HPV & Genital Warts

I was recently diagnosed with genital warts (caused by a non cancer causing strain of HPV). It was highly confusing (how long have I had HPV? why did the warts show up where they did?), and a bit distressing (what will my new partner say? how will future conversations go with future partners?). There isn’t a lot of great and solid information out there about genital warts (even my doctor was like “Yeah, it’s always risky to have genital-genital contact. I don’t know what you should tell your partners”), and it was even more stressful having to talk to my new partner about it. Luckily for me, both J and my new partner S are communicative, loving, and flexible, and I didn’t have to go through any additional relationship stress.

Like herpes, genital warts are pretty dang harmless. If you see them early and treat them quickly (usually with a topical cream), they go away pretty fast. But people don’t want them. “STI” connotes something scary and dangerous, and even while genital warts are harmless and non-life threatening, because they fall under that STI umbrella, I think may of us think of them as scary.

The reality is, the majority of us are exposed to various HPV strains causing genital warts by the time we are middle aged. Many people will have one outbreak and never have another, and many people don’t even realize they have an outbreak before their body clears the virus. Some people have the virus their whole life and never experience an outbreak. It spreads like nobody’s business, and it can be such a mild (or nonexistent) experience for many, many people; many sexual health websites say that genital warts and HPV are the common cold of STIs.

Do I have an obligation and responsibility to tell new partners that I have had one outbreak and that it was treated successfully? I lean towards yes, but I don’t really know.

The risk of transmission is much lower when there are no warts present (much like how the transmission of herpes is much lower when there are no sores present), but there’s always a risk- unless my body clears the virus completely. But I won’t ever really know, so it seems like a tough thing to be able to communicate to partners and to know how to support people in figuring out how they want to calculate risk-taking for themselves.

An aside: dental dams suck. They just do. I wish there was a better way to use a barrier on a pussy, because god damn it, dental dams just stink. I want to like dental dams and I want to be a reliable, consistent, and perfect user of them with new partners. But I don’t and I’m not.

Another aside: it has been truly hysterical and amazing how the clients I work with have come in with mirroring experiences to my own. I had a client a few weeks ago talking about her distressing week from being diagnosed with genital herpes. I wanted to be like “Omg, girl! I get you!!” but I obviously cannot do that. Instead, I nodded my head and validated her fears and concerns and worries, and helped her explore why she had such a strong reaction to her own diagnosis.

I experienced some self-shaming with my diagnosis: I’ve had sex with so many people, this is what I get, right? A frickin’ STI that may never go away? I’m so terrible! I should have done better talking to new partners about their sexual history, I should have done better using barrier methods.

Luckily, that self-shaming went away pretty quickly. I’m proud of my sexual history, adventuring, and gallivanting, and all of the communication I have had with past partners, and I don’t expect much of that to change.

Nonmonogamy research, gender, self care, and HIV

Links to share:

This is a pretty fascinating summary of research done on the perception of different types of nonmonogamy; spoiler alert, poly folks were perceived to be more moral while swingers were perceived to be more adventurous.

A pretty awesome piece written on the lessons to be gained from dating someone in an open relationship

A fun compilation of vagina facts

Ginny on using language to be more gender-inclusive

The Gottman blog on self care, autonomy, closeness, and relationship interdependence

Interesting ideas on why childfree couples seem to cheat less than their counterparts with children

I love this infographic from The Lancet on HIV and sex workers:

Lancet-sex-work-infographic_930px (1)

IUDs & Pain

My first IUD insertion went a little something like this:

Fucking painful.

I’ve always said it was the worst pain in my life, a 10 out of 10 on my pain scale. When the NP dilated my cervix, my legs were shaking crazy bad, I had trouble breathing, my whole lower abdomen cramped up as if to say I don’t fucking think so! It took her three times before she made the insertion.

So you might understand why I have been just a tad apprehensive about getting my new one reinserted.

Two weeks ago J went with me to my primary care office to have the removal and reinsertion done. I was completely amped up, and not in a good way, although having J there to rub my shoulders and help me breathe felt like an amazing gift. Ultimately, my GP was unable to finish because she said my strings had been cut too short. She recommended I go to a provider who could remove it with the help of an ultrasound. I cried afterwards because of how anti-climactic the whole thing was and how stressed I had let myself become.

Fast forward to this past week. I made an appointment at the Women’s Health Center at OHSU, and was relieved to see that my doctor has done research on pain during IUD insertions. I tried not to think about my appointment until the night before. I tried on a new mantra of It’s worth it, it’s worth it, it’s worth it (supposedly, that helps). I got up, and took the 4 recommended ibuprofen. I got there, and got to talk to the nurse, the doctor, and the resident a lot about how nervous I was.

Because of my first experience and my nervousness they said I was a good candidate for a cervix numbing blocker. Which was an injection, and felt like a dull ache that referred straight up my abdomen for about 3 seconds. Pulling the old IUD out was uncomfortable. Using the uterine sound to measure my uterus was a dull ache that referred straight up my spine and lasted for about 5 seconds. Inserting the new IUD hurt for about 3 seconds. I was even able to close my eyes, envision Little Beach, and breathe through the whole thing- I think that probably helped too. (PS- no ultrasound needed. They used a special tool that allowed them to yank on the extra short strings)

I almost cried afterwards from pure relief and happiness. I felt like a rock star all day. I’m so proud of my cervix!

Despite my low pain tolerance and hard first experience, I’ve always pushed IUDs on anyone who has asked my opinion about birth control options. They are one of the most effective forms after tubal ligation, and are the most cost effective. Get one, yo!

The less-than-great part of my appointment: the resident was reviewing my medical history with me, and when we got to the part where we discuss my sexual partners, the doctor pretty instantly was concerned that I have more than one male partner. “Well, we definitely need to test you for chlamydia and gonorrhea.” I have had one other male partner besides J since I was last tested for STIs, and I am pretty sure I would know if I had had one since then. Even after saying I was completely comfortable without a test, she pressed the issue. It could have been more for liability, but I don’t know. This obnoxious part of my appointment was well worth the fabulous experience I had otherwise.

Porn & Condoms

Apparently I am a little late to this scene, but Tristan Taormino has added a new twist to her condoms-in-porn stance. You can read her full piece here and the CNN coverage about it here. (yeah, they were published in late September. I don’t know how I just found out about this!)

Taormino was deeply against Measure B, proposed in LA county this past year, mandating condom use on porn sets. A big reason she cited was the fact that the use of condoms while shooting porn can create major internal wear and tear for female-bodied people, actually increasing their susceptibility to contracting STIs. Another was that condoms don’t protect against all STIs. Some people develop latex allergies. She also thinks that the government involvement in porn is about politics and not about sex worker rights, health, and safety.

However, her commitment to porn actor health and safety, and her own personal story (her father died of AIDS in the mid-90s), has caused her to change her professional standards. While before she allowed actors to freely choose to shoot scenes with condoms or without, now she will be requiring condom use in her porn productions. 

I definitely encourage you to read the piece on her site (the first link) and read on to hear from porn actors about their preferences for shooting with condoms or not and why. It was fascinating and enlightening for me to read about, and there are a variety of views represented. One major theme from many people was that they would prefer condom use be normalized.

I would tend to agree with Taormino- that the fight over condom-use regulation is about politics and not the actual safety of sex workers. I think porn actors should truly have the choice to use condoms or not; they shouldn’t have to worry about marketability, profit, or branding in making the choice to have sex with a barrier. Safer sex shouldn’t be dependent on a company’s profit margins. 

My logical brain wants condom-use in porn to be normalized. Actors deserve to practice safer sex, just like anyone else. My lustful brain fantasizes about condom-free sex and probably would be a bit more turned on watching condom-free sex. But this also relatively moot, since I don’t watch porn. I opt for erotica that simply describes condom-free sex 😛

Regardless, I am glad that Taormino is as brave, ethical, and reflective as she is: it takes guts to have complex motivations and reasoning behind professional decisions, to own personal experiences that inform them, and to publicly acknowledge when your professional stance changes.

Safer Sex Advice

Gah, I haven’t been here in forever! Haha, not really… but we’ve had a lot going on! I have a post up and coming about our party and honeymoon (spoiler alert: it was the BEST!), but first:

My DA post on Safer Sex went live on August 11. Read it and make safer sex sexy! 🙂 Here’s the end (make sure to read the rest!):

“When adding more sexual partners to the mix, it is important to communicate clearly with everyone about your sexual practices.
In my relationship with my primary partner, we have unprotected sex (I have an IUD that we rely on for birth control) and use male condoms for intercourse with all other partners.
We both get tested every three to four months for chlamydia, gonorrhea, syphilis and HIV.
We make sure to get hard copies of our results in case any of our future partners want reassurance about our negative test results.
We both talk with any new partner about these practices and ask similar questions of them:

  • When were you last tested?
  • What were you tested for?
  • Who else are you involved with sexually?
  • What safer sex practices do you use with them?

From there, we are able to make an informed decision about what kind of sexual relationship we want and are comfortable with.
If I have a few different partners at any given time, I make sure to keep the lines of communication open, so if anyone has any questions about my safer sex practices with other people, I can talk about it.
Talking about safer sex practices can feel unsexy, but it gets easier and more natural with practice.
It’s important for your health, can help you relax with a new partner and shows you care about your partner’s health, too.
It’s the responsible and ethical thing to do if you do have a chronic STI, and it also demonstrates to any new partners that you care about and respect them enough to provide them with that kind of information.
How do you make safe sex sexy? How do you talk about it with your partner or partners? What tips can you offer to make the conversation more comfortable?”

Safer Sex

The authors of The Ethical Slut (Easton and Liszt) maintain that the phrase “safer sex” has been around for a while, but I have only encountered “safe sex” in my sexuality education. The difference of “safer” versus “safe” makes a lot of sense to me now (I also encountered this subtle difference when reading Opening Up—see post below; J also has his own thoughts on the use of the two phrases). Sex is never 100% “safe”: there are always emotional, psychological, and mental consequences of sex, positive or negative. We can do what we can to mitigate negative consequences through healthy coping mechanisms- journaling, talking with friends or trusted figures in our lives, talking with partners, seeking professional help, etc. We can build on positive consequences, too (give me more of THAT please!). Most of us (i.e. not those without access) also have a lot of control in using physical barriers to mitigate the physical consequences of sex, which are the consequences most of us are familiar with—STIs (sexually transmitted infections), unwanted pregnancy, etc.
Sex, I think, is supposed to be a positive experience. It is a way for people to show caring, respect, and interest in a healthy and natural way. We don’t want negative consequences with sex to be the norm!
J and I have pretty strict rules about our safer sex practices. For one, we are constantly communicating about how our encounters go, to make sure that negative feelings aren’t cropping up and being repressed. We need to talk about potential and real negative feelings so we can address them and make sure that our experiences are as wonderful as possible. We also get tested for STIs every six months and make sure to have hard copies of our test results to share with potential partners. We expect the same of our other partners, and are unlikely to play with people who don’t get tested regularly, who can’t show us paperwork, or who do have an STI(s). It can be an initially difficult and disappointing decision to make: aw, darn! She is really cute! He made me laugh all night! But that is also the beauty of having these unabashedly open and honest relationships with other people: we trust others to be honest with us and respect our boundaries around safer sex, and we still gain awesome sexy friends! Both J and I highly value our mental and physical health. Sex would not be a positive experience if we had to lay wide awake at night wondering and agonizing over if we contracted an STI or had put ourselves or someone else at risk for an unwanted pregnancy.
One difficult thing J and I have encountered is our inability to find specific information about the transmission, risk levels, and ways to avoid contact with various STIs. We both have a basic understanding of many STIs, but without the guidance of a close family member in the women’s health field and medical school, we may have made different choices about playing with partners who have STIs.
Information about safer sex should be easy to understand and accessible—and not just to those of us who are over 18 and have family members in medical school. There should also be resources available to those who experience the historical and systemic counterparts of human sexuality—sexism, homophobia, rape, patriarchy. Everyone should feel empowered to protect themselves and have the ability to seek help from violent situations. Everyone’s body is worthy of respect and dignity. No one deserves his or her physical and emotional space to be infringed upon without explicit permission. Counseling, birth control, and access for these sorts of services (including financial access) should be available to everyone, regardless of age, ability level, gender, sexual orientation, religion, ethnicity, or race.

Sex should and can be a naturally safe way to express love, respect, caring, trust, and friendship. Keeping it safe and positive through respecting your boundaries and others’ boundaries is AWESOME! 😀