpected — but not too much possibility of the unexpected.”

Boundaries, as any therapist would tell you, are necessary and important. By defining the scope of what isn’t wanted or acceptable, they lay out a space for everything else that might be. And in our haste to liberate ourselves, we may have left something important behind.

Dr. Bialek went on to use the analogy of a dinner party to explain some of the shortcomings of our current romantic landscape. “I mostly know what’s going to happen when I go to a dinner party. And the fact that unexpected things happen in the course of conversation is pleasurable, because the unexpected can be pleasurable. But it’s within a fairly tight boundary.”

She continued, “I can be interested in what someone says instead of worrying that they will stab me with a dinner knife. Not having to worry about all these radically unexpected things frees up that attention and that possibility of enjoyment.”

But these days, Dr. Bialek told me, many people “experience a lot more unexpected interaction in a sexual context than they do at dinner.” Because of our unwillingness to acknowledge a shared set of norms for sex beyond the bare minimum of consent — let alone the fact that we haven’t even gotten that bare minimum completely right — our current sexual culture can feel painfully unmoored.

It’s easy to see how overly stringent social regulation caused harm in the past; the sexual revolution happened for a reason. Yet we can recognize the benefits we have gained — less shame, more acceptance of sexual minorities, a recognition of the value of women’s sexual agency — while acknowledging the problems that persist or have worsened. Are there norms we might create or reclaim today that might paradoxically make our romantic landscape freer for everyone?

That enjoyment of dinner parties rests on a clear set of social standards: broadly shared, community-regulated understandings of what we hope a gathering will look like and how attendees should behave. For sexual encounters, setting these standards will require heated debate, and our vision for what sex means in our society must be corrected together.

We will need to make substantive claims about what we think a good sexual culture looks like but also be willing to acknowledge the ways in which certain definitions might be exclusionary and how some norms have negatively affected women and others. We will have to be open to negotiation and open to hearing from voices that have been excluded from such conversations. And we will have to have these debates in public.

Still, some new understandings may be in order. Maybe even casual sex is significant, an act unlike any other. Maybe some porn-inspired practices — those that eroticize degradation, objectification, harm — shouldn’t be mainstreamed. Maybe we do have a duty to others, not just to our own desire. We need norms more robust than “anything between two consenting adults goes.”

It’s time to raise the standard for what good sexual encounters look like and hold ourselves and our peers accountable to it. Good — that is to say, ethical — sex is not simply about getting consent so that we can do what we want. The ideal we might strive for instead is to will the good of our partners, too — and hold ourselves back from having sex if we cannot or are unsure that our partners do.

This might lead to less casual sex, at least in the short term. But, considering the clear dissatisfaction with the current landscape, that might not be so bad.

On a freezing cold Sunday morning in January, I caught up with some college students at a noisy brunch spot on the Upper West Side of Manhattan. A 21-year-old woman described a hookup in which her partner said he didn’t want to have sex, to the amazement of the friends she told about it afterward.

“We were taken aback that there was someone with the opportunity to potentially have sex who would refrain from it to prioritize getting to know someone?” she said, sounding still amazed. “It was really nice, but that shouldn’t be so —” Her friend cut in, saying, “We shouldn’t have to treat it like he’s a unicorn.”

“When you imagine some pleasure,” the Stoic philosopher Epictetus wrote to his students, “wait a while, and give yourself pause.” We need to reclaim this pause. To those of us brought up in the wake of the sexual revolution, this might sound like a call for repression. But it doesn’t have to be a rejection of our sexuality or desire. On the contrary, it can be more freeing (and agency giving) to be able to say no or “not right now,” especially in a culture that pushes us to say yes whether we want to or not. Embracing the pause might give us the space to stop and think, to decide what we don’t want — and to make room for what we do.

In every other situation common to the human experience — eating, drinking, exercise, even email — we have come to realize that limits produce healthier results. It’s unlikely that sex and relationships are exceptions to the rule. An unrestrained sexual culture hasn’t necessarily led to better sex for all or to better relationships. In many cases, it has inspired numbness, callousness, hurting others and being hurt. And rather than being titillating, sexual overload has become boring.

Rules can make things more exciting, more beautiful, more open to the possibility of something better — even if we aren’t there yet.

https://www.nytimes.com/2022/04/07/opin ... 778d3e6de3
kmaherali
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F.D.A. Authorizes Underwear to Protect Against S.T.I.s During Oral Sex

Post by kmaherali »

It’s the first time underwear has been authorized for this purpose, and it provides a new choice for protection where the few options have been unpopular.

This is a story about infections, sex and underwear. More specifically, it’s about sexually-transmitted infections, oral sex and ultrathin, super-stretchy, vanilla-flavored panties.

The Food and Drug Administration has authorized the panties to be considered protection against infections that can be transmitted from the vagina or anus during oral sex. It is a first for underwear.

The undies are part of an understudied but important area of sexual health where the few options for protection are considered cumbersome and hardly used.

“Oral sex is not totally risk-free,” said Dr. Jeanne Marrazzo, director of the division of infectious diseases at the University of Alabama at Birmingham. She said the need for protective methods was of growing importance because more “teenagers are initiating their first sexual activity with oral sex.” For people of all ages, she added, a protective barrier that is enjoyable to use could “reduce anxiety and increase pleasure around that particular behavior.”

Infections like herpes, gonorrhea and syphilis can be transmitted through oral sex, according to the Centers for Disease Control and Prevention. The risk of transmitting H.I.V. from a vagina through oral sex is considered very low, the C.D.C. said. But HPV — human papillomavirus — is more easily transmitted that way, and mouth and throat infections from some types of HPV may develop into oral or neck cancer, the agency said.

How often people transmit infections in this manner is unclear and difficult to study because most people who have oral sex have vaginal or anal sex in the same encounter, said Dr. Kenneth Mayer, the medical research director for Fenway Health, a community health center in Massachusetts that focuses on patients who identify as L.G.B.T.Q.

“The F.D.A.’s authorization of this product gives people another option to protect against S.T.I.s during oral sex,” said Courtney Lias, director of the F.D.A. office that led the review of the underwear.

The only product previously authorized for protection during oral sex was a dental dam — a thin, rectangular sheet of latex (or sometimes polyurethane) that typically must be held in place with one’s hands to form a barrier between the mouth and genitals.

Although several brands of dental dams have received F.D.A. clearance for protection against sexual disease transmission, the devices have not exactly been a hit.

“They’re extremely unpopular,” Dr. Marrazzo said, adding: “I mean, honestly, could there be anything less sexy than a dental dam?”

More...

https://www.nytimes.com/2022/05/12/heal ... 778d3e6de3

As the name suggests, dental dams, invented in 1864 and originally made of rubber, were designed to isolate teeth during dental procedures. But the AIDS crisis ignited concern about sexual transmission of infections, and in the early 1990s an Australian company, Glyde Health, created a dental dam that was primarily inspired by concerns of women who have sex with women, an official with the company has said.
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Why Are Sexually Transmitted Infections Surging?

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After reaching historic lows more than a decade ago, rates are on the rise again.

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Last month, the Centers for Disease Control and Prevention released its latest data on cases of sexually transmitted infections during the first year of the pandemic. In the early months of 2020, the number of people diagnosed with gonorrhea and syphilis declined, as you might expect — it was, after all, a time of extreme isolation for many. Subsequently, though, infection rates surged so much that by the end of the year, the case counts were 10 percent and 7 percent higher than in 2019. In total, there were some 134,000 reports of syphilis and 678,000 reports of gonorrhea. These were “stunning” increases, says Hilary Reno, an associate professor at the Washington University School of Medicine and medical director of the St. Louis County Sexual Health Clinic. “I can’t tell you how many primary-care physicians have called me recently and said, ‘I just saw my first-ever case of syphilis this year.’”

Indeed, syphilis was nearly eradicated in the United States around 2000; gonorrhea reached its lowest rates of infection in 2009. Many doctors who began practicing during that period haven’t had experience diagnosing these S.T.I.s, particularly in their female patients. According to Ina Park, a professor of family and community medicine at the University of California, San Francisco, “There’s an entire generation of physicians and clinicians who had never seen syphilis in women and babies before.”

This is a significant problem: S.T.I.s can irrevocably damage the reproductive system. At least 20,000 women are rendered infertile by untreated S.T.I.s in the United States each year. Syphilis can cause sores and rashes and, if untreated for decades, fatal damage to the brain, heart and other organs. Gonorrhea can be painful and may result in pelvic inflammatory disease in women. Each condition is caused by bacteria and can be cured with antibiotics (though drug-resistant strains of the bacterium that causes gonorrhea are on the rise). Unfortunately, they are often asymptomatic, especially in women, and for them it can be harder to see signs of infection and easier to mistake some of those signs as normal discharge or yeast infections.

The ease with which S.T.I.s spread undetected makes it crucial to screen for them regularly. Yet that is not happening. “The pandemic made S.T.I.s worse in America — for the first year, people all but stopped getting testing and treatment,” says David C. Harvey, executive director of the National Coalition of S.T.D. Directors, a trade association for state and local S.T.I. Health Department programs that collected its own data during the pandemic. (The C.D.C. data comes from a national surveillance system that includes mandatory lab reporting and sample surveys.) Moreover, contact tracers, assigned to notify sexual partners of exposure, were redeployed to focus on Covid.

Historically, the highest rates of syphilis have been among gay and bisexual men, then among heterosexual men. And while that is still true, cases among gay and bisexual men have risen more slowly in recent years and even declined slightly in 2020. Cases among heterosexual women, on the other hand, increased 30 percent from 2018 to 2019 and 21 percent from 2019 to 2020, jumps that experts attribute in part to the increasing prevalence of opioid and methamphetamine abuse, which makes risky sexual behavior — transactional sex, condomless sex — more likely among all genders.

This trend among women has fueled a corresponding surge in syphilis among newborns. In 2020, there was a nearly 15 percent increase in congenital syphilis — amounting to a 235 percent increase from 2016. Congenital syphilis can lead to severe lifelong health complications and stillbirth; of 2,148 infants who contracted syphilis in 2020, 149 did not survive. When women who are engaging in substance abuse become pregnant, they frequently avoid prenatal care for fear of being drug-tested and potentially losing custody of the child. That means many of them aren’t tested for syphilis and don’t receive the treatment that would prevent their baby from getting it. The C.D.C. recommends testing for the infection at the first prenatal visit and, for women who test positive or are at increased risk, early in the third trimester as well as at delivery. (Most states require doctors to perform the initial test, but only 19 also require screening in the third trimester.)

Perhaps the simplest explanation for the overall rise in S.T.I.s between the 2000s and now is that lawmakers reallocated funding to other problems deemed more dire. Many S.T.I. clinics that provided free or low-cost testing and treatment closed or scaled back hours. Other factors contributed to the problem. The growth of online dating expanded sexual networks. The ability to prevent H.I.V. infection with prophylactic medication reduced the inhibitions against having sex without a condom. And most states still do not provide comprehensive sex education. If they did, more people would know that it’s important to treat S.T.I.s and not wait, says Whitney Irie, a lecturer in population medicine at Harvard Medical School. As it is, a popular impression is that S.T.I.s are “essentially obsolete,” she says. “I don’t think there’s a clear understanding, especially among people with a uterus, of the long-term impact on your reproductive organs. There’s this casualness about it that lends itself to being casual about preventive measures.”

Reducing the burden of S.T.I.s will require outreach, particularly for marginalized groups, including women, people in the L.G.B.T.Q. community, Native Americans and Alaskan Natives and people of color, all of whom suffer disproportionately high rates largely because the health care system has neglected them. Black women, for example, have rates of syphilis, gonorrhea and chlamydia that are as much as seven times that of white women, and they face additional hurdles to receiving sexual health care. Black women, Irie says, must also contend with the “perceived stigma and perceived shame from their community” that receiving sexual health care means you don’t share its values, such as female monogamy. That’s a stereotype applied to women across many demographics.

To reach those who have been disenfranchised, providers need to be trained to offer sexual health care to patients who have experienced historical trauma and sexual trauma, including assault and abuse. “If they’re met with a system that doesn’t use open terminology or doesn’t recognize their trauma, their experience can be horrible,” Reno says. “We can retraumatize them, and they don’t come back ever.”

Public-health initiatives have also succeeded by partnering with local institutions people trust. In St. Louis, which has some of the nation’s highest rates of S.T.I.s, many barbershops and beauty salons offer testing information and free condoms; elsewhere, projects in partnership with churches have been able to increase mammograms and H.I.V. testing among Black women. Half of all new S.T.I. infections are among 15-to-24-year-olds, but school-based health centers that offer comprehensive health services on campus have been shown to improve attendance and graduation rates and decrease urgent-care visits.

The pandemic has interrupted countless health services. But it also generated solutions. For example, in March 2020, a program called TakeMeHome began mailing out free H.I.V. self-test kits, with a focus on reaching gay and bisexual men. Half the recipients had not been tested within the previous year, and more than a third of them had never been tested at all; after using the kit, more than 10 percent reported accessing other sexual-health services. “You have to make it as easy for people as possible,” Park says.

If you’re sexually active, you will inevitably be exposed to pathogens, just as you are by shaking hands with or breathing the same air as others. “Your clothes are off,” Park says. “That’s the only difference.” S.T.I.s “are not a personal failing,” Reno says. “This is a systemic societal challenge.” Thus, talking openly about sexual health care stands to benefit everyone. Park recommends pressing your provider for testing; ideally, S.T.I. screening would be treated like a trip to the dentist. “Put it in your routine as something you do regularly.”

https://www.nytimes.com/2022/05/17/maga ... 778d3e6de3
kmaherali
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America May Soon Have Another Sexually Transmitted Infection

Post by kmaherali »

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By Jay K. Varma

Dr. Varma is a professor at Weill Cornell Medical School. He is a physician and an epidemiologist focused on large-scale responses to infectious diseases.

Monkeypox infections are spreading rapidly in many countries, and the United States has, yet again, been caught flat-footed when confronted with another virus. Many problems with the Covid-19 response by the United States are being repeated: limited access to testing, contact tracing, vaccination and isolation support, and scant data from public health officials about how and where people are being infected. With infections currently concentrated among men who have sex with men, monkeypox has also exposed another critical vulnerability in the U.S. public health system: limited sexual health services in many parts of the country. That will make it more difficult to know how many monkeypox cases there are and to stop the virus from spreading.

The general public needs to demand that elected officials recognize the urgency of having a strong national strategy and budget focused on sexual health. By making sexual health a routine part of wellness and by funding it sufficiently, we can lower the barrier to essential services and protect everyone from emerging health threats, such as monkeypox.

Monkeypox is caused by a virus similar to smallpox, and many outbreaks were thought to begin with human contact with infected animals in central and western African countries. The virus often causes several days of flulike symptoms, followed by a skin rash.

Since May 2022, monkeypox cases have been reported in many states in the United States and in Europe, primarily associated with men who have sex with men. Public health investigations strongly suggest that infections are spreading during sexual contact, likely from an uninfected person’s skin touching an infected person’s skin in the genital or anal areas. While there is some debate among epidemiologists about whether to call monkeypox “sexually transmitted” versus “sexually transmissible,” it is reasonable to consider that sex is one activity that transmits infection, similar to other infections that are transmitted by skin-to-skin contact during sex, like herpes, syphilis and the human papillomavirus. While no deaths have been reported in the United States, more widespread infections will result in some people experiencing severe complications, such as damage to the brain, eyes and lungs. Infections may also be more severe in people with H.I.V., which is more common in men who have sex with men in the United States.

Many cases of monkeypox during the recent outbreak in Europe and the United States have been detected at clinics dedicated to treatment of sexually transmitted infections. But there are reasons to believe the United States is missing many more cases than have been reported. The Centers for Disease Control and Prevention has said that it does not know how some U.S. patients acquired the virus, suggesting that there are likely people spreading infection not yet diagnosed. The C.D.C. has also reported at least two different variants of monkeypox in the United States, suggesting more than one outbreak at the same time. And my personal experience has shown that young men who have sex with men are likely being misdiagnosed when they go to emergency departments.

Why are cases being missed? One reason is that the United States lacks a sufficient number of clinics that specialize in sexual health, including family planning, sexual dysfunction, gender-affirming services, and S.T.I.s. Historically, most of these clinics have been affiliated with local health departments with public funding.

The clinics have several advantages over primary care or urgent care centers. Patients often perceive them as more welcoming, because they can ensure anonymity, have staff members well versed in gay men’s health, often charge no or minimal out-of-pocket fees and may provide rapid screening options and vaccines particularly important to sexually active teens and adults. They also have clinicians who have expertise in accurately differentiating one S.T.I. infection from another and providing treatment to patients and their exposed sex partners. Widespread availability of sexual health clinics lowers the barrier for people to get screened, seek care for any symptoms and get vaccines when available.

Controlling epidemics of S.T.I.s depends on prompt diagnosis and effective treatment of infected people and their contacts. Yet government funding for diagnosis, treatment and contact tracing has been declining. In the 2010s, many health departments reduced hours at sexual health clinics, and prevention programs were further disrupted starting in 2020 because of Covid-19. In part because of these reduced health services, S.T.I.s have been rising for years, and the C.D.C. estimated that, on any given day in 2018, one in five Americans had one of these infections. Rates are particularly high in people 15 to 24 years old and men who have sex with men.

Other experts and I fear that monkeypox will exploit this vulnerability and become a permanently entrenched S.T.I. in the United States, as has happened with syphilis and H.I.V. Initial skin changes in this outbreak often appear innocuous and can occur in locations that are easy to miss, such as inside the anus. Nevertheless, these lesions are highly contagious and can even contaminate surfaces or materials such as towels, which can spread infection to other people. The skin changes can also mimic those of other infections, such as herpes, molluscum or syphilis, so monkeypox can be easily misdiagnosed by someone not expert in evaluating S.T.I.s.

As we know from other S.T.I.s, patients who have genital or anal symptoms that they believe are associated with sex may be reluctant to see a primary care physician in part out of fear that their diagnosis will be documented in their medical record and jeopardize their health insurance (if they have insurance). The current absence of easily accessible clinics that offer monkeypox testing will make it more likely that infections will go undiagnosed early and continue to spread. And the dynamics of some sexual networks among men who have sex with men — in which men with multiple sexual partners have sex with men who also have multiple partners — are likely to contribute to ongoing monkeypox transmission in this population.

Federal and state governments should immediately begin large-scale campaigns to educate health care providers of all types about monkeypox. Public health officials cannot assume that doctors will simply know when to test for it and how to navigate the process of swabbing a skin lesion and getting it to a specialized lab.

Public health agencies need to dramatically increase collaborations with community groups and hookup apps, party promoters and travel companies that specialize in gay, bisexual and other men who have sex with men to promote self-screening for skin changes. Some gay men are quite comfortable taking and sharing photos of their penis and anus while flirting; encourage them to do it for their health as well. The federal government also should authorize state health departments to use unspent Covid-19 funds to support S.T.I. supplies, equipment and staff for expanded hours and outreach at sexual health clinics, as well as contact tracing and support for isolating infected persons.

Monkeypox is unlikely to affect as many Americans as Covid-19. Nevertheless, an important lesson of the past decade of Covid-19, Ebola and Zika epidemics is that unchecked transmission means a virus will not stay limited to any one subset of the population and will lead to unpredictable health complications. Strengthening sexual health services now can serve the dual purpose of stemming the monkeypox outbreak and the ongoing one of S.T.I.s.

https://www.nytimes.com/2022/06/27/opin ... 778d3e6de3
kmaherali
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‘Captain Condom’ Turned the Tide in Thailand’s War on AIDS and Overpopulation

Post by kmaherali »

At a time when most Thais avoided discussing safe sex and family planning, Mechai Viravaidya promoted condom use with spectacle and humor, saving millions of lives.
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Concerned that Thailand’s population was growing at an unsustainable pace, Mechai Viravaidya began promoting condom usage in the early 1970s, when few were willing to broach the subject.Credit...Lauren DeCicca for The New York Times

BANGKOK — Mechai Viravaidya twice saw Thailand in desperate trouble — first from a ruinous population explosion and then from the AIDS epidemic — and he responded to both crises the same way: with condoms and his own considerable charisma.

Birth control was something Thais neither talked about nor very much practiced in the early 1970s, when the country’s population was growing at an unsustainable pace and the average family had seven children.

So Mr. Mechai decided to tackle the subject that no one else would touch, spearheading a nationwide campaign to publicize and demystify contraceptives.

“It wasn’t a job for intelligent people, smart people, respectable people, aristocratic people,” he said in a June interview.

Mr. Mechai, now 81, is in fact all of these, the foreign-educated son of two doctors, the husband of a former private secretary to the king and, over the years, a government minister, organizational leader and senator.

But he is also uninhibited, unpretentious and always willing to put on a show to persuade people.

His goal with the family-planning campaign, he said, was to make condoms just one more item shoppers picked up in the market, along with soap, toothpaste and dried fish. To pull that off, he knew it would help to lend condoms positive associations, something that made people smile.

“If I can accomplish that by blowing up condoms or filling them with water,” he said, “then fine, I’ll do it.”

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A photo of Mr. Mechai with a condom around his thumb during a campaign to promote safe sex and family planning.Credit...Lauren DeCicca for The New York Times

Mr. Mechai was speaking not far from the Bangkok offices of the Population and Community Development Association, the organization he founded nearly 50 years ago to fight poverty in Thailand, with family planning a linchpin.

He toured the country, village to village, with an endless array of gimmicks and publicity stunts that linked condoms with fun. Filling them up with water past the point of breaking was a staple performance.

“Who can blow up the biggest condom?” he would call out to the crowds. “Who can make it burst!”

He opened what he called family-planning “supermarkets” at bus stations to distribute contraceptives and persuaded Buddhist monks to bless condoms, distributing videos of the ceremonies. To educate younger Thais, he produced a safe-sex English alphabet that included letters like B for birth control, C for condom and V for vasectomy.

In addition to the spectacle, the campaign had serious infrastructure behind it. He mobilized and trained a network of 350,000 teachers and 12,000 village community leaders.

And he didn’t limit his family-planning efforts only to condoms. In Bangkok, he offered mass free vasectomies on a parade ground near the palace to celebrate the king’s birthday.

Some found his methods offensive, or at least insufficiently decorous. A newspaper columnist, trying to formulate an insult, suggested that people start calling condoms “mechais.”

The idea caught on, and Mr. Mechai framed a copy of the article to hang on his wall.

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Mr. Mechai founded the Population and Community Development Association nearly 50 years ago to fight poverty in Thailand, with family planning a linchpin.Credit...Lauren DeCicca for The New York Times

It all added up to more publicity, the main weapon in his arsenal, and the results of his campaign were dramatic. Thailand’s population growth rate fell from more than 3 percent in 1974 to 0.6 percent in 2005, and the average number of children per family shrank from seven to fewer than two.

The World Bank called Mr. Mechai’s campaign “one of the most successful and effective family planning programs in the world.”

In 1970, both Thailand and the Philippines had equivalent populations of 36 million.

“Now we have about 70 million and they have 107 million,” Mr. Mechai said in the interview, actually understating the Philippines population, which is over 110 million. He added that if Thailand hadn’t addressed its population issue it, too, would be sending millions of its citizens abroad to find work.

“If we hadn’t stepped in it would have been to the deep detriment of the economy of Thailand and the quality of life,” he said.

When the AIDS pandemic began to overwhelm Thailand in the late 1980s, Mr. Mechai employed the same knack for publicity, persuasiveness and showmanship in combating the disease.

As with his first condom campaign, he initially struck out on his own as the government refused to back a safe-sex campaign, fearing it would hurt the lucrative sex-tourism industry.

So Mr. Mechai turned instead to the military, a powerful institution beyond the reach of civilian government, which agreed to air regular safe-sex announcements on its 300 radio stations and five television stations.

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Mr. Mechai giving a talk during a workshop on food security for the elderly, in Bangkok on Wednesday. In addition to his work on family planning and safe sex, he has focused on addressing a range of social and economic issues in Thailand.Credit...Lauren DeCicca for The New York Times

Then in 1991, a new prime minister, Anand Panyarachun, embraced AIDS prevention, making Mr. Mechai his minister of information and tourism. Every government ministry was now called on to play a role in AIDS education.

“We had condoms out everywhere on the streets — everywhere, everywhere,” Mr. Mechai said in a TED Talk recounting his approach. “In taxis, you get condoms, and also, in traffic, the policemen give you condoms.”

And Mr. Mechai — despite or perhaps because of his M.B.A. from Harvard — took it upon himself to become the recognizable symbol that he said every successful marketing program needs, dubbing himself “Captain Condom” and going to schools and night clubs to promote safe sex.

The World Health Organization called Thailand’s approach to the AIDS crisis “the quickest response to the problem that we have ever seen.” The United Nations said Mr. Mechai’s program had achieved a 90 percent decline in new infections, and the World Bank estimated that it had saved 7.7 million lives between 1991 and 2012.

Mr. Mechai was born in Bangkok in 1941, to a Scottish mother, Isabella MacKinnon Robertson, and a Thai father, Samak Viravaidya, both doctors, who had met as students at the University of Edinburgh Medical School.

Raised speaking Thai and English, he went to high school and college in Australia, earning a bachelor’s degree in commerce in 1964 from the University of Melbourne.

His comfort among both Thais and Westerners, Mr. Mechai said, has enhanced his ability to pitch his programs — and lobby for financing — in different cultures, successfully courting substantial grants from foundations, development organizations and foreign governments.

Returning to Thailand in 1966, Mr. Mechai thought at first of becoming a doctor like his parents. “I helped my father stitch up a finger that had been cut off, holding on to a rubber tourniquet,” he said, “and I realized, that’s not for me.”

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Free condoms on offer at Cabbages and Condoms, a condom-themed restaurant in Bangkok whose profits got to fund Mr. Mechai’s work.Credit...Lauren DeCicca for The New York Times

Attracted by the wide range of issues it addressed, he joined the government’s National Economic and Social Development Board, where he served for eight years as an economist.

At the same time he found other outlets for his energies, writing a newspaper column, hosting an evening radio show and teaching a part-time university English course.

His penchant for performance also led him to acting, and he appeared in a popular, sentimental TV drama, “Star-Crossed Lovers,” playing a Japanese army officer who falls in love with a Thai college student during World War II.

In 1971 he married a childhood friend, Thanpuying Putrie, with whom he has one daughter. His wife is a cousin of King Bhumibol Adulyadej, the father of the current king, and she served for years as his deputy principal private secretary. Mr. Mechai delights in saying that his mother was the doctor who delivered his future wife.

In his role as a government economist, he toured the country and saw firsthand the poverty, and the social and economic dislocations that he later devoted his life to addressing.

“There were children everywhere,” he said of Thai villages. “This was the great problem. And I realized I was wrong in thinking the government could do everything. So I decided to go out on my own.”

In 1974 he left government to found the Population and Community Development Association. It flourished and branched out to address a range of social and economic issues, from rural development to environmental protection.

In the years that followed, his career path took him in and out of government roles, including as cabinet spokesman, deputy industry minister and three terms as a member of the Senate between 1987 and 2006.

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Cabbages and Condoms showcases Mr. Mechai’s activism and is famous for its condom-themed décor, including bouquets of condoms, condoms offered in place of dinner mints and a year-round Christmas tree festooned with condoms.Credit...Lauren DeCicca for The New York Times

In addition to his work on family planning and safe sex, developing Thailand’s rural economy has been a decades-long focus of his activism. In the 1990s, he founded the Village Development Project, which aims to foster entrepreneurship and create income-generating activities in rural Thailand.

It has set up small factories in the countryside to lure workers back home from sweatshops in Bangkok, part of an effort to combat the urban migration that has debilitated rural economies.

His said his greatest pride now is the Mechai Bamboo School in northeastern Thailand, set up to “re-engineer rural education” by turning the school into a lifelong learning center and an active contributor to life in its community.

A boarding school with a student body of 180 that makes a point of including undocumented and disabled students, it extends the concept of education into a set of life skills, according to Mr. Mechai.

“The school aims to foster good citizens who are honest, willing to share, and truly accept and practice gender equality,” Mr. Mechai said.

Its outreach programs offer assistance to older villagers, give nutritional advice to pregnant women and assist in small-scale agriculture.

Mr. Mechai said more than 100 small rural schools have begun to follow his lead in becoming more involved in their communities.

Though now at an age when most people are slowing down, Mr. Mechai has no plans to stop addressing what he said were his life’s main concerns: “to combat economic and social inequality by reducing births, reducing deaths from AIDS and reducing poverty, financial dependence and ignorance.”

https://www.nytimes.com/2022/08/05/worl ... 778d3e6de3
kmaherali
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Spain Passes Law Requiring ‘Freely Expressed’ Consent for Sex

Post by kmaherali »

The law comes six years after the gang rape of an 18-year-old woman stirred mass protests and a general reckoning over the rights of sexual abuse victims.

By Emma Bubola and José Bautista
Aug. 25, 2022
Six years ago, an 18-year-old woman was raped in a building lobby by five men during the bull-running festival in Pamplona, Spain. The men filmed it on a cellphone video, which showed her still and with her eyes shut during the assault.

Her case — and the initial failure to convict the men of rape — galvanized Spain, and on Thursday it helped inspire Parliament to pass a law on consent that observers say could transform sexual behavior in the country.

“It is not my law, but a law for all the women, so let’s move on,” the victim, whose identity has been protected by the authorities, told the Spanish newspaper El País.

Under the measure, any sex that takes place without clear consent can now be prosecuted as rape. Before passage of the law, for an act to be considered rape, it needed to involve some sort of violence or coercion. Otherwise it fell into the category of sexual abuse — a lesser crime.

Advocates of the new law have welcomed it as a strong statement about the rights of women, with Spain joining countries including Canada, Sweden and Denmark that have adopted a similar approach to rape and consent.

“The feminist call of ‘only yes means yes’” has “finally become law in our country,” Irene Montero, Spain’s minister of equality, said Thursday.

The law does not require that a “yes” to a sexual act be expressed verbally. But it does say that “there is consent when it has been freely expressed through acts that, in view of the circumstances of the case, clearly express the will of the person.”

It remains to be seen how courts will interpret what that means as prosecutions are brought under the new law. But some experts hailed the measure as a big step forward.

The law “is a very significant shift” since it moves away from “consent being what usually a man imagines a woman is thinking,” said Lise Gotell, a professor of women’s and gender studies at the University of Alberta, Canada.

“There is a recognition that consent is subjective from the perspective of the person experiencing the sexual contact,” said Ms. Gotell, an expert on sexual consent issues.

The proposal took roughly two years to go through the legislative process. On Thursday, Spain’s lower house gave it final approval, with 205 votes in favor and 141 against.

The law requires what is often called “affirmative consent.” It makes clear that consent cannot be given if a person is unable to understand the situation because of the effects of drugs or alcohol, or if they have fallen asleep.

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International Women’s Day in Pamplona in 2020.Credit...Alvaro Barrientos/Associated Press

A 2020 study by Amnesty International found that only 12 European countries out of 31 analyzed had laws defining rape as sex without consent. In most of them, the definition of rape required proof of some use of force, threats and coercion, as well as the victim’s inability to defend oneself.

“But most rapes do not fit stereotypes such as a ‘stranger jumping out of the bushes,’” the organization noted. Victims are often shocked by the attacker, it said, and one reaction can be to freeze, even with no physical violence involved.

Supporters of Spain’s legislation argued that in the absence of such a law, victims often faced a second trauma: having to prove in court that they had tried to resist the aggressor.

The new law sets different levels of convictions for sexual aggressors, depending on the severity of the case, with offenders facing anything from fines to 15 years in prison. It also sets out some aggravating circumstances for rape cases, with tougher sentences if rapists act in a group, if the victim is a vulnerable person, if the rapist is a boyfriend or a relative, or if the suspect drugs the victim.

The law also allows for prosecution in cases of street harassment.

The new law was spurred by the anger and huge protests that followed the trial of the defendants in the rape of the 18-year-old woman, which helped fuel a Spanish version of the #MeToo movement.

The five men were initially cleared of raping the woman and sentenced to nine years in prison for “continuous sexual abuse,” rather than the almost 23 years in prison that the prosecution had sought. The judges found that there was not sufficient evidence of violence or intimidation; they said the victim had been passive during the intercourse.

The decision set off widespread outrage and drew tens of thousands of protesters to the streets in hundreds of demonstrations all over Spain, leading politicians to call for an overhaul of the country’s rape laws.

The attackers had labeled themselves a “manada,” a term often used to refer to a wolf pack.

“If what the wolf pack did as a group wasn’t violence against a defenseless woman, what do we then understand to be rape?” Pedro Sánchez, then leader of the main Socialist opposition party, and now the prime minister, wrote on Twitter.

The outcry increased when the men’s lawyers portrayed the victim as a consenting sexual partner, and when the men were released on bail.


In 2019, Spain’s Supreme Court overruled the previous decisions and sentenced the five men to 15 years in prison for rape.

During the final arguments before the Supreme Court, the defendants’ lawyers said that the victim should have spoken out during the attack.

“She simply had to say, ‘No,’” Agustín Martínez, a defense lawyer, told the court.

According to the new law, it’s enough that she did not say yes.

https://www.nytimes.com/2022/08/25/worl ... 778d3e6de3
kmaherali
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The mobile app giving girls in Kenya the freedom to choose

Post by kmaherali »

On Day of the Girl, learn about AKF’s partnership with Triggerise to scale the Tiko app, a platform improving access to sexual and reproductive health services for girls and young women

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“I am a passionate girls advocate, and I know what girls go through. I have to fight for girls’ rights, because we’ve had cases where girls can’t speak for themselves, and they need someone who can speak for them.”
Steasy Atieno – Tiko community mobiliser, Kisumu, Kenya

A young woman herself, Steasy Atieno understands the challenges girls face throughout their formative years. Where she lives in northern Kenya, many of these revolve around health, and in particular sexual and reproductive health rights (SRHR). A lack of access to SRHR services, including contraception, coupled with ongoing cultural stigma surrounding the issue, makes it extremely difficult for girls to exercise agency and take control of their bodies. With the movement restrictions and school lockdowns imposed during the COVID-19 pandemic, it has become even harder for girls to access SRHR services, and Kenya is one of several countries that has seen a spike in unintended pregnancies, HIV infection rates, and gender-based violence as a result.

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Steasy Atieno, a Tiko community mobiliser

Choice is an essential factor in SRHR; something which many girls and young women lack worldwide. In Kenya, young people like Steasy are part of a growing force determined to make sure girls are better informed about their bodies and their rights. She is one of more than 950 community mobilisers for the Tiko platform, a mobile app designed and implemented by Triggerise, one of the Aga Khan Foundation’s (AKF) partner organisations in East Africa. Triggerise is a global NGO harnessing the power of tech to connect young people with health services, community networks, and life skills. Triggerise’s Tiko platform gives girls and women between the ages of 15 and 19 access to free SRHR products and services. Tiko currently has more than two million users and is one of the most impactful health programmes in East Africa.

Recognising the urgent need to improve access to SRHR services during and since the peak of the pandemic, AKF partnered with Triggerise to scale the Tiko platform in Kenya as part of our wider COVID-19 response programme, funded by the EU. The programme is divided into three pillars: community resilience, health system strengthening, and youth wellbeing and livelihoods. The latter includes expanding the reach of SRHR services for adolescents and youth, in particular young women and girls. Since the inception of the programme, more than 35,000 girls have been positively impacted.

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Community mobilisers use the Tiko app to provide services, materials and information to Tiko users

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Tiko cards make it easy for girls to access services without the need for technology

The Tiko platform is more than just an app. To function effectively and in a way that is empowering for its community of users, it requires an ecosystem of people, institutions, and processes. Steasy works in Kisumu’s Nyalenda slum, where there is a Tiko clinic – one of 270 in Kenya. Tiko clinics are existing private clinics and pharmacies which provide a space to offer confidential SRHR services and distribute SRHR materials.

When a girl or young woman visits a Tiko clinic and accesses services, she earns Tiko points which she can spend in a Tiko store. Like the clinics, Tiko stores are existing local businesses, including shops and beauty salons, that are walking distance from a clinic. This incentive scheme is not only encouraging girls to better look after their health, but is also boosting the local economy. Business owners see the value in Tiko and have seen increased sales since establishing as Tiko stores, of which there are currently around 250 across Kenya.

Tiko also partners with local pharmacies as another location for users to spend their Tiko points and access SRHR services. In Nyalenda, the nearest Tiko pharmacy is just a short five-minute walk from the Tiko clinic.

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A Tiko shop in Nyalenda

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Tiko users can spend their Tiko points in local shops and retailers

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Maurice, the pharmacist at the local Tiko pharmacy in Nyalenda

It’s not just the community of users that benefit from the Tiko ecosystem. Tiko mobilisers like Steasy also earn points by referring girls and young women to the platform, which they can do via SMS (low-tech) or a Tiko card (no-tech). Doing so isn’t always easy because of the stigma surrounding SRHR in the communities. Being a Tiko mobiliser is a challenging job – they are often turned away by parents and have to come up with creative ways to educate the community about the importance of SRHR.

Tiko community mobilisers are all volunteers, recruited from local civil society organisations. Steasy is a member of a volunteer-led youth group called Amazon Theatrics Ensemble (ATE), which primarily uses performing arts to raise awareness of the issues impacting their community. Steasy explains, “Performing arts is really effective, because it helps people relate to what girls are going through. We turn up at the local market and start a skit, then we explain what Tiko is. It’s quite discreet, we don’t put up banners or play loud music, but it draws a crowd and provides a platform for us to advocate for girls”.

Of the 964 community mobilisers, around 80% are young women. The remaining 20% of young men are playing a crucial role in breaking the stigma around SRHR. Edwin Koga, founder of ATE, says that it’s important that “we don’t leave boys behind; we have to empower them and encourage them to be male champions of women and girls’ rights”.

“We don’t leave boys behind; we have to empower them and encourage them to be male champions of women and girls’ rights”
Edwin Koga – Founder of Amazon Theatrics Ensemble, a youth group in Kisumu, Kenya

From the Tiko store business owners to the young community mobilisers providing a safe and confidential service through the app, communities across Kenya are coming together to fight for the rights of young women and girls. These emerging ecosystems of support are helping girls make positive life decisions, creating an environment where everyone, no matter their gender, has the freedom to choose.

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Moses Ramoth, a Tiko community mobiliser

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A team of community mobilisers gather outside a Tiko pharmacy in Nyalenda in Kisumu

Learn more about Triggerise and Tiko https://triggerise.org/news/

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swamidada
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Re: Solutions to Sexual Problems.

Post by swamidada »

The Telegraph
Sex is a ‘beautiful thing’, says Pope Francis

Our Foreign Staff
Thu, April 6, 2023 at 8:02 AM CDT

Pope Francis has praised the virtues of sex in a documentary released on Wednesday, describing it as “one of the beautiful things that God has given to the human person”.

The 86-year-old pontiff made the comment in The Pope Answers, a Disney+ production, which captures a meeting he had last year in Rome with 10 people aged in their early 20s.

Francis was quizzed by the young people on a variety of topics, including LGBT rights, abortion, the porn industry, sex, faith and sex abuse within the Catholic Church.

“To express yourself sexually is a richness. So, anything that detracts from real sexual expression lessens you and depletes this richness,” he said, referring to masturbation.

When asked whether he knew what a “non-binary person” was, Francis replied in the affirmative, saying that LGBT people must be welcomed by the Catholic Church.

“All persons are the children of God - all persons. God does not reject anybody. God is a father. And I have no right to expel anyone from the church,” he said.

On the subject of abortion, Francis said priests should be “merciful” towards women who have terminated a pregnancy, but he said the practice remains unacceptable.

“It is good to call things by their name. It is one thing to accompany the person who had one (abortion), quite another to justify the act,” he said.

The pope’s remarks were published by L'Osservatore Romano, the official Vatican newspaper, which described his conversation with the young people as an “open and sincere dialogue”.

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kmaherali
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Navigating Differences: Clarifying Sexual and Gender Ethics in Islam

Post by kmaherali »

PUBLIC STATEMENT
PUBLIC STATEMENT
Navigating Differences: Clarifying Sexual and Gender Ethics in Islam
May 23, 2023
List of signatories was updated on June 7, 2023 at 3:41 pm ET.

Public discourse on sexuality over the past few decades has presented challenges to faith communities. Today, Islamic sexual and gender ethics are at odds with certain recently popular societal views, causing tension for Muslims between their religious beliefs and societal expectations. At the same time, public disapproval of LGBTQ practices, beliefs, and advocacy is increasingly met with charges of intolerance and unwarranted accusations of bigotry. More troubling still, there is an increasing push to promote LGBTQ-centric values among children through legislation and regulations, disregarding parental consent and denying both parents and children the opportunity to express conscientious objection. Such policies subvert the agency of Muslim parents to teach their children their religiously grounded sexual ethics, violate their constitutional right to freely practice their religion, and contribute to an atmosphere of intolerance toward faith communities.

We are Muslim scholars and preachers representing a diverse range of theological schools. Below is our collective, non-partisan articulation of Islam’s position on sexual and gender ethics. As a religious minority that frequently experiences bigotry and exclusion, we reject the notion that moral disagreement amounts to intolerance or incitement of violence. We affirm our right to express our beliefs while simultaneously recognizing our constitutional obligation to exist peacefully with those whose beliefs differ from ours.

The Source of Morality for Muslims

The most essential requirement for accepting Islam is to submit to God completely, voluntarily, and lovingly. God says, “It is not for a believing man or woman—when God and His Messenger decree a matter—to have any other choice in that matter” (Quran, al-Aḥzāb:36). By submitting to God, we declare that only He possesses absolute knowledge and wisdom. Therefore, it follows from this submission that the ultimate source and basis of morality is Divine guidance, not just reason or societal trends.

Islam enjoys a rich tradition of jurisprudence that allows for diverse perspectives and accommodates various cultural norms. However, particular principles that are explicitly stated in revelation, known to be necessary elements of Islam, and unanimously agreed upon by qualified scholars are deemed immutable and not open to revision by any person or entity, including the highest religious authorities. As God asserts, “And the word of your Lord has been fulfilled in truth and justice. None can alter His words, and He is the All-Hearing, the All- Knowing” (Quran, al-An‘ām: 115).

Islam’s Position on Sexuality and Gender

By a decree from God, sexual relations are permitted within the bounds of marriage, and marriage can only occur between a man and a woman. In the Quran, God explicitly condemns sexual relations with the same sex (see, e.g., Quran, al-Nisā’: 16, al-A‘rāf: 80–83, and al-Naml: 55–58). Moreover, premarital and extramarital sexual acts are prohibited in Islam. As God explains, “Do not go near fornication. It is truly an immoral deed and a terrible way [to behave]” (Quran, al-Isrā’: 32). These aspects of Islam are unambiguously established in the Quran, the teachings of Prophet Muhammad (peace be upon him), and a chain of scholarly tradition spanning fourteen centuries. As a result, they have gained the status of religious consensus (ijmā‘) and are recognized as integral components of the faith known to the general body of Muslims.

God defined humanity as consisting of males and females and declared that He “… created [humans] from a male and a female and made [them] into peoples and tribes so that you may come to know one another” (Quran, al-Ḥujurāt: 13; see also al-Najm: 45). Islam affirms that men and women are spiritually equal before God, even though each has different characteristics and roles. The Prophet Muhammad (peace be upon him) referred to women as equivalent counterparts of men. Yet, he (peace be upon him) explicitly condemned imitating the appearance of the opposite gender. Further, God calls on humanity to respect His wisdom in creation (see, e.g., Quran, al-Nisā’: 119). As such, as a general rule, Islam strictly prohibits medical procedures intended to change the sex of healthy individuals, regardless of whether such procedures are termed gender “affirming” or “confirming.” For individuals born with biological ambiguities, such as disorders of sexual development, Islam permits them to seek medical care for corrective reasons.

Islam distinguishes between feelings, actions, and identity. God holds individuals accountable for their words and actions, not for their involuntary thoughts and feelings. As our Prophet (peace be upon him) said, “God has pardoned Muslims for what they think, as long as they do not speak of or act on it” (Bukhari, 2528). In Islam, the sinful actions of an individual do not and should not dictate his or her identity. As such, it is impermissible for Muslims to take pride in identifying with labels that categorize them by their sins. It is important to note that the stance of Islam on illicit sexual relations goes hand in hand with its protection and promotion of the individual’s right to privacy. Islam prohibits prying into others’ private lives and discourages public disclosure of sexual behavior (see, e.g., Quran, al-Ḥujurāt: 12 and al-Nūr: 19).

We recognize that some religious groups have reinterpreted or revised religious doctrine to be inclusive of LGBTQ ideology. The Muslim community is not immune to such pressures. Indeed, some have attempted to reinterpret Islamic texts in favor of LGBTQ affirmation. We categorically reject such efforts as theologically indefensible because these aspects of sexual ethics fit within the category of immutable tenets and are therefore not subject to revision.

Our Constitutional Right to Hold Our Views

We recognize that our moral code conflicts with the goals of LGBTQ proponents. We also acknowledge their constitutional right to live in peace and free from abuse. Nevertheless, we emphasize our God-given and constitutional rights to hold, live by, and promote our religious beliefs in the best manner (Quran, al-Naḥl: 125) without fear of legal reprisal or systematic marginalization. Peaceful coexistence does not necessitate agreement, acceptance, affirmation, promotion, or celebration. We refuse the false choice between succumbing to social pressures to adopt views contrary to our beliefs or facing unfounded charges of bigotry. Such coercive ultimatums undermine prospects for harmonious coexistence.

We call on policymakers to protect our constitutional right to practice our religious beliefs freely, without fear of harassment, and to oppose any legislation seeking to stifle the religious freedoms of faith communities. Consistent with our claim of non-partisanship, we are committed to working with individuals of all religious and political affiliations to protect the constitutional right of faith communities to live according to their religious convictions and to uphold justice for all.

To Our Muslim Community

We urge Muslim public figures to uphold the sanctity of our faith and refrain from making erroneous pronouncements on behalf of Islam. We reject any attempt to attribute positions to Islam concerning sexual and gender ethics that contravene well-established Islamic teachings. To be clear, we cannot overstate the detrimental spiritual consequences for those who intentionally reject, advocate the rejection of, or misrepresent the will of God, as in doing so they endanger their status as believers (Quran, al-An‘ām: 21).

To those among us who struggle with desires that fall outside the boundaries set by God: know that even the most righteous can commit sins and that every Muslim, no matter how sinful, has the potential to be forgiven. Practicing self-restraint in devotion to God is considered heroic. Its spiritual reward increases proportionally with the level of struggle involved. Our ultimate purpose is to prioritize devotion to God over our desires and not sacrifice our faith. We pray to God to grant us the necessary strength and unwavering commitment to live up to our ideals. May we find inner peace and satisfaction through loving submission, and may God deem us worthy of being counted among the believers, the most honorable of titles.

https://navigatingdifferences.com/clari ... -in-islam/
kmaherali
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Teens in Search of Birth Control Have Embraced the Hormonal Implant

Post by kmaherali »

The implant is effective, low-maintenance and relatively pain-free to get.

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The hormonal implant, a long-acting reversible contraceptive, is an increasingly popular choice among teenagers, according to data published last week from the Centers for Disease Control and Prevention. Just over 13 percent of sexually active teenage girls used the implant between 2015 and 2019, compared with 0.6 percent between 2006 and 2010. This represents the biggest jump in usage compared to all other contraceptive methods.

The uptick “probably contributed to a decline in teen pregnancies and births that we’ve seen,” said Joyce Abma, a social scientist with the National Center for Health Statistics and co-author of the latest C.D.C. report. The report notes that both teenage pregnancies and births have reached “historic lows.”

The implant, called Nexplanon, is a tiny rod that sits under the skin in the upper arm and releases progestin, a synthetic hormone that mimics progesterone, into the bloodstream. This is designed to suppress ovulation, though it might not always do so for everyone. The progestin also thickens the mucus of the cervix in order to prevent sperm from reaching an egg, if ovulation does occur. The implant is considered over 99 percent effective at preventing pregnancies.

The needle used to insert the implant is “a little bit bigger than a typical needle used to draw blood,” said Dr. Anne-Marie Amies Oelschlager, chair of the American College of Obstetricians and Gynecologists clinical consensus committee for gynecology, which develops clinical guidance. “You tent the skin so that you don’t go deep into the muscle or blood vessels or nerves and then you basically put the needle in, remove the needle and the implant stays in place.” Doctors will provide a local anesthetic at the spot where the needle is inserted.

The findings of the C.D.C.’s report echo those of a 2011 study, called the CHOICE project, in which younger teenagers, aged 14 to 17, were found to be more likely to choose an implant than an intrauterine device, or IUD — another long-acting reversible contraceptive. Older teenagers, aged 18 to 20, preferred the latter.

A big draw of the implant is that getting it is far less painful than an IUD and “no pelvic exam is required,” said Dr. Paula Castano, an associate professor of obstetrics and gynecology at Columbia University. It is also easier to train more health care providers to place an implant than an IUD, she added. “That may help expand availability to other clinicians that teenagers may interact with” — a pediatrician or a nurse practitioner can insert the implant, she said, whereas an IUD “requires someone who is much more familiar with pelvic anatomy.”

Another benefit is that the implant is what is known as a “forgettable method,” Dr. Amies Oelschlager said; once it is inserted, it can last for three years and requires no other action. Other contraceptive methods, like the pill, patch or vaginal ring, require upkeep. The pill, for example, needs to be taken every day at the same time and “adolescents have a lower rate of perfect use compared to older people,” she said. Many also “don’t have money, they don’t have transportation to get to the pharmacy, they don’t have the ability to make doctor’s appointments and get to doctor’s appointments for refills.” Studies have found that adolescents who use either an implant or an IUD are more likely to continue to use it and be satisfied with it, compared to those who use other methods, like condoms, the pill or withdrawal.

The implant, however, may not address heavy, painful periods, Dr. Castano said, which is a common complaint among adolescents. It is less likely to completely stop periods than other hormonal methods, she said. In fact, one of the most common side effects of the implant is irregular and unpredictable bleeding, “which can be difficult for patients to adjust to.”

But, Dr. Castano added, against the backdrop of restricted access to abortions, “it’s good to see that we’re already on a trajectory of an increase of use of these more effective contraceptive methods.”

Alisha Haridasani Gupta is a reporter on the Well desk, focused on women’s health, health inequities and trends in functional medicine and wellness. Previously, she wrote the In Her Words newsletter, covering politics, business, technology, health and culture through the gender lens. More about Alisha Haridasani Gupta

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kmaherali
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Re: Solutions to Sexual Problems.

Post by kmaherali »

First U.S. Over-the-Counter Birth Control Pill Will Be Available Soon

The News

The first nonprescription birth control pill in the United States will be available in stores and online in the coming weeks at a price of $19.99 a month, the manufacturer, Perrigo Company, announced on Monday.

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A teal box containing Opill, a daily oral contraceptive.
Credit...Perrigo Company, via Associated Press
Why It Matters
The medication, called Opill, which was approved for over-the-counter sale by the Food and Drug Administration last year, will be the most effective birth control method available without a prescription, research shows — more effective than condoms, spermicides and other nonprescription methods.

Reproductive health experts said that its availability could be especially useful for teenagers, young women, and others who have difficulty dealing with the time, costs or logistical hurdles involved in visiting a doctor to obtain a prescription.

Some experts said they thought it might be a particularly good option for teenagers, who might otherwise rely on condoms.

Lupe M. Rodriguez, the executive director of the National Latina Institute for Reproductive Justice, said in a statement Monday that “over-the-counter access to birth control will greatly reduce the barriers like transportation, cost, language, and documentation.”

Opill is not a new medication — it was approved for prescription use 50 years ago. Reproductive health experts and members of an F.D.A. advisory panel cited its long history of safety and efficacy. It is 93 percent effective at preventing pregnancy with typical use. Women with certain conditions — primarily breast cancer or undiagnosed vaginal bleeding — should not take Opill. But for most women, “the risk is very low, and almost nonexistent if they read and follow the labeling,” Karen Murry, the deputy director of the F.D.A.’s office of nonprescription drugs, said in a memo explaining the approval decision.

Since the Supreme Court overturned the national right to an abortion in 2022, the accessibility of contraception has become an increasingly urgent issue. But long before that, the move to make a nonprescription pill available for all ages had received widespread support from specialists in reproductive and adolescent health and groups.

The approval of Opill faced very little public opposition from conservative groups that are often critical of measures that increase access to abortion, emergency contraception and sex education. Opposition appeared to come primarily from some Catholic organizations and Students for Life Action.

In a survey in 2022 by the health care research organization KFF, more than three-quarters of women of reproductive age said they favored an over-the-counter pill, primarily because of convenience.

The Details

Opill is known as a “mini pill” because it contains only one hormone, progestin, in contrast to “combination” pills, which contain both progestin and estrogen. Cadence Health, a company that makes a combination pill, is also in discussions with the F.D.A. about applying for over-the-counter status.

Perrigo said Monday that Opill can be preordered from some online retailers. A three-month pack of Opill will also be sold by retailers at a price of $49.99. The company’s Opill.com website will also sell the three-month pack, as well as a six-month supply that will cost $89.99.

In its announcement, Perrigo said the company would provide a “cost-assistance program” to “help qualified low-income, uninsured individuals obtain Opill at low or no cost.”

What Happens Next

Making the pill affordable to all women remains a goal for reproductive health advocates, many of whom said Monday that the cost would be out of reach for some populations.

“As a high school student in Texas who struggled to get on the pill under the current system, and faced social stigma while trying, I know firsthand how important it is to ensure young people can walk into a store and easily access the contraception they need,” Maia Lopez, 17, a member of the FreeThePill Youth Council at the nonprofit Advocates for Youth, said in a statement. “While today is a huge step forward, the price is still steep for many teenagers I know.”

The Affordable Care Act requires health insurance plans to pay for prescription contraception, but not over-the-counter methods. Some states have laws mandating coverage of over-the-counter birth control, but most do not.

The KFF survey found that 10 percent of women would not be able or willing to pay any out-of-pocket cost for contraception. About 40 percent would pay $10 or less per month, and about a third would pay between $11 and $20.

Three Democratic senators — Patty Murray of Washington, Mazie Hirono of Hawaii and Catherine Cortez Masto of Nevada — issued a statement on Monday urging passage of legislation to require insurers to cover over-the-counter birth control. They have also pressed the federal government to do something similar under an executive order to improve contraception access that President Biden signed last year.

“The work doesn’t stop here — more needs to be done to make sure every American can access and afford the pill over the counter,” the senators said.

Pam Belluck is a health and science reporter, covering a range of subjects, including reproductive health, long Covid, brain science, neurological disorders, mental health and genetics. More about Pam Belluck

A version of this article appears in print on March 5, 2024, Section B, Page 6 of the New York edition with the headline: First U.S. Over-the-Counter Birth Control Pill Is Headed to Stores. Order Reprints | Today’s Paper | Subscribe
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Birth Control Methods

Seven gynecologists and reproductive health experts told us about the types of contraceptives currently available and the risks they carry. https://www.nytimes.com/article/birth-c ... ide_recirc

The birth control pill is known for having ushered in a sexual revolution. But for some, it can dampen libido. https://www.nytimes.com/2024/01/23/well ... ide_recirc

The hormonal implant called Nexplanon, a long-acting reversible contraceptive, is an increasingly popular choice among teenagers. How does it work? https://www.nytimes.com/2023/12/21/well ... ide_recirc

The intrauterine device, or IUD, is one of the most effective birth control options, but inserting one can be excruciatingly painful. Why don’t more doctors offer effective relief? https://www.nytimes.com/2023/12/14/well ... ide_recirc

A medication called Opill will soon become the most effective birth control method available over the counter. Here’s what to know. https://www.nytimes.com/2023/05/10/well ... ide_recirc

A generation of women grew up with hormones as the default option for birth control. The makers of Phexxi, a non-hormonal contraceptive gel, are trying to appeal to them. https://www.nytimes.com/2021/06/10/styl ... ide_recirc

Despite encouraging research, here’s why male birth control methods remain elusive. https://www.nytimes.com/2022/03/25/well ... ide_recirc

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kmaherali
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Re: Solutions to Sexual Problems.

Post by kmaherali »

The Quest for a New Vision of Sexual Morality

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The death of Hugh Hefner and the dawn of the #MeToo era, coinciding in the autumn of 2017, seemed to mark a turning point in the history of social liberalism in America.

Out, at last, went Hefner’s sex-positive utopianism, the no-prudes-here giddiness and aspirational promiscuity that linked his “Playboy philosophy” to 1980s sex comedies, 1990s lad magazines, liberal excuses for Bill Clinton’s priapism and the sweeping cultural triumph of pornography.

In came #MeToo feminism, founded on outrage over rape and sexual assault, but inclined more broadly to regard hookup culture as a zone of danger, male desire as a force in need of correction and control, and bare consent as an insufficient criterion for sexual morality.

From the start the #MeToo movement was criticized, usually from a libertarian or classical liberal perspective, for reviving socially conservative or even Victorian impulses under a feminist and progressive guise. But it was precisely that remix that made the movement interesting: #MeToo took what had often been a conservative-coded critique of the sexual revolution — one that emphasized the ways that Hefnerism made life easy for pigs and libertines, forcing young women to accept male sexual expectations in the name of liberation — and promised to make it serve a more progressive and egalitarian vision.

The question seven years later is whether that vision actually exists — whether social liberalism can find a standard for sexual morality that’s better for human flourishing than bare consent, and a mechanism to constrain sexual misbehavior that’s more effective than the traditional emphasis on monogamy and chastity.

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To illustrate where the quest for this vision stands, consider three recent cover stories in New York magazine.

The first is a profile of Andrew Huberman, a pop neuroscientist, podcaster and all-around male influencer. The author, Kerry Howley, does a lot of work excavating Huberman’s manifold limitations — as a lifestyle coach and medical guru (don’t trust the effectiveness of the supplements he endorses!), a friend and colleague (don’t expect him to make good on his promises!), and especially as a boyfriend and lover (he controls, he lies, he cheats on six women at once).

The portrait of a figure like Huberman would be interesting under any circumstances. But the special focus on his sex life, the detailed testimony from allegedly mistreated girlfriends, marks this as very much a post-#MeToo profile. Huberman is not accused of any sexual crime; he’s seemingly just a creep, cheat and control freak. But that kind of misbehavior is treated as essential to any judgment of his public career. Whatever the new rules of sex might be, it’s clear that we’re supposed to judge the cad’s lifestyle as regressive, deplorable and wicked.

So what kind of lifestyle might be preferable? Well, here we can turn back a few issues to a New York magazine January cover story on polyamory, featuring both a profile of a specific polycule and an extensive guide to “opening” your relationship or marriage.

When the Huberman profile appeared, some social-media voices suggested that there’s a tension in publishing a takedown of a man juggling six girlfriends after celebrating the juggle just a couple of months previously. But in reality the two cover stories are entirely of a piece. The implied critique of the neuroscience cad isn’t just that he has sex with lots of different women but that he does so deceptively and selfishly — instead of following the kind of open, complex process of negotiation that’s ethically required to be the kind of person who has sex with six different people at a time.

That idea of sex-as-process, with the sexual act itself embedded inside a kind of “best practices” of dialogue and interaction, seems to be where social liberalism has settled, for now, in its attempt to create a post-Hefnerian sexual culture. Thus the general fascination with polyamory, manifest in trend pieces, books and essays too numerous to count, isn’t just about envelope-pushing and shock value. It also reflects a desire to maintain the permissive sexual ethic that men like Hefner turned to their own exploitative ends, but to make it healthier and therapeutic, more female-friendly and egalitarian, safer and more structured.

Polyamory isn’t being offered as an alternative to conservative monogamy, in this sense, so much as an alternative to more dangerous, irresponsible, and deceptive forms of promiscuity — a responsible, spreadsheet-enabled, therapeutic version of the sexual revolution, in which transparency replaces cheating, and everything is permitted so long as you carefully negotiate permission.

A glance at some actual human relationships should raise some doubts about how well this model really works. Whatever Huberman’s failures of honesty and communication, for instance, he appears extremely well versed in the kind of therapy-speak that’s supposed to tame libidinous excess — suggesting that predators and cads can work through this system as well as any other. Or again, the new mom-with-an-open-marriage memoir by Molly Roden Winter, “More,” reads more like a testament to marital suffering than any kind of guide to the good life.

But the depth of the problem with the attempt to establish “safe” forms of liberation is suggested by yet a third New York magazine cover story, the most controversial of the lot: the transgender cultural critic Andrea Long Chu’s recent essay “Freedom of Sex,” which makes a case for allowing kids experiencing gender dysphoria to undergo interventions like puberty blockers and mastectomies regardless of what medical or psychological claims are made about where the desire to change their sex comes from.

Against liberal doubters who emphasize the gap between our understanding of gender dysphoria and the extremity of the treatments being offered to minors, Chu insists that the right to choose your sex (which implies a right not to go through puberty) is as inalienable as any other, and cannot be subordinated to some kind of rigid medical-therapeutic conception of what’s really in the best interests of the dysphoric child or adolescent.

“It does not matter where this desire comes from,” Chu writes of, say, a 12-year-old’s preference to have a male body rather than a female one despite having two X chromosomes. Whether it reflects a tidy therapeutic concept like “gender identity” or simply the unique desires of the individual, whether it leads to happiness or regret or both, in a free society the personal choice must be honored, the unwanted puberty prevented, the right to choose one’s sex preserved.

What Chu is attacking, in the name of a more radical liberation, is the way that youth transitioning has been presented to the public across the last decade: as a matter of certain, “settled” science, as a therapeutic best practice backed up by careful study and trustworthy expertise, in which the fraught, life-altering desire of a teenager can be granted so long as the right safeguards are in place. This runs in parallel, tellingly, to the way that polyamory is often presented: as the safe kind of liberation, the therapist-approved form of promiscuity, with the potential risks and regrets more limited than they would be if the individual libido were simply given rein.

The problem with this presentation, in the case of transgender issues, is that institutions of liberal expertise, in Western Europe especially, are increasingly doubtful about the scientific-therapeutic structure in which transitioning is taking place. The science isn’t actually settled, the safeguards aren’t necessarily effective, the decision to stop puberty or proceed to surgical modification carries all kinds of unsurprising risks.

In which case social liberalism cannot simply promise what it’s been trying to offer since the #MeToo shift: an absolute form of individual freedom wrapped in a protective carapace of expert management and therapeutic process. You can have a culture of hard moral constraint, a conservative order that imposes norms that intentionally limit human freedom — remain faithful to your chosen spouse, live with your given body. Or you can have the kind of freedom-maximizing culture that removes limits and strictures but creates new regrets, new kinds of suffering, new dangers for the vulnerable and weak.

What you probably can’t have is the world where Judith Butler links hands with the American Medical Association in a stable regime of permissive safety, or where “ethical” polyamory transforms the impulse to cheat on your spouse into a pro-social act. At the very least that world remains an undiscovered country — fervently theorized but thus far out of reach.

https://www.nytimes.com/2024/03/27/opin ... 778d3e6de3
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