Weekly Pulse: Prostate Health is Girly and Other Health Care Paradoxes

Lindsay E. Beyerstein

This week’s health care news was full of mind-bending paradoxes:  Prostate health is girly, abstinence-only education works through  failure, “principled” libertarian Rand Paul would protect all-white  lunch counters but ban private abortion clinics, and more

This week’s health care news was full of mind-bending paradoxes: Prostate health is girly, abstinence-only education works through failure, “principled” libertarian Rand Paul would protect all-white lunch counters but ban private abortion clinics, and more.

Prostate health is girly

The Prostate Cancer Foundation recently rolled out one of the most bizarre and ill-advised public health advisories in the history of advertising. The takehome message? That there’s something sissy, or god forbid gay, about getting checked for prostate cancer.

The ad features a bunch of retired sports legends in a suburban living room, knitting. They proceed to quiz each other about their prostate exams.

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Jessica Valenti of Feministing has the transcript:

Man 1: How did that prostrate exam go today?

Man 2: Very well, thank you for asking. (Looking to Man 3) Hey aren’t you due for one pretty soon?

Man 3: I guess.

Man 4: Whoa there, big guy.

Man 3: I’ll get around to it sooner or later.

Man 1: Sooner or later? 1 in 6 are diagnosed with prostate cancer.

Man 3: Alright! I’ll do it.

Man 4: That’s all we wanted to hear.

Man 5: Dessert is served.

The tagline is “Why can’t men express themselves more like women?” No doubt, the copywriters thought they were complimenting women. But if they want men to be more comfortable talking about their health, they shouldn’t reinforce the myth that broaching the subject is emasculating.

Abstinence-only, until adultery

It’s official: abstinence-only education works by failing. When people fail to practice abstinence and go on to ruin their lives, it just goes to show how great abstinence would be if anyone took it seriously. More federal funding, please.

As TPM reports, former GOP congressman Mark Souder says he’s happy that the abstinence-only video he filmed with his mistress and erstwhile staffer Tracey Jackson is the butt of late night talkshow jokes.

“If some people see this abstinence video, I’m living proof of what we’re saying in it. If they actually listen to the words, maybe it’s worth it,” Souder told an Indiana newspaper, adding, “You’ll go crazy if you don’t have some sense of irony.” Indeed.

Sex ed activist Shelby Knox writes in AlterNet, “If we can thank Mr. Souder for anything this week, it’s putting failed abstinence-only-until-marriage programs in the public crosshairs once again.”

Rand Paul: Fairweather libertarian

Last week, the Republican senate candidate in Kentucky, Rand Paul, made headlines when he argued that Civil Rights unjustly infringed upon the right of private business owners to segregate their establishments by race. Astonishingly, some liberals rushed to defend Paul against charges of racism on the grounds that he was merely expressing “principled” libertarian views. On this view, Paul’s not a racist, it’s just that the country would be a lot more racist if he were in charge. Comforting?

Katha Pollitt of the Nation points out that Paul’s “principles” are very selective. He wouldn’t dream of restricting a Woolworths’ right to hang up a “whites only” sign, but he’s perfectly comfortable using government power to restrict a woman’s right to choose:

In countries where abortion bans are taken seriously, the prospect of performing even the most medically necessary abortion terrifies doctors and hospitals. Law enforcement treats miscarriages as possible crimes. Women and doctors go to prison. How does a police officer showing up at a patient’s hospital bed to question her as a possible murderer, with a mandatory investigation of the premises of the alleged crime—her vagina and uterus—square with libertarianism? Like his support for increased Medicaid payment to physicians, a profession he just happens to follow, the exceptions to Rand’s libertarianism miraculously track his own preferences. Somehow the market, which is supposed to miraculously produce food that doesn’t poison you, cars that don’t explode, oil wells that don’t pollute and mines that don’t collapse, is useless when it comes to forcing women to stay pregnant against their will and making sure doctors make plenty of money.

The only way Paul can keep the libertarian high ground is if he comes right out and says that women are the property of men.

Red tape effective barrier to abortion access

Jodi Jacobson of Rewire reports on a new study by the Guttmacher Institute on why so many young obstetrician-gynecologists who are trained and willing to provide abortions don’t end up offering those services. The findings are based on interviews with 30 OB-GYNs who completed their residencies between 5 and 10 years ago. All received abortion training; 18 said they intended to provide elective abortions, but only 3 were actually doing so.

The doctors said that they were unable to offer the service because of formal and informal restrictions imposed by group practices, employers and hospitals. This small, qualitative study points to an unexpected conclusion: When it comes to abortion access, red tape can be a bigger barrier than the threat of violence, at least among doctors who have already decided to provide abortions.

Kagan Hearings Set for Late June

In other news, confirmation hearings for Supreme Court nominee Elana Kagan are scheduled to begin on June 28. No doubt abortion issues will remain in the spotlight in the weeks ahead. Hopefully, pundits will remember that Supreme Court Justices wear robes to work and stop obsessing about Kagan’s wardrobe.

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Roundups Sexuality

This Week in Sex: Why Men Fake Orgasms and How Real Ones May Help Them Avoid Prostate Cancer

Martha Kempner

Many men pretend to have orgasms to make their partners feel better—and report higher levels of sexual satisfaction, at the same time. Another study suggests that the more ejaculation, the better if men want to reduce their prostate cancer risk. And there may be more help for women with sexual arousal problems.

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

When Men “Fake It,” Their Motives Are Often Altruistic 

In the pilot episode of the TV show Masters of Sex, Dr. William Masters seems shocked to learn that women might fake orgasms. When he asks his new assistant, Virginia Johnson (who becomes his research partner and later his wife), why women might do such a thing, she replies: “To get a man to climax quickly. Usually so the woman can get back to whatever it is she’d rather be doing.”

Masters and Johnson, whose real-life work and relationship was fictionalized in that Showtime series, were pioneers of sex research in the 1950s and 1960s. Those who follow in their footsteps today are still trying to answer some of the same questions.

A new study from two Canadian researchers looks not at why women fake orgasms, but why men do—and what, if any, correlation there is between faking it and relationship satisfaction.

Researchers surveyed 230 young men between ages 18 and 29 who had admitted to faking an orgasm at least once in their current relationship. Using an online survey, they asked these men at what point in their relationship they began to fake orgasms, how often they did so, and why. They also measured sexual desire and relationship satisfaction.

On average, the men began faking orgasms 14 months into the relationship. On average, the men said they faked an orgasm in about 30 percent of their sexual encounters; 71 percent of participants reported having faked an orgasm during penile-vaginal intercourse; 27 percent during oral sex; 22 percent during anal intercourse; 18 percent during manual stimulation by a partner; and 5 percent while being stimulated with a sex toy by a partner.

Many of the reasons the men gave for faking orgasm revolved around making their partners feel better—including giving their partner an ego boost, feigning simultaneous orgasms, or avoiding upsetting their partner.

Interestingly, men who faked it for these relationship reasons tended to report higher levels of sexual desire. The authors theorize, “It is possible that men feel good when giving a partner pleasure, either out of love and generosity, or because it provides indirect reassurance of their own sexual adequacy, leading them to associate this reward with sexual activity, further leading them to seek more sex (i.e., experience higher levels of sexual desire).”

Men who faked orgasms also had higher levels of relationship satisfaction, though the authors point out that pretending might not lead to relationship satisfaction; those who are already satisfied may be more likely to fake orgasms for the sake of their partner’s feelings.

While it’s reassuring to know that some men fake orgasms for altruistic reasons, we here at This Week in Sex are not big fans of the fake orgasm, regardless of the gender or the reason. Once in a while is understandable “to get back to whatever it is [you’d] rather be doing,” as Johnson said. But, for the most part, we think it’s better to talk to partners about why you didn’t have a real one this time and what could be different next time.

Is Frequent Ejaculation a Cancer Prevention Method? 

Another new study found that men who ejaculated more frequently were less likely to be diagnosed with prostate cancer. Researchers followed about 32,000 men for almost 20 years, using the national Health Professionals Follow-up Study  at the Harvard School of Public Health. The men were all in their 20s when the study started in 1992 and therefore their 40s (or close to it) when it ended in 2010. They filled out questionnaires that asked about their sexual behavior (including masturbation), and researchers also looked at the men’s medical records.

During the course of the study, about 4,000 of the men were diagnosed with prostate cancer. The researchers’ analysis showed that men who ejaculated at least 21 times a month in their 20s were 19 percent less likely to be diagnosed with prostate cancer than men who ejaculated no more than seven times a month at that age. Similarly, men who ejaculated more often in their 40s were 22 percent less likely to be diagnosed with prostate cancer diagnosis.

There are some limitations of the study, including the possible inaccuracy of self-reported data on ejaculation and the lack of diversity among participants. In addition, one urologist who spoke to Reuters questioned the fact that the relationship between ejaculation and prostate cancer applied mostly to less invasive forms of the disease. Dr. Behfar Ehdaie of the Memorial Sloan Kettering Cancer Center in New York, who was not part of the study, noted: “If ejaculation frequency was truly a causal factor for prostate cancer development, we would expect to find the association across all prostate cancer risk categories.”

And, of course, correlation does not equal causation. There could be other reasons that men who ejaculate less often are more likely to get prostate cancer. Specifically, as study co-author Dr. Jennifer Rider points out, men who ejaculate less than three times a month may be suffering from other health issues.

Still, there could be a prevention strategy in the findings. Rider told Reuters in an email: “The results of our study suggest that ejaculation and safe sexual activity throughout adulthood could be a beneficial strategy for reducing the risk of prostate cancer.”

Given that ejaculation tends to be enjoyable, it seems like a pretty good idea to try even while more research into the correlation is being conducted.

Emerging Options for Women With Sexual Arousal Issues

When the drug Addyi was under development, people referred to it as “female Viagra” because it was intended to address women’s sexual dysfunction. But the two treatments actually work very differently. While Viagra causes an erection by increasing blood flow to the penis, Addyi (or flibanserin) works on chemicals in the brain to increase sexual desire.

Now, researchers are developing a new treatment for women that is actually much more similar to Viagra. A company called Creative Medical Technologies filed a patent last week for a treatment that uses regenerative stem cells to increase blood flow to the vagina. Unlike Addyi, this treatment is designed for women who desire sex but are having trouble becoming aroused. Increasing blood flow to the vagina can cause the clitoris to become erect and the vagina to lubricate, both of which are important parts of the arousal stage of sexual response.

The treatment still needs more research and, of course, FDA approval, which was a very controversial process for Addyi’s maker. Moreover, it’s not clear how big the market is for female sexual dysfunction treatment, as prescriptions for Addyi have been low since its market release last October.

Commentary Abortion

Your Right to Abortion Care Is in Danger—No Matter Where You Live

Katie Klabusich

Since the Supreme Court gave people in the United States the legal right to abortion care with Roe v. Wade 42 years ago, residents of historically “safe” states have too frequently taken our access to reproductive rights for granted.

Read more stories commemorating the 42nd anniversary of Roe v. Wade here.

Since the Supreme Court gave people in the United States the legal right to abortion care with Roe v. Wade 42 years ago, residents of historically “safe” states have too frequently taken our access to reproductive health care for granted. As someone who has lived in the blue states of Illinois, Maryland, New York, and now California, I’ve seen the pervasive assumption by those who identify as pro-choice that candidates on the left will prioritize access to abortion care—and that we need to do nothing more than dutifully pull the lever for them each November.

This is simply not the case. It’s time we in blue states engaged en masse to demand bold, proactively pro-choice talking points on the campaign trail and in platforms from our would-be legislators and direct action from current office-holders. We should be aggressive about storytelling to end stigma, changing culture by posting our lived experiences on our social media networks, and normalizing abortion care so others in our networks also expect and demand access. If we do not curb our complacency, we risk the complete curtailing of our rights.

Those of us born around or after 1973 often have little, if any, personal connection to the time of abortion prohibition. We assume that although individual legislatures might propose, and even pass, bills restricting our rights, they’ll never get away with it in the long term. After all, we think, that’s what the court system is for! To protect us from extremist legislators and their fits of fancy! We rely on the courts because the media typically refers to Roe as the presiding law without including the effects of Planned Parenthood v. Casey, Gonzales v. Carhart, or other successful measures that have chipped away at our ability to obtain abortion care over the past few decades.

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Week one of the 114th Congress should have gotten everyone’s attention. With the reintroduction of the “Pain Capable Unborn Child Protection Act,” which would ban abortion after 20 weeks in all states, the GOP-led House of Representatives declared its top priority for the session: the contents of Americans’ wombs. The following day, not to be outdone by his pseudoscience-obsessed colleagues Reps. Trent Franks (R-AZ) and Marsha Blackburn (R-TN), Sen. David Vitter (R-LA) picked up the anti-choice baton by proposing four abortion-restricting laws. Vitter’s bills would see Planned Parenthood completely stripped of federal funding (a fight that led to the last government shutdown), outlaw the non-problem of sex-selective abortion, require admitting privileges for all providers, and allow doctors and nurses to refuse abortion care even in life-threatening situations.

These restrictions would endanger abortion access in every state: red, purple, and blue.

Currently, we have a presidential veto to fall back on. With primaries less than a year away and a new administration around the corner, however, that safeguard is not ensured. We can’t wait for that uncertain outcome to urge our elected and would-be legislators to make reproductive health care a priority.

And for those of us in progressives areas, our rallying cry must not simply be, “Please don’t let those restrictions creep across our state’s border!” It’s not just unconscionable for us blue-staters to breathe sighs of relief, confident that our access to safe, legal abortion care will hold as we watch it crumble for our neighbors in red and purple states; blue state access has been slowly and quietly eroded as well. If you’ve been one of those people waiting for restrictions to affect you before engaging, consider this your call to enlist: Your state is not safe, and your rights are not guaranteed.

This year, the Guttmacher Institute deemed more than half the states in the nation to be “hostile” to abortion care. Twenty-four prohibit Affordable Care Act (ACA) health insurance plans from covering abortion, most with only extreme exceptions such as in cases of rape or incest. Eighty-seven percent of U.S. counties have no abortion provider. None of these anti-choice environments are limited to red states.

In fact, in a recently released report card on reproductive rights and health from the international nonprofit group the Population Institute, only 17 states managed a rating of B- or above, based on a combination of factors that include affordability, implementation of comprehensive sex education, and access to clinics and emergency contraception. We should not look at the report card itself as a comprehensive depiction of the health-care access situation in the United States; after all, those of us living in the four A-rated states—California, New Mexico, Oregon, and Washington—can and do face significant barriers to abortion care. My newly adopted home of California, with its vast social safety net and recently enacted abortion provider-expanding law, still only offers care in 55 percent of its counties. My ACA plan through Blue Shield of California may have recently updated its policy to remove the words “medically necessary” from the abortion provision, but I’m still going to fork over substantial travel costs in order to use the coverage I pay for if I move to a rural area. This means none of us can afford to thank our lucky stars and call it a day. People are already being left behind in the “A” states—with more in jeopardy if we don’t safeguard against restrictions enacted on a national level.

In fact, the only reason we aren’t worse off nationally is the implementation of the ACA’s contraception mandate, which greatly improved prevention across the country. When it comes to the Population Institute’s report card, the ACA should have led to drastically higher marks, but thanks to the 231 laws enacted at the state level over the past four years, we’re barely clinging to our C grade overall. And we’re in serious jeopardy of backsliding.

So those of us in blue states with friendly representatives and the rare, but not yet extinct, pro-choice champion must make a habit of letting our legislators know we oppose coverage bans like the Hyde Amendment. When Congress debates a federal budget, Hyde will be reintroduced—as it is every year—in order to prevent Medicaid funds from being used to provide low-income Americans with safe, necessary abortion care. Furthermore, we must also press them to stand against TRAP (targeted regulation of abortion provider) laws that would make it even more difficult for patients to realistically access care. Legislators from conservative districts will seek to continue the tradition of punishing the poor, so we need to embolden our blue state reps by writing, tweeting, and signing petitions asking them to speak for us as well as for those whose representatives work against their interests.

Roe should have been more than a court decision; it should have cemented the right to safe, legal abortion care for all. That is not the case. As of 2012, just 15 percent of Americans said they required a candidate to agree with them on choice—but far more than that will be directly affected by the decisions their candidates make on their behalf. The time to ramp up our stigma-fighting, legislator-lobbying, and capitol-protesting is right now. Legislators in the state houses and in Washington need to hear loud and clear that bodily autonomy isn’t something we take for granted and that we expect them, no matter the ZIP code of their constituency, to affirm our right to decide what happens in our doctors’ offices.

Become part of the storytelling movement—something anyone can do in any state. Speak out against red-state-shaming and lift up the activists fighting uphill battles in their extremist state legislatures. And find out the state of access in your ZIP codes: Are there clinics? If so, do they need support, volunteers, or advocates? What’s the policy on sex ed in your school district? The full slate of positive reproductive health-care policies gets a massive lift when complacently pro-choice blue state residents get off the sidelines.

Take this week’s recognition of Roe and run with it. Use the anniversary as an excuse not just to demand proactive policies from your legislators, but also to discuss abortion and the reality of access in your networks. Then keep at it as though your bodily autonomy depends on it. Because, no matter where you live, it does.