Provisional DSM-V available for comment – add your views now!

By Dr Petra | Published: 24 May, 2011

You may remember my previous post on the revisions being made to the DSM (Diagnostic and Statistical Manual of Mental Disorders). Over the past few years the existing DSM (IV) has been revised and the public invited to consult on its content. The DSM covers a range of mental health issues, which other bloggers and activists have been reflecting on. For the purpose of this blog I’ve focused on how the DSM will be approaching psychosexual issues – although it is worth noting concerns have been raised about how gender will also be approached (particularly around transgender issues).

The provisional DSM-V is now available for public comment, you have until June 15 to read, critique, question and add your views. Information about how to do this can be found via the DSM-V website .

To help us reflect on the psychosexual aspects of the provisional DSM-V I’ll draw your attention to the thoughts of the indomitable Leonore Tiefer who has shared these thoughts:

“Within the whole sexuality area, there are separate working groups (and webpages) dealing with Gender Identity Disorders and Paraphilias, but I will just comment here about the stuff on Sexual Dysfunctions since that has been our focus in the New View.

1) Without the introductory material, we cannot know the status in the DSM-V of “the human sexual response cycle.” Long-time New Viewers will know that our New View Manifesto is particularly critical of the reliance of the diagnostic nomenclature on the definition of “dysfunctions” as “disturbances in an assumed universal physiological sexual response pattern (“normal function”) originally described by Masters and Johnson in the 1960s” known as “the [sic] human sexual response cycle.” Our manifesto devotes quite a bit of space to criticizing “the shortcomings of the framework” and it remains to be seen how the DSM-V deals with this presumed biological bedrock.

2) Many many small details are changed in each and every category, and it is interesting to compare the wordings from the DSM-IV to the DSM-V as they are given on each dysfunction’s website. You don’t need a copy of the DSM-IV, as the DSM-V webpage for each dysfunction gives the proposed definition, the DSM-IV definition, the rationale for the change, and other material.

3) Those familiar with the New View will recognize the new and expanded qualifiers and modifiers that are attached to almost every dysfunction, including partner/relationship, individual psychology, and culture/religion as coming directly from our insistence that these contributing factors be recognized. While we were not the only ones arguing this need for contextualization, I think we were the most persistent, consistent, and insistent! However, we were arguing that these factors made a difference to sexual life, norms, experience, and expectations, and to see them here “used” to modify the presence, nature, and intensity of “disorders” is NOT altogether thrilling!!

4) The modifiers are absent from the “sexual aversion disorder” now renamed “Sexual dysfunction not elsewhere classified” which is preposterous, since every woman or man with sexual aversion that I saw in many years of sex therapy was chock full of partner, individual and sociocultural red flags. However, under “rationale” is the comment that the group isn’t yet finished with this category, so I assume we will see the modifiers in ALL the dysfunctions when the working group is finished.

5) It seems to me that larger swaths of experience are captured (i.e. medicalized/pathologized) in each category. I think this represents an attempt to do greater justice to the variability and diversity of sexual experience, and yet, paradoxically, it ends up putting more aspects of sexual experience under the medical gaze. Thus if simple-minded journalists ask us if the DSM-V represents a step forward or a step backwards, I suggest we say “Both”!

6) For example, look at Female Orgasmic Disorder. In the DSM-V you have a dysfunction if you are distressed about not having orgasms often enough OR concerned that they aren’t strong enough, whereas in the DSM-IV the only female orgasmic dysfunction was distress about frequency. Take a look at the rationale, and you see the apparently benign justification that since some women complain of reduced intensity, this should be included. Does this represent a more female-friendly approach to diagnosis? Yes, and no. Ultimately, it’s a more disease-mongering approach. I think the New View perspective is that women are being spooked by media, science, and “experts” on all sides to self-monitor their sexuality, inevitably creating distress insofar as sexual response and experience are notoriously variable and influenceable.

7) When you write to the DSM-V, don’t go on and on (the way I have here!!), but pick one point and make a strong argument. Maybe 200 words. Pick a dysfunction that you feel strongly about E.g., are you glad to see the disappearance of vaginismus and dyspareunia in favor of Genito-pelvic pain/penetration disorder? Do you think the changes in the orgasm category encourage hypervigilance? Do you think combining arousal and desire makes sense? Do you like the new modifiers/qualifiers or do you think they are window-dressing? Have they left anything out you wish were there (e.g., Male romance disorder)? etc.”

Tiefer makes some important points here about how psychosexual disorder is being characterised within the proposed DSM-V but you may also have your own thoughts about the way sex/relationships/intimacy is being constructed/pathologised when you read through the DSM-V draft.

Do please add your thoughts, send in your observations and particularly record any concerns that you have. It’s important we all try and do this if we are worried about medicalisation, commercialisation and sex. Many of the discussions on this topic have focused on female sexual functioning/medicalisation, but it’s important to note the DSM-V is also focusing on how male sexual problems are viewed, so focus your critiques here also. This is particularly important given how often male psychosexual issues and the manipulation of male anxieties around premature ejaculation and erectile dysfunction are ignored.

If you’re a journalist you may also want to use the pointers above to think critically about the provisional DSM-V, or more widely about how we conceptualise sex, gender and relationships.

Remember you’ve until June 15 to do this so get lobbying, write about this on blogs, share on twitter and where possible within the mainstream media and healthcare settings.

Posted in Activism and Open Access, Critical appraisal, Female Sexual Dysfunction, Medicalisation | Comments closed

¼ men worried about the amount of porn they watch online

By Dr Petra | Published: 22 April, 2011

There’s been a substantial amount of media attention today for a survey by BBC Radio One’s Newsbeat and the Portman Clinic. Suggesting porn ‘use’ among men is endemic and in many cases problematic.

It’s led to a slew of scary headlines including:

Men view two hours of porn a week – The Sun
Young men worried about the amount of porn they watch – Mirror
Men ‘worried’ about heavy online porn use

What did this survey cover?
This survey heard from 1057 18-24 year old women and men (no information available about how many males and females made up the final sample). They completed an online survey via TNS Market Research Company between March 18-21 2011. It asked about their porn consumption and attitudes to porn and relationships.

What were the main findings?
8/10 men and 1/3 women had looked at porn online
The most popular place to access porn was free websites
The ‘average’ man in study (no figures given for this) looks at porn for 2 hours a week, the average woman around 15 minutes
4% of male respondents ‘used’ adult sites for more than 10 hours per week – these were reported as having a ‘problematic and potentially compulsive’ condition
¼ men said they were worried about the amount of time spent looking at porn
¼ men said they were worried about the content of porn
61% of respondents (gender unspecified) said porn could make you less interested in sex with a partner

Should we be concerned about these findings? Not until we’ve looked more closely at this survey.

Problems with the survey
It is not clear exactly how participants were recruited/heard about this research. Market Research Company TNS administered the online survey but it’s unclear who responded, the characteristics of those who didn’t respond, and how representative of the wider population respondents were. The survey was only run over a three day period which is not unusual in commercial online surveys, but doesn’t always allow for generating reliable data – particularly about sensitive issues.

The full list of survey questions have not been made publicly available. Without these you can’t work out what people were asked. Whether questions were leading, potentially distressing, counteracted/contradicted each other, were confusing or didn’t match the final data reported.

I’ve spoken to nine journalists from different broadcast outlets about this survey over the past two days. All have called me for comment about the survey. All have taken it at face value. None had seen the original survey questions. None had asked to see them either.

This isn’t something unique to this Radio One survey however. Most commercial and academic surveys don’t make their original survey questions available when press releasing their work. It remains a problem as you cannot make any judgements about how useful a survey is without seeing what people were asked. This survey may have been amazingly well designed, carefully piloted, developed and run. Or it may not have been so stringently managed. The problem is without making both the methodology behind the research and the survey questions public it is impossible to know whether to trust in the data or not.

One question was reported in the Radio One report of the study. It asked ‘How have you ever looked at porn?’ It then gave respondents the choice of magazines, DVDs, TV, Free and Pay websites, mobile phones and file sharing.

The problem with questions phrased like this is they may look sensible at first glance, but actually are highly problematic and potentially meaningless.

If we take ‘ever looked at’ first, what does that mean? Ever looked at as in sat down, watched a lot and masturbated yourself stupid? Or ever looked at as in was shown by some mates for a laugh, or ever looked at as in accidentally found when looking for something else online or on TV?

‘Ever looked at’ seems to be taken here to mean regular porn use, or at least some porn use. Whereas it doesn’t tell us anything about the context people are viewing porn – or the amount. I may have ‘ever looked at’ porn once ten years ago and never again. But this survey would put me in the same category as someone whose ‘ever looked at’ definition included looking at porn several times a week over months or years.

The lack of clarity in the question also doesn’t explain whether people are looking at porn alone, with a partner, when single or a relationship. Nor address whether their porn ‘use’ is consistent over time or varies depending on their relationship status or other life events.

Also what does ‘porn’ mean in this survey question? Is it an erotic scene in a movie shown on mainstream TV? Tuning into Babestation? Reading Nuts, Zoo or Cosmo? Visiting YouPorn? This survey asked respondents to state the format in which they access porn, but they are not asked to explain what they mean by porn. That means we’ve no idea what it is they’re looking at.

This is a classic problem in poor survey design. That terms used aren’t operationalised. Meaning neither the respondents or the researchers actually have any idea what it is they’re asking about, or what the data means when it comes back.

‘Heavy’ porn use was described in this survey report as 10 hours or more. But it is not clear how this was decided upon as a measure of ‘heavy’ use.

¼ male participants stated they were worried about the amount of time they spent looking at porn. But since we don’t know what they were asked we can’t tell if this was based on a leading question, or whether they would have said they were worried if not prompted. It doesn’t tell us what exactly they were worried about (i.e. did they think they were spending too much time in general online, or had a specific concern re porn use).

¼ respondents also said they were worried about what they were looking at, but we can’t tell from this whether this meant they’d already stopped looking at the problematic porn. ‘Worried’ by content doesn’t tell us whether they had issues over the wellbeing of actors in porn; a person’s sexual prowess in comparison to what they were viewing; or whether their gender, sexuality or relationship was being challenged by the things that they found a turn on. In short we may know a fair number of participants expressed concern, but we’ve no real clue about the source or magnitude of that worry.

Usually with media surveys of this kind the standard approach is back of the envelope question design, based around a predetermined angle that’s being picked to generate publicity. Radio One aren’t unique in this approach (although they do have form for running similarly questionable sex surveys in the past). It is likely this current survey is more about generating publicity for Radio One and Newsbeat than really addressing issues about our relationship with sexually explicit materials. It seems the main purpose of the survey was both to inform a report for Newsbeat and draw attention to said programme.

Unusually this research has teamed a media outlet (Radio One) with clinicians from an NHS trust. Specifically practitioners from the Portman and Tavistock NHS Trust who apparently designed the survey.

This raises more complex issues than just the usual shoddy media approach to surveys. If NHS staff are involved in research they ought to be grounding this within a critical appraisal of the published evidence in this area. They also ought to ensure they employ research tools correctly (in this case completing a quality survey, piloting and reviewing it – or better still basing it on an existing measure). And if they’re doing the work on NHS staff or patients or in their role as an NHS clinician then it ought to be subject to ethical approval.

Not all health research is subject to peer review, but usually if a survey is going to be made public – either through publication in a journal or through a report launch or similar – then you would expect a thorough peer review of the work before it hit the headlines. Peer review here could have helped spot potential problems in both survey design and delivery, and ensure the relevant background literature (of which there is a lot in this area) had been carefully consulted. It would also have guarded against making claims that go beyond the data.

This may have happened in the case of this survey but that information has not been made transparent. If that is the case it is a pity since it doesn’t put the research in context nor show it in a good light. If these checks and balances hadn’t been put in place again transparency might help us assess whether this work is reliable or not.

Given the example of the questions asked of participants along with conclusions drawn it does raise serious questions about the quality of the survey. Along with the ethics of using such a tool to draw clinical conclusions – as has happened around the diagnosing of those with ‘heavy’ porn use.

Journalists I spoke with about this survey felt the inclusion of medics in the survey meant it was more trustworthy. One said to me that because a doctor had designed the survey it had to be good. As someone who’s been teaching medics internationally how to evaluated, design and use surveys in health research for the past fifteen years; I can confidently report most are pretty dreadful at this craft. Indeed, as with any other social research skill it takes time to learn how to create a quality questionnaire. Without disrespecting the skills of the medics in this survey, you cannot conclude because a doctor helped put the survey together that it’s automatically accurate.

There are in fact many people actively studying pornography – some of whom can be found here. All of whom Radio One could have teamed up with had they genuinely wanted to explore our relationship with porn. This IS an important area that is worth studying and is currently hampered by a lot of poorly conducted academic studies, mostly based on undergraduate student samples. So we need to have more quality work conducted and there are plenty of people Radio One should have involved. The fact that some of the leading names in this area weren’t even mentioned or consulted points to either a lack of awareness of the subject area. Or deliberately avoiding to engage with those who may not be fitting with a predetermined porn/shock angle. Radio One should have been clearer about why did they pick this particular team from the Portman to collaborate with? Were there any agendas there? Certainly given the worries over medicalising our sexual behaviour one might argue it could be in a clinic’s interest to set up a figure of ¼ men being anxious about porn use. After all if you’ve identified a problem you are in a very good position to offer a cure.

Finally there’s no real context about why Radio One thought this was a major area worth studying. Given it’s a youth channel it could have easily picked up on numerous other social issues – poverty, employment, education, university fees. Or if they wanted to be sex campaigners to perhaps look at the issue around how sex education is haphazardly (and often poorly) delivered in schools. Are all young people really worried about online porn, or are there other things directly affecting their lives that may be more relevant (but perhaps less publicity generating?).

Despite all the percentages shown in this report and warnings about ‘heavy’ porn use there seems to be no take home message for people about what this means. If you suspect, after reading about/hearing Newsbeat’s survey, that you have a ‘problem’ – what should you do? If you have questions about porn, where could you ask them? In this case the audience are given some dire warnings but no referrals to sources of help or advice. Which again makes the overall purpose of this research unclear.

I may be being very disingenuous about the researchers from the Portman. But it worries me that their relationship with this research has not been fully declared. No doubt they acted with good intentions, and obviously drew upon their experiences as psychotherapists (one author has written about internet porn and psychoanalysis). But it is concerning that journalists covering this story didn’t think to ask more about who was doing the research, and what their motivations might have been.

Which brings us on to…

Problems with media coverage
I’ve already mentioned how the journalists I’ve talked to hadn’t seen the survey nor saw this as important. What was more worrying was the unquestioning pickup of this story. Journalists weren’t asking what was asked in the survey, of whom and why. What they were doing was accepting the figures from the survey – particularly the amount of time men were spending looking at porn, and how they were worried about porn use.

They were then using this as a jumping off point for other discussions. For example to talk about porn addiction, how pornography use could change men’s brains, what women felt about men who used porn. As a psychologist they wanted me to come and talk about neurological changes from porn use, and as a female psychologist they wanted an insight ‘as a woman’ to talk about how all women felt about their men’s porn use (more on this later).

What journalists didn’t want, was me talking about this survey from the perspective of someone who teaches survey design. They didn’t want the survey critiqued because their editor/producer had already fixed it as their angle. Indeed they’d already accepted it as ‘true’. Most worryingly those from the BBC seemed least keen to critique the research. One researcher calling from BBC Radio 5Live Drive Time confirmed they didn’t want to question the survey because it was done by Radio One – and as such they couldn’t challenge the output from a sister station.

It really does beg the question what is going on with the BBC College of Journalism that such problematic research can be put together to begin with – and how it can continually be endorsed even when flaws are being pointed out. (Sadly I’ve tried previously to help the BBC College of Journalism to think more critically about sex research but have got nowhere. I have alerted them to the current Radio One survey and uncritical coverage on twitter today. Let’s hope they decide to take this further) .

This case has been a useful example in seeing how journalists lack the understanding to critique research, but also the practical reasons they’re unable to do so. Moreover it gives us an ….

Insight into journalists views of sex/pornography
If you look at the press coverage of this survey (alongside reflecting on the discussions I had with journalists today) some very definite patterns of how journalists/the media see sex/relationships and porn.

The view from medialand is as follows:

Who looks at porn? Well, it’s men. They are all straight and the porn they are seeking out is also heterosexual. Women are constructed as having problems/concerns about pornography – but only in relation to their (male) partner’s use of it. ‘Pornography’ as a term is used to mean one genre from one format (the internet). Looking at mainstream porn in moderation is okay, but if you do it often then it becomes a problem. Quite often described in the medicalised language of addiction.

Men are naturally sexual and so can’t help liking porn, but if they do look at it they’ll become abusers or change their neurological makeup or sexual behaviour. Women don’t like porn, those who do are presented as being in a minority, probably deluded, or liking romantic/couples-based/equality-based/feminist porn. Porn within relationships is only permissible if it’s to spice things up (or encourage reluctant wives to get in the mood). LGBT folk aren’t even thought about.

Alongside this is a widespread acceptance that porn influences sexual behaviour (i.e. shaving pubic hair, trying anal sex, different positions etc). There is no insight from journalists or often the public that these issues all have – and continue to be – widely covered in mainstream media, not just porn.

If you’re starting from this as your standard position it makes thinking critically about pornography difficult. It means journalists will be tasked (or choose) to find evidence to stack up this world view. It also means it’s risky to find other ways to think about/explore porn for fear of being seen to endorse it.

Why is coverage of porn research so poor?
Coverage within the media tends to be poor because journalists are always on tight deadlines, lack skills to evaluate both research and critically reflect on their own assumptions about ‘normal’ sex. Finding experts who can talk clearly on the topic or searching through evidence is often difficult. And not helped when the standard way to approach this issue is in a false debate format where you have to find a pro and anti porn person in the mistaken belief there are clearly defined ‘sides’ in this area.

The pressure from editors to fit particular (and usually sex negative) agendas leaves little autonomy for journalists to tackle problems they may spot with research. Freelancers in particular may struggle as if they don’t write what the editor wants they won’t get a commission. Staffers may struggle with bullying if they don’t deliver an angle to deadline.

Journalists are not impartial. Many lack basic sex education or have particularly sex negative views. It is threatening for them to have this questioned – especially when on deadline. And if something seems intuitive then it won’t be questioned. Indeed if you try you’re more likely to be seen as a crank. Or unhelpful.

Part of our problem is there is a lack of funding to really investigate porn use in sensitive and open ways. Where quality research is undertaken in this area it’s often more nuanced and doesn’t lend itself well to scary headlines and battle of the sexes style debates. This means quick and dirty studies get completed and hit the headlines far more readily, and inform public opinion more often. That can be dangerous and misleading, particularly when behaviours that may not be a problem become medicalised.

What can be done about this issue?
Offer better training for journalists to understand surveys and other social methods. You might find these guidance papers I’ve written on the topic helpful:
Administering, analysing and reporting your questionnaire
Selecting, designing and developing your questionnaire

Reaching beyond the white middle classes

Make editors and broadcasters more accountable – challenging them when they run poor research or give bad science uncritical coverage.

Require media outlets that create surveys need to be completely transparent about the work they’ve done (as we equally should with academic researchers).

Encourage the public to engage in discussing and critiquing sex research from media outlets via social media. Today we saw two things happen. The media lost the news, while the public via social media (particularly on twitter) got to the bottom of a problematic story and had a much more interesting time doing it than if they’d relied on old media coverage alone.

Posted in Addiction, Bad science, Critical appraisal, Internet, Journalism, Pornography | Comments closed

Lapdancing research update – The Regulatory Dance

By Dr Petra | Published: 5 April, 2011

There are many times in a researcher’s career when you really wish you could have come up with a particular study idea, got it funded, and supervised it to completion.

One recent example for me was the ESRC funded project that aimed to find out more about lap dancing. Over the past year researchers have been talking with dancers, industry management and regulators to capture a snapshot of what’s currently going on with lap dancing.

You may remember how this study started out. It was the one picked up by the News of the World and other media outlets who, perhaps predictably, failed to notice how this work was needed (and how many limited existing studies on this topic were biased). Instead they attempted to make out the research was either smutty or not worthy of academic investigation. (You can read my somewhat ranty response to that coverage here).

Despite this somewhat shaky start, I’m glad to report the research is now in the preliminary stages of being reported by Drs Teela Sanders and Kate Hardy. You can see their initial findings here.

Their key findings are interesting and may surprise you:
* The continuous supply of dancers, rather than the demand for erotic dance, accounted for the expansion of the industry.
* The overwhelming majority of women were satisfied with their jobs as dancers, although they also identified negative elements.
* Advantages included: choosing own hours; getting money instantly; earning more than in other roles; being independent; combining fun with work.
* Disadvantages included: never knowing how much money they would make; keeping the job secret; customers being rude/abusive; competing with other dancers.
* Most women felt safe at work, although nearly half reported frequent verbal harassment and unwanted touching from customers.
* Only a minority of women were solely dancing, most combined dancing with other work and education.
* Dancing was used as a strategy to enable and facilitate career prospects and security in the future.
* Dancers’ status as ‘self employed’ workers resulted in exploitation as they had no rights or recognition in the workplace.
* Overheads were high: house fees, commission on dances, and fines (often arbitrary) for breaking ‘house rules’ reduced capacity to earn and most dancers had left a shift not making any money.
* The current focus on licensing does not consider the welfare or working conditions of the dancers.

You might also be interested in the other ways the researchers have chosen to represent their initial findings. Including this more visual account, reflections on both this study and research-led teaching, and a short piece from the researchers challenging the media coverage of the preliminary findings from the study.

No doubt this study will be welcomed by those interested in research, healthcare and activism related to sex work. It is also of use to those teaching or researching within the social sciences as an example of good practice. Particularly how the researchers have reflected on their work, have reported at various stages of the study, and highlighted how research and teaching can be intertwined.

The problem with writings about lap dancing in the past have been either they’ve focused on entirely positive accounts, or been overtly negative and often hostile to/about dancers. That’s been the case whether it’s media accounts or academic studies. This research is different as it takes the experiences of dancers and discusses their lives in a way that doesn’t flinch from the problems they face when dancing, or the positive (and mundane) parts of their work.

I wonder whether the media will notice how different this research is. Or whether they’ll continue with the standard judgemental approach that combines judgement with sexualising ‘brainy beauties’.

Posted in Lap/pole dancing, Newspapers, Surveys/questionnaires | Comments closed

Lovely news – this blog’s been longlisted for an Orwell Prize!

By Dr Petra | Published: 31 March, 2011

If you aren’t aware of it, The Orwell Prize celebrates political writing across books, journalism and (since 2009) blogs.

The prize aims to commemorate George Orwell’s desire to ‘make political writing into an art’. More information on the prize (particularly the application process and values of the award) can be found here.

Yesterday the longlist of writers, journalists and bloggers was announced. I was very excited to learn my blog was included.

This year there was an unprecedented number of entries from bloggers (205 of them!) which was narrowed down to 22 by the judges. I found the original list of 200 bloggers was inspirational, introducing me to a whole range of writing I’d not previously focused on. It also interested me to see the range of bloggers who saw their writing as ‘political’. Something I think is reflected in the longlist where there are contributions from those focusing on party politics, through to people reflecting on health, justice, science, skepticism, feminism and gender.

I admit hesitating over whether to submit my blog or not for consideration. Aside from being intimidated by knowing a whole load of friends and colleagues who I felt were far superior to me in their writing were entering, I also wasn’t completely convinced my writing was always ‘political’.

Certainly sex and relationships aren’t strangers to politics. Sex work, pornography, gender, sexuality, sexual health, reproductive health and sex education are all core areas where public, personal and academic debates consistently play out. Many of these areas are deeply intertwined with political ideologies, movements and regulation. I was less certain when I wrote about some of these topics that it fitted the criteria of ‘art’ or ‘politics’. Perhaps because I (probably wrongly) see political writing as taking a particular line, and I see my blog (again probably wrongly) as trying to set out key issues for consideration but leaving it more to the reader to decide where they see themselves in relation to a particular issue or topic.

Having been persuaded by several friends and loved ones that I ought to enter, the task of identifying ten posts from the previous year helped convince me that some, if not all, of the writing on this blog is most certainly political. That is if you use as your definition of ‘politics’ the aim to make complex and sensitive issues accessible to a wide audience. It also reminded me of one of the core values I operate from – the awareness that I have easy access to a lot of academic and policy material which can often be used to reassure, challenge, or otherwise motivate people to tackle their own sex and relationships issues – or address wider topics such as poor sex coverage in the media or bad policy making by politicians. And certainly often needs a thorough critical appraisal.

The ten posts I picked can be found here and I deliberately tried to capture a range of issues representative of my blogging. Obviously a major focus was on posts tackling my particular bugbear of bad media coverage and the medicalisation of female sexual functioning. I also flagged up the exploitation of men’s sexual problems (an issue I still feel is massively neglected by the mainstream media and healthcare), reflecting on being involved in government-led sexual health campaigns, and highlighting the difficulties of well intentioned sex positive initiatives that can easily backfire if not thoroughly thought out.

Working from the longlists of books, journalists and bloggers the judges will now work to create a shortlist which will be announced in April, followed by an awards ceremony shortly after for the winners in each of the three categories. You can keep up with progress on these events via the Orwell Prize Website or by following @theorwellprize on twitter.

As you may expect the announcment of the longlists have met with a lot of interest – and debate. Some of which was started at last night’s event (some video of which is available here), some of which has spun across twitter today on the hashtag #orwellprize, and some of which has been picked up in blogs reflecting on both the prize and the current status of blogging (two interesting examples can be found here and here).

Hopefully the chat around the longlists and the subsequent awards will attract even more interest for the prize. I’m a great fan of a number of blogs that tackle sex work, gender, sexuality, disability, international sexual politics, sexual and reproductive health and sex education and I hope writers there will consider submitting their blogs for consideration next year. In the meantime I’ll definitely be updating my blogroll to reflect the sheer volume of fantastic work that I regularly draw upon for inspiration.

I recommend checking out all the entries in the longlists listed at the start of this post (for all three categories). It’s an amazing collection of diverse work, and while you may not like all of it, it may give you ideas for political writing of your own. It’s certainly given me pause for thought about what and how I’ll continue to write on this blog in the future.

Posted in Activism and Open Access, Reproductive health | Comments closed

‘Oi missus, where’s your blog gone?’

By Dr Petra | Published: 28 March, 2011

A friend emailed me today, asking why I’d not posted anything on the blog for weeks.

I was about to reply telling her she’d obviously not noticed I’d only just written something. Then I realised of course she was right. I have been extremely remiss in my blogging chores.

After sharing my excuses with her, I thought it best to also explain them here. A house move, pregnancy, no home internet access for weeks, plus less childcare than I’d had previously have meant I’ve been struggling with juggling part time work, motherhood and life generally.

One of several casualties of this has been the blog, which I’ve kept meaning to write but haven’t exactly got around to.

So my apologies for the slackness and my promise that things will improve from now on. In the coming weeks I’ll be updating on the female sexual dysfunction/medicalisation debate; critiquing how sex education is delivered via the media; and reflecting on how sex and relationships issues can effectively be tackled in science communication activities. Plus an update on where we are with the complaint to Channel 4 regarding The Joy of Teen Sex, and some musings on how sex and relationships advice is framed for mothers-to-be.

Posted in Uncategorised | Comments closed

Channel 4 sent complaint from practitioners re problem sex broadcasting

By Dr Petra | Published: 9 February, 2011

Over the past few weeks parents, practitioners, young people and journalists have been concerned about the Channel 4 series ‘The Joy of Teen Sex’. This has led to a number of us deciding to complain to the Channel and recommend a way forward to ensure future programming is improved.

Below is a copy of our letter, sent to the Chief Executive (David Abraham) and Commissioning Editors yesterday. Myself and others will be reproducing this letter on our blogs and you are welcome to share it on forums, your own blog or for teaching/discussion purposes. If you have been worried by the series and believe Channel 4 should address the current poor standards in sex and relationships broadcasting you may also want to contact the Channel yourself.

Dear David Abraham

Cc: Sue Murphy, Andrew Jackson, Katy Boyd, Liam Humphreys, Kate Teckman, Dominique Walker

We are a group of professionals who are pro-sex education and accessible sexual and reproductive healthcare. We believe in accurate and open discussions about relationships and sex, and feel television can be an effective and powerful medium for sex education programmes that are entertaining as well as informative.

For the past decade Channel 4 has been making programmes addressing sex and relationships issues for teens and adults including: The Sex Inspectors (2004), Orgasmatron/Body Shock (2005), The Dark Side of Modern Love (2005), Am I A Sex Addict (2007), The Sex Education Show (2008-present), and most recently The Joy of Teen Sex. This clearly demonstrates a commitment on behalf of the Channel which we feel is important given how little coverage these topics receive.

While these programmes may have attracted high viewing figures, they have been criticised by therapists, healthcare providers, and educators for portraying inaccurate or outdated and misleading representations of sex education, healthcare, clinical treatments and therapies.

Many of us have been approached to participate on these programmes, or publicise them to our colleagues/clients. We have repeatedly shared our worries about the direction programmes appear to be taking, although have had little success in having those concerns heard.

The recent series The Joy of Teen Sex has been even more problematic than previous similar shows, raising complaint and concern from sexual and reproductive healthcare staff, sex educators, youth workers, sex researchers, parents and young people. In particular they have been worried by:

- the range of topics covered, which may not be representative of the needs/questions teens may have

- some of the skills and qualifications of the professionals used in the programme

- the advice given to programme participants which left little room for exploration, choice, and the right to refuse sexual activity that doesn’t appeal to them

- misleading and/or factually incorrect information, and frequently used unreliable statistics to back up points made. For example the inaccurate claim made at the start of each programme that the average teen has had three sexual partners by the time they reach 16. In fact reputable research finds most teens have not had intercourse before they are 16.(1).

- little attention paid to communication, confidence, respect, romance, affection, closeness

- an overemphasis on sexual techniques and products

- offering options that may not be realistic for viewers, particularly younger teens or those on a low income

- valuing the ‘televisual’ over more relevant issues to young people – e.g. exploring vajazzling

- consistent muddling of key terms (e.g. vagina used when vulva is meant), or using outdated terms such as ‘hymen’

- inaccurate representation of what sex education is like, what sexual health services deliver, and how sex education and healthcare professionals should act. For example a medic making a client cry by showing her graphic images of STIs; telling young women to expect bleeding as part of losing virginity; or not making clear the difference between normal vaginal discharge and an STI

- mixed messages from programme makers in their casting calls to young people/parents, and what professionals being consulted for the series were told it would offer (see Appendices 1 and 2)

- an overall tone that encouraged teen blaming, slut shaming and homophobia, while perpetuating messages of hegemonic masculinities and narrow sexual norms

- not listening to numerous professional concerns during the development stage

- no awareness of, or respect for, cultural diversity

- producers of the show using twitter to promote the programme while simultaneously dismissing professional and parent complaints of the series, referring to anyone who questioned the series as ‘haters’ (see also Appendix 3)

We are concerned the Commissioners and Channel Four have not shown due diligence over this series. It seems to be fitting a pattern of programme development where viewing figures are prioritised over empowerment but where programmes are still marketed as ‘educational’. It does not appear to fit with the Channel’s Public Service Remit or Corporate Responsibility.

We are worried misinformation about sexual and reproductive healthcare and education has been grossly misrepresented, leading to parents feeling anxious, young people’s right to accurate information not being delivered, and professional advice being ignored at all stages of programme development.

The right of young people to comprehensive sex and relationships education is still contested in this country. Many individuals and organizations oppose sex education on the grounds it will sexualise their children, claim it will not give accurate information, or will encourage sexual activity rather than encouraging thoughtful decision-making about relationships. For this reason it is vital that any programme claiming to provide education about sex and sexuality does not provide fuel for these arguments. Sadly we have seen reactions to The Joy of Teen Sex in public discussions and on places like twitter that indicate the programme is already being used as evidence of the ‘failings’ of sex education.

As a result we fear this style of programme making could lead to young people and adults not getting the sexual and relationships advice they need; making the job of healthcare providers, therapists, educators, parents and youth workers more difficult; and causing distress to young people and parents. We have been overwhelmed with emails from anxious teens and parents who support sex education, but are concerned about the messages of teenagers, sex, relationships and sexuality portrayed in this series.

Channel 4 clearly intends to continue making programmes about sex and relationships. We are hoping as Channel Directors you will wish these future broadcasts to be accurate, entertaining and empowering. To ensure this happens we are calling on Channel 4 to establish an advisory group made up of sexual and reproductive health practitioners, sex educators, youth workers, parents and young people to oversee the development of future programming and ensure that it is entertaining, accurate and empowering. This idea is endorsed by Brook, the young people’s sexual health service. All of the signatories below are happy to help you with this endeavor, and are now expecting you to listen to our concerns, and promise quality sex and relationships broadcasting in the future. We look forward to hearing your response soon.

Signed
Petra Boynton PhD, Social Psychologist and Sex Researcher, University College London
Dr Stuart Flanagan, Genito Urinary Physician
Justin Hancock, Bish Training, trainer and consultant
Lisa Hallgarten, Director, Education For Choice
Wendy Savage MBBCh FRCOG MSc (Public Health) Hon DSc
Marge Berer, Editor, Reproductive Health Matters
Romance Academy – a nation-wide, holistic, relationships and sex education initiative
Dr. Meg Barker, Sex therapist and social psychologist, The Open University
Chris Ashford, Principal Lecturer in Law, University of Sunderland
Alice Hoyle, Sex and Relationship Education Advisory Teacher
Alison Terry, Second year student, Applied Community and Youth Work Studies, University of Manchester
K. Barratt, Second year student, Applied Community and Youth Work Studies, University of Manchester
Becca Thompson, BSc MA COT
Steven Norris, Student Teacher
Clare Bale, RGN, BA (Hons),MPH, PhD Candidate, University of Sheffield
Dr. Lesley Hoggart, Principal Research Fellow, School of Health and Social Care University of Greenwich
Matthew Greenall, advisor on international HIV & sexual health programmes
David McQueen, International Speaker and Youth Advocate
Janet Horrocks, Healthy Schools Project Officer
Joelle Brady, MSc, Researcher
Kendelle Bond, MD of Zest Consultantancy, Public Health Consultant
Dr Jayne Kavanagh, Medical Ethics and Law Unit Lead, UCL Medical School and Associate Specialist in Sexual and Reproductive Health, Camden Provider Services
David Evans, Researcher and Chief Executive SRE Project
Peter Bone, Chair of the Advisory Council, PSHE Association

(1) Wellings, K, Nanchahal, K, Macdowall, W, McManus, S, Erens, B, Mercer, CH, Johnson, AM, Copas, AJ, Korovessis, C, Fenton, KA, Field, J Sexual behaviour in Britain: early heterosexual experience. Lancet, 2001: 358; 1843-1850

APPENDIX ONE
Example email correspondence from researchers on The Joy of Teen Sex, to professionals:
“We are in the early stages of shaping our series and are keen to talk to industry professionals, so we can get it right. I understand your concerns and I can reassure you that our aim is to make a thought-provoking and positive series that will look at relationships, emotions and identity as well as “the act of sex”.”The Joy of Teen Sex will not be gratuitous, voyeuristic or salacious. Our aim, working alongside dedicated professionals, is to provide a platform for teenagers and parents to discuss the emotional, physical and psychological pressures young people face when they are seeking to forge loving relationships.”

APPENDIX TWO

Example of casting call information to recruit participants to the programme (reproduced and discussed in this previous blog post about The Joy of Teen Sex).


APPENDIX THREE
Metro Newspaper’s account of Twitter remarks from one of the producers on The Joy of Teen Sex, made during and after episodes were aired. (These have since been removed from twitter by said producer).


Update
Our letter has been reported in The Guardian and Channel 4 have since sent the newspaper this response (reprinted below). For the record the Channel have not as yet been in touch with any of the signatories of the letter and have not even acknowledged receipt of our letter. We await their promised correspondence.

Channel 4 has been committed to programming that addresses the lack and inadequacy of sex education in schools for many years through programmes such as the Sex Education Show and The Joy of Teen Sex. We are proud of our programming in this field as well and their ability to bring large audiences to the often difficult issues they have addressed. We have a hugely successful Sexperience website which has consistently been a leader in the field and has seen millions log on for further advice or information after watching the programmes. Anecdotally we also know from healthcare professionals that viewers have sought medical advice and treatment as a result of watching the programme.

While the programme makers of The Joy of Teen Sex consulted with a number of sexual healthcare professionals to ensure the information provided was accurate and appropriate, we realise that this type of programming will not always appeal to everyone. However, Channel 4 is always willing to listen to the concerns of viewers and interested parties following its broadcasts and we will correspond with the authors of the letter directly about their concerns.

A few thoughts on this response (from me, rather than on behalf of everyone who signed our letter). Given the major problems with The Joy of Teen Sex, it seems more than disingenuous for them to claim the series has been addressing the lack of and inadequacy of sex education. The point of our letter is to highlight how the misinformation in Channel 4′s programming is misleading regarding sex education, and may in fact be causing more work for parents and practitioners while giving ammunition to the anti sex education lobby. There are plenty of ways to support sex education but causing concern to young people, educators and parents is not the way to do it. Nor is creating programmes which feature mainly 18′s and over (not representative of ‘teens’). Or making programmes for teens that are screened after 10pm, and are blocked to under 18s when they’re archived on 4oD. The Channel can’t even claim they’ve not been told about the problems around delivering SRE and how media can inform this – they’ve asked me to speak at their education events twice to specifically tackle this issue (see here and here).

Anecdotes are fine, but how many healthcare professionals have said people have sought advice? Presumably if this is being reported to the Channel they’ll have some record of it? Why are these professionals listened to, but those of us who are raising concerns (based on what we’re seeing in practice) are not?

The Channel mention they consulted with ‘a number of sexual healthcare professionals to ensure the information was accurate and appropriate’. How many professionals and who were they? Six people/organisations signing our letter were directly approached to appear on the Joy of Teen Sex when it was in development. We all shared our concerns about the programme idea at the time but were unable to participate because the producers would not alter their focus. So that’s several professionals we directly know about who gave extensive feedback who were ignored. It would be useful to know who the healthcare professionals who were ultimately used by the Channel, because if they were responsible for signing off the inaccurate statistics and misleading examples of practice screened week on week there are, sadly, questions to ask about their competence.

It is not enough to say our complaint about this series and other programming is just a matter of taste. It is a matter of accuracy and broadcasting ethics. Our reason for writing to the Channel is not to have a grumble about a few things we just don’t like the tone of. It’s a serious catalogue of consistent problematic practice.

The Channel states how it ‘is always willing to listen’. Presumably that includes all the parents and practitioners who have also contacted the Channel separately from our group letter? People who are still waiting for any reply? Channel 4 has not, so far, indicated they are listening. They need to respond to us directly for us to know this is happening. And to continue a dialogue that shows they are taking on board feedback. Not fobbing people off with vague PR speak.

I will keep you posted on any further correspondence from the Channel who I hope decide to revisit our letter and realise we are offering them an opportunity to ensure they provide accurate, entertaining and empowering sex programmes in the future. It would be supremely arrogant of them to continue to decide they know better than young people, parents, practitioners – in other words, their audience.

Posted in Activism and Open Access, Bad science, Homo/transphobia, Parents, Reproductive health, Sex education, Sexuality, Teenager(s), Television | Comments closed

“The Joy of Teen Sex”

By Dr Petra | Published: 19 January, 2011

Last summer myself and several other sex educators, therapists and reproductive healthcare staff were approached by researchers from Betty TV working on a new programme commissioned by Channel 4 called ‘The Joy of Teen Sex’. The show was described as a cross between the established (and popular) Embarrassing Teenage Bodies and The Sex Education Show. The Joy of Teen Sex would be set in a mock clinic where young people who had sex and relationships questions could get advice. The TV company was looking for people to appear as experts on the series (who’d play the role of ‘clinic staff’), and/or to refer them young people for possible inclusion.

After friends and family the media is often one of our main sources of sex information (acting as a ‘super peer’ – who doesn’t always have the right answers). Young people particularly appreciate sex and relationships advice from broadcast and online media. Providing sex information via the mainstream media is not new and has been well received by young people, parents, educators and healthcare staff (a classic example can be found here, see also here).

I am very much in favour of using the media to share information on sex and relationships (and other health topics). But I had reservations from the outset about this particular series. All of which I shared with the researchers at the time, and I’ll repeat now.

The series was billed as being a ‘youth’ programme. Although that doesn’t necessarily mean young people were actively involved in its creation. The title ‘The Joy of Teen Sex’ sounded like something by an adult trying to impress the kids rather than generated by a youth audience.

As I heard more about the planned content of the series it seemed profoundly out of touch with the title. The title implied an attempt at celebrating sex, while the calls for participants suggested it was mostly negative and problematising sex (more on this later). The proposed content did not match the kind of things I’ve noted young people are worried about (through my research and work over the past decade as an agony aunt; and from listening to parents, sex educators and healthcare staff).

Given both Embarrassing Teenage Bodies and The Sex Education Show had received some criticism for their approach to sex-related topics , I was concerned that merging them for a new format without learning from the feedback for existing programmes was not good practice. When I shared these worries with the researcher from Betty TV they did not appear interested.

Setting up a ‘pretend clinic’ was also perhaps unhelpful as it may give an inaccurate impression to young people of what sexual health services are like. If the mock clinic appears off-putting to an audience it may also discourage them from attending a sexual or reproductive health clinic in real life (for more ideas on what a ‘real’ GU clinic is like click here).

The ‘clinic’ setting also framed sex and relationships issues within a health or medical format. Which may be appropriate for tackling the treatment of STIs or contraception, but given this programme was also being presented as providing advice about relationships was a medical tone the best to use? After all, do you head to your GP when you want tips to spice things up sexually? Given the wider concerns about medicalisation and sex, presenting young people with the idea sex and relationships are a primarily medical issue (as opposed to social or cultural) is unhelpful.

Those worries, however, were insignificant compared to my anxiety when I received the advert the company wanted me to pass on to young people, which read:

SO YOU THINK YOU KNOW IT ALL WHEN IT COMES TO SEX?

• How much is too much porn?

• Which STIs are untreatable?

• Are you still a virgin?

• How easy is it for a girl to orgasm?

We want to talk to teenagers, 16+ who need sex and relationship advice or who are keen to share their sex and relationship experiences.

OR

We want to talk to teenagers and their parents who need sex & relationship advice from a team of professionals.

No issue is off limits.

Sex is the most important thing in a teenager’s life….and the biggest worry for their parents…

If you’re a parent, concerned about what your teenagers are getting up to in the bedroom, we want to hear from you.

• Do you think your teenager is addicted to porn?

• Do you think your teenager is sleeping around?

• Has your teenager told you they’re bi-sexual?

• Is your daughter a virgin, but you fear her boyfriend is pressuring her into having sex?

• What do you do when your son says he wants to have unprotected sex?

TV Production company betty are making a new Channel 4 series featuring frank and candid discussion of sexually aware teens.

(The above advert was also posted here with other casting calls can be found here and here)

Let’s unpack this advert.

First of all the programme starts with a challenge – asking if young people know it all. None of us ‘know it all’ when it comes to sex. Such an approach runs counter to working with young people on sensitive issues, where the aim is usually to create a safe space where people can ask questions or debate issues with confidence, rather than feeling judged, silenced or challenged.

‘Sex’ is not transparently defined. Discussions with the TV researchers making the programme indicated they understood ‘sex’ as penis in vagina intercourse (or anal sex in the case of young gay men). This is an extremely limited view of ‘sex’, the meaning of which has been explored in depth here.

Yet ‘sex’ and relationships are constructed in a particular way by this advert. For young people the advert focuses on ‘sex’ as whether or not they know much about infections, problematising porn, ‘losing’ virginity, and young women’s orgasmic difficulties. That leaves out a whole range of other issues young people may wish to talk about while reinforcing many gender and sexual behaviour stereotypes.

When it gets to the parent section of the advert it becomes even more judgemental. Here we see ‘sex’ categorised with more mentions of porn, a brief nod to sexuality, value judgements about ‘sleeping around’, and the setting up of girls as victims, boys as predators. There is nothing positive for parents. Only a list of potentially scary issues a parent might get in touch with. Indeed sex is stated as ‘the biggest worry for parents’.

Is that true? Are parents not also worried about their child’s future? Their academic progress? Their friendship groups? Risk of violent crime? Their health and wellbeing? Financial worries? Some parents may well be anxious about their child’s sexual development, but I’m confident most parents will have additional, and equally pressing, concerns. Realistically if sex really is your prime concern as a parent is television the best place to get support? Particularly if your worries are linked to the motional or physical safety of your child. This is not to say parents should not want advice, just that framing conversations with young people about relationships in purely negative ways is unhelpful.

The advert does indicate what the aim of the series might be. Rather than an opportunity to empower parents or listen to young people, it seems to be designed for the viewer to judge the wayward teen or hapless parent. Previous programmes and wider media coverage about young people’s sexual behaviour have been criticised for creating a format which slut shames young women, makes young men appear to be perverts, presents a heteronormative tone (while pretending to be right on about sexuality), and generally suggests sex is a scary issue – for both young people and their parents. It harks back to an old fashioned view (explored in depth here) that if we had to deliver sex education we might as well make it as offputting as possible to dissuade young people from considering trying it. Aside from this being limited, it is also disempowering. And it shifts topics that young people may not necessarily be seeing as a negative, into a problem. Although in this case dressing it up as a ‘sex positive’ series.

The phrase that put me off supporting the programme most was ‘Sex is the most important thing in a teenager’s life’. It may surprise you, but I profoundly disagree. ‘Sex’ may be important to some teens some of the time, but not to all teens all the time. For many young people the most important thing in their lives may be their friends, their schooling, hobbies or sports, their pets, their faith, music or a whole slew of other stuff I’m probably to old and boring to know about.

Indeed when you talk to young people, often what they are interested in is being in a relationship, being close to someone (either in the short or long term). They may certainly have questions about ‘sex’, and have a range of feelings attached to it – curiosity, anxiety, and excitement. But they will also have other questions that go beyond the mechanics of intercourse.

The majority of young people (2/3 of the UK population) do not have ‘sex’ (at least defined as penis in vagina intercourse) until they are 16 or over (the UK’s age of consent). Many young people aged under 18 have not have sex or a relationship. Those having sex at a very young age tend to be more vulnerable due to numerous reasons (covered here) and are of particular concern to educators, healthcare staff and youth workers.

When you talk to people who deliver sex and relationships education via schools or youth groups, those who are working ethically and appropriately are not trying to convince young people sex is the most important thing in their lives. Indeed, they are usually stressing to young people the importance of having many interests, and encouraging them to delay sex. Alongside tackling wider problems or opportunities facing young people (like schooling, home issues etc). Critics of sex education often argue that talking about sex encourages early experimentation, which is not accurate. However, you can see why critics get worried when young people are being encouraged to view sex as the cornerstone of their entire lives, when for many it isn’t (at least not all the time).

From the calls for respondents the programme ‘teen’ has been defined as young people aged 16+ (or in some cases 18-20). Meaning the focus of the series is better described as being aimed at ‘young adults’.

Setting up a post watershed series (screened at 10pm) aimed at ‘teens’ but really meaning over 16s raises issues over what topics will be covered. Working with young people on sex and relationships issues reveals lots of diversity. You may find a nine year old asks a question that seems very ‘adult’ while a fourteen year old wants to know something that you’d expect a much younger child to be aware of. Part of the skill in working with young people (as it is with adults) is pitching what is discussed at their level, within their comfort zone. Not talking about issues they are not yet confident to understand, or that may be beyond their comprehension or are age inappropriate.

There is always a dilemma in education and advice giving about to provide information that does not patronise young people nor decide for them what they ‘ought’ to know. Young people have a right to sex and relationships education, but when television programmes muddled entertainment and advice (ignoring the latter for the sake of the former) this can mean young people either get information that is not useful, or are presented with concepts that may not be appropriate to their needs.

My worry with this programme is the topics selected for the series were chosen to attract an older audience, rather than truly deliver sex information to teens based on issues young people really want answers to.

It is important to stress I only had involvement at the early stages of development, when practitioners were being approached to be part of the series or find potential participants. I don’t know whether the focus of the programme has altered since, but reading pre-reviews of the series suggests concerns myself and others had with the series have not been resolved.

According to press coverage, in the first show we will meet a woman called Michelle whose 17-year-old daughter Rachel got pregnant last year, is sexually active, but ‘refuses’ to go on the pill. Already we can see the cards being stacked against the mother and the daughter. The danger of such programming is it becomes an opportunity for audiences to judge others who are not fitting particular expected roles. Worryingly there is often a class and race based subtext to this kind of media coverage where audiences are invited to judge chavvy youth or those from ethnic minorities or different faiths.

Other press discussions of what we can expect from the programme, from sex tips to ideas about techniques suggests the focus is a primarily adult one – but one that is also problematic. Adult sex advice (from the media and self help market) is preoccupied with positions and performance. Where ‘perfect’ sex is something to continually aspire to, is measured by how much you do it (not what you do), and where orgasms are something you ‘achieve’ not ‘experience’. It is a space where relationships are usually defined as monogamous (usually heterosexual but sometimes lesbian or gay sexuality is acknowledged). It is not a place where diverse sexualities are talked about in depth – or if any kink or alternative sexualities are focused on it is usually in a fairly sanitised or problematised way.

Sex for grownups (in the mainstream media and popular culture) excludes those who can’t fit into size 10 sexy lingerie, afford the latest sex toy, or whose bodies can’t mould themselves into 101 different positions. It is not a place for people with disabilities to have a voice, nor for those who are Trans, queer or asexual to speak out. If you are single you are allowed to be sexual so long as you can talk (albeit not very explicitly) about friends with benefits, or better still indicate you are trying your hardest to get into a relationship.

Many researchers, therapists and sex educators feel the stifling mainstream depictions of sex and lack of adventure and exploration – and absence of focus on communication – is a problem for adults who want to experience enjoyable sexual encounters or relationships. As a result, the aim of teaching young people to view sex and relationships in more diverse ways is to overcome many of the bad advice aimed at adults, or at least develop the critical thinking and life skills to see through the commercialised, pressurised and frequently unrealistic versions of sex currently on offer in mainstream popular culture.

It is therefore worrying the ‘The Joy of Teen Sex’, rather than tackling what ‘sex’ might be and how young people may look forward to experiencing it, may just serve up a predictable platter of Cosmo-esque sex tips. This is not what youth-focused sex and relationships education should be.

The media frequently distorts the teaching of sex and relationships. This can frighten parents and disempower teachers. Yet with programmes that provide unrealistic ideas about advice giving for young people this could easily give parents the wrong impression, suggesting as the norm activities that are not considered appropriate within school based or healthcare settings. It would be damaging if a programme that misrepresented both sex education and sexual health care contributed to a backlash against supporting parents, schools and healthcare providers from giving relationships information to young people.

Parents already worry about tackling sex and relationships issues with young people although they play a fundamental role in educating children. Media coverage that exaggerates the concerns of young people, presents an overly sexualised focus, or does not tackle the more mundane (and less ‘sexy’) questions young people may have can do two things. Firstly it can suggest to parents they need to be fearful for their child (and their potential sexual interests), and secondly imply the issues their child wants to know about are completely outside a parent’s ability to tackle. Neither are empowering for parents or young people. It is perhaps for this reason parents have already started speaking out about the programme.

What is not clear is why young people and parents wanted to participate in The Joy of Teen Sex. Were they seeking attention or fame? Or did they need advice? If it’s the latter it would be useful to know what led them to get this through a television programme rather than existing services – particularly if people had encountered barriers with existing education or healthcare on sex and relationships issues. Were people unaware of, or unable to access existing sources of free help and information? What about the participants in the programme? How representative are they of young people generally – and how many would-be participants for the show were not included? Why was that? It would be interesting to see journalists follow up on these questions, rather than just inviting us to gawp at and judge the participants in this series.

I have not seen the programme, so I my concerns could be completely misplaced. I will watch it and see if it manages to provide accurate and empowering information. I sincerely hope it does, but I am not confident this will happen. As a supporter of mediated sex advice it infuriates me programmes continue to be made where experts are ignored, where unethical practice is permitted, where young people are not involved, and where the end result does not educate but may well disempower parents, teachers and young people. It represents an endless stream of programming that wastes time, money and opportunities to share accurate advice people so desperately want.

I am always happy to support programmes that cover sex and relationships in an affirmative and diverse way, that move beyond ‘sex’ as intercourse, positions, techniques or infections to answer the questions young people really have in a sensitive way.

I did not feel The Joy of Teen Sex was offering this (although as already mentioned I am happy to be proved wrong). When I was asked to participate as a presenter and to refer young people to the researchers I refused. I felt the TV researchers were not listening to the feedback I shared on how they might make this programme more accurate and empowering, or my concerns about the wellbeing of young people and parents.

Equally worryingly the researchers warned me and other educators not to criticise or question them in public (i.e. on Twitter) or share our concerns about the series.

When a TV company commissioned to make a youth focused programme tells practitioners concerned about young people to keep silent, you really have to wonder who they are trying to benefit.

The Joy of Teen Sex is on Channel 4 tonight at 10pm (GMT)

Posted in Commercialisation, Intercourse, Medicalisation, Parents, Sex education, Sex positive, Teenager(s), Television | Comments closed

Looking ahead: plans for this blog in 2011

By Dr Petra | Published: 12 January, 2011

Now we’re into January I wanted to share some plans and developments for this blog. I’ve been blogging for six and a bit years, as a hobby in my spare time. It’s a space where I’ve been able to reflect on issues that bug me (like experiences in dealing with the media), highlight resources in sexual and reproductive health, or address more serious subjects (e.g. the medicalisation of sexual functioning). I’ve very much enjoyed doing this, particularly the freedom to talk about different issues as they’ve arisen, and tackling topics people have asked me to address.

However, I’ve recently felt a sense of disconnectedness between the blog and my working life. At work I lecture postgraduate students in International Primary Health Care – focusing on critically appraising evidence, putting that into practice, and reflecting on working effectively with communities and colleagues. Alongside this I supervise and carry out research on sex and relationships health, and apply this work by teaching continuing medical/professional education students core issues around understanding psychosexual and relationships topics and communicating with confidence with patients on sexual health issues.

That work has always informed what I write on the blog, and how I get to write it, but most of my writing hasn’t really been about my teaching or research.

I think the time has come to change that.

In recent years my research has moved from focusing on assessing psychosexual problems, through to evaluating how sexual and reproductive healthcare services are modernising (e.g. here, here and here). I’ve continued to be interested in how the media talks about sex and relationships (particularly around advice giving and public health messaging) (see here, here and here).

That work has led me to focus more on issues relating to sex and relationships when people are trying to conceive, during pregnancy, and when they have children. This interest has been sparked by feedback from participants and professionals during research; observations on what is available to parents to be and parents regarding advice on intimacy; and assessing how these topics are dealt with via the media and self help market. Completing systematic reviews on the academic literature has also informed my growing understanding of this area. Including topics such as psychosexual functioning following birth; relationship quality during pregnancy and parenthood; the impact on relationships following miscarriage, stillbirth or cot death; or how breast/bottle feeding impacts upon intimacy.

I’ve been amazed how in some areas there is a lot of really useful, critical and applied research on sex/relationships and pregnancy/parenting, but relatively little adoption of said evidence into practice in healthcare, education, therapy or media. For example there’s some fantastic writing unpacking some of the myths and stereotypes about breastfeeding and sex, and yet this seems to be largely ignored by midwives, health visitors and journalists.

There are also cases where there is nowhere near enough research completed, mirrored by relatively little discussion of the topic in healthcare or general advice for women and their partners. For example intimacy after miscarriage; or discussions on sex and relationships issues for people with disabilities, who are LGBT, single parents, or teen parents.

I’ll be focusing on these areas for the foreseeable future. Which brings me back to the blog – and where you can help.

I’ll be writing here about issues arising from my research, reading and teaching. For example covering topics like addressing relationships issues following miscarriage or stillbirth, intimacy and IVF, and breast/bottle feeding and the impact on libido. I’ll be focusing on reviewing evidence around core areas of sex/relationships and parenthood, and tackling problems identified in reproductive/maternal health care on these issues. Since many groups of people are excluded from research and writing around parenthood and intimate relationships, I’ll be seeking advice and input from people about their experiences of relationships and trying to conceive; pregnancy, surrogacy or adoption; or in parenthood.

Alongside this I’ve taken on board feedback I’ve had via email and from people I’ve met at public events discussing sex and science. In particular I’ve been asked to provide more practical guides around finding research papers, tools to aid critical appraisal of research, and information on how to apply sex research to our lives. Other requests include sharing ideas about how we can bring sex research to the public in innovative ways and will be reflecting on some opportunities for doing this over the coming months.

I’ve also been asked to clarify often used terms like ‘evidence based’, ‘sex positive’, or ‘behaviour change’. These phrases are often discussed in unproblematic ways – as if we all know and agree upon what they mean. I’ll be unpacking some of those core topics and thinking more widely about what they can mean (positively and negatively) within research and practice. If there are any poor or misleading media stories on sex and relationships I’ll do my best to debunk them.

I’ll continue to share information about interesting research papers, forthcoming conferences and events, and topical issues relating to sexual and reproductive health via twitter (@drpetra). I’ll also be sharing links to writing and projects by other inspiring and interesting people tackling diverse topics around sex, relationships, gender, sexuality and politics (sometimes all at once).

Your feedback via email (info@drpetra.co.uk) is always welcome. As I embark on this new role for the blog do keep me posted about what you like about it, where it needs to be improved and anything you think I need to be tackling. As much as time and work allows I’ll do my best to accommodate.

Wishing you all the best for the coming year and looking forward to sharing the next stage of my blogging journey with you. I hope you’ll find it useful and interesting.

Posted in (In)fertility, Critical appraisal, Postnatal, Pregnancy | Comments closed

Contraceptive Implants and Media Panics – what you need to know

By Dr Petra | Published: 6 January, 2011

Yesterday evening (05_01_11) Channel 4 News featured a story about the contraceptive implant (Implanon). They revealed a number of NHS trusts have paid £200,000 in clinical negligence compensation to women who’ve become pregnant or experienced injury when using the contraceptive implant. 584 women have reported unplanned pregnancies, and 1067 complained about scarring or other injuries to the Medicines and Healthcare Regulatory Agency. At this time it is not clear how Channel 4 heard about this story. It could be through their own research, from a tip off within the MHRA, or direct contact from a law firm.

This story was hotly adopted by the rest of the media, particularly broadcast media and newspapers, with coverage like:

Evening Standard – Ban this contraceptive implant pleads mother scarred for life
Telegraph – Woman whose marriage collapsed after Implanon implant ‘failed’ among those suing NHS
Guardian – Hundreds become pregnant despite contraceptive implant Implanon

The majority of these reports were characterised by a lack of context for the numbers given, and no reproductive health care experts/medics to put this data into context. I’ll focus on why this is a problem shortly, but first, here’s what you need to know about the contraceptive implants.

Contraceptive Implants (Implanon)
Implants are small, flexible tubes around 4cms long that contain the hormone progestogen and are injected under the skin in a woman’s upper arm. They are a form of a hormonal contraception, so they release hormones over a period of time (3 years) and fall into the category of Longer Acting Reversible Contraception (LARC). (Implants used before 2010 go under the brand name Implanon, those fitted after this date are called Nexaplanon. The latter has reportedly been designed to be easier to insert).

This kind of contraceptive is suitable for women who find it difficult to remember to take the pill every day, and who are certain they don’t want to be pregnant for a set amount of time. It’s around 99% effective if fitted correctly and used according to instructions. But, as like any form of contraception it isn’t 100% effective and because it only prevents pregnancy, condoms should also be considered to protect against STIs.

It has a number of side effects including periods stopping (which some women see as an advantage), irregular bleeding, acne, sore breasts, mood changes, and reduced sex drive.

Its use is recommended only after considering other contraceptive options and a thorough discussion and health assessment with your GP/Family Practitioner or Reproductive Health Clinic.

You can find out more about the contraceptive implant here, here, and here. (A statement from the MHRA on implanon can be found here).

Why is the media coverage problematic?
Press coverage on this story has been largely context free. That has meant we’ve been told how many women have experienced problems but not within any timeframe; how many problems were reported as compared to women not experiencing difficulties; how the implant compares with failure rates of other kinds of contraception; how many of the pregnancies were present before the woman went on Implanon and how many occurred due to incorrect fitting of the implant?

Without this information the majority of media coverage suggests that the Contraceptive Implant is not an effective form of contraception, is always painful to fit and remove, will cause disfigurement when removed, and result in an unplanned pregnancy where women will be forced to have a termination.

Because this information is misleading, and doesn’t come with additional reproductive health details to put it into context, it fails to make clear the positive aspects of implants for women who choose this method, nor that the majority of women who select the implant do not experience problems.

The coverage is also irresponsible because of the timing of the story. The post-Christmas and New Year period is always busy within General Practice and Reproductive Health Clinics. Not least because of people who have had unprotected sex over the holiday season will be anxious about pregnancy and seeking advice about their options.

The difficulty in criticising the story as it stands, is that you can find yourself easily cast in an unsympathetic role. In healthcare terms proportionally 584 cases compared with the number of people using contraceptive implants (1.4 million according to the Department of Health) is pretty low. That is of no comfort to those who experienced an unplanned pregnancy when they thought they were protected by a contraceptive. So in critiquing the media coverage here we need to be mindful it is based on difficult and upsetting cases that will have had widespread impact on people’s lives.

It is negligent of the media to not report this within any appropriate context. The result is scaremongering and is not helpful to anyone. Including those who have had bad experiences with the contraceptive implant.

What does the data show?
The contraceptive implant was introduced in the UK in 1999. It has been used by around 1.4 million women over the past 11 years. This figure comes from the Department of Health although is still unclear if that means women in UK or Europe. Some practitioners feel the 1.4 million figure is high, even over an 11 year period. Part of the problem with this story is the uncritical media coverage is throwing numbers around like there’s no tomorrow, but health agencies have also been somewhat unclear on exact figures and where they’ve sourced them from. This leaves us with the less than ideal situation of matching unclear data from media coverage with unclarified data from the Department of Health/NHS. NHS advice is the 584 pregnancies reported seem to be mostly related to incorrect insertion of the device rather than the device itself being faulty. It is not clear how many of these pregnancies had begun before the device was fitted. Currently around 800,000 women in the UK are believed to be using this method of contraception. 14 women have been compensated for either getting pregnant while using the implant or being injured through incorrect insertion or removal (source info here). While the figures from media and health sources remain unclear what does seem to be fair to claim is the number of women who use the contraceptive implant without difficulty far outweighs those who have experienced problems.

Long Acting Reversible Contraception has been recommended for use by the National Institute for Clinical Excellence (NICE) (details here). This has resulted in reproductive health practitioners recommending the use of the contraceptive implant and other LARC options (e.g. the IUD) to women seeking contraception. The guidance states women being offered LARC should have this as part of ‘women centred care’:
“This guideline offers the best-practice advice on the provision of information and care for women who are considering or using LARC. Treatment and care should take into account women’s individual needs and preferences. Women who are considering using or who use LARC should have the opportunity to make informed decisions about their care and treatment. If a woman does not have the capacity to make decisions, healthcare professionals should follow the Department of Health guidelines, Reference guide to consent for examination or treatment (2001) (available from www.dh.gov.uk).
Good communication between healthcare professionals and women is essential. It should be supported by the provision of evidence-based information offered in a form that is tailored to the needs of the individual woman. The treatment, care and information provided should be culturally appropriate and in a form that is accessible to people who have additional needs, such as people with physical, cognitive or sensory disabilities, and people who do not speak or read English.”(p.5)

Whether this was always completely followed in a drive to encourage women to opt for LARC is not clear. Careful assessment of this should be made within the context of health care practitioners working hard to encourage their clients to have a range of contraception choices. It should not detract from wider discussions about uptake and overall safety, but is relevant if health practitioners or patients felt pressured towards LARC as opposed to other forms of contraception. This is a highly sensitive area to address and given the media’s poor record of talking about the issue so far is a worry that critical discussions around the promotion and uptake of LARC could be further used to devalue health professionals or scaremonger around contraception choices.


What could the result of this coverage be?
Perhaps unsurprisingly the media coverage has led to a lot of anxiety among the public. Women are worried about whether they were right to choose this method of contraception – and whether they might still find themselves pregnant or will face painful removal procedures resulting in permanent scarring.

Anecdotal reports from reproductive health clinics and GPs, as well as reproductive health charities suggest the number of calls from concerned women and their partners have risen dramatically today. We will have to see longer term what could also be the result of this coverage but it is not unreasonable to assume it could lead to women using the implant wanting it removed. Other women may be put off selecting this method, seeing it as ineffective and unsafe. It is reminiscent of the 1990s when media scares over the contraceptive pill led to widescale rejection of this method (and subsequent unplanned pregnancies).

Was the media wrong to cover this story?
No, they weren’t wrong. This is an interesting story. However it’s not exactly ‘news’ (problems with the contraceptive implant and legal actions have been noted for some years). It didn’t need to have been reported right now, particularly during a time when health services are under pressure. It should have been reported within a clear context to allow people to understand there have been problems with the contraceptive implant, but it is a method of contraception that suits many women, is effective and widely used.

What to do if you are worried?
If you are already using the Contraceptive Implant and are not experiencing any problems you probably don’t need to worry. However if this coverage has concerned you then you can speak to your GP, Reproductive Health Clinic or call the FPA on 0845 122 8690.

Remember this form of contraception is more than 99% effective and for the majority of women who opt to use it they experience no problems and are happy with it as their contraceptive choice.

If you’re using the Contraceptive Implant and are experiencing side effects or think you may be pregnant see your GP or Reproductive Health Clinic as soon as you can. Make your situation clear when you call so they can prioritise you for an appointment.

If you can feel your implant below the skin near where it was inserted it will continue to work effectively (but again do ask for a second opinion if you are worried). If you cannot feel your implant or are in any way worried it isn’t working then either avoid sex or use condoms until you have seen your GP or Reproductive Health Clinic.

It goes without saying that you should not try and remove the implant yourself. This has to be done by a professional and only if you are experiencing problems.

If you are thinking about using the implant but are now worried to do so, talk to your GP or Reproductive Health Clinic staff who can discuss your contraception choices and see which suits you best.

If you are not using the implant but still have anxieties about your contraception choices then do talk to a health professional about your concerns.

What health professionals can do
In the first instance you may need to recheck and advise women fitted with the contraceptive implant. It’s worth remembering the reasons why a contraceptive implant may fail and increase a risk of an unplanned pregnancy:
- Unrecognised non-insertion
- Unrecognised pre-existing pregnancy, or pregnancy risk, at the time of fitting
- Concomitant use of interacting medications
- Use beyond its 3 year lifespan.
If you are unsure about your skills in fitting implants or need retraining or support your local PCT or Sexual Health Service Provider should run courses. Book a place now if you feel underconfident or stressed by this story breaking.

You may find this story has increased your workload at a busy time so you may not be feeling inclined to tackle this story. However if you are able to do the following it could be very useful:
- Provide easily accessible information to your patients about the contraceptive implant
- Post resource information (such as the FPA details) around your clinic. A great resource has been created for you by @bishtraining (click here to download)
- Ask patients you know are using the implant or are considering using it if they have any concerns they need you to address
- Challenge poor or misleading media coverage if you are able
- Offer interviews with your local print and broadcast media to explain about the contraceptive implant and provide reassurance
- Request the DH/NHS who are circulating data about the use of contraceptive implants clarify the data (how long has it been collected for, where from, how much of an estimate is it) to help you put any questions your clients have in their proper context

What journalists can do
Much of this media coverage has been poor but there is still time for science/health journalists to challenge what has already been written and put a wider context on the story. Channel 4, after breaking this story, have now included more information on the Implant, but as others have noted this may be too little too late. All media covering this story in a simplistic and scaremongering way must bear responsibility of the repercussions on women’s reproductive health. It would be ironic if those papers gratuitously reporting on the NHS facing lawsuits over failed contraceptives could themselves be looking at similar lawsuits if they scare women enough to avoid contraceptive use and contribute to an unplanned pregnancy.

If you are in a position to rectify the poor coverage or explain more about the contraceptive implant that would be very helpful. This story, as with others on contraception, indicate journalists often have very basic understanding of contraception choices and how reproductive health services operate. If you know you’re not confident to cover stories of this time approach organisations like Brook or the FPA who can give you further information and advice.

Immediate tasks requiring attention from journalists are to:
- check the data that’s been talked about. Both from the MHRA and Department of Health. Source where the figures come from and put into specific context the number of problems women have experienced with the overall use of the contraceptive implant
- clarify the complaints made. How many of these were down to incorrect fitting of the device, faulty implants, pregnancy before the implant was fitted or injury from the implant or its removal (at present this information is not clear)
- try and track the source of this story. How did Channel 4 hear about it. In particular focus on whether this was brought to their attention by any law firms or a source within the MHRA.
- talk to the manufacturer of Implanon and identify from them their reports of problems/malfunctions/complaints recieved. So far most press coverage has focused only on MHRA and DH data (without clarifying those figures much). Additional attention should be paid to the manufacturers of the contraceptive implant who should have data on the number of devices provided along with complaints recieved and any legal actions taken. (They may, of course, not share this information, but it should still be sourced).
- provide information about the implant and what women can do if they want to use it, or are concerned about it, with links to sources of help
- give balanced accounts so while you may talk about women who’ve had awful experiences with implanon talk to those who may have had no problems and found it effective
- be careful not to make claims about the contraptive implant (or any form of contraception) without carefully investigating how it works.
- Talk to health professionals working in reproductive health to find out more about how the implant works, and which women it is suitable for (or not)


What everyone can do
If you spot poor coverage complain to the editor. If you are able to post comments to online coverage or call into broadcast media discussions do share accurate information about contraceptive implants and why this story is currently so problematic. The more we make it clear to the media we won’t put up with irresponsible reporting on our health, the less likely they may be to produce poor reportage in future. Obviously if you see good coverage, ensure this is flagged up and praised (some good examples here, here, here and here). If you have a blog, are on twitter or facebook you can also share accurate information and raise awareness over the poor media coverage.

With grateful thanks to
@DeborahAzizi for alerting me to this story and @dasilva_uk @K4Health @bishtraining @SexEdUKation @EdForChoice @bohaynowell @Abortion_Rights @NoRisks @BrookCharity @michaelgrayer @Matttskimo @dianthusmed for critical reflections on the coverage, data and health implications. And to my many friends working in reproductive healthcare and general practice for providing me with medical information for this post. (Please remember I’m not a medic and this isn’t a replacement for medical advice so speak to your GP or Reproductive Health Clinic or call the FPA on 0845 122 8690 if you are worried).

Posted in Contraception, Critical appraisal, Journalism | Comments closed

My sex and relationships predictions for 2011

By Dr Petra | Published: 4 January, 2011

Pierre et Gilles Crystal Ball

Christmas is over, the New Year has begun. There’s only the last few unwanted choccies left in the tin and it’s time to take down the decorations. Pour yourself a glass of good cheer (or make a cup of tea), settle down, and let’s anticipate the year ahead. What’s 2011 going to bring us in terms of sex and relationships?

This is an annual task I set myself. To forecast things I think are going to happen which I glean from on my work as a Social Psychologist researching sex and relationships in an International Health context – and listening to other educators, practitioners, therapists, bloggers and healthcare staff working in the areas of sex/relationships. For this reason some of the predictions are focused more towards sex/science/health. You’ve doubtless got predictions of your own based on your interest in sex and relationships, so please don’t see this list as exhaustive. Maybe use it to create your own list of predictions for the coming year. (If you want to see my predictions from last year and whether I got any right, click here).

We’ll all get wedding fever
Well we might not, but the media certainly will. It’s no secret there’s a Royal Wedding in the spring. This is going to put the press into an absolute frenzy. The opportunities to talk about not only a Royal Wedding but also weddings generally will be too good to miss. Imagine the endless opportunities to discuss wedding dresses, rings, pumpkin coaches and no end of commercial nuptial possibilities you probably didn’t even know existed. There’ll be scores of chances for psychologists, body language experts and relationship therapists to discuss the ins and outs of the engaged couple’s experiences before, during and after their wedding. And loads of opportunities to speculate about the Royals’ lives, or prescribe to us how weddings and marriage should be.

Opportunities to talk about diverse relationships – non monogamies, cohabitation, or being less judgemental about singledom, will be few and far between. Although we may see the Royal Wedding be something to revisit debates around civil partnerships vs marriage. Whatever happens I predict if we’re not already heartily sick of the Royal Wedding and wedding fever – we most certainly will be by the end of April!

The ‘science of sex’ is going to be super popular
From kissing to orgasm we’re going to get very interested in the ‘science’ of sex in 2011. Books, television and radio programmes, plus public science events will be tackling a wide range of topics including the science behind sexual behaviours and sexuality. Along with deeper explorations into the methods used to study sex – and an insight into the lives of (some) sex researchers.

Some of these are going to be amazing, groundbreaking and exciting. Others will be the predictable reductionist approach to both ‘science’ and ‘sex’. These accounts will focus more on biology and neurology (although not necessarily in a cutting edge way). In the process ‘sex science’ will be treated in an ahistorical, heteronormative and culturally biased fashion. The media is going to love ‘sexy science’, will treat it as if it’s an entirely new discipline, but will give far more attention to the more simplistic views of sex/science than the more nuanced, interesting and ethical research that many sexologists strive for.

Related to a fascination with sexy science there are also several large scale (epidemiological) sex surveys already underway (such as the NATSAL survey which is in the midst of data collection currently), and a major International sexological conference in Glasgow this Summer there’s plenty to be interested in relating to sex research.

This isn’t a prediction but I do hope sex researchers take the opportunity to reflect on and share more of their work via blogs and the mainstream media as it is something that continues to fascinate the public and yet often remains highly inaccessible. Let’s make sexology more open access in 2011!

Sex research is going to have to do more for less
Academics are seeing cuts across the board, but sexology (particularly critical sexology) is going to be one area that is more affected than other disciplines. Sex research that falls within the health/medical areas may fend better, but critical research and practice around less ‘mainstream’ topics is certainly going to struggle. Topics such as non monogamies; challenging heteronormative approaches; critical thinking around mainstream topics like ‘sexualisation’; researching pleasure; porn studies; Queer and Trans studies and research on alternative sexualities and BDSM are in need of inquiry but will struggle to get funding. For this reason practitioners, academics and activists are going to have to work more collaboratively, find ways to do ‘more for less’, consider methodological approaches that permit them to ethically explore areas without large scale budgets, and think about new ways to share information with colleagues and the public.

It is going to be a difficult year for those working in the more thoughtful and political areas of sex research. Fortunately networks such as Onscenity are already being established among academic communities, working internationally and cross disciplines to try and broaden research opportunities and mentor researchers.

Similar problems will also be affecting sex and relationships research in international health/development, although I’ve not see the same kind of mobilisation there, particularly not in public health. With the exception of some more foresighted groups and individuals, the majority of research on sexual health internationally seems to becoming narrower in focus – not least because of budgetary restrictions. This in turn is having a depressing effect on training and support for people working in reproductive healthcare and education.

One thing is certain, money may be limited but people’s need for information on sex and relationships is not.

Austerity measures will affect our sexual (and other) lives
It’s all a bit doom and gloom with my predictions this year, but unfortunately we are looking at a bleak year ahead. Financial cuts plus increased demands will undoubtedly affect Sexual and Reproductive Health Services. Practitioners are already warning particularly about the negative impact this will have on GU clinics and maternity services. With the end of the Teenage Pregnancy Strategy it is unclear what established services for teen parents will be retained. Sexual, reproductive and relationships outreach services may also be affected by local government cuts – and we can be certain where this happens the first to be affected will be projects aimed at sex workers, LGBTIQ groups, ethnic minorities and excluded young people.

Also additional cuts on benefits, rising unemployment and stealth cuts to educational, youth and arts charities will have a knock on negative impact on the nation’s relationships health. This may not seem obvious but proposed cuts aimed at people with disabilities won’t just impact on standards of living and opportunities for work, they will also impact on the ability to be able to date, socialise, form or maintain relationships (or generally have any energy or confidence for intimacy). Young people face losing clubs and activities that give them things to do, aspirations and goals. After school clubs and similar social activities face closure as to arts programmes – all having funding cut via stealth. Realistic efforts to tackle housing and poverty issues seem unattainable (or counteracted by benefit cuts elsewhere). We know young people who lack supervision, activities and who live in poverty and without adequate schooling and support are at a far higher risk of unplanned pregnancy, early sexual debut and STIs (more info here). It is perhaps unsurprising many practitioners, educators, parents and young people are already anxious about what the year will bring – and sadly we may see many casualties of the cuts before the year is out.

You might get ‘nudged’
It’s not as naughty as it might sound. If you’ve not heard about ‘nudging’, it’s a theory by economist Richard Thayler that was popular in the US prior to being noticed here by civil servants, politicians and some health/social care practitioners. Sometimes described as ‘libertarian paternalism’ it’s a form of behaviour change. It was designed from a financial perspective but has been applied to various areas – including healthcare (particularly issues like reproductive health, obesity etc).

Because previous attempts at behaviour change (in healthcare at least) were viewed as clunky, top down and overbearing ‘nudging’ aims to still manage people’s behaviour but through changing aspects of their lives to making them feel more in control over what they are doing. Critics obviously still see this as top down and oppressive, not fully engaging communities and focused usually at particular groups politicians view as ‘problematic’ (the poor, ethnic minorities, young people). David Cameron has been a fan of nudging for a while, and it has slowly been gathering momentum within political and policy making circles. However, as with any theory it has limitations and requires understanding and critiquing within an academic context. There’s no real evidence the coalition has done this so in 2011 we will see a version of ‘nudging’ being adopted and sold to us via politicians, charities, healthcare groups etc. Most of whom will be keen on this latest buzzword but won’t necessarily understand the theory behind it. It won’t stop it becoming popular, however. Not just in the UK. Practitioners keen on behaviour change models are already adopting this theory for use in the global South – frequently overlooking cultural differences that may make such interventions untenable.

Sexualisation will remain a popular political cause
Over the past few years we’ve seen the term ‘sexualisation’ enter popular culture with several countries commissioning reports into its effects. In the UK these reports are currently being re-evaluated. In 2011 we’ll continue to see the media focus on this subject and politicians see it as a major issue (particularly for young girls). Critical debates of the term will be less common, but we will see debates on the impact on sexualisation extend to talking about porn – with more conservative plans suggested to implement various blocks and bans on accessing materials. Addressing wider issues around gender, sexuality, sex education access to information and advice for young people will not be given priority. Nor will listening to young people themselves or acknowledging they may have any opinions or agency in this area. I think we can also anticipate growing links between Conservative/faith based groups and anti porn feminists moving to make porn/sexualisation more of a campaign issue – much like some of you will remember from the 1980s and early 1990s, and echoing what has already happened in Australia.

Mainstream media sex coverage will become increasingly limited
I know I’m a bit of a broken record over poor media sex coverage, but I’m going a bit further and predicting this year it is going to get worse. I’m probably setting myself a hard task with this prediction since I’m going to have to find evidence to support such a claim at the close of 2011. Or perhaps journalists could just save me the job by vowing to produce quality sex reporting? My hunch is they won’t, not because they’re not aware of the problems with reportage, but because they are restricted by time, budgets, overreliance on PR stories (and surveys) and editors’ daft ideas about sex. An example of just how reductionist and poor media coverage is at the start of the year comes courtesy of USA Today who’ve already set the bar massively low – surely it can’t get any worse? (I bet you it can).

Self reflection and diary keeping will become a major phenomenon
After all this misery and grouchiness here’s a more positive prediction. Sex researchers have been inviting people to keep sex diaries for years. Sex bloggers have taken this a stage further by reflecting on their relationships adventures. But this year I think we’ll see the idea of self reflection and sexual diary keeping become more of a mainstream phenomena. We might be using these for erotic entertainment, to communicate with a partner, or to identify particular problems we wish to tackle. Susie Bright has helpfully paved the way with her Sex Journal (which gives you pointers about what to write and space to share your reflections). Numerous magazine features are set to follow. You can easily join in by writing about and reflecting on your intimate life/lives online or in private. I’ll share more tips on how you might do this later in the year.

What’s definitely happening
There are some things I don’t need to predict as we already know they’re taking place. In February the Natural History museum delves into Sexual Nature with a fascinating exhibition on animal sex – easy tiger! Sex work is back on the political agenda (see here and here) and sex workers are particularly encouraged to get involved with consultation and lobbying on this issue (see here for more on how to do this). Debates are taking place around age of consent in Ireland (as is the topic of policing prostitution). In the UK the future of sex education will be debated in the early part of 2011 but we’re still uncertain what will happen.

So there you have it. Not perhaps a particularly cheery year to look forward to financially, but that doesn’t mean there’s not a lot of interesting things happening in sex and relationships research, education and activism in 2011. And plenty of work to be getting on with! On that note join me later this week when I’ll be outlining my plans for this blog for the next 12 months. I’m changing approach and format somewhat so I’m hoping it’ll be more useful and interesting for you.

Here’s wishing you a fantastic New Year!

Posted in Activism and Open Access, Alternative relationships, BDSM, Health/care, International, Marriage/civil partnership, Predictions | Comments closed