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Email them about trans lecture series – transgender patients and sexuality – move case to

there, how and what does sex mean to these patients

Ask about mirrors for pap

all sounds good to me. i think focusing on sexual health and pleasure/busting
myths/language/promoting autonomy can all be incorporated into a presentation on
"what's our role/what info do we need to know to begin?"

i don't think it should be full of "women men respond x way until they are menopausal and
then it's y", etc. instead developing some questions that offer patients the opportunity to
talk w us if they choose.

Josh—- i like all of this. Would love also to emphasize reframing “dysfunction.” And if useful
to bring in a bit of the history of thinking of it as dysfunction... I don’t know much about
this, but suspect that there’s a large pharmaceutical company slash medical industrial
complex push for medicalizing this.

I really like the idea about giving important tips about language. Including how to ask if
someone has a concern about sexual function or sexual pleasure. Because sometimes docs
just don’t know how to break that ice!

I think it might also be helpful to think about “problem posing” in this setting, Josh. How do
providers ask questions in a way that allows patients to explore which parts of their life
contribute (a) to lack of sexual pleasure, or to (b) the perception that they have a problem.

sexual pleasure among women/children (that is the population of the year) lecture.
So I'm taking suggestions.

I'm also thinking about including a case with a transpatient.

Oh, I'd include sensuality and alternatives to the sex response cycle in the case of the older patient

Maybe another about sex and a constellation of chronic illness - this can be about an older
body, maybe about depression, illnesses that impact sex
Or another on a younger person and anorgasmia - discussing self-exploration, toy safety,
identifying sexual pleasure goals

I feel like the goal should be around developing language and resources.

hile these texts underlined female sexual pleasure. etc. A forensically minded sexology classified sexual behaviors. men. and criminology in the last quarter of the 19th century. polygamy. wrote Huhner [17] (p. The salience of psychiatry in discussions of female sexual problems has its roots in the mutually entangled development of psychiatry. never experiencing sexual pleasure. and . sadism. heterosexuality. same-sex activity. or indifferent to it.html#afp20150815p281-b1 Intro The goals of this lecture is to Practice using sex positive language Identify tools to address common sexual concerns Talk to patients about sex 2 minutes – Reflect and write on our own thoughts and comfort with sex What are your feelings about masturbation.7].? Do you feel comfortable talking about these practices with patients? Monogamy.aafp. and relationships. In the early Men. mistakenly believing ‘women do not have pronounced sexual feelings as they.nih. do’ [17] (p. suffer in silence’. https://www.org/afp/2015/0815/p281. polyamory. this could make them either unaware of how to elicit female pleasure.6••. masochism. sexual functioning.ncbi. fetishism. unmarried sexual expressions. some ‘never know the cause of their irritability or hysteria. sexual health. 394). identities. they also sought to contain it by emphasizing the role of husbands in eliciting and managing it within social norms of gender. 400). sexual positivity. Women’s lack of education in their own sexual capacity meant that many ‘not knowing any better. sexual pleasure https://www. will often have experienced sexual intercourse with prostitutes before marriage. and so on) flourishing from the late 19th century well into the 20th [3–5. they also sought to contain it by emphasizing the role of husbands in eliciting and managing it within social norms of gender. as prostitutes ‘from long experience’ know ‘how to simulate passion’.nlm. and motherhood. nymphomania. sexology. heterosexuality. with nomenclature (homosexuality.gov/pmc/articles/PMC2978945/ understanding female sexual pleasure.Sexual difficulties. criminology. one-night stands Understand the medical communities reflex too is very much set in the 19th century context of psychoanalysis.

Washington. Since the launch of sildenafil (Viagra) in 1998. Correspondence to: R Moynihan. Over the .45(Published 04 January 2003)Cite this as: BMJ 2003. For the woman unable to reach coital orgasm. And in a sense insurance companies http://www. clearest example we have. threatens to tip into voracious nymphomania [17.bmj. USA Is a new disorder being identified to meet unmet needs or to build markets for new medications? The corporate sponsored creation of a disease is not a new phenomenon. sitting astride the man ‘is certainly better than titillation of the clitoris Sexual dysfunction has it’s roots in DSM and psychology British Medical Journal (BMJ) article on FSD entitled ‘The making of a disease’.1 but the making of female sexual dysfunction is the freshest.1136/bmj. To build similar markets for drugs among women. are likewise expected to have annual markets in excess of $1bn each. more than 17 million men have had prescriptions written for it as a treatment for erectile dysfunction.2 The emerging competitors. DC.24] – a condition with often tragic consequences such as incarceration in insane asylums.moynihan@verizon. Bayer's vardenafil and Lilly-ICOS's tadalafil. accusing him of accusing women of lying or inventing their distress. 326 doi: https://doi. Female sexuality is to be elicited from women’s asexual innocence. The most recent gathering.326:45  Article   Metrics  Responses 1. 20036. if too assiduously awakened. motherhood. but. The venue? The Pfizer Foundation Hall for Humanism in Medicine at New York University Medical School. 4/1312 21st Street NW. Ray Moynihan.5bn.org/10. with Pfizer reporting sales in 2001 of $1. featured Pfizer as chief sponsor and Pfizer-friendly researchers as chief speakers. outraged responses flew in.com/content/326/7379/45 Education And Debate The making of a disease: female sexual dysfunction BMJ 2003.326. A cohort of researchers with close ties to drug companies are working with colleagues in the pharmaceutical industry to develop and define a new category of human illness at meetings heavily sponsored by companies racing to develop new drugs. companies first require a clearly defined medical diagnosis with measurable characteristics to facilitate credible clinical trails.7379. arguing that Big Pharma were significant in shaping the category. journalist (raymond.net) Author affiliations 1.

but these experts were predominantly white. and its representatives have in some cases attended.” Men often experienced sexual intercourse with prostitutes before marriage which made them unaware or indifferent to eliciting female pleasure. Suffrage was beginning. Electric lights were invented so it was safer to be out at night and more women participated in nightlife. It was illegal to give. working. a series of meetings to come up with just such a definition (table). write about. women were becoming more independent. Religious temperance was taking hold “fighting” the immorality of suffrage and Anthony Comstock introduced harsh anti-obscenity laws in the 1870. protestant. and women were targets of purity propaganda So women’s sexuality then became a “husband’s privilege to arouse and maintain. middle-class family” “selfish women. and college produces women with monstrous brains and puny bodies. going to school. These experts saw the women in the brothels as harborers of diseases and saw infertility and teratogenic effects of venereal diseases as a manifestation of evil. Psychology and medicine were exponentially developing theories on health. Like we’re now starting to frame medicine from a health-first model. Birth control methods were developing. some ‘never know the cause of their irritability or hysteria. as it is often diagnosed. Women on the other hand lacked education in their own sexual capacity meant that many ‘not knowing any better. This was when “hysteria” was highly researched and nymphomania became grounds for being sent to a lunatic asylum. contraception or abortion (women’s issues) and then he was appointed to chief postal inspector. There were also increasing rates of divorce.past six years the pharmaceutical industry has funded. second-wave feminism tries to frame female sexual experience away from pathology Within the model of health as illness Took steam in the mid-late 1800s during a period when prostitution was vital to the economy (it wasn’t looked upon favorable but it was a recognized industry). Summary points Researchers with close ties to drug companies are defining and classifying a new medical disorder at company sponsored meetings Many critics have argued that the inclusion of FSD in the manual is inappropriate because the DSM is in the business of pharmaceutical medicalization of sexuality. Women were free from the feelings of physical yearning or sexual desire. Great mental exertion is injurious to the reproductive power. suffer in silence’. And women were seen as “the assassins of the white. middle-upper class. Prohibition on alcohol and sex was then enforced. And they developed false beliefs: It was thought that sexual acts that could not lead to pregnancy were unnatural – this included oral sex and masturbation. socializing.” And American Medical journals in 1910s at one point recommended that physicians should recommend marriage over careers. never experiencing sexual pleasure. For the . Women were constitutionally weaker than men. Anything that could generate impure thoughts were obscene even medical journals about birth control.

female sexual dysfunction was codified into the first DSM in 1950 as psychophysiological genitourinary disease which included frigidity which was defined as the failure to reach vaginal orgasm or absence of desire.dbsalliance.pdf?docID=10141 How can we engage our patients in talking about sex? What are things we can say? When can we integrate talking to our patients especially female patients about sex and sexuality? Case 1 Goals of this case: To practice engaging a patient in talking about their sex experience – ask what do you call your parts Anorgasmia Self-exploration Toy safety . so that the focus of female sexuality and femininity was vaginal orgasm. companies first require a clearly defined medical diagnosis with measurable characteristics to facilitate credible clinical trails. Over the past six years the pharmaceutical industry has funded. Psychoanalysis posited that female erotic zones were vaginal. sitting astride the man ‘is certainly better than titillation of the clitoris.pdf http://www.org/site/DocServer/Restoring_Intimacy_CSFQ_Handout. and its representatives have in some cases attended. changes slowly. And the human sexual response cycle was studied under the context of dysfunction. And in this context. A cohort of researchers with close ties to drug companies are working with colleagues in the pharmaceutical industry to develop and define a new category of human illness at meetings heavily sponsored by companies racing to develop new drugs. To build similar markets for drugs among women. clearest example we have. but the making of female sexual dysfunction is the freshest.org/148d/01296542724100f8ede59d5bd49e9065493e.woman unable to reach coital orgasm.semanticscholar. a series of meetings to come up with just such a definition Why we are learning this https://pdfs. The DSM. Pharma continues to create a negative culture for sexuality. The corporate sponsored creation of a disease is not a new phenomenon.

Can explore what was different with her and the ex vs other partners there is no “right” way to engage in sex and express your sexuality as long as everything involves consent. use her words). I dunno. Can talk to patients about their organs What turns you on? Kissing Stress and orgasms? Why might she feel uncomfortable sharing that she hasn’t orgasmed yet with a partner . immediate reassurance. How would you ask this patient to open up about her sex life? My favorite: Do you have any concerns about sex? – open ended – What concerns. if any. worry that they think she’s not into them 2. and I’m in the mood. Desire – presumably she’s asking you about it. may feel like they think it is something wrong with her. Why is it I only have orgasms with one guy? Sasha’s father? What more do you want to know? I’ve had sex with several guys but he’s the only guy I’ve had an orgasm with. I’ve tried to masturbate before. She is single.Machissimo. I haven’t tried any sex toys but my friends keep telling me I should try. How to talk to a partner about sex. Nothing is wrong with you (say it directly. I have been thinking about this a lot. just want routine visit including STI screening. it’s just weird. Thank you for being so open about your experience. I’ve slept with him a couple times since we broke up. do you have about sex? How is your sex life? – can imply that someone needs to have a sex life to be normal Caution about using STI screening as a jumping point to discuss sex. may feel like a failure. may feel like it is something wrong with her. empowerment. You know. It doesn’t hurt and sex doesn’t usually feel bad. Explore what she has been told about orgasms.23yo female with one 4 year old daughter routine annual. I just don’t have an orgasm. so she has interest in having sex Arousal – check So is something wrong with me? I’d like to have orgasms with a future boyfriend. but I don’t want to be with him like I don’t want to be in a relationship with him. how might you counsel her to talk to a new partner . She has no chief complaint. and respect. Do not want to imply that sex is diseased. but it’s weird? So I usually stop after a few minutes. too nice.

com Ospomifene. dressing up. self-exploration. nipples Where Doing in mirror What makes you feel sexy.Have orgasm before can help take pressure off of the woman to get herself off How would it feel to masturbate together or in front of have them holding you. is a SERM that acts as an estrogen on vaginal and vulvar tissue but as a blocker around the rest of the body – side effects? FDA approved for dyspareunia and vaginal dryness Kissing zones – folds. Mindfulness. vaginismus – trainers. writing erotica – narrative med. can help partner understand how you like to be pleased Normalizing. Massage .vaginismus. could be erotic. powerful . exploration with partner There is a vaginismus community www. it may feel awkward for many people at first Finding out what is good for you and communicating that Do you talk during sex? Some people only orgasm from masturbation Make sure to ask why Vulvodynia Pg 771 Case 2 Interpartner communication Chronic disease and sexuality Sensuality What are some things you might want to explore with the patient? If there was vaginal dryness – safety of vaginal estrogen? Lube. THC If there is pain.

how you would say it.adobeconnect. . make it a girls’ night http://www. what you’ll be doing. tell me what setting. cosmo’s steamy sex games Role playing and practicing language – can we talk about sex. Practice makes easier Get a group together. can put condom to minimize toxins Making sure they are water proof A lot will say novelty.Creating environment Asking for a date night to help with someone they trust Using testosterone for desire in women – please don’t How to talk to an existing partner Use props .com/_a1123264708/sexuality/ Safe toys – if cheap. talk to a sexologist. romantic rendezvous. throw it out.Getting a book or agazine. I worry I take too long Reclaiming your sexual self wiley & sons 2004 Pg 767 Powerpoint module https://sciontario. sex card game Talk about it while playing a board game – enchanted evening. unbound girls I worry I smell. not regulated If it’s broken or chipped or whatever. movie. how would you ask your partner to talk with you about sex.wocshn. tv.org/membership-directory/ Go to a conference – lots of free ones in NYC Babeland.

babble.com/the-most-ridiculous-sex-laws-in-every-state/ Page 956 Missouri – “the privilege of admiring the curvaceous unencumbered body of a young woan should not be denied to the normal.kinja.huffingtonpost. cock sucker.html https://www. ho .com/mom/20-seriously-strange-us-sex-laws/ http://twentytwowords.How to clean vagina that’s been in your booty without thoroughly washing it or swapping condoms.com/the-complete-list-of-weird-sex-laws-in-the-u-s-a-1485048155 https://mic. Lube – chapter 12 – lube for prone to itchiness or fungal infections – try one without glycerin 1800s birth of obscenity laws . why is having sex a put down Calling people slut or whore Bitch. red-blooded American male Maine.com/articles/131616/14-outdated-sex-laws-that-need-to-change-this-year-in-one- map#.E7niyyXER https://www. only physicians can sell condoms Ohio. condoms can only be sold at licensed locations Nebraska.com/2014/03/14/state-laws-women_n_4937387.Talk about obscenity laws and how they stem from a sex negative culture and continue to reinforce sex negative culture or male dominant evil woman sex culture – please fact check Start with list – focus on those with implications for women https://observationdeck. it’s illegal for a woman to strip off her clothes while standing in front of a man’s picture Then talk about the most recent upheld in 2007 Alabama banned sale of devices that are designed or arketed primarily for stimulation of human genitals William v Morgan Other concern is language contributing to sex negative culture – chapter 66 Use of the word fuck as an explitive Calling people by female genitalia Using sex to argue – suck my balls.

edu/sexinfo/ https://www.guide2getting.https://health.soc.org/2015/03/feminine-odor-problems-what-you-should-know- about-douching/ Vaginal steaming Shaving chapter 52 Harm reduction Women peak sexually in their 30s g-spot Kinks fetishes Resources http://www.Powerpoint 2? Common myths Douching .clevelandclinic.com/ Talking about sex G2G ch 34 .ucsb.