Category Archives: sexuality and age

But will Medicare pay for lube?

drawing You might have missed the part about the penis pumps. It was in a New York Times article about Medicare overpaying for things like oxygen tanks. Apparently Medicare, despite its potentially enormous bargaining power, spends more for many items than they would cost in your neighborhood pharmacy or surgical supply store. In the midst of the article is this paragraph:

For example, last year Medicare spent more than $21 million on pumps to help older and disabled men attain erections, paying about $450 for the same device that is available online for as little as $108. Even for a simple walking cane, which can be purchased online for about $11, the government pays $20, according to government data.

The article doesn’t comment at all on whether penis pumps are a legitimate Medicare expense, which I think is interesting. Given our government’s very conflicted attitudes about sex, I find the news both heartening and irritating. I am glad that Medicare takes the needs of aging men seriously and considers sex a part of healthy living. We were just discussing that when we were discussing Pepper Schwartz’s book Prime. TracyA linked to a great post by Supercrone about sexual desire in her 80s, Mimi of Sexagenarian in the City writes about her own re-entry into dating and sex, and so I’m glad that the US takes the sexual needs of the elderly — at least elderly men — seriously. I wonder why it denies the sexual needs of so many of the rest of us. Our own internal contradictions around sexuality are pretty amazing. Medicare, an entitlement program for older folks, will pay for penis pumps. Medicaid, the program that provides health care for poor people, does not cover abortion services (thanks in large part to Henry Hyde, who died the other day) though states are apparently free to provide such coverage. (For example, in New York State residents enrolled in Medicaid are entitled to “Free access” family planning — including contraception and abortion — even if their Medicaid Managed Care Provider does not cover those services.) We see inability to have intercourse as an illness for the elderly but don’t want to teach young people about safer sex.We spend our tax dollars foolishly in either case, overpaying for penis pumps or paying at all for abstinence-only education.But back to the penis pumps again: is this an example of sexism in health care again? I mean, older women are less likely to be in need of contraception or other family planning services, but does Medicare pay for lube? Or are women expected to deal with the changes in their sexual function on their own while men’s physical changes get medical attention? (And if Medicare does cover lube, what are they paying for a bottle of Astroglide, do you think?)And is Medicare paying for condoms to keep these older men from getting and transmitting STIs? Or are we again in a situation where we’ll pay to address the disease (inability to maintain erection) but not to prevent disease?If, like me, you were wondering about the efficacy of penis pumps in the first place, here is a link to Corey Silverberg’s piece on them from About.com. He points out that penis pumps are pretty reliable at generating erections but that unless well aroused, or if the man has a problem maintaining erections, that the erection created by the pump might not last. He mentioned that better penis pumps, of the sort sold by medical professionals (which he says run about $200, not the $450 that the US pays) come with “constriction rings” (read: cock rings) that help maintain the erection.I wonder if Medicare would cover the cost of cock rings alone for men who have no trouble getting erections but do have trouble maintaining them.And what about sex ed for older folks so that they know that there is plenty of good sex to be had without erections and penis-vagina penetration? What about some workshops on manual sex? Oral sex? Sex with toys? Training in orgasm without intercourse, anyone?Meanwhile, lets make sure that all government provided health care treats sex as an important component of healthy living. Lets make sure that Medicaid and Medicare cover sexually-related health care costs, whether those be penis pumps or lube, or contraception or abortion. If sex is a party of a healthy life, those things are all important.Lets make sure that private insurance plans do the same!And lets pay for smart sex education for sixty-year-olds and for sixteen-year-olds!Illustration, “Penis Pump,” by Derek on Flickr, and used under a Creative Commons Attribution, Noncommercial, Share alike license.NOTE: This is also published on our community site, SexInThePublicSquare.org. Join us there!

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Pepper Schwartz joins us on SexInThePublicSquare.Org

Come, talk about sex and older women with Pepper Schwartz!

Pepper SchwartzStarting this weekend, Pepper Schwartz will join us on SexInThePublicSquare.org for a discussion of her new book, Prime: Adventures and Advice on Sex and Love in the Sensual Years.

Please join us!

Jeffrey Rosenfeld reviewed the book for us here. We’d especially love to hear from people who have read the book, but all are welcome.

Dr. Pepper Schwartz is a noted sociologist specializing in sexuality. She has written over 40 academic research articles, and also many accessible books on sex and relationships including, including The Great Sex Weekend and Everything You Know About Sex and Love is Wrong, along other books aimed at helping people keep their sexual relationships interesting and vibrant. She has also written Ten Talks Parents Must Have With Their Children About Sex and Character and 201 Question to Ask Your Kids / 201 Questions to Ask Your Parents, books that help parents talk about sex with their kids, Pepper Schwartz has dedicated her career to opening up sexuality as a realm of sociological study, but also to making that study useful and accessible to the public. In Prime, she does something academic-types rarely do under their own names: she reveals much about her own sex life, using her own experience as a prompt to offer advice to herself and to other women experiencing the dating and relationship-building world in their 50s.

This conversation marks the beginning of a new feature for us at SexInThePublicSquare.org. We’re initiating a series of conversations with authors of the books we review, and we’re thrilled that Pepper Schwartz has agreed to kick off the series for us.

The conversation will take place in the comments section of Jeff Rosenfeld’s review. When we start, I’ll put a direct link to the conversation on the sidebar of the site so you can get there quickly!

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Filed under culture, Gender, public discourse, sex, sexuality, sexuality and age, Travel

Prevention bill(s)* still stuck in committee while Democrats increase Abstinence-Only Funds

File this under “with friends like these…”

What has happened to the Prevention First Act (H.R. 819/S. 21)? Why are these bills stuck in committee while the Democrats are INCREASING funding for abstinence-only education? Don’t they at least have an obligation to hold the line on such misappropriate of funds? We’re talking about the spending of 141 million dollars on programs that we know don’t work and that actually put our communities at risk. And we’re talking about the party in control, the one that is supposed to be friendly to smart sexual health policy, granting this increase in spending and as a result teaching kids that abstinence-until-marriage is the only legitimate approach to sexuality and that condoms don’t work well.

James Wagoner at RH Reality Check, expresses his outrage about this far more articulately than I could express mine. He writes:

I am constantly told that it’s not “politic” to call out our friends on an issue like sex education. There are bigger fish to fry. I’m not buying that anymore. Not when ten thousand young people get an STD, two thousand become pregnant and fifty-five contract HIV every single day in this country. Not when poll after poll shows this issue to be a political winner, not a loser, for Democrats. Not after Democrats exploited this issue in opposition and now, with control of Congress, act like it’s an insignificant chit to be bartered away at the whim of a recalcitrant committee Chairman.

It is now time to call this what it truly is. A stunning disgrace.

A stunning disgrace, indeed. And this is not a new story. We wrote about this here back when the Dems in the House of Representatives voted to approve the increase when they passed the Labor/Health and Human Services appropriations bill. But its in the news again because the bill has just come out of the Democrat-controlled conference committee and the increase is intact. And the increase is outrageous. SIECUS reports that the Senates version of the bill would have reduced funding for abstinence-only programs. Why didn’t they hold that position in the conference committee?

We’re nearing election day and it is important to remember that the Democrats are not so clearly our friends. And they ought not be allowed to continue to get away with hurting us just because the Republicans might hurt us worse.

You know, it really starts to feel like an abusive relationship, doesn’t it? You know, the kind where you are being beaten but feel trapped because if you leave you’ll be worse off?

We need shelters for the battered body politic. I think they’re called multiple-party systems. You know, where real choices are possible.

Maybe that would be a truly “pro-choice” system.

I think we need to start building one.

Now.

*The Prevention First Act is only one of a slew of bills that were introduced to try to make sane sex ed and contraception policy. The REAL (Responsible Education About Life) Act is another that is stuck in committee. For a look at the whole list, depressing though it is that none are moving, click here.

Note: This piece is also published on my blog at our community-building site, SexInThePublicSquare.org. Drop by and join in!

Photo of “Condom Police” sign not taken in the US no matter how much it may feel that way. The sign was photographed in Vanuatu by “Phnk“, posted on Flickr and used here under a Creative Commons Attribution-Noncommercial license.

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Filed under abstinence only, Education, Health, News and politics, public discourse, reproductive freedom, sex, sex and health, sex and the law, sex education, sexuality, sexuality and age

Genarlow Wilson is Free

I posted yesterday at SexInThePublicSquare.org that he had been ordered freed, but this morning’s Times has photos of him outside the prison. It’s about time!

That’s the good news, and I wish the best to Wilson and his family. We’ve been pulling for Wilson for a long time here at Sex in the Public Square. And we know it is not easy to put a life back together after spending time in prison, and Wilson’s prospects — which had looked bright — have been damaged. We hope he finds the kind of external support and inner resources necessary to make things work.

At the same time, we need to remember that Genarlow Wilson was not the only one. The Atlanta Journal Constitution ran this piece yesterday describing how other teens have been caught up in sex offender registration rules for consensual sexual activity.

We need a serious discussion in this country teens and sex. Right now we’re in the untenable position of denying teens sex education, thus making it very difficult for them to make smart sexual decisions, and then treating them like criminals when they have sex.

We need to treat teens like they are people with rights, and we need to treat sex as a legitimate human interest. There are lots of ways that teens need support as they develop their sexualities. Draconian enforcement of age-of-consent laws is not one of them.

UPDATE: I’ve created a forum on SexInThePublicSquare.org where we can have that discussion. Click here if you’d like to join in

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Filed under culture, Genarlow Wilson, moral panic, News and politics, public discourse, sex, sex and the law, sex crimes, sex education, sexuality, sexuality and age

Canada, Church, Charters and Choice

I’m back in the city, which means I’m back in the country.

I just returned to NYC from Alberta and British Columbia where I spent six days meeting cousins on one branch of my partner’s family tree, seeing beautiful countryside. We put over a thousand miles (1707 km) on our rental car, saw the oil industry service sector outside of Edmonton, the ranch land west of Calgary, the mountains separating Alberta and British Columbia, the lush greenness of British Columbia’s Shuswap Lake region, and even got a peek at some of the disappearing glacier behind Lake Louise. And of course, as all my travels do, this one generated some sex-related insights.

One of the most unexpected was this: Conservative Christians sometimes sing very passionate songs in church! We went to a Christian Reformed Church service with my partner’s uncle and aunt (the CRC being nearly as close to Dutch Calvinism as one can get in an organized church in the US or Canada). The CRC congregation that my partner’s mom belongs to doesn’t sing much that doesn’t come straight out of the Psalter Hymnal in the back of the pew in front of you. But the CRC congregation in Red Deer sings Christian Rock type songs that include verses like this one from Beautiful One by Jeremy Camp:

You opened my eyes to your wonders anew
You captured my heart with this love
Because nothing on Earth is as beautiful as you
You opened my eyes to your wonders anew
You captured my heart with this love
Because nothing on Earth is as beautiful as you are.

(chorus) Beautiful one I love you
Beautiful one I adore
Beautiful one my soul must sing.
Beautiful one I love you
Beautiful one I adore
Beautiful one my soul must sing.

All the singing was led by the youth chorus (one young man on the piano and five young women: three singing, one on the keyboard and one playing flute). The singing was passionate. The young people in the front of the church had exactly the look that the singers of love songs have in their music videos: full of longing and desire and adoration. And it wasn’t just the young people. At times I could hear passion in the voices coming from the pews around me.

I wondered about the wisdom of inflaming desire through music, a very powerful medium. On the one hand, the collective singing of music binds people together in really powerful ways. On the other hand, there was no denying the undercurrent of sexuality running through these songs. Another song focused on the act of giving one’s heart, and ended with the word “come” repeated insistently as the music faded:

Come, now is the time to worship
Come, now is the time to give your heart
Come, just as you are to worship
Come, just as you are before your God
Come

(Come, Now is the Time To Worship, by Brian Doerksen.)

Meanwhile at roughly the same time as this passionate singing other young folks were out distributing sex ed materials, answering questions and promoting sexual civil rights for young people in Canada. From Canada.com:

Throughout July and August, the Know Your Rights street team — made up of young people — travelled across Canada stopping at county fairs, music festivals and a regatta.

Not only did they answer questions youth might have about sexual health or contraceptives, but they also gave out an estimated 6,000 condoms, held condom rolling contests and demonstrations and collected more than 500 signatures for a petition.

These young folks wrapped up their tour this past Sunday as I was listening to the passionate voices of CRCers in love with their God. The petition the Know your Rights team is supporting is directed at the House of Commons, pressing them to adopt the Charter for Sexual and Reproductive Rights for Youth, which is being drafted with direct input from young people across Canada.

These young activists are proudly and vocally pro-choice, and they have a pretty nuanced take on that label, too. They believe, and the Charter expresses, that ” choice encompasses all ideologies, even if that means choosing abstinence or being anti-abortion.” The charter is really very clear and very simple. It lists the “fundamental rights” that youth must have in order to “have and maintain their sexual health.” Among those rights are the right to accurate information about sex (something that some religious organizations interfere with), the right to decide when and if to have sex or bear children (something that many laws interfere with), and the right to confidentiality and care without seeking permission from parents or guardians.

This put me in mind of our discussion a while back about Michelle Vitt and whether she had been raised in a way that allowed for choice or not. It made me wonder how to reconcile the choices of parents with the rights of children and teens. It made me think back to the singing I’d witnessed Sunday morning, and the way that it very likely helped to redirect the passions felt by the young singers away from boys or girls or sex and toward the church and ideas of holiness. Another song, Refiner’s Fire, by Brian Doerksen, sung with the same kind of fervent passion, included this chorus:

Refiner’s fire, my heart’s one desire
Is to be holy,
Set apart for You Lord.
I choose to be holy,
Set apart for You my Master
Ready to do Your will

How likely is it that one of those singers would feel free to choose other than “holiness” as defined by the congregation gathered there that day? Certainly some rebel and are rejected, while others rebel and are ultimately accepted at home even if not in the Church, and certainly the passions ignited or fanned by these songs can set a person on a very thin double edge: bonding them closely to their community on the one hand, and then on the other hand enflaming emotions that can easily be sexual and unruly and difficult to contain.

This strange confluence of events, my sitting in church listening to passionate love songs as young people toured the country promoting sexual rights for youth, really focused my thoughts on the tensions between our various rights and freedoms. Sexual freedoms, religious freedoms, parents’ rights and rights for youth, these are territories that overlap. If you map the boundaries of one so that they lie just where you think they should, you have probably taken over some part of one of the others.

I come down on the side of sexual rights and accurate information for youth over parents’ rights to limit their kids access to information or to limit their informed decision-making. But would I go so far as to say that a parent did not have the right to raise her child in the faith that she chose? I can’t bring myself to say so. But, I would be more than willing to insist that regardless of faith all kids must be exposed to scientifically accurate information about sex and health and given access to nonjudgmental and independent sources of advice about sexual behavior.

That exceedingly sharp double edged passion that is ignited by religious fervor can slip, even in the hands of the faithful, and those youth need the information necessary to protect themselves when it does.

(Note: This post is also published at SexInThePublicSquare.Org)

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Democrats vote to increase funding for abstinence-only “education”

I don’t know how I missed this item posted on the Advocates for Youth web site last week:

Democrats INCREASE Funding for Discredited Abstinence-Only Policy
Ignore Findings that Programs Don’t Work

WASHINGTON, DC (July 19, 2007) Today, by a vote of 276 to 140, the House of Representative passed the Labor-HHS Appropriations Bill which included an unprecedented $27.8 million increase for failed abstinence-only-until-marriage programs, bringing the total annual funding for Community-Based Abstinence Education (CBAE) to $141 million.

“In one spectacularly cynical move, the Democrats turned their backs on science-based public health and chose political expediency over the health and well-being of young people,” said James Wagoner, president of Advocates for Youth. “With friends like these, who needs conservative Republicans?”

Democrats who have been ardent critics of abstinence-only voted to increase the very programs they opposed when Republicans controlled the Congress.

“With this vote, reproductive health ‘champions’ like Representative Nancy Pelosi and Nita Lowey have aligned themselves with ultra-conservative abstinence-only proponents,” added Wagoner. “They are now complicit in funding programs that promote ignorance in the era of AIDS.”

Since 1982, Congress has allocated over $1.5 billion for abstinence-only-until-marriage programs that censor information about birth control and the health benefits of condoms in the prevention of sexually transmitted diseases. A 10-year congressionally mandated evaluation conducted by Mathematica Policy Research, Inc. and released in April, 2007, found that “youth in the [abstinence-only] program group were no more likely than control group youth to have abstained from sex and, among those who reported having had sex they had similar numbers of sexual partners and had initiated sex at the same mean age.”

“It’s becoming increasingly difficult to tell our friends from our opposition these days,” concluded Wagoner. “The majority of Democrats say they oppose these ineffective programs because they withhold life-saving information, yet they failed to act on those beliefs. Shame on them!”

Cynical? Cynical doesn’t even come close.

Now I know these provisions are buried in huge appropriations bills. And this one is interesting because in at least some states (New York, California, I haven’t checked them all!) it is the Democrats who tended to support the bill and Republicans who tended to it. So clearly the vote wasn’t “about” abstinence-only “education.” It was more likely about the funding of things like public schools and hospitals, for museums and libraries, public broadcasting, programs for the blind, for Medicare, for the National Labor Relations Board, and other important stuff. (Click here for the text of the bill, its provisions, and the programs it funded.)

But Democrats certainly had an opportunity in moving the spending bill through the House to amend it or alter provisions to which they objected, and they certainly could have cut funding for abstinance-only programs and allocated money instead for comprehensive sex education programs (which, by the way, also promote abstinence as the best policy for teens).

Here is the section of the bill that deals specifically with “abstinence education”

Provided further, That $136,664,000 shall be for making competitive grants to provide abstinence education (as defined by section 510(b)(2) of the Social Security Act) to adolescents, and for Federal costs of administering the grant: Provided further, That grants under the immediately preceding proviso shall be made only to public and private entities which agree that, with respect to an adolescent to whom the entities provide abstinence education under such grant, the entities will not provide to that adolescent any other education regarding sexual conduct, except that, in the case of an entity expressly required by law to provide health information or services the adolescent shall not be precluded from seeking health information or services from the entity in a different setting than the setting in which abstinence education was provided: Provided further, That within amounts provided herein for abstinence education for adolescents, up to $10,000,000 may be available for a national abstinence education campaign: Provided further, That in addition to amounts provided herein for abstinence education for adolescents, $4,500,000 shall be available from amounts available under section 241 of the Public Health Service Act to carry out evaluations (including longitudinal evaluations) of adolescent pregnancy prevention approaches: Provided further, That up to $2,000,000 shall be for improving the Public Assistance Reporting Information System, including grants to States to support data collection for a study of the system’s effectiveness.

We are now spending almost 137 million dollars to teach teenagers that abstinence is the only acceptable method of preventing STDs and pregnancy, and we are prohibiting organizations that accept grants from this allocation from offering “any other education regarding sexual conduct.”

Ironically, or not, this same bill in Title V section 517 b provides that “None of the funds made available in this Act may be used to disseminate scientific information that is deliberately false or misleading.”

Click here to find out how your legislators voted (once there, click on your state to see each of your legislators’ votes) and then call them or email them and let them know you’re outraged that they didn’t address the problem of abstinence-only funding but instead voted to increase funding for the very programs they claim are harmful to kids. You can use the “Speak Out!!” box on the left side bar to find contact info for your representatives.

By the way, this same bill in Title V section 507, continues the ban on spending federal money to provide abortions (so they aren’t covered for poor women, or for women insured under federal health insurance programs).
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This is posted here and also at SexInThePublicSquare.org

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Interpreting the new research on child pornography use and child molestation

The New York Times reports today on research that demonstrates a very high correlation between use of child pornography and the actual molesting of children. The Times did a good job of reporting why it is so important to be cautious about interpreting a study like this one. And it also does a good job of reporting on the need for continued research on child molestation.

Because of the tremendous moral panic risks that are attached to publishing anything about htis kind of research I am going to focus entirely on the cautions. There will be lots of voices out there focusing on the tentative conclusions of the study itself, so here lets just focus on the limitations:

1. Remember when thinking about these results that they were produced using only already-incarcerated men convicted of child pornography charges. These men may well not be representative of all people who have ever downloaded or viewed child pornography.

2. The men who were studied were not only incarcerated, they were voluntary participants in treatment programs for sex offenders. It is quite reasonable to ask whether men who volunteer for sex offender treatment are like other users of child pornography. There are several ways in which they could be different. They could be more likely to be men who had in fact molested children and thus believed they could benefit from treatment, for example.

3. The Times reported that the study found that 85% of the child-porn convicts in their sample also admitted to “acts of sexual abuse with minors,from inappropriate touching to rape”. But we can’t tell what to make of this statistic. We don’t know whether the use of child pornography came after the acts of sexual contact with kids or before it. (The study has been at least temporarily blocked from publication by the Federal Bureau of Prisons whose psychologists conducted the research, so we can’t yet evaluate it in its entirely.) Given the lack of complete information, it would be dangerous to interpret the statistic reported in the Times. Correlations are notoriously misinterpretable. For example, what if there is a correlation between use of child pornography and likelihood of molesting children. Does it matter whether it is the inclination toward molesting children that causes the use of child pornography, or whether it is the use of the child pornography that causes the molestation? Of course it does. It also matters whether there is some external variable that causes a person to be inclined toward both of those other activities.

The limitations of the study that the Times reported today should not be cause for putting down the research itself. Rather, they should be used as a guide for interpreting the findings and for highlighting where more study needs to be done.

The Times has, in the past, discussed the difficulties with studying sex offenders. While some of the challenges are methodological, and some are ethical, in an article published in March, a professor from a law school in Minnesota pointed out that some are cultural:

Professor Janus said he hoped for “an explosion of knowledge” about how to prevent sexual violence before it happened, which he said would prevent far more sex crimes than civilly committing offenders.

That sort of research is unlikely to happen in the United States, Dr. Berlin and other experts said, because so many Americans believe that the only investment in sex offenders should be punitive.

Research on sex offenders, on their treatment, and on preventing sex crimes is all very important and needs to be encouraged. It’s difficult to encourage research in an environment like ours, where findings — whatever they indicate — are so potentially explosive because of the moral panic that characterizes our approach to policy around kids and sex and crime. If as Dr. Berlin suggests many of us believe that punishment is the only thing to consider when we address sex offenders, we will never get any clear understanding of how to prevent those crimes in the first place. Such an attitude essentially guarantees that more kids will be harmed and more adults will become criminals.

In encouraging more research on sex offenders and sex crimes, we need to keep the following goals in mind:

1. To develop prevention strategies that work so that harm is avoided in the first place.
2. To develop treatment strategies that work to reduce rates of reoffending.
3. To better understand adult sexuality, childhood and teen sexuality, and to better understand consent so that we can distinguish between criminal acts with real victims, and loving, affectionate or simply playful acts that harm no one.

This last is a controversial goal to be sure. When Bruce Rind and colleagues published an article in Psychological Bulletin (a peer-reviewed and widely respected academic journal) in which they found that not every instance of sex between a child and an adult caused harm to the child, they were the subject of a firestorm that even led to their being “unanimously condemned by Congress.” And when Judith Levine published Harmful to Minors, perhaps the clearest discussion of kids, sex, and policy out there, she writes that “overnight I became the author of ‘the pedophilia book,’ even though the book only touches on pedophilia in a few of its 300+ pages. University of Minnesota Press, which published the first edition, was overwhelmed with calls “demanding that the press’s management resign and Harmful to Minors — and maybe its author — be burned.” (p. 229, Afterword, Harmful to Minors, 2002 edition.) The book went on to win the 2002 Los Angeles Times Book Prize and its 2002 edition, published by Thunder’s Mouth Press, has a foreword by Dr. Joycelyn Elders.

Yet this last goal is ultimately important if we are to avoid the kinds of harm we cause to children, teens, and adults when we make policy based on fear rather than on evidence. Prevention, treatment, and a clearer understanding of the sexuality of kids, teens, and adults are all essential if we’re going to get a handle on sex crimes.

This entry is published on SexinthePublicSquare.org and also SexinthePublicSquare on WordPress.com

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