There goes 'Tell me pastor' again pushing reparative suggestions to a bisexual woman

There goes Pastor Aaron Dumas again pushing a reparative therapy line despite the practice is not recommended to be used by psychologists but he still persist in recommending same. His column in the Star had a recent letter (seems to well edited) of a woman complaining of struggling with her sexuality. 

Interestingly the title is 'I want to change my bisexual lifestyle' but lifestyle and orientation for all intents and purposes are two different things; it has bee shown to be dangerous to suppress one's feelings as it may have disastrous consequences for those who do.

Here is the letter and response:

Dear Pastor,

I am 21 years old and I am having a serious problem. It seems as if a battle is going on inside me between my good conscience and my bad conscience.

At times I wonder if I will go insane. I am a strong believer, in God and I want to serve and live for Him, but there are certain things in my life that are causing me concern. I met a man online two years ago.

This man is good to me, but there are certain things that I do that he likes and if I stop doing them, I fear I will lose him. He likes the fact that I'm bisexual. He buys me sex toys and I make videos and take certain pictures for him.

He says he wants to spend the rest of his life with me and he also wants to have a child with me. I told him about my decision to no longer have sex with him out of wedlock and he agreed with my decision, but his tone of voice says otherwise. This man is a good father to his son and mine - both are honour role students. He is also a believer in God, but he does not read the Bible or pray as much as I do. He says he supports my decision, yet he does not try to help me stay true to it. I told him about it and we talk about it, yet the next day, we are back to the same thing.

Pastor, I need your help because something inside me is telling me to live my life, while something else is telling me that I am here for a purpose and not just to live. I know that if I stop what I am doing, it will be the right thing.

But I am afraid that these thoughts will drive me crazy. Pastor, I need your advice. The things I get involved in sexually make me weak when I'm trying to be strong, and my boyfriend does not try to help me stay strong. He still asks for what I can give him and there is no one around me to help me on my path. I am on my own.

D.W.

Answer:

Dear D.W.,

If you are serious about bringing a change into your life, you need to seek help from the minister of the church I am assuming that you are attending. If you do not attend church, I suggest that you need to start doing so and make an appointment to see the minister or pastor, who would become your spiritual adviser, so to speak. You need help - spiritual help. You cannot fight this battle alone. And I say battle because it is, that is why you have great turmoil within and you speak of the turmoil as your conscience. You admitted that you are bisexual, but you have not mentioned the other persons in your life with whom you are actively having sex. Although you are having sex with them, you consider this man who has promised to marry you to be your main sexual partner. You want to stop having sex with him because you want to get married, so I suppose that that desire of not having sex outside of wedlock would also go for everybody. This man is also agreeing with you, but his action shows that he is not serious. He is not willing to stay away from you and to stop having sex with you.


PROMISES

He gets tremendous kicks out of the things you do. I am sure that you have heard that promises are a comfort to a fool. When he is around you and he wants to have sexual thrills, he can get it from you anytime - and you are too weak to resist him. That is what he is accustomed to, that is what holds both of you together and nothing else. I wish you could see the tremendous danger in making sexual videos and taking pictures of yourself and others and giving them to this man. You are making a big mistake. Have you considered what impact that would have on your son and your relatives if this man were to release such videos and photographs to the public? Oh my! What would happen if this man were to place some of these things on social media?

I am not condemning you at all. I know you are young and sometimes young people don't think of the negative impact things like these can have on their lives.

However, you are crying out for help. I know some folks would not like what I am about to say, but I will say it nevertheless. I believe that you are a good girl in your own right. You need some guidance, spiritual guidance. You are crying out for help. You have come to realise that having fun, the way you are going about it, is not satisfying. Therefore, I ask you to pray about your situation, go to church, drop all these girlfriends and boyfriends that you have. Tell the man that you consider your main beau to come to church with you, but if he doesn't want to do so, go nevertheless. Talk to the pastor or his wife and ask them for help. They will do their best to help you. You did not mention with whom you are living and whether you are working, or if this man is taking care of you. I wish you had divulged that. I hope you are employed. You have my prayers and if I can be of further help to you, please contact me again.

Pastor

ENDS

The American Psychiatric Association “opposes any psychiatric treatment such as reparative or conversion therapy which is based upon the assumption that homosexuality per se is a mental disorder or based upon the a prior assumption that a patient should change his/her sexual homosexual orientation.” The DSM is also quite clear on the matter.

A word to the wise is sufficient.

Peace & tolerance

H

Touching penises in double penetration does not make one gay ...........

Saw this one recently and had a little laugh but realized how serious it actually is. The concerned man asked if he was gay even after losing his erection turned off by the accidental touching of the other male in the arrangement. I have to disagree with the goodly doctor though in the response where it is stressed that the worried man should not have a foursome again, if his wife is consenting then so be it I imagine; frankly that is his choice in my view but he should get over worrying that because his penis came into contact with the other man while penetrating one woman does not make him gay.

Here is the question and response below:

Q: I am a guy who has had a really unpleasant and shocking experience. So I wonder if you could help me? I am 34, happily married. My wife is lovely and a very sexy woman.

Unfortunately, I let another guy at work persuade me to arrange a foursome, involving our wives and ourselves.

I was very into the idea because his wife is a fantastic-looking woman. She is a little older than my spouse and I, but she is in great shape.

To be honest with you, Doc, I could not wait to get my hands on her. As for my wife, she quite liked my colleague, so she was easily persuaded into it.

We all discussed the details and we agreed that the 'big night' would be at their place one Saturday evening. When we got there, my colleague and his wife were well dressed. She was wearing a sexy red dress with a plunging neckline. My wife looked very good as well.

We had a few drinks and some snacks, which they had prepared, then we got down to business. Everybody took off their clothes, and we danced together and had some more drinks.

I was smooching with my friend's wife he was 'necking' with my wife. Everything seemed to be going well.

The next two hours were a bit of a blur. I know that I penetrated the other woman several times, though I took care not to orgasm. I also remember seeing my colleague having intercourse with my wife for quite a long time.

Around 10 p.m., we all kind of piled into a heap on the bed. I suppose it was like an orgy. There were all kinds of things going on, especially between the two women. I admit I was really turned on.

However, suddenly something dreadful happened. Both my colleague and I were trying to penetrate my wife. By the way, she was totally happy about this. She seemed to like the idea of two men almost 'fighting' for her.

Then to my horror, my genitals accidentally touched the other guy's. I was disgusted by that, so I pulled away. I lost my erection immediately. In fact, I went outside and was sick. The worst thing was that just after all this, I think he orgasmed.

Neither of the women seemed upset by what had happened, but I felt terrible! As soon as possible, I got my wife to put on her clothes and we left.

Since then, I have been feeling very depressed. I have not discussed it with my spouse, but she knows I am unhappy.

Doctor, I would like to ask you three things:

1. Does this most unfortunate contact indicate that my colleague is secretly a homosexual?

2. Or am I perhaps secretly gay?

3. Could I have caught anything from the other guy?

Answer: 

Oh dear, oh dear, oh dear! Several times I have warned about the psychological ill-effects which can result from 'threesomes' and 'foursomes'.

You have become unhappy - possibly even clinically depressed - as a result of the fact that your penis seems to have touched another man's organ during your adulterous frolics.

Incidentally, female readers may be astonished by your distress. But, in fact, quite a lot of men do react negatively to any form of contact with another man's penis. I recently discovered that in the United States, there are a few 'swingers' clubs where they actually arrange counselling for men who have accidentally touched another man's organ.

In fact there is an 'orgy society' in Florida, which warns new members that this sort of contact might occur while two men are trying to have sex with the same woman. Their website says that this is nothing to get distressed about. That is correct.

Now let me try and answer your three questions:

1. I don't think there is the slightest evidence that your colleague is a homosexual. This was obviously an accidental contact. The fact that he may have 'discharged' shortly afterwards means nothing.

2. I do not believe for a moment that you are 'secretly gay'. To put it mildly, your entire story seems to be highly heterosexual.

3. It is unlikely that you have 'caught anything' from this brief contact with the other man's organ.

However, you have had sex with his wife and, if she is a regular 'swinger,' then there has to be a possibility that she might have had germs in her vagina. If in doubt, see a doctor for some tests.

My advice: Talk to your wife about what happened. Stop worrying. If you are still having these 'low' feelings, see a counsellor. And, please, do not do a foursome ever again!

Transgender people are at high risk for HIV, but too little is known about prevention and treatment for this population

Tonia Poteat (you may remember her from the 'For The Bible Tells Me So' documentary)

Transgender women have among the highest rates of HIV infection but little is known about HIV prevalence among trans men, Tonia Poteat of Johns Hopkins Bloomberg School of Public Health said in a plenary lecture on transgender health and HIV at the recent Conference on Retroviruses and Opportunistic Infections (CROI 2016) in Boston – the first ever on this population at CROI. A growing number of studies and prevention and treatment programmes are addressing transgender populations, but more research is needed.

Dr Poteat noted that while mainstream knowledge about transgender men and women is relatively new in the US and Europe, largely thanks to celebrities such as Chaz Bono and Caitlyn Jenner, people outside the male-female gender binary have long existed in many cultures, such as the hijra in India.

The size of the transgender population is uncertain, in part due to varying definitions. One estimate put the number of transgender people in the US at approximately 700,000, or 0.3% of the population. Estimates range from 0.1% to 0.5% in Europe, and from 0.7% to 2.9% in South Asia, where some countries legally recognise a ‘third gender’.

Traditional ‘one-step’ data collection approaches can make it difficult to accurately identify trans people in HIV research. Many investigators have categorised study participants according to either their current gender identity or their assigned sex at birth, both of which can result in misclassification. A ‘two-step’ method that asks about both initial sex assignment and current identity is more accurate and inclusive.

“The way you ask the question makes a big difference,” Dr Poteat stressed.

For example, the international iPrEx trial of tenofovir/emtricitabine (Truvada) for pre-exposure prophylaxis (PrEP) included transgender women in its population of 2499 men who have sex with men. The initial published iPrEx report said the study included just 29 trans women, but a later analysis used a broader definition – including people assigned male at birth who identified as women, trans or ‘travesti’, and those who identified as men but used feminising hormones – bringing the total up to 339.

HIV rates in trans populations

As Susan Buchbinder of the San Francisco Department of Public Health said in her introduction to the lecture, “There is probably no population that is both more heavily impacted [by HIV] and less discussed around the world than transgender people.”

Dr Poteat said that very little is known about HIV rates among transgender men. A recent systematic review found six US studies, including a self-report study with a prevalence of 0.4% and five studies based on laboratory testing with rates ranging from 0.5 to 4.3%, but actual numbers were small. Among non-US studies, three based on self-report found prevalence rates of 0.6 to 0.8%, while two based on lab tests had rates of 0 and 2.2%.

A bit more is known about trans women, who were the main focus of the talk. Trans women who have sex with men have one of the highest burdens of HIV infection among key affected populations, which also include gay and bisexual men and people who inject drugs.

One worldwide meta-analysis of 39 studies from 15 countries found that transgender women had an HIV prevalence rate of 19% – 49 times higher than that of the general population. In high-income countries the prevalence was 22%, with the highest rate among trans women of colour.

A more recent meta-analysis by Dr Poteat’s group looked at 49 new studies, which showed both an exponential increase in research and an ongoing high burden of HIV infection. Among the included studies based on lab testing, prevalence rates ranged from 2% among trans youth to 45% among trans sex workers. The three studies that estimated incidence, or new infections, reported rates of 1.2 to 3.6 per 100 person-years.

Even in countries where HIV prevalence in the general population is high, trans women still face a disproportionate burden. In Lesotho, for example, overall prevalence is estimated at 18% for all cisgender (non-transgender) men, 27% for all cisgender women and 28% for men who have sex with men, but rises to 60% for trans women.

Vulnerabilities affecting trans people

A number of factors may make transgender people more susceptible to HIV infection or less likely to use prevention methods or access treatment if they become infected.

Biological factors include hormone therapy, which has the potential to interact with PrEP or antiretroviral treatment (ART). While no clinically significant interactions have been confirmed between feminising hormones and tenofovir/emtricitabine PrEP or most antiretrovirals, many trans women worry about them and prioritise hormone use.

To date, no randomised clinical trials have looked specifically at PrEP for transgender women, but aniPrEx substudy led by Madeline Deutsch from the University of California at San Francisco’s Center of Excellence for Transgender Health found that Truvada appeared to protect trans women who took it consistently. No seroconversions occurred among trans women with tenofovir drug levels indicating they took at least four pills per week. However, their level of adherence was lower than that of gay men in the study, which Deutsch suggested could be due to concerns about PrEP and hormone interactions.

Prior studies have shown that tenofovir reaches higher levels in rectal tissue in men than in cervical or vaginal tissue in women. This could in part be related to hormonal differences between cisgender men and women, although some have found that tenofovir levels are lower in cervical-vaginal tissue samples than in matched rectal tissue samples obtained from the same women.

Some researchers hypothesise that exogenous or administered oestrogen may affect tenofovir pharmacokinetics, for example by interfering with creatine kinase phosphorylation of tenofovir disoproxil fumarate to its active form of tenofovir diphosphate. This could mean that trans women taking oestrogen and PrEP will have lower tenofovir levels in rectal tissue than cisgender men, and therefore may need higher doses – a prospect that requires further study.

Hormones could also potentially cause changes in rectal or vaginal mucosa that increase susceptibility to HIV. Further, sharing needles to inject hormones or fillers such as silicone can transmit HIV and hepatitis B or C. It is not known whether trans women who have genital sex reassignment or affirmation surgery are more vulnerable to HIV infection.

Social and structural factors

Social and structural factors that increase trans people’s vulnerability to HIV include stigma, fear of disclosure, sexual networks that include more people with HIV, poverty, lack of employment opportunities which leads many trans women to engage in sex work, homelessness or unstable housing, violence, lack of access to health care or insurance, substance use and mental health issues such as depression.

Although many transgender women are eligible for PrEP according to US Centers for Disease Control and Prevention (CDC) or World Health Organisation (WHO) guidelines, most are not yet using it and may not be aware of it. One study found that only about 14% of trans women in San Francisco – a city were PrEP awareness and use among gay and bisexual men are high – had heard of PrEP at the end of 2013.

Dr Poteat reported that among people with HIV using Ryan White HIV/AIDS services, transgender people were less likely than patients overall to remain in care (78 vs 80%) and to achieve viral suppression (74 vs 81%).

A survey of trans women with HIV conducted by the Transgender Law Center found that gender-affirming care and hormone therapy were their top priority, considered more urgent than HIV treatment. But trans women who had the same provider for both hormone therapy and HIV treatment were more likely to stay in care and have an undetectable viral load, demonstrating the benefit of integrated care.

“Transgender women have disproportionate HIV prevalence and incidence due to the interplay of biological and intersectional social factors,” Dr Poteat concluded. “Gender-affirming approaches are necessary to achieve optimal outcomes.”

To address barriers to care for trans women it is important to “reduce stigma and prevent secondary trauma including racism, transphobia, economic disadvantage and other structural factors,” she said. “HIV services we have available, mostly geared towards gay men, do not meet the needs of trans women.”

Resources for trans women and men

New resources for trans people have recently begun to appear, including the National Center for Innovation in HIV Care brief Transgender Women and Pre-Exposure Prophylaxis: What We Know and What We Still Need to Know and the booklet Transcending Barriers for Safer Pleasure from Project Inform and Outshine NW. Project Inform's booklet for men who have sex with men, Is Taking PrEP the Right Choice for You?, has also been updated with inclusive language and information for gay and bi transgender men.

In the United Kingdom ClinQ at 56 Dean Street, London, provides holistic sexual health and well-being services for trans people.

Reference

Poteat T HIV in transgender populations: charted and uncharted waters. Conference on Retroviruses and Opportunistic Infections (CROI), Boston, abstract 79, 2016.

View the abstract on the conference website.

View a webcast of this session on the conference website.

Blakka Ellis: Let's talk about sex and sexuality

"Let's talk sex baby, let's talk about you and me, let's talk about all the good things and the bad things that may be, let's talk about sex..." Who remember those lyrics from the 1991 hit by Salt-N-Pepa?

Well between, you and me, is that kind of meditation I man a pree. Yuh nuh waan pree di meds and reason wid me?

Whether you call it the battle of the sexes, the great gender debate, or plain old 'man an woman business', the discussion around gender, romance, sex and sexuality is always topical, often trending, always relevant and never ending. Yeah man, everybody likes to talk about it, especially those people who are probably not doing it!

So, where, when and how then do you join the conversation? What's your favoured angle of entry? Me, I love to deal with things up front.

And that I'm doing with help of an amazing cast and crew in 'He Said, She said'. The riotous revue opened at Courtleigh Auditorium last Friday, and from the opening song, Too Much Sex, the audience was comically aroused and arrested. 'He Said, She Said' is an adults-only production that enters the sometimes delightful and sometimes disturbing sex/gender dialogue from a place of playful provocation. It's an eclectic collection of skits, songs, poetry and parodies that delve into some popular perceptions, tease out touchy taboos, and confront common contradictions. And di actors dem dweet good - the onstage performances!

From the night club to the bedroom, from the corner shop to the front lawn and from various other intimate and public spaces in between, they stroke some pun, poke some fun and 'tek some bad ting mek laugh'. They expertly engage the exhilarating edge of 'naughty' with entertaining stuff that will make you laugh, think and talk. And, well, if you do anything else, don't attribute that to the show. So wah yuh say, when yuh coming?

rumour

In fact, I'm not really sure, but I think I kinda hear that there is a 'students-only' two-for-one special for tertiary students with ID at the show on Friday. Like ah said, mi nuh sure, but shhhh ... Look here nuh, don't tell dem say mi tell yuh this, but even if it never really go so, if yuh call call the ticket line at 542-4160 and tell dem dat is Blakka spreading the rumour, dem will have to sell yuh di ticket! So come check it out.

Another great thing to check out this week is the annual Kingston Book Festival (KBF) - a full week of events for readers, writers, publishers, distributors, buyers, sellers of all things 'bookish' - whether fiction, non-fiction, poetry or play writing. This year's festival started on Sunday with 'Love Affair with Literature' at UWI. It is continuing with a number of events all over, including visits to school - where students get to talk and interact with writers about what it means to be a writer. I had the pleasure of being part of a KBF 2016 event on Monday, as I joined novelist Melanie Schwapp, poet and entertainment journalist Mel Cooke and writer/publisher Tanya Batson-Savage in a lively chat with some very bright and engaging grade eight students at Dunoon Park Technical High School in Kingston and it was a blast!

There's a fresh and innovative KBF event on today as well, called 'Literary Lunch' put on by Susumba's Book Bag. And tomorrow night is 'Late Night Lit' at Red Bones Blues Cafe in New Kingston. It will feature saucy satire and provocative poetry and prose from Andrew Stone, Carla Moore, Karen Carpenter, Michael Abrahams and Tony 'Paleface' Hendriks. Fun week in city Kingston, eh?