Over the past few months, geeks, scientists, writers and presenters have been mulling over how to raise more funds and awareness for libel reform. This follows a number of recent high profile libel cases in the UK which have been seen as attempts to silence debate – particularly in areas of health and science.

While the Libel Reform Campaign has been involved in a number of activities to boost awareness, those of the geekier persuasion wondered if there might be something they could also contribute. After some discussion a charity calendar was hit upon as a way of uniting and celebrating geekiness in all its guises – while celebrating a good cause.

A number of high profile scientists, writers, artists, performers and broadcasters were invited to take part – including Simon Singh, Gia Milinovich, Jonathan Ross, Brian Cox, Chris Addison, Ben Goldacre and Evan Harris.

I was particularly glad to see several of my favourite journalists, artists and performers featured including Aleks Krotoski, Hannah Devlin, Adam Rutherford, Mark Henderson, Ed Yong, and Matt Parker.

The calendar was put together by a team of enthusiastic volunteers including
Alice Bell, Louise Crane, Mun-Keat Looi with photographers Ben Gilbert and Greg Funnell. Each ‘geek’ had a photo depicting different aspects of their lives, work or hobbies. Everyone involved with the calendar gave up their time for free.

Given this stellar line up I was massively surprised and extremely flattered to be asked to feature in the calendar. Although I’d deny it if you asked me, it’s fair to say I am a geek. I’m fascinated with research methods, the whole process of research and how it works, and deconstructing how we study people in the health and social sciences. I’m obsessed with critical appraisal and applying evidence to practice and evaluating our health and educational activities. I’m driven to improve research practice internationally, along with increasing our understanding of research ethics, and the safety and wellbeing of researchers. Clearly when your interests are that dull you need to liven them up – and I do that through adding sex to the mix. You’d be amazed how much more understanding research governance becomes if you’re considering the ethics of studying our intimate lives.

Once I’d agreed to take part the dilemma of what we’d do for my photo shoot began. I was offered the choice of how I’d like to be photographed, with ideas from shoots already undertaken provided for inspiration. With that encouragement my first choice was to recreate this shot of Josephine Baker with her cheetah Chiquita*

Ms Baker is my hero and has been since I first saw a photo of her when I was six. I thought she was the most glamorous woman I’d ever seen. I still think that. Having a pet cheetah was the icing on the cake. In true geek style over the years I’ve been obsessed with La Baker, her career, her values, her trials and tribulations and her achievements. (If you’d like to know more about her this book is a great introduction).

However, I wasn’t sure my fandom of Baker would be clearly conveyed within the calendar, and anyway I couldn’t find a co-operative cheetah for love nor money. So that idea was out.

Because my research involves talking to people about sensitive issues photographing me actually doing any research or training introduced ethical problems around consent which made that kind of photo shoot inappropriate for a calendar.

Since sex research and education is so important to me I really wanted to have a photo shoot that captured that passion, as well as indicating how varied sexology is – and why it’s important.

So we eventually settled on a shoot at Crossbones Graveyard in Southwark. If you’ve never heard of it you wouldn’t be alone. It’s a pretty much forgotten part of London where ‘single women’ (aka prostitutes) were buried, along with paupers (male and female), and infants. Although it’s part of old, hidden London people clearly haven’t lost touch with their history as the gates of the old graveyard remain adorned with ribbons, mementos and messages to ancestors and those who have passed more recently.

I thought it would be an excellent choice of venue because history is vital to sex research – you can’t understand your present situation without understanding what has come before. Given the histories of the poor, the oppressed and particularly sex workers is so often airbrushed from our cultural memories, the idea of commemorating those who lie buried at Crossbones was a privilege. It also drew together for me the core aspects of sex research – understanding history, geography, anthropology, plus documenting and interrogating people’s lived experiences. I hoped including it in the calendar would encourage people to think more about those we often ignore and overlook, those whose sexualities or sexual lives differ from our own.

Knowing those buried there included sex workers, unmarried mothers, impoverished fathers and infants drew upon my commitment to researching and educating in sexual health. It reminded me why this work is so important – and how gender and health inequalities have harmed and oppressed in the past and continue to do so today in many parts of the world. The tributes to infants who’ve died that are still lovingly placed at the memorial also serve as a poignant reminder for any of those working in reproductive and maternal health (and more personally for those of us who have lost a baby through miscarriage, stillbirth or cot death).

As you can see I didn’t make this choice lightly. One of the core criticisms made by sex workers regarding how they’re represented by research revolves around being misrepresented, patronised, sidelined or spoken for. The frequently made criticism that (some) academics work ‘off the backs’ of sex workers and benefit (while workers may not) always needs remembering – even if those being represented in this case have long departed. In choosing Crossbones as a venue I didn’t want it to seem we were ignoring those who lay there, nor that we were glossing over or in any way making light of their histories.

This extended to how we’d photograph the gates of Crossbones. Among the ribbons and adornments include many messages, including names and personal details of people’s relatives – many of which are deeply moving. Some of which speak of very recent losses. All of those involved in the calendar felt it wasn’t appropriate focus on this identifying information and so we used the gates as a backdrop to avoid this.

Aside from the wish to link with sex worker history there were additional reasons for me wanting to be photographed south of the river. Apart from being proud of my South London roots (I was born in Lewisham), other members from my family on my father’s side come from Southwark. I have also worked with healthcare practitioners and young people across many South London boroughs, as well as conducting research (with colleagues) on modernising sexual health services there.

You can see an additional write up on the actual process of the photo shoot here and background photos here.

UK libel laws currently restrict our ability to raise questions about many social and health issues. The fear many journalists, bloggers, academics and activists have around being sued for asking questions or highlighting inequalities or poor practice has a potentially devastating chilling effect. We can all do our bit to challenge this problem but you can do something right now by ordering a calendar (you can buy one here).

And to give you a little more inspiration here’s a trailer of the calendar showing the geeks in all their glory….

* most accounts of Baker refer to her having a leopard although I’m told on good authority she actually owned a cheetah.

This post is based on a true story. I’ve altered identifying details, but the events described are real. I wrote it a while ago as a training activity for healthcare practitioners to consider some of the fuzzy boundaries that exist around mobile technology and our working practices. In an era where we’re eager to use new technologies to improve healthcare and health education there can also be hidden issues we’ve perhaps not focused on as much as we should.

See what you think about the case described below. What would you do if you were the healthcare practitioner, the patient, or the carer talked about in the story?

Darrell, a newly qualified physiotherapist was talking animatedly with his colleagues over lunch about a new patient Ketan, a six-year-old boy recovering from a car accident that had left him with severe leg injuries. ‘He’s amazing’ enthused Darrell, explaining how Ketan was slowly learning to walk again, ‘here, let me show you’. Darrell produced his mobile phone, and after pressing a few buttons showed his colleagues a series of photographs. There was Ketan concentrating hard, frowning as he performed his exercises. Next a shot of the injured leg, followed by a beaming Ketan giving a gap-toothed grin and thumb’s up to the camera. Louise, one of Darrell’s co-workers was the only one to appear concerned. Raising her voice above the ‘isn’t he adorable?’ comments of her colleagues she asked ‘is it okay to take pictures like this?’ ‘Oh yes’ Darrell reassured her ‘I asked Ket’s mum and she said it was fine, in fact, here they are together’. A fourth photograph was shown, picturing a smiling Ketan seated on his mum’s lap, pointing at his leg, whilst she looked uncertainly into the camera.

Darrell’s case probably isn’t that unusual. With new technologies it’s now easier than ever to capture a memorable moment, and that includes colleagues, patients and their families. Darrell wasn’t using the images for research or training, he was inspired by Ketan and wanted to share that feeling with others. He genuinely meant no harm. Ketan was clearly happy to show off his ‘poorly pins’ as he and Darrell had come to name them. Ketan’s mum probably was happy that such an enthusiastic health professional admired her son enough to take his picture.

But would she have agreed so readily knowing Darrell intended to show the picture to his colleagues, friends, and relatives? Perhaps Ketan’s mum thought that Darrell’s photo taking was part of his job, so didn’t question it. Or maybe she felt unable to say no. Given many people aren’t aware you can take photographs with mobile phones Ketan’s mum might not have even been properly aware that pictures were being taken.

Consistently we ask patients to share their stories, lend us their images, and let us sample bits of their bodies. We use this to diagnose, help and treat patients, to teach medical students, or to make new discoveries in research. Patients can expect to be asked to share their histories, be photographed, filmed or audio taped. That doesn’t mean they always understand what they are consenting to, nor have control over how the information, images, or samples they provide will be used.

And outside of this process are the health care staff like Darrell with their own agendas. They collect images or stories to explain their work, to move others as they’ve been moved, or even to make themselves look good in front of friends and colleagues. Maybe like Darrell they show a picture of a cute case study, or perhaps regale squeamish friends down the pub with a story of a particularly gruesome illness or difficult patient. Shouldn’t we be training our staff to respect patient confidentiality and privacy? Or in criticising someone like Darrell are we stifling their skills, and denying them job satisfaction?

In an era where public access is greater than ever, where we’re used to seeing candid shots of celebrities, Darrell’s behaviour isn’t out of place. But in a hospital setting where his job is to provide care, is it appropriate? Ketan’s recovery made a remarkable story – but maybe it wasn’t Darrell’s to tell.

June 14 to 20th is Men’s Health week, with numerous practitioners, charities and healthcare organisations hosting events and conciousness raising activities.

One area that probably won’t be falling under any of the public campaigns for Men’s Health Week – but ought to be a priority for us to tackle – is taking on the organisation known as the Advanced Medical Institute.

You may remember I’ve covered this organisation previously. It is notorious within Australia, the UK and other parts of Europe for aggressively selling products to men for erectile dysfunction and premature ejaculation. Over the past year the number of emails I’ve had from men who’ve had distressing experiences with the company has increased every month, many asking if there is anything I can do to help tackle AMI. As more men have bravely decided to start speaking out against the organisation I think it’s time we offered them some support.

Concerns about AMI are numerous. These include:
- The sales techniques used by the organisation
Men who contact the organisation do speak to a medic (more on this shortly) but mostly discuss the products they want to purchase with salespeople from the organisation. They use particularly emotive and distressing techniques to get men to place an order. I have heard taped conversations with staff from AMI and read transcripts of calls. If men hesitate over purchasing their products AMI staff tell them their wives will leave them or have affairs if they do not buy their products. Salespeople tell men their partners are lying if they’ve not complained about the situation or have been supportive of them. Men are also told they are ‘losers’ for having psychosexual problems. Medics working for the company tell men not to talk to their GP and advise their GP’s won’t know about the products AMI offer and don’t fully understand men’s psychosexual problems. They also wrongly advise men there is no help for psychosexual problems on the NHS. Men who have had experiences with the company have complained of inadequate medical history taking or staff not taking account of existing health problems such as epilepsy. Men calling with psychosexual problems linked to their sexuality, body image etc have told me these issues have been ignored by the company who solely focus on a medical solution and advise against seeking further psychosexual counselling.

None of these activities are ethical or acceptable within clinical practice or psychosexual therapy. A man seeking help and advice needs to be giving a thorough medical check as well as a sensitive sexual history. Factors indicating existing health problems need investigation as do any symptoms or behaviours suggesting psychosexual therapy is more appropriate. Certainly no reputable practitioner would pressure someone into any treatment, nor call anyone struggling with problems a ‘loser’ or threaten their spouse would leave them or cheat if the refused treatment. These aggressive sales techniques are applied only when men appear to be deviating from purchasing AMI products – for example questioning the cost of items or asking whether it’s okay to also speak to their doctor.

-Misleading advertising
Aside from adverts in newspapers and on billboards causing offence, there is some suggestion men see the adverts as a form of helpline. So when they call the organisation it may be unclear it is simply designed to sell a product. Talking to a salesperson on the phone may be confused with a counsellor (partly because they are referred to with titles like ‘clinical co-ordinator’), and because men also talk to a medic who takes their sexual history. This is used to establish the men are eligible to purchase products, not that they necessarily have a psychosexual problem. However this is not clarified to the client. Those who have seen AMI staff at their offices report similar confusion and even greater sales pressure techniques used in face to face settings. If you check the company’s website it implies there is no sales pressure and people can opt out, however this does not happen in practice and those approaching the company through hearing about them from newspapers or billboards have no information on consumer rights.

- Purchasing Policies
Aside from the issues of advertising and sales techniques another major concern about the company is how much it charges for the products it sells. In calls I listened in to last year the salespeople (clinical co-ordinators) were telling clients the product costs “£75 a month with a £399 deposit up front, global cost of that with VAT is £1299 or you can do a one off payment of £999 that’ll save you £300 and that pays for everything in advance”. This is a lot of money for men to pay, however the stigma of sexual problems, fear of seeking medical advice or lack of awareness of where support could be given ensures men may well feel this is their only option. Particularly when aggressive sales techniques are additionally employed. However, men who have had experiences with AMI tell me that the contracts are difficult to break, cash continues to be withdrawn from accounts even if men ask for a refund or explain the products haven’t worked for them. In such cases men are either blamed for the failure of the product, or the company becomes unreachable. Most men I hear from about AMI are extremely distressed by the experience of talking to the company, and upset that the guaranteed refunds they were promised are not honoured. They are ashamed of their condition and using AMI and feel unable to get help from outside organisations to obtain a refund.

- The role of medics
Doctors are employed by AMI. Their job is to take medical histories from men seeking AMI products. Those who call or visit AMI are told the doctor’s medical registration number, although men I’ve talked to say they often don’t realise they ought to note this down. The medical histories taken seem acceptable although the psychosexual histories taken seem somewhat basic. Aside from the ethical question of practitioners working for companies that use aggressive sales techniques and inadequate refund systems, there is also the question that many practitioners working for the company appear to breach medical codes of conduct in the advice they give. For example dissuading men from talking to their GP about physical or mental health problems.

- What is sold
AMI’s website implies they offer a range of therapies, whereas they mainly focus on selling products for erectile dysfunction and premature ejaculation. While it seems the products sold are genuinely designed for use in these conditions, it is unclear how effective the products for premature ejaculation are – particularly delivered in a nasal spray form. Moreover, there has not been (to my knowledge) any investigation of what products men receive, whether they are genuine or effective. Given that many psychosexual problems are not easily ‘fixed’ with a medical intervention simply providing a product without additional therapy is likely to be ineffective – and may explain why so many men complain the products they get from the company do not work. Alternatively it could be because what they are sold are not effective/genuine products. Further testing would be needed to establish this.

If you’ve been affected by AMI, what can you do?

Contrary to what AMI may have told you, you can get help from your doctor about this. In the UK your GP is able to talk about psychosexual problems and refer you to a therapist on the NHS. Or you can refer yourself to one via BASRT. You should tell your doctor about your experiences with AMI as in many cases the encounter with the company seems to add to men’s distress and psychosexual problems. Certainly you should speak to your GP if you are experiencing erectile problems on a consistent basis as this may indicate other health problems (such as heart disease or diabetes). If you are worried about premature ejaculation therapists can help you learn stress relieving/meditation techniques or encourage using a condom that prolongs sex. More resources about help with premature ejaculation are described in this post.

Trading Standards can offer advice and you can find your nearest office via their website (linked). Suffolk Trading Standards have been particularly helpful and recommended that men also may wish to speak to staff at Consumer Direct for further ideas about making a complaint. You may feel very anxious about discussing such a personal issue but staff are trained to hear about such cases and will be sympathetic and discreet.

If you’re a journalist, blogger, health practitioner or member of the public who wants to take action, what can you do?
Men’s sexual problems are something of a joke, we don’t take them very seriously and the stigma associated with this area is part of the reason men feel unable to frankly talk about their problems or ask for help. While other areas within medicine/healthcare have been tackled by skeptics, medics and activists this particular area and company have not been really addressed. It is time that changed.

You can do several things. If you’re a journalist or blogger you can find out about the company’s sales techniques and investigate medics involved with the company. You can also investigate the company’s policies and practices around refunds as well as what is contained within the products they are providing. You can flag up some of the issues I’ve already highlighted here as more proof of bad practice as well as providing answers to some of the things we don’t fully understand about the company. Let me know if/when you do this and I’ll add links to any activity against AMI on this post.

If you’re a healthcare provider you may also wish to support such investigations, but you may also wish to focus more on making your psychosexual services on offer to men more readily available and accessible. Signposting men to clinics you may run or advice services can be invaluable. As can campaigning for more services on offer for men and their partners.

There are sources of help available to men in the forms of therapists, help groups and General/Family Practice. We need to all do our best to share widely this help is out there.

You can put pressure on newspapers who carry advertisements from AMI to drop these. Again you may wish to speak with Trading Standards about this. Name and shame newspapers who won’t do this.

AMI have been causing distress to men for years in the way they promote and sell their products. We should not let the fact their products are for sex-related problems distract us from the very real harms the company may be causing. Let’s work together and ensure this company is fully investigated and prosecuted as appropriate.

What made me start blogging?
Five years ago I sat down on a dark November evening and wrote my very first blog entry. It was a bit ranty. I’d been misquoted by a journalist and was anxious it would get me into hot water (again).

I didn’t have a game plan when I started blogging. My partner (who’s way more tech savvy than I am) thought it might be a good way of sharing ideas I was struggling to convey via the mainstream media (I was writing several advice columns in magazines at the time, as well as hosting a regular radio phone in for BBC Five Live).

I approached the blog as a form of therapy. I wanted to work with the media but was getting a lot of stick for it professionally (I’m an academic as well as a sex educator). Having a place to blog would allow me to correct any errors in reporting and disclose bad journalism. I even hoped it it might even let me bring evidence into sex/relationships reporting – and show it was possible to do so without things becoming worthy or dull.

One thing I felt sure of early on was this blog was something I enjoyed writing, but I wanted to be useful, and most importantly to deliver things about sex, relationships, science and journalism that readers wanted to know about. Which is why the blog has always been shaped by things you’ve asked for.

Readers make this blog (or “why don’t you have comments?”)
Last summer I asked regular readers to give me feedback on this blog and got some very helpful responses. It’s taken me a while to implement some of these, but I have now upgraded the blog to include the things you asked for – photos and images to liven things up, a better blogroll, summaries at the start of most entries so you can decide if you wish to read on. And categories. Something I didn’ think about five years ago and really wish I had. I’m now in the process of going back through all the 800+ posts and adding categories to them, which I hope will make this blog a lot more useful to you.

The one thing this blog doesn’t have is comments. I did start off having them, but encountered several problems. As I was offering advice within columns and websites elsewhere I hadn’t planned to also answer problems on this blog. However, not all readers understood this so I frequently found requests for advice on anything from infidelity to penis size included in discussions about blogs relating to research design or journalism ethics. This sometimes led to some readers mocking those asking for advice, which of course is completely unacceptable for me as an educator.

Moreover, I’ve always blogged openly – never behind a pseudonym. I work within the community on sex/relationships projects and educational activities (in the UK and internationally). This meant I was very accessible, and felt vulnerable when those whose comments were deleted or not posted, made very personal threats.

I found moderating the comments was time consuming and took me away from other educational activities which I felt were more worthwhile. So I decided to remove the comments option. When I’ve asked readers if they want them back the general response is ‘no’. That’s mostly from people who feel the blog’s a safe space to get information which they can use as they wish elsewhere.

Of course I strongly welcome respectful email feedback and am always happy to add information or correct errors within the blog. You’re always welcome to start discussions on other forums or your own blog about issues raised here. For now I’ve no plans to reinstate comments, but since I’m occasionally asked why I don’t have them I thought this was a good a time as any to clarify the issue.

Achievements so far
Having read back to 2004 I’m pretty pleased with this little blog. It’s nice to see it’s grown into a resource that people trust and enjoy reading.

The things I’m most proud to have written are activist blogs that highlight medicalisation, exploitation and abuse. These include the debates around female sexual dysfunction, questioning high street stores stocking ‘herbal’ erectile dysfunction drugs (not approved by the FDA), exposing the Advanced Medical Institute’s aggressive sales technique for men affected by premature ejaculation, or highlighting misleading media coverage of the availability of Viagra on the high street.

I initially planned to use the blog to set right bad sex coverage in the media (or occasions where I’d been misquoted). This has been a theme within the blog although I think it’s become more focused over time (although not necessarily less ranty than my very first post). I can’t say whether it’s made much difference to journalists, and I hope it’s not put people off working with the media. I’ve found it helpful to describe poor practice – not least because the general trend for ‘experts’ working with the media is to act grateful for any exposure, not publicly discuss poor experiences or document bad practice. Gems for me include an expose of GMTV sending a cab to my home at 6am on the off chance I might wake up and come to their studio. Or how a TV show wanted to discuss female sexual confidence without mentioning genitals or masturbation. Or some rather nasty experiences with snotty TV producers just after I’d had a baby. Not to mention the hilarious case of the science journalist who really took a dislike to me (and colleagues). Oh, and let’s not forget the journalist who wanted me to recommend them an ‘unethical psychologist’ .

Of course, the past five years have not been spent simply slagging off journalists. No. Sometimes I’ve also turned my gaze to bad science too. Where it’s been depressing to report on a carnival of studies which seem to set us back sexually. Studies complaining women orgasm too easily, or there’s a ‘clitorocentric conspiracy’ against the vagina, how sex with a partner is 400% better than any other kind of sex you might have, and you can tell whether a woman has vaginal orgasms by her walk.

Let’s not forget my other bugbears. The fake formula and shonky surveys and my goodness this blog’s a treasure chest for those. And if I’m not being irritated by that, then there’s always the problem of psychologists talking about celebrities, or the general ethical issues raised by Big Brother for me to moan about.

Of course, it’s not all been bad news. Anyone would think this blog is only about gripes and grumbles. I’ve always wanted to showcase a variety of sexual experiences within this blog and not just think about sex just for a Western audience. I’ll continue to discuss issues relating to sex and seniors; teenagers; disability; transsexuality; lesbian, gay and bi issues; open relationships; BDSM; sexual health; contraception; prostitution; pornography; reproductive health; pleasure; desire; asexuality; dating; psychosexual problems; showcasing great sex pioneers; talking about safer sex; and as many other topics as I can find for you to read about.

Where to next?
Unlike five years ago, I’m now thinking strategically about this blog – who it’s for, what it does, and seeking to find ways to assess any impact it may have. I’ve noticed over the years it sometimes deviates into areas that interest me, but may not appeal to all readers. So my aim is to ensure the focus of the blog remains around the core things you’re most interested in when you visit – sex, science, and media.

I’m currently involved in overhauling the site so in the new year I hope to have far more open access materials available for you – relationships and sex guides, information about sexual and reproductive health, more advice and links to sources of help, along with practical information for journalists, healthcare professionals, parents, teens and teachers.

I’ve been asked by many readers for more information about how to become an agony aunt/media sex educator, so I’ll be blogging about this – as well as how to write a sex blog – in the not too distant future.

I’ll also be making use of twitter soon, as sometimes I blog about issues people need to hear about fast (particularly developments in science/health), so hopefully that will make messages more accessible. I’ll let you know once I’ve sorted it.

Obviously I’d like to hear what you’d like to see. How would you like this blog to develop over the next year (or five!). Are there any particular things you’d like to see more/less of? Topics you want covered? People you’d like me to interview for the ‘quickies’ section of the blog? Campaigns you want covered? Let me know what your vision is for this blog.

So, happy fifth birthday blog. Big birthday kisses to those of you who’ve been with me from the beginning. For those of you who’ve only recently found this blog I hope you like it enough to stick around for the next half decade. I notice one of my favourite other blogs Mind Hacks has also celebrated it’s fifth birthday too, so congratulations to them.

Time to blow out the candles and make a wish. Of course, I can’t tell you what it is. You’ll have to come back in five years to find out if it’s come true.

On 12 November 2009 the Policing and Crime (P&C) Bill went through Parliament. The hotly contested and controversial Clause 14 – originally proposed to prosecute anyone having sex with a prostitute who was ‘controlled for gain’ (a vague and unworkable term) – was changed so people will now only be prosecuted for paying “for sexual services of a prostitute subjected to force”. This will now become law.

New legal changes will also be coming into effect soon. According to the English Collective of Prostitutes these include “a new definition of
“persistence” for loitering and soliciting which makes street workers more vulnerable to arrest; removing “persistence” from the kerb-crawling law so that guilt can be proved on the first offence; compulsory ‘rehabilitation’ orders, though the government has had to limit to 72 hours the time street workers can be detained before they are brought to court for breaching the order; more powers to close premises where they suspect that certain prostitution offences are being committed, including someone being ‘controlled for gain’; more powers under the Proceeds of Crime Act to seize people’s assets and property and profit from them”.

These proposed legal changes have been subject to political debate for many years now, and the P&C Bill was noteworthy for the deliberate disregard by many politicians for independent evidence on prostitution. Many academics, sex workers and those campaigning for better health and social support for anyone involved in prostitution see the proposed changes as continuing to put prostitutes at risk, and will continue to challenge the current trend of policy making based on opinion rather than evidence.

Still on the topic of prostitution the unmasking of popular blogger Belle de Jour has been a media favourite over the past couple of weeks. In case you don’t know the history Belle de Jour is a blog about a high class call girl that proved so successful it led to a book deal and spin off TV series. It also led to some frankly astonishingly bad sex features in women’s magazines (where high class prostitution was mixed in with aspirational and commercial sex messages). And complaints from some quarters that the TV series in particular was glamourising prositution. All the while debates in mainstream media raged about whether Belle really was a prostitute, or whether she was a male journalist making up stories.

It turns out Belle is a scientist, Dr Brooke Magnanti. She was a prostitute for several months after submitting her PhD thesis (a time well known for being strapped for cash and in-between jobs). Having already been a science blogger, she then blogged about her sex work experiences. This would have remained secret but an ex boyfriend threatened to out Dr Magnanti who decided it was safer to tell her own story to the media.

This has led to a really odd mix of media coverage with journalists expressing surprise that a smart woman was also a prostitute, rehearsing sad stereotypes about prostitution, and in the name of ‘balance’ contrasting Belle as the happy hooker with dismal stories of drugs and disease. It’s been open season to revive the ‘glamourising prostitution’ argument – although now with added bite as critics have a named person to go after, rather than an anonymous blogger.

Channel 4 news did host an interesting discussion on the topic (albeit with the standard hat tip to high class prostitution vs. murdered prostitutes – an unhelpful comparison which does nothing to respect the memories of those prostitutes who have been killed or injured).

This whole case raises a number of issues for academics and universities. We know from bitter experience that academics involved in prostitution (or who support sex workers) have faced discrimination at work. I’ve written a short piece for the Times Higher on this topic, feel free to join in the conversation about this issue that’s running below this piece.

Many of those involved in the debates and campaigns around supporting sex workers identify as feminist. It was unfortunate, then, that a key component of Saturday’s Reclaim the Night march focused on celebrating Clause 14 (see above). Given the fact that many sex workers had felt excluded by radical feminism in this debate – and many academics also felt the agendas and so-called ‘research’ of such groups was given greater weight by the government – it’s a shame the divide was further emphasised on an event that should bring women together. Not least sex workers who are more likely to be at risk from sexual violence. Penny Red has a candid take on this story, while Sarah the bringer of tea explains why trans women are also excluded by some feminists involved with Reclaim the Night. Distressingly it seems that a woman was attacked while on the demonstration (which is both ironic and depressing).

I’ve no quibble with the right to protest against sexual violence or for women’s safety. My concern, however, with events like this is they don’t present a safe space for all women and often have the effect of alienating the very women those organising such activities are claiming to protect.

The National Chlamydia Screening Programme has been reviewed by Dr Ruth Hussey for the Department of Health. You can read the five page summary here. This indicates there are concerns over whether the programme will be continued, too many (and as a consequence confusing) sexual health branding messages (via websites etc). The report also reveals problems with funding, agreement on which services are responsible for delivering testing, and PCTs that are not aware of/up to speed on evidence and so are promoting ‘good ideas’ rather than evaluated best practice. Well worth a read if you’re a healthcare practitioner, health commissioner or anyone working in sex education.

Spot what’s unethical about this research. A Leeds University professor asks four of their female students to hang out in nightclubs and observe whether women pull more men if they’re wearing more revealing clothing.

Following on from recent research about the lack of evidence underpinning cosmetic genital surgery The Guardian has an interesting feature exploring issues about vulval ‘enhancement’. While Vagina Dentata takes a more sex positive view with some handy hints for some vulva-related gifts. Just in time for your Christmas list.

Cory Silverberg has details of what promises to be a fantastic online course about Disability, Sexuality and Rights which could be very useful to those of you working in healthcare, education or social care.

If you’re around tomorrow evening you may want to pop along to Westminster Skeptics in the Pub where a number of science bloggers will be debating What next for science activism in the new media?. Here’s a summary of what will be discussed:

The rise of science blogging and the effective exploitation by activists, scientists, and science writers, of online communication has been a significant but fairly recent phenomenon. This meeting, which is an unofficial sequel to the Science OnLine conference in London earlier this year, will focus on the strengths and weaknesses of this phenomenon, both now and in the future. A stellar panel of Martin Robbins, Petra Boynton, and Hauke Riesch, as well as the writer of Gimpyblog and a writer from Evidence Matters, will set out their views on the current problems and challenges facing science bloggers, activists, and online communicators. They will reflect on what has so far been achieved and also offer thoughts and insights on what can – and cannot – be achieved next. This will then lead into a general discussion and Q&A session.

Hope to see you there!

Finally, you may have noticed I’ve organised the links on the blogroll over to your right. I’ve had a number of emails from people asking me to link to their blogs. Please do feel free to let me know of any blogs on sex education, activism or science/psychology/journalism you think I’d be interested in. I won’t endorse blogs that are judgemental, sex negative, promote commercial or aspirational views of sex that are unrealistic, or endorse outdated or unhelpful ideas. But I am happy to link to blogs that are evidence based, represent critical thinking, and are accessible.

A brief history of formulas as marketing tools

Over the past few years we’ve got used to seeing formula used as a promotional tool by PR companies. Sometimes these are simply presented as just a formula, other times they are fronted by an academic or other ‘expert’. This has presented problems for universities where staff members (or people claiming an affiliation with a particular institution) use the institution’s name as part of the formula promotion.

Critics of the ‘fake formula’ approach have argued they are often not based on sound science, make little or no mathematical sense, and usually seem to be created by the PR company for an ‘expert’ to front (although this is often disputed by those promoting formulas). There’s also the concern that such formula appearing in the media may devalue robust academic research and reduce public trust in science.

Those academics who do front such activity (and there’s a core group who specialise in this practice) argue they’re merely promoting science and engaging with the public. A view that might be easier to believe if the formula stood up to scientific scrutiny.

Until now, debates on this issue have focused on academics fronting formula, but recently PR companies have taken a new tack and have used undergraduate students to promote their products.

This raises a lot of issues for universities and students and we need to think carefully about how it ought to be addressed.

The new PR approach – the case of the ‘Perfect Night Out’
The case in question began with a competition for ‘Britain’s Best Job’. Drinks Company Global Brands wanted to promote VK Vodka Kick (primarily, it seems, at Fresher’s events). The job advert stated “Wanted! Talented maths or science student or graduate to spend the summer literally discovering the formula of fun. Must be over 18 years of age like bars, clubs and pubs and be prepared to have a fantastic time in the quest for knowledge, science and the pursuit of the perfect night out.” The press release also stated “But there is a serious side to this and the applicant will be expected to deliver a full thesis at the end of the trip that must stack up to academic scrutiny by Britain’s best brains”.

PR Company Brahm worked with Global Brands for this activity. 50 students applied, and one Biology undergraduate student from Leeds University was picked for the task – to identify the formula for a ‘Perfect Night Out’ (PNO) based on undertaking a survey, then creating the formula.

The report created by the student can be found here (as text document) and here (as pdf). (This was described by the PR company as the ‘full thesis ‘ that ‘Britain’s best brains’ would be scrutinising).

I will leave you to critically evaluate the student’s report. Further discussions of the formula comes courtesy of Steve at Irregular Shed. Meanwhile Tristan O’Dwyer at Cargo Cult Science tackles the wider issues about this formula in relation to science communication.

I’m going to focus on key methodological and ethical issues that the research invites, and the wider implications of such research for students and universities.

Perfect Night Out – Survey and Semi Structured Interviews
The survey can be found here. It mostly seems to be asking general questions about a night out. PR company Brahm confirmed the survey was designed by the student. While the questions may seem fairly standard (although not particularly robust) there is the wider issue of how this survey was conducted. The student’s report (linked above) states “an online questionnaire was completed by 2000 people (male and female) and had a 100% response rate”.

It is not made clear how this survey was delivered online. Who hosted the survey? How long was it available for? How were participants recruited? I’m also curious about the 100% response rate which is pretty much unheard of in genuine social research. I can only assume there’s been a misunderstanding in understanding completion and response rates.

Contradiction exists between the report and the promotional activity. The student’s report stresses data were collected by an online survey. But the Global Brand’s website show the survey being conducted inside clubs as part of promotional activity – for example at Chester University and Manchester Metropolitan University.

The student’s report does state they conducted additional semi structured interviews, but it’s not clear how many were undertaken and whether they based activity shown in the clips above (which indicate a survey being used, not semi structured interviews). It is therefore unclear whether the student knows the difference between the two methods, or whether reporting on two approaches is confused in their write up.

The report does not make it clear how the semi structured interviews and survey worked together. While it is perfectly fine to use a variety of methods within research (sometimes called ‘triangulation’) it is standard practice to demonstrate how those methods link together. In this report we’re told the semi structured interviews were carried out post survey, but not shown whether the survey answers informed the semi structured interviews or how both of these informed the subsequent formula.

Ethical questions about the research
What is more worrying is the study was conducted in part within clubs and social events. This raises key issues of researcher safety and wellbeing, ethics and consent. Those who may be drunk are not in a strong position to consent to research (and may pose potential risks to researchers or other participants). Indeed if you wish to study people who are drinking alcohol or may be drunk it requires particular sensitivity and ethical approval. [Leeds University confirmed this study was conducted independently of their institution and therefore had no ethical approval].

A press release for the activity states “The official VKendology tour will start on Saturday 19th September, where the Research Team will hit UK Student’s Union’s during Fresher’s Week and students will be in with a chance to win their Perfect Night Out.”

This indicates participants were directly incentivised to complete the survey, something that is frowned upon in reputable social research (and also requires careful management in market research). The mention of the ‘research team’ also suggests aspects of this work were not simply down to one student, a survey and subsequent formula. I’m not sure whether the ‘research team’ are actual researchers or glamorous guys and gals dressed up to deliver a survey (or both). I would question the former, as presumably anyone who did know anything about social (or market) research would know this activity wasn’t the most robust or ethical.

I would like to think this report and the research described represents something casual and fun, not the best quality work the student could offer – nor representative of research writing skills she may have been taught on her degree programme. There are key details missing and as a result the write up does not appear particularly professional or scientific (see critique and links above).

I can understand that this activity would appear very exciting. (In the past I have undertaken PR-based research and know how beguiling such an activity may appear – at first). In this case the student was promised loads of fun nights out, the promised opportunity to do a bit of science, the chance to get some media coverage – and most importantly for a student it also is a paid post.

My concern is that in undertaking such activity, what may look like a fun opportunity may result in numerous problems for students and Universities.

What issues does involving students in PR activity raise?
Firstly, we have the question of student wellbeing. Usually students who are conducting research will require ethics approval and tutor support for studies they’re undertaking. There are three main reasons for this:
- to protect the participants researchers are interacting with and ensuring they are not harmed by the research process
- to ensure the research undertaken is appropriate and of a high quality
- and to protect the wellbeing and safety of the researcher.

It’s easy to say in this case it was basically a promotional activity and nobody was likely to be harmed. The questions seemed innocuous and unlikely to upset anyone. However, if a participant had disliked the research, or someone had threatened or harassed the researcher, who would be responsible? The point of having ethical controls over research is to ensure people can’t be harmed, and that researchers don’t play god and decide just because they don’t think their research is problematic then it won’t be bothersome to the public.

University staff are often aware of students who don’t let them know about research they are undertaking, often trying ambitious projects without notifying tutors or gaining ethics approval for their work. This can make students very vulnerable.

If PR companies intend to continue to use this method of getting students to front their campaigns, who is going to look after student or participant welfare? (Particularly if the ‘research’ is of a more personal or invasive nature). PR companies are keen to use Universities to add clout to campaigns, but where do Universities’ responsibilities lie if the student technically undertakes work without informing them and any negligent or non negligent harms arise?

No doubt PR companies and the commercial organisations who hire students may care little about the actual quality of research and be in no position to check on key questions about consent, ethics and personal safety. That is why both researchers and participants could be at risk if such activity becomes standard practice.

We know researchers can and do make mistakes. In fact it’s part of the steep learning curve of being a researcher in the natural, health or social sciences. Usually such problems around misunderstanding methods or poor report writing can be overcome with tutor feedback and practice. And remain relatively private.

However, if you undertake PR activity like this you run the risk of any errors you make being picked up on in public. Already bloggers have begun critiquing this particular study for example here and here.

This raises further issues about student wellbeing. After all, if you undertake a piece of work that’s promoted as fun and exciting, but the backlash is to label you a poor scientist, then that’s got to hurt (it’s partly why I’ve not named the student in this blog and am focusing more on the wider issues this case raises as opposed to a personal attack).

But if you undertake research outside of your institution who will be there to support you when things might go wrong? And what issues might this raise for your future career if, when you apply for a job, you’re known not as someone who advanced public understanding of science, but someone who undertook a piece of substandard PR research?

There’s also the wider issue of student responsibility to their fellow students and academic institution. As well as thinking about your own possible career pathway, you also need to consider the impact of your work on the reputation of others who might be associated with you. You may not appreciate that presenting ‘science’ or ‘research’ in a particular way may actually make other genuine researchers lives a lot less safe, and recruitment a lot more difficult. Not to mention reducing public trust in science.

Sadly, not many universities teach this within methods training (and it’s fair to say many academics don’t always reflect in this way). You can see why an enthusiastic student being wooed by a PR company is probably not going to think twice about what the end result of their work might be for either their own reputation, or for those associated with their subject area.

I emailed Leeds University’s PR office to ask them if the student in question was studying with them (she is), whether she had applied for ethics approval for the study (no, since the research was not conducted as part of the institution), and whether she undertook the research in her capacity as a Leeds student (the PR office said no it was unrelated to Leeds, although they had put journalists in touch with the student so they could write their own stories/take photographs of her).

This is a key issue for me. We can’t really expect students to be aware of wider ethical and methodological issues that underpin research. That’s our job to teach them. We can’t blame students for wanting to earn cash and seeing PR activity as a fun way to do this. We can’t also blame students for being unaware of the background to the whole ‘fake formula’ issue (after all many academics don’t take it that seriously).

Universities and PR companies need to be responsible here. PR companies cannot use institutional names as part of promotional activity without ensuring that institution is aware of what they are doing and approves it. [Not that I expect PR companies to take any notice of this]. Universities also can’t play the ‘research wasn’t conducted as part of our university so it’s nothing to do with us’ line. If students are getting involved in so-called research activity and are allowed to be linked to it with mentions of the university in the press or passing on the student’s contact details to journalists, then the work is partly linked to the institution.

Universities need to be aware that the problem of PR activity in misusing scientific approaches has now been extended to students. They need to consider what this means for their students wellbeing and institutional reputation. Some institutions may not care, perhaps they’ll just be glad of some publicity. However there is the wider duty of care issue, and if any student is undertaking research-related work during their time studying with you then you have a responsibility to ensure you are aware of what they are doing and can ensure they work safely.

If PR companies are going to use students for promotional events then the media will report this and draw attention to your institution. Do universities want to be associated with studies that imply their teaching of research and ethics plus their pastoral care is substandard?

The problem is we have no clear guidelines on this issue. It is something that is new and many institutions won’t have had to think about it.

However, we’ve seen the uptake of using academics for fake surveys and formula has grown and it is likely using students (particularly to promote products to other students) could follow the same path.

The issue we must now face is what our approach should be on this issue. Let students do as they wish, so long as we can argue it’s not done in our name/on our time? Or take a stand and make it clear we do not endorse student activity in this way?

After all, if students really are keen to learn more about research methods, want to undertake studies, write reports, or bring science to the public there are numerous ways that can be done. As academics maybe we should make these opportunities more obvious (and focus on making our teaching of these topics more engaging).

Sure, they may not pay as much as a PR activity like this one. But in the long term they might be a whole lot better for a student’s reputation and personal development.

One story you can’t have missed in the past week or so was the sacking of Professor David Nutt in a situation where the government (yet again) disregarded evidence. Sadly it’s something we’ve got used to with this current administration. There’s been an interesting discussion about this over on Bad Science forums, although my favourite story on the issue comes courtesy of the Daily Mail whose attempts to smear scientists is pure comedy gold. I’d strongly recommend using this piece in teaching around journalism/science communication. I particularly like the Mail’s understanding of science as lab-based, unimaginative, not working in the real world, arrogant, and resistant to being questioned/challenged. Unfortunately many people also hold those views about science – although they probably don’t go as far as the Mail and equate scientists to Hitler :-0

While we’re on the topic of science communication and evidence based practice, here are two very useful dates for your diary. On November 16 2009 Westminster Skeptics in the Pub are hosting an event ‘Evidence based policy making’ with Dr Evan Harris MP and Professor David Nutt. On November 24 (again hosted by Westminster Skeptics) there’s an event ‘What next for Science Activism and New Media’ where a group of science bloggers and activists will be discussing issues around science communication and the impact of science blogging. If you’re a science journalist it would be particularly great to see you there to get some additional input from you about your views on science blogging/activism.

Stonewall hosted their annual awards ceremony this week (which seemed a lot less controversial than last year). They named journalist Jan Moir as their ‘bigot of the year’ following her attack on the late Stephen Gately. It’s always good to see those supporting LGBT issues rewarded, although while the folk at Stonewall are celebrating it might be worth looking to other countries where thinks are not so good for lesbians and gays. Like Uganda, who are seeking the death penalty for LGBT people (and requiring friends/family to turn in their loved ones suspected of being LGBT). It’s truly terrifying stuff, but worth reminding ourselves about the situation many LGBT people are faced with across the world.

I’ll leave you with a spoof documentary from The Onion about sexual arson (which actually does exist, although not perhaps in the way described in this clip

Crime Reporter Finds Way Of Linking Warehouse Fire To Depraved Sex Act