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What a sex therapist wishes all couples knew

— Desire doesn’t have to dwindle in long-term relationships, says Dr Stephen Snyder. Here’s the advice he gives married couples in his clinic

By Anna Maxted

How do you keep the passion alive when you’ve been with your partner for decades? Dr Stephen Snyder, the therapist and author whose book Love Worth Making: How to Have Ridiculously Great Sex in a Long-Lasting Relationship is a bestseller, has the answers. Having worked with hundreds of married couples over 30 years, he explains why desire often dwindles over the years — and how to rekindle it.

Don’t expect sex to knock your socks off every single time

If you ask people to recall the greatest sex of their life, most will admit that it wasn’t in the context of a committed relationship. More often they’ll recall something novel, unexpected, or possibly even forbidden. There is something uniquely thrilling about the first time you get naked with someone.

If you seek that kind of thrill within a committed relationship, as many do, you’re likely to be disappointed and frustrated. I tell couples in my clinic, don’t compare apples and oranges. Better if you can learn to listen carefully to your own arousal, and to the particular feeling your partner arouses in you. I don’t think of it as a “spark” — that word is too dramatic. Pay attention to that vibration, and be open to hearing it. You never know where sexual inspiration will come from. Don’t try to control it.

Don’t schedule a time for sex

Many sex therapists advise couples to just “put sex in the diary”. I think that’s a recipe for bad sex. It’s like making a dinner reservation, but when you get to the restaurant you’re not hungry. Instead, I recommend couples schedule a time to go to bed together to do nothing at all. Allow yourself to shift from your ordinary state of mind. You don’t always have to be “doing”. Take a breath and feel the air. If you’re feeling something, maybe express it to your partner. Or turn to them and say: “Hey, talk to me, what’s going on with you?” But keep it simple. Focus on the here and now.

In sex therapy, we call this the 2-Step, where Step 1 is cultivating awareness by going to bed with no agenda except to do absolutely nothing. That gets you ready for Step 2, where you let yourself become physically aware of your partner and notice any erotic feelings that might arise. Stay in the moment, if you can. Don’t try to arouse your partner. Just experience them — their voice, the scent of their hair, the way they feel in your arms and on your lips. You don’t need to feel desire to 2-Step, just a willingness to go wherever it might take you.

If you want lust to last, appearance matters

In my practice, what I hear most often from women is that they like their man to be diligent about grooming. He doesn’t have to be impeccably turned out just to watch TV on a Tuesday, but there’s no reason a man can’t be careful about how he presents himself, even if it’s just getting a nice haircut and trimming ear hair, nose hair, and eyebrows if they’re unruly, and maybe investing in a nice new set of boxers. And what about weight gain? It’s a sensitive subject, but it can matter. How lucky that near vision deteriorates in midlife. Every couple over 40 should have a dimmer switch in the bedroom, since none of us looks quite as good as when we were teenagers.

Truth is, most women in my practice say they’re turned off if a man has a pot belly, which is where most men tend to put on weight. But I haven’t seen much success with women telling their husbands to do sit-ups and watch their diet. That doesn’t seem to work any better with a man than it does with a woman, and it certainly won’t put your partner in the mood for sex. Instead, I recommend for a woman to lie him on his back, where his belly won’t look so prominent. Get on top, and focus on the parts of him that you do like.

Women like to feel passionately desired

Desiring a woman is more than just wanting to have sex with her. Most women crave a kind of erotic attention that has nothing to do with penetration or orgasm. It’s more likely to be from a shared look across a room, or in the moments before a first kiss. At its most intense, it’s feeling irresistible. That’s what makes erotic novels compelling for many women: the hero finds the heroine irresistible. He can’t stop thinking about her. So many women in my practice tell me they need to feel strongly desired. But that’s a tall order when you’ve been together for a long time, you’re busy with work and kids, and you both probably value a good night’s sleep more highly than sex.

I advise husbands, whenever you feel sexually attracted to your wife, don’t waste the moment. Act on it. Let’s say she’s in the kitchen wearing something nice, or changing, or just out of the shower. If you feel drawn to her in that moment, walk over, take her in your arms and hold her like you mean it — which of course you do. Kiss her passionately, inhale the scent of her hair, and say: “Did I ever tell you how attracted I am to you?” Most women in relationships say they need that show of desire more than they need sex.

Accept your partner for who they are

A wise old sex therapist colleague once asked me: “Why do women get bored with their husbands but not with their dogs?” I suspect it’s because most women accept that their dog is just a dog, but many have trouble accepting their husband for who he is. Some women tend to think of their male partner as a project, or a work in progress, and they forget to be thankful for what they’ve got. Most men are like cactus flowers — they don’t need much watering to bloom. Sometimes it’s best to leave your list of projects to the side and find something about your husband to enjoy or appreciate.

Be connoisseurs of your arousal

The happiest lovers savour arousal wherever they find it, whether it’s with a partner, alone, or through fantasy. They pay attention to what their arousal feels like. And happily, since taboos around female pleasure and sexuality have fallen away — and sex toys have improved — fewer women worry about having an orgasm through penetrative sex, making it easier to relax and enjoy the moment.

Cultivating arousal can be like learning to enjoy good wine. You begin to notice its components, like how arousal grabs your attention and makes you forget about non-essential things; how it makes you regress to a more spontaneous version of yourself; and how it touches your core sense of being. Many people spend lots of energy trying to produce strong arousal, as if that’s something you can control. Established couples who have good sex understand that there’s a passive element to it, as if you are riding a wave.

Remember to enjoy each other

In my practice I often ask women what they crave most in lovemaking. For some it’s a feeling of “surrender” with a partner who knows how to take charge. They appreciate a certain kind of male energy — confident, decisive and fully engaged. Many relationships start out with plenty of it, but as time passes the man runs out of steam and becomes inert and lacking in initiative. When couples like this are in treatment, the male partner will sometimes tell me he feels nothing he does makes her happy, so he withdraws to protect himself — which definitely makes her unhappy. And so her unhappiness and his lack of confidence just keep reinforcing each other in a vicious cycle.

The truth is that many men are quite sensitive to their partner feeling disappointed. It’s often worth reminding a man that a woman’s disappointment doesn’t have to be a calamity. It’s worth reminding her to enjoy him for who he is, rather than complaining about who he’s not. Male or female, deep down we all need to be enjoyed. Many men start manifesting confident male energy again once they feel their partner really appreciates them.

Most long-term committed couples don’t get excited together unless they’re going to have sex, which is an enormous mistake. This is a fork in the road early in a relationship. Once the fever of having sex passes, you’re faced with the decision whether to go right or left. Almost everybody goes left; they keep desire toned down, unless sex is on the menu. They don’t wear anything sexy to bed, they don’t play footsie under the table in a restaurant. It never occurs to them that arousal might have independent value. Why save it just for sex? The happiest couples, meanwhile, enjoy feeling turned on together just for its own sake, even if it’s just for a minute or two, even if they’re not going to have sex.

In sex therapy, we call this “simmering”. It’s what most of us did as teenagers — passionately kissing in the hallway between classes, then hearing the bell ring and darting off in opposite directions, feeling deliciously buzzed. In most adult relationships, the simmering is at least as important as the sex — if only because it’s easier to find time for. I suggest, whenever you might ordinarily kiss your partner, consider simmering them instead. Instead of waving them off to work with a peck on the cheek, simmer them goodbye. Hold them tight, feel their body, maybe rumple them up a bit, then send them on their way. And men, if you’re watching TV and your wife comes to kiss you goodnight, grasp her around the waist, pull her down to you and hold her tight. It may well lead to something more later — but it doesn’t have to.

Take responsibility for your own orgasm

Many women still think that if their male partner gets an erection, they’re responsible for relieving him of it. This makes no sense, since no one should ever feel obliged to do anything in bed they don’t want to do. What’s more, we men like being aroused. It’s not painful and if nothing sexual happens, an erection simply goes down. So if you’re lying in bed with your man and he gets excited, it’s totally fine to say: “Nice to know you’re happy to see me, but I’m really tired. OK if we just simmer for a minute, then go to sleep?”

Sometimes, though, he’ll crave an orgasm — just like sometimes a woman might crave an orgasm. He could always go to the bathroom to deal it himself, but it’s cold and lonely in there. The sexually happiest couples tend to compromise with something we sex therapists call “lazy sex”. They kiss, he holds her passionately with one hand, and with his other hand gives himself an orgasm. Some couples tell me they’ve always done this, especially when they were new parents and exhausted, or because their libidos don’t always align. Other couples, when I mention lazy sex, look at me as if I have three heads; as if taking a vow of marriage means swearing never again to touch your own genitals in bed. Obviously that’s a misreading of the marital contract.

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Let’s Talk About Sex and Cancer

— A cancer diagnosis can change your sex life, but patience, experimentation and communication can help you get back on track.

By Liz Highleyman

Sexuality is an important part of life that contributes to overall well-being. Getting a cancer diagnosis, undergoing treatment and becoming a survivor can affect sexual desire and function. Surgery, radiation and chemotherapy not only alter the body, but they can also change how patients—and their partners—feel about their bodies and about sex.

“Sexuality is not synonymous with sexual activity. It covers intimacy, desire, arousal, orgasm and satisfaction,” says Don Dizon, MD, director of the Pelvic Malignancies Program and the Sexual Health First Responders Clinic at Brown University Health Cancer Center. “When it functions normally, we don’t think about it, but when something negatively affects who we are sexually and how we experience pleasure, it can be quite distressing.”

Research suggests that as many as 90% of people with breast, gynecological or prostate cancers experience difficulties with sexual desire or function. For women, the most frequently reported problems include vaginal dryness or atrophy and pain during intercourse (dyspareunia). For men, erectile dysfunction is a common problem. People of any gender may experience loss of sexual desire (libido) and difficulty reaching orgasm.

Treatment for breast, cervical, ovarian or prostate cancers may involve removal of the ovaries or testes or use of hormone therapy to slow the growth of tumors with estrogen, progesterone or androgen (male hormone) receptors. This can put younger women into sudden menopause and can cause numerous side effects for postmenopausal women and men as well. In an effort to prevent cancer recurrence, such treatment may last for years.

But sexual problems are not only a concern for people with cancers that affect the reproductive system. Surgery or radiation for any type of cancer in the pelvic region can lead to scarring and damage to organs, nerves and blood vessels that play a role in sexual function. Treatment for anal cancer can impact the sex lives of gay men and others who enjoy anal sex. Some people with bladder or colorectal cancer will need an ostomy bag to collect urine or feces. One bright spot, however, is that the recent trend toward active surveillance, less invasive surgery, more targeted radiation therapy and lower medication doses can lessen negative outcomes.

Beyond the direct physical effects, cancer and its treatment can also take an emotional toll. Chemotherapy, other cancer medications and radiation can cause side effects such as fatigue, nausea and pain that can leave people uninterested in sex. Hair loss or weight changes due to chemotherapy or removal of a breast can lead to self-con­sciousness or a poor body image. And simply facing cancer can trigger stress, insomnia, anxiety and depression, all of which can kill the mood.

Often, the cancer experience brings couples closer together, but sometimes it can drive them apart. Partners might have a hard time understanding a lack of sexual interest and may need time to adapt to changes in appearance and function. Some partners may withdraw emotionally or fear that sex will cause harm. What’s more, changing roles—for example, when a spouse becomes a caregiver—can affect sexual relationships. Single people may have concerns about when to bring up cancer while dating, and they may be hesitant to start new relationships if their prognosis is uncertain.

“Sometimes cancer can make a relationship stronger. My partner was so loving and supportive, I fell more in love. But for some, it’s a deal-breaker,” says Annie Sprinkle, PhD, a former adult film star and current performance artist who holds a doctorate in human sexuality. “Cancer is going to change you. You have to accept that, and your partner has to accept it.”

Sprinkle was diagnosed with early breast cancer about 20 years ago and had lumpectomies, radiation and chemotherapy, which caused “instant menopause.” Years later, when she got scans after a car accident, doctors found signs of lung cancer, and she underwent surgery again. In characteristic fashion, Sprinkle and her partner, University of California Santa Cruz art professor Beth Stephens, PhD, made cancer a theme of their art.

Cancer patients and survivors can take steps to improve their sexual desire and function before, during and after treatment. Patience, experimentation and communication are keys to a better sex life.

For women, estrogen replacement therapy may improve menopausal symptoms, but this is often not possible for those with hormone-driven cancers. Estrogen creams or vaginal rings can relieve dryness and irritation without increasing the risk for cancer progression or recurrence. A recent study showed that Addyi (flibanserin), a drug that helps balance neurotransmitters in the brain, improved sexual desire, arousal and satisfaction for women with breast cancer. Modern breast surgery techniques are less likely to cause lasting changes in mobility and sensation. Most women have reconstructive surgery after breast removal, but going flat is also an option.

For men, decisions about testosterone replacement therapy to revive a flagging libido can be a balancing act between managing symptoms and minimizing the risk of cancer recurrence. For some men, drugs like Viagra (sildenafil) or Cialis (tadalafil) are effective for treating erectile dysfunction. Penile injections, inflatable implants or vacuum pumps may also be an option. Some experts recommend “erectile rehabilitation,” or regular use of medications and vacuum pumps to achieve an erection even when sex is not desired.

For everyone, eating a balanced diet, getting enough exercise, maintaining a healthy weight and getting adequate sleep contribute to overall quality of life, including sexual well-being. Studies have shown that aerobic exercise, pelvic floor exercises, yoga and meditation can help improve libido and sexual function. Exercises that strengthen the pelvic muscles, in particular, can reduce pain during intercourse, prevent urine leakage during sex and lead to firmer erections.

Time and patience can go a long way. Some sexual symptoms are likely to improve after treatment is completed. Nerves and blood vessels injured by surgery or radiation can sometimes repair themselves, but this can take months or even years. Give yourself time to heal before resuming vaginal or anal sex. Due to a waning libido, sex may not be as spontaneous as it used to be. You might need to plan ahead for when you have more energy or to give erectile dysfunction meds time to work. Adapting to physical and emotional changes can be a prolonged process for both the person with cancer and their partner.

“I like to say, the only answer to any question about sex is, ‘It depends.’ That’s spot-on when it comes to sex and cancer,” Sprinkle says. “Parts of your body might be numb or nervy or have scar tissue, or you can’t have weight on top of you. Forget everything and do it your way. There’s no right way—there’s just what works for you.”

Experimentation is key. Before resuming sex with a partner, it might be helpful to explore your own body and its changing sensations to figure out what feels good—or doesn’t—now. Tune in to novel sensations, and try new positions that might be more comfortable. Some people may choose to wear sexy clothing to hold a breast prosthesis in place or cover a chemo port or ostomy bag. Lubricants can relieve vaginal dryness—many different types are available. Likewise, there’s a wide variety of vibrators and other sex toys to try. Men who are unable to have an erection can usually still experience sexual sensations and learn to achieve orgasm without ejaculation. If intercourse is not possible, explore other ways to maintain intimacy. Your sex life may be different than it was before cancer, but it can still be pleasurable.

“Sometimes people have too narrow a definition of sex,” says Sprinkle. “Get out of the idea that sex is only about intercourse. Find what turns you on. If nothing does, at least have sensual pleasure, like massage or cuddling. Anything can be sex if it gives you pleasure or you find it sensual or erotic. Your sex life can become your pleasure life.”

Open communication is among the most important factors, both between partners and between people with cancer and their health care providers. Talk to your partner about how you’re feeling physically, mentally and emotionally. Discuss what you want out of your sex lives and how to satis­fy both of you. If this is difficult, a marriage or couples counselor or sex therapist might be able to help.

Early in your journey, have frank discussions with your care team—doctors, nurses, mental health therapists and social workers—about how cancer and its treatment could affect your sexual well-being and how to prevent or ameliorate problems. Some cancer centers have sexual health specialists and offer sexual rehabilitation programs. Forewarned is forearmed.

Unfortunately, a majority of cancer patients report that they did not receive adequate sexual health information before, during or after treatment. In part, this is due to a stereotype that older people are not interested in sex. Finding appropriate information can be especially challenging for gay, lesbian, bisexual and transgender people. For their part, most oncologists say they never received training in managing sexual problems. Patients often say they don’t want to make their doctors uncomfortable, while doctors say they don’t want to make their patients uncomfortable. Don’t be afraid to make the first move.

“Sexuality does not have to be another part of one’s life ‘lost’ to cancer,” says Dizon. “To avoid conversations around sexuality after cancer robs people of the opportunity to fully participate in a domain that defines us as human beings.”

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I’m Abstinent For My Faith

— But I Can’t Stop Thinking About Sex

By Hena Bryan

I came to the unsettling realisation that the Christian girls I grew up with were rarely taught about sex, sexuality, or even our own bodies. In fact, of all the Christian girls and women I’ve spoken with, none shared being spoken to about sex in a way that explained it; instead, sex was only shunned. As a result, we spent much of our religious journeys subduing our sexual urges that we overlooked said lack of guidance and education—coming to terms with this was difficult.

We were all once told to wait until marriage before engaging in any sexual activity, with almost no guidance on what to expect when puberty hits and sexual desire becomes overwhelming. When sex is finally discussed, it’s often framed as something we should endure rather than enjoy, and our sexuality is suppressed rather than explored. We’re taught that desire is sinful, and sex—unless within the confines of marriage—should be avoided. Even then, it’s often implied that it should be vanilla and restrained. This lack of education can create deep-seated issues that take years, sometimes decades, to unpack and overcome.

Growing up in a Pentecostal Church and Christian household, I spent most of my childhood and adolescence surrounded by adults who adhered strictly to biblical principles. As a result, I held onto my virginity until curiosity and hormones ultimately prevailed. I had sex for the first time at 18 and the experience was underwhelming, both physically and emotionally. By that age, I had seen enough media to know that a first sexual encounter is often awkward and uncomfortable. Yet surprisingly, the physical discomfort wasn’t the hardest part; it was the alien sensation of sexual feelings within my own body. For the first few years of being sexually active, I wrestled with the belief that I was doomed to eternal damnation, not only for having sex but for wanting it.

Sex eventually became more enjoyable, though I can’t pinpoint exactly when or how this shift occurred. I credit it largely to Christian women who bravely shared that they too struggled with similar feelings. Through countless stories of unwanted pregnancies, poor sexual health, sexual assault and the emotional toll of navigating sex without proper guidance, I discovered a common thread: a lack of sexual education.

Whilst this is not the case in all churches, many of us received ill-informed abstinence-only sex education from our religious leaders, and the consequences are striking when considered against research. In the American Journal of Sexuality Education, researchers Sharon E. Hoefer and Richard Hoefer suggest abstinence-only education is less effective at preventing pregnancy and sexually transmitted infections (STIs) than comprehensive sex education. Also, American sex-positive therapist and educator Ann R., in her essay “The Intersection of Faith and Sexuality: Focusing on Female Sexuality and Shame”, notes that “Christian teachings have framed sexuality, especially female sexuality, in terms of purity and sin, often leading to a culture of shame. This framework not only restricts women’s understanding of their own bodies and desires but also places a heavy burden of moral responsibility on them.” Sadly, many of us were left to navigate our sexual desires and bodies without understanding how they fit within our faith, leading to years of internal conflict as we grappled with the notion that sexuality and spirituality couldn’t coexist.

In my mid-20s, I rededicated myself to Jesus Christ. By then I had gained enough spiritual insight to understand why, within Christian teachings, God commanded that sex be reserved for marriage. Through my experiences, I realised that when defined solely by worldly or scientific standards, sex often felt devoid of deeper meaning — an understanding that ultimately conflicted with both my faith and my nature as a sexual being.

This realisation led me to a renewed commitment to my faith as well as to abstinence but the journey has not been without challenges — especially as a single woman who is open to dating and romantic connections. The most difficult times are around ovulation when, due to my biological makeup, my sexual desires become incredibly strong. During these periods, it’s almost as if my body and mind are working against my faith, making it hard to focus on anything other than the desire for sexual intimacy. When I’m dating someone I’m attracted to, it becomes even harder because those thoughts aren’t just abstract; they’re about someone real, someone who’s right there, making it easy to imagine actualising those desires.

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Every girl and woman deserves to be educated by their caregivers and their church in a way that affirms that our desires and our faith are not separate forces working against each other.
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Despite my strong faith, these moments feel like a test of my Christian walk and the struggle to remain abstinent can feel like a setup for failure. It’s during these times that I wrestle most with my beliefs, questioning not only my ability to stay true to them but also what this struggle means for my spiritual journey. The tension between my physical desires and spiritual conviction highlights a deeper internal conflict. On one hand, my faith teaches me that abstinence is a virtue, a testament to my dedication to God. On the other hand, my body’s natural urges are an inescapable part of who I am and denying them can sometimes feel like denying that I’m human.

This ongoing battle raises important questions about how we navigate faith, desire and identity in a world that often sees these aspects of our humanity as incompatible. I’ve come to understand that this tension isn’t just about sex or abstinence; it’s about the broader challenge of integrating faith with the reality of human experience. It’s about learning to live in the space between desire and devotion, where the two don’t have to be at odds. This understanding doesn’t necessarily make the struggle easier but it offers a framework for approaching it with compassion.

I’ve often found myself scouring the internet, searching for literature that makes me feel less alone in this battle, but I often come up short, typically encountering women using aliases to ask similar questions or men of faith offering half-baked answers. I wish more people contributed to this conversation because a lack of sexual education can lead women to believe that sex is a matter of servitude, where our needs are secondary or even irrelevant and the maintenance of purity — real or assumed — is paramount. The more I’ve reflected on my own journey, the more I’ve realised that we have to do the work collectively to reconcile the fact that God created us as sexual beings. Every girl and woman deserves to be educated by their caregivers and their church in a way that affirms that our desires and our faith are not separate forces working against each other but integral parts of our human experience and God’s design for us.

As I continue on this journey, I realise that the questions and conflicts I face are not unique to me. Many Christian women grapple with similar issues, caught between the teachings of their faith and the realities of their bodies. What’s important is that we create spaces where these struggles can be discussed openly and without shame, acknowledging that our desires don’t make us less faithful or less worthy of God’s love.

Ultimately, my journey has taught me that faith isn’t about having all the answers or living without doubt — it’s about the constant effort to seek understanding and reconcile the parts of us that feel at odds with one another. For many Christian women, there’s a pervasive belief that our sexuality and our spirituality must be kept separate and, most importantly, secret. But my experience has shown me that this division isn’t necessary or even healthy. Our spiritual journey isn’t a straight path; it’s a complex, winding road that demands patience, self-compassion and a willingness to embrace all aspects of who we are, including our sexuality.

I’ve learned that true faith isn’t about following a set of rules — it’s about navigating the intricate balance between desire and devotion with a heart that is committed to love, both for God and for ourselves. This process has required me to challenge long-held beliefs, to seek out conversations that are often avoided and accept that my sexual desires are not separate from my spirituality but are a part of the beautiful, complex human experience God designed for me. All Christian women deserve to be educated and empowered in a way that honours this truth so that we can fully integrate our faith with our human nature and live lives that are whole, authentic and deeply connected to God’s purpose.

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How condomless sex is driving the increase in STIs in Europe

– And what can be done about it

By

September still holds that back-to-school feeling for many of us, no matter how long ago we left the classroom. For many young people looking forward to freshers’ week or returning to their studies, though, the continuing rise in sexually-transmitted infections (STIs) might be good reason to revise guidance on safer sex and condom use to ensure their studies aren’t interrupted by an unwelcome infection.

In September 2023, the UK Health Security Agency urged students to use condoms and get tested regularly for STIs to help prevent the spread of infections. This is wise advice for everyone, not just students.

The most recent data from the European Centre for Disease Prevention and Control shows that syphilis cases rose by 34% from 2021 to 2022, chlamydia cases by 16% and gonorrhoea cases by 48%.

Reflecting broader European trends, Ireland – where my own research on sexual health is based – has also experienced a significant spike in STI cases. Health surveillance data show between 2019 and 2022, cases of chlamydia rose by 20%, gonorrhoea by 45%, and syphilis by 14%.

The incidence of STIs is notably high among young people, particularly those under 30. Women aged 20-24 have the highest notification rate for all STIs at 3088 per 100,000 population. Surveillance reports from 2023 indicate a 133% increase in gonorrhoea cases among women aged 20-24 and a 55% increase among males aged 15-19 since 2022.

Gay, bisexual, and other men who have sex with men (MSM) represent another key affected population in Ireland, accounting for 84% of gonorrhoea and 71% of syphilis infections in 2022.

Data on STI rates among migrants in Ireland are sparse, however, among new HIV diagnoses, the rate of bacterial STI co-infection was 17%, rising to 26% among MSM. Significant proportions of new HIV diagnoses were among people from Latin America (24%) and sub-Saharan Africa (20%).

European-wide data from the European MSM Internet Survey (EMIS) – an anonymous online survey for gay, bisexual, and other men who have sex with men – also indicate that migrants face barriers in engaging in safer sexual behaviours.

Obstacles can include inadequate knowledge of sexual and reproductive health, financial constraints, language barriers and experiences of stigma and discrimination. Around one in five refugees experience sexual violence (likely a conservative statistic given low reporting rates of rape and sexual assault), which means that they can be at increased exposure to STIs.

Compared to those born in their country of residence, the EMIS study reported higher rates of condomless sex among refugees, asylum seekers and those who migrated to live openly as gay or bisexual.

Decline in condom use

The decline in condom use is a major factor contributing to the rise in STIs, especially among key populations like young people and MSM.

So what’s driving this decline?

Unfortunately, we don’t know.

Our sexual health, like our health more broadly, is influenced by a complex interplay of individual, social, and structural factors. This perspective is known as the socio-ecological approach, which takes into account the social, political and policy factors that shape individual behaviour.

The impact on sexual health of recent significant shifts in the social, cultural and technological landscape are starting to come into focus, yet remain under-investigated.

For example, the proliferation of smartphone technology has meant an increase in the use of online dating apps and the ready availability of pornography. There is evidence that increased pornography use is associated with higher likelihoods of engaging in condomless sex, while dating app users report higher rates of gonorrhoea and chlamydia.

The availability of pre-exposure prophylaxis (PrEP) has been crucial in reducing HIV rates among MSM and is an essential preventative tool. However, PrEP use is also associated with higher rates of STI diagnoses. Recreational drug use is another factor: MSM in Ireland diagnosed with an STI are 53% more likely to engage in drug use.

Housing instability has been linked to less safe sexual behaviours, meanwhile youth homelessness is increasing in Europe. For example, the number of young homeless people in Ireland increased by 57% between 2017-2022.

Inward migration to Ireland increased by 31% in 2023 and this may play a role. Barriers to accessing sexual health services for migrants are well documented. Concerns about access to condoms has been raised by national migrant rights organisation, Nasc.

Addressing the challenge

Development of interventions is key. Addressing socio-cultural and economic determinants of sexual health is also vital. It will require careful planning and investment from governments to improve education, access to housing, and living conditions more broadly, especially for marginalised populations. An environment that supports rather than hinders people to mind their health is essential to reduce the current uptick in STIs.

Enhancing access to services is crucial. The recent introduction of SH:24, a free at-home testing service, has improved access to testing in Ireland. Peer-led community testing programmes have proved successful in Dublin, but are lacking outside the capital.

We all have a right to a safe, healthy, and pleasurable sex life. By ensuring availability of and universal access to culturally appropriate services, education and information, and by implementing legal and policy frameworks that promote dignity, equality and non-discrimination, we can improve sexual health and stem the tide of STIs in Europe.

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How Queer, Disabled People Are Finding Pleasure and Community Through Kink

— For decades, kinky disabled people have been creating intentional, accessible spaces where their own sensuality, agency, and erotic connection is at the center.

By Sara Youngblood Gregory

Artemis and Greta met in 2021 at a Brooklyn rope jam, a type of casual, low-pressure community event where people gather to hang out and practice rope play. The meeting, Artemis jokingly tells Them, was a business partnership at first sight.

Not long after she met Greta, Artemis began working at a woman-owned boutique sex shop — something she initially looked forward to as a kinky and disabled trans person. But Artemis quickly realized the shop wasn’t as inclusive of her community as she’d hoped.

Not only do many sex shops lack basic sexual health and gender-affirming products for trans folks, Artemis says the physical layout of these spaces are often exclusionary for disabled people. “You go in [these stores] and you’re already knocking everything over. We need spaces where fat people can move, people with limited mobility can move around and sit, [where there are] chairs and couches for people for when you’re overstimulated,” Artemis, 30, says.

Not long after working at the boutique, Artemis pitched Greta on the idea of a sex shop that catered to their community: people who are queer, trans, disabled, and decidedly kinky. Greta, a 29-year-old with autism, was immediately sold on the idea. For them, access to kink had long been central to their sex life and sense of identity.

“I’ve never had the option to come out as disabled, it’s been since day one,” says Greta. “Kink gives me a space where my support needs are the crux of what happens, and my ability to be nonverbal is both a tool and a strength.”

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Less than a year later in January 2024, the pair formally launched the Toolbox Collective in an inconspicuous brick building in New York City’s West Village. To their knowledge, the Toolbox is the first and only trans-owned, queer-centered sex shop in New York City.

The launch was so busy there was a waiting list at the door. (I should know; I was on it!) Everyone was masked, and the tables were brimming with pleasure products, many designed specifically for transfemme pleasure and with accessibility in mind. There were racks of kink gear and gender-affirming apparel, along with an abundance of free resources: educational zines, harm reduction treatments like Narcan, drug testing kits, and condoms. Though the initial launch was in a basement, requiring a narrow journey down a flight of stairs, the Toolbox Collective has since hosted events and workshops in many different venues and are working toward a permanent brick-and-mortar shop that’s fully accessible.

“The ultimate goal of the Toolbox Collective is building a space where people can go and have the tools and resources to access a more autonomous and embodied relationship to their pleasure,” says Greta.

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For decades, kinky disabled people have been creating intentional, accessible spaces where their own sensuality, agency, and erotic connection is at the center. But as with the Toolbox Collective, much of this work comes from a place of necessity and exclusion. Although one in four adults in the U.S. is living with a disability, disabled adults are often infantilized, desexualized, or reduced to harmful tropes — and that’s to say nothing of the legal disparities that impact disabled folks, including marriage equality. Even in queer and trans spaces, it’s common for disabled people to be treated as an afterthought.

Kink, both as a practice and a community, can offer a space where queer and trans disabled people get to experience their own bodies on their own terms. From BDSM and beyond, kink can happen anywhere desire happens and be adapted across a full spectrum of bodies and abilities. It ranges from sensation play and bondage to power exchanges and roleplay.

“Kink gives me a space where my support needs are the crux of what happens, and my ability to be nonverbal is both a tool and a strength.”

As Anna Randall, a clinical sexologist and executive director of The Alternative Sexualities Health Research Alliance (TASHRA) points out, research has even proven that kink can offer particular benefits for disabled folks. As both a practice and community, kink can encourage confidence, personal healing, body acceptance, community building, and in some cases, even pain or symptom management, Randall tells Them

“BDSM is a playground of somatic experiences,” Randall says. Kink often encourages embodiment — or an intentional connection between the mind, body and senses — which can be especially valuable for people with disabilities and those with certain sensory needs and cravings, Randall adds.

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For Sara Elise, a 35-year-old autistic leatherdyke, embodiment is one of the main benefits of her kink practice. “[BDSM play] allows me to be fully body-present, open, and flowing, the best version of myself,” she says. Elise discovered kink over a decade ago and soon began exploring bottoming and submission, as well as other power dynamics and ritualized play.

“Before developing a relationship with kink and receiving my diagnosis, I knew that I felt too much but I didn’t know why and I didn’t know how to deal with it,” Elise says. To cope with her symptoms, she regularly turned to self-harm and self-medicating with drugs and alcohol.

“When I discovered kink, I discovered an outlet for self-regulation and play, a boundaried, clear, communicative, and constructive outlet for processing the intensity of energy and feelings I experience,” Elise says.

Like Elise, 23-year-old Juno uses kink to connect with their body — and to reclaim their power after negative healthcare experiences. During their sophomore year of college, Juno was often in and out of the hospital. These visits, alongside a childhood fear of needles, left them with a strong aversion to medical settings.

But while researching body modifications for their thesis, Juno decided to explore sharps play, which involves using sharp objects like needles on the body. Pretty soon, they were hooked. “I developed this really interesting relationship with [needles] where I decided, this is scary, but I have control over it,” they say. “It’s exposure therapy almost and it makes it so much easier to just look at a needle and be like, that’s nothing I can handle that.” Juno gets blood work done every few months; the appointments have transformed from uncomfortable to mundane.

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But kink isn’t just about finding joy and agency in a sometimes-tenuous body; it’s also a way to build community. Though most queer people understand the importance of chosen family, these networks of care can be especially vital for disabled people who are more likely to lack adequate healthcare, housing, employment and other basic resources than their non-disabled counterparts. Though they often go underappreciated, these communities are deeply tied to LGBTQ+ history and survival. During the AIDS crisis, for example, leather families and lesbian activists helped popularize what was called the “San Francisco model of care,” a then-radical approach that prioritized holistic care for people living with HIV and AIDs — including home-delivered meals and other services — rather than solely focusing on medical treatment.

Today, the internet is transforming how kinky disabled people can find one another. In her research with TASHRA, Anna Randall says approximately 80% of kinksters go online to find community — and that includes Pup Quincy, a 26-year-old living with Multiple Sclerosis and chronic pain.

After exploring the New York city play party scene, Pup Quincy decided to fully embrace kink online, especially as various parties began lifting their COVID-19 guidelines. Online, they’ve attended workshops and monthly meet-ups and regularly connect on Discord.

“When it comes to the kink disability community, I would not have been able to connect with as many people or really as regularly or intentionally if it had not been for the spaces that I found online,” Pup Quincy says. “We’re [in these spaces] because we can’t engage with sex in the ways we like to or want to on a regular basis and finding that community has been very, very fulfilling and rewarding.”
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These disability-centered spaces and relationships have helped Pup Quincy enter their self-love era, where they connect with and care for their body through self-domming (depending on the person, self-domming can be focused erotic acts like masturbation or non-sexual activities like self-care). “The more I talk to other disabled people, I’m like ‘you guys are fucking smart,” they say. “[I] walk away feeling like, oh wow, there’s really so many possibilities to feel good in a world and a body that might feel really fucking bad. The perseverance and resilience to do that all the time is truly one of the most beautiful things in the world to me.”

There’s also a demand for IRL spaces where disabled pleasure is baked into the culture of the play, not sprinkled on top as an afterthought.

“The rope scene is not untouched by white supremacy, and in turn, ableism, fatphobia, and transphobia,” says Salem, a 26-year-old rope switch. When some friends introduced them to their local rope scene, Salem was immediately drawn to the social atmosphere of rope jams and the way relationships between rope facilitates intimate, non-normative dynamics. But a lot of rope education excludes modifications for bigger, disabled, or hypermobile people, and according to Salem, many riggers just aren’t that interested in learning these modifications.

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“Though shibari is Japanese, the idealized body in rope, at least in the U.S., is a thin, able-bodied cis white woman,” they say. “I would say the scene largely pedestalizes ties that are intense and risky, while ties that are more comfortable, lower risk, and more accessible are seen as ‘boring,’ which unfortunately leaves a lot of people on the margins.” In response, Salem co-founded a rope jam that centers trans and marginalized kinksters — one of the few monthly rope spaces that still practices COVID precautions.

Now, Salem’s rope community is largely made up of other trans people of color, sex workers, and disabled folks. Salem reports that people often find their rope jams to be one of the only spaces they feel comfortable tying. Like kink itself, community spaces are co-created by all those involved, meaning they can be shaped and reshaped to fit the needs of all parties.

“Rope is like a language, and you give yourself a loose script. It feels like a safe(r) container where genuine play and vulnerability become accessible,” Salem says. “Through rope, I’ve found a lovely community of weirdos who see me for who I really am, who take care of each other, and who are willing to have hard conversations about important things.”

Complete Article ↪HERE↩!

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Sober sex is on the rise

— This is the month to try it

Avoid the ‘next morning regret’

By Ebony Leigh

With new stats revealing that the majority of Aussies prefer to boink without the booze, Sober October is a great time to give sex without the sauce a red hot go. 

It’s a tag that plenty of us wear proudly. “We’re Australian – we’re a nation of big drinkers,” we laugh, before raising another tinnie.

But what about when our rich culture of beers at the footy, pints at the pub and a few too many on a Friday starts to have ramifications on our sex lives?

Because that’s exactly what’s happening according to new data from Lovehoney, the leading sexual wellness brand.

A country of ‘next day regret’

When it comes to who’s done the dirty while drunk, seven in 10 (69 per cent) admitted that they’d had sex intoxicated, while a quarter of the nation (24 per cent) said that most of the one-night stands they’d had had been while drinking. This last stat was highest among 35 to 44 year olds with one in three (33 per cent) going home with someone after a boozer.

Which of course begs the question, was it any good? For 3.4 million Aussies the answer is tragically no, according to Lovehoney’s survey, with 16 per cent of people confiding that they’d had a negative experience while having drunken sex.

“Probably anyone who has had a drink and gone home with someone is going to have experiences like ‘next day regret’,” Lovehoney sex and relationship expert Christine Rafe tells Body+Soul. “Whether it’s something they said or something they did.”

Because while we think we need alcohol to give us a bit of Dutch courage to let go and lower our inhibitions, it doesn’t always turn out so well. “We think we are going to be more confident and more able to ask for things that are maybe outside of our character or things that we potentially wouldn’t do as our sober, fully conscious selves,” the expert explains.

But the thing about alcohol is that it impacts our blood circulatory system, which isn’t great for sexual function. “So, yes, confidence is one thing, but actually once you have a few drinks sometimes you can end up in situations where you find it more difficult to get or maintain an erection, or you experience difficulties with ejaculation or even the engorgement of the clitoris which is responsible for pleasure,” Rafe says.

Which is absolutely worth keeping in mind. “Consider what actually is the quality and the pleasure of the sexual experience when alcohol is affecting you from a physiological sense,” she suggests.

More Aussies prefer sober sex

The great news is that we might be turning a corner in the cornerstone of Australia’s drinking culture, with a sober lifestyle more on trend than ever. Lovehoney data shows that only half (53 per cent) of the country now drink regularly, while 15 no longer turn to booze and nine per cent have never tasted alcohol. This is largest in the 18 to 24 year old cohort, with 18 per cent not having ever picked up a drink.

Which leads us to the bedroom with 51 per cent of people saying they prefer to have sex sober and 42 per cent calling intimacy more enjoyable when they’re teetotal.

“Sober sex heightens the emotional connection because we can really connect with someone properly, and it opens the door for clearer communication,” says Rafe. “And also, it’s more pleasurable because we have more access to blood circulating to our genital region, which supports with arousal, pleasure and sexual function.”

It also makes future sex with that person even better. “When it comes to arousal, remembering a previous sexual experience acts as foreplay for the next one,” the sex and relationship expert says. “So we really want those memories to be clear so we can actually remember the things that we did.”

How to build sexual confidence without needing a drink

With Aussies reevaluating their relationship with alcohol, Rafe says there are plenty of ways to boost confidence in bed without a glass of grog.

#1. Practice sexual communication outside of sexual experiences

“Try writing down what you know you like and what you want,” the sexpert says, “and practicing that so you don’t need to have five wines to be able to say, ‘I really want you to go down on me’.”

#2. Plan sober dates

“Look for ideas that don’t involve bars or drinking,” Rafe encourages. “So I know Lovehoney has their Oh! Sexploration Vouchers 52 Weeks of Adventures set to guide couples through a year of exciting and spontaneous sexual experiences. So trying something like that can give you ideas for what to do on a casual date or even with a long term partner.”

#3. Get sexting 

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Take away the pressure and say it in a text instead. “If you feel like you don’t know how to be confident, sometimes sending something over text can help,” the intimacy expert says. “You could say, “I really want to try that new toy’, or “I really want you to go down on me’, or “I love the way you _ when we have sex, what I’d really love is to _.”

#4. When in doubt, make out 

“When people are nervous to initiate sex, they think they need alcohol for that,” Rafe says. “So initiate a make out instead. You don’t have to initiate full blown penetrative sex from the get go. Starting with, ‘I’m going to initiate to make out with this person’. And then once you have a bit of arousal, it actually supports your confidence in initiating something further. So you don’t have to initiate penetrative sex from moment one.”

Complete Article ↪HERE↩!