The Guide to Getting It On (163 page)

So what we ended up with was a number of biological boys with ambiguous genitals who had been raised as girls, who never felt like girls. And once they started going through puberty, they particularly did not feel like girls. Ditto for bio girls who were raised as boys.

Today we know to leave well enough alone. While there will be social hurdles, kids with ambiguous genitals will probably do better if their genitals are left for them to decide what to do with. Their parents can raise them as boys or girls based on best guess, the way we were all raised. And if those kids decide to reshape their genitals later, that will be their choice. As we have discovered, only a very small percentage of intersex people who are raised this way go on to change gender or feel bi-gendered.

This is particularly important to know, now that there are so many chemicals called estrogen disruptors in the environment. These estrogen disruptors seem to do a number on the sexual development of the human fetus. We should probably brace ourselves for a lot more intersex babies in the future.

Teens and Young Adults with Intersex

The following thoughts for readers of
The Guide
are from William Reiner, MD, a professor of urology and psychiatry who works with children and teens who have intersex conditions:

“Often, teens with intersex conditions have been afraid of their sex organs, embarrassed by them, and they have had them examined by doctors far too many times. They tend to think that their sex organs make them freaks or weird. In fact, their sex organs are designed for pleasure just like anybody else’s, even if theirs look a little different (typical penises and vaginas actually look a little bizarre anyway).”

“For teenagers in particular, how they feel about themselves and how they feel about their bodies can be very important to their happiness and sometimes even to their successes in relationships. Most typical teenagers have fears about being rejected by the person they are sexually attracted to. Teenagers with intersex conditions often have these same fears, but they may be far more than in other kids.”

“Teenage boys and girls fall in love with a person (so do adults). They do not fall in love with penises or clitorises or vaginas. I try to help teenagers with intersex conditions learn how to talk about their sex organs to their lover, before they touch each other’s genitals or try to have sexual intercourse. And I let them know that they must ask what makes their lover feel good. How else would you know? Sexual relations among teenagers, as among adults, is all about relating to the one you are in love with.”

Intersex vs Transsexual

When your feelings of being a man or a woman don’t line up with what’s in your pants, you fall into the area that’s called genderqueer or transsexual. The official medical term is Gender Dysphoric or GID (Gender Identity Disorder).

GID is usually very different from being intersex, given that people with gender dysphoria usually have typical genitals and the “right” chromosomes. There’s nothing ambiguous about what’s between their legs, and their factory equipment is just fine.

The gender issue for people with GID often seems due to how their brain was either feminized or masculinized while they were still in the womb. As a result, the big head above the shoulders may feel like that of a woman, but the head down below shouts “I’m a guy.” Or, the head up above says “I’m a dude,” while the vagina down below says, “Uh, we’ve got a bit of a disconnect going on here.” Chapter 79:
Gender Benders
is entirely about that.

Highly Recommended:
These are excellent and highly regarded resources:

“Intersex in the Age of Ethics” edited by Alice Dreger, University Publishing Group.

“Hermaphrodites and the Medical Invention of Sex” by Alice Dreger, Harvard University Press.

“Intersex and Identity: The Contested Self” by Sharon Preves, Rutgers University Press.

Sugar and Spice and All Things Nice
to Alice Dreger, Ph.D., from Northwestern University, who was very helpful with this chapter—and a few puppy dog tails for Bill Reiner M.D., Director, Psychosexual Development Clinic (Child and Adolescent), University of Oklahoma Health Sciences Center.

CHAPTER

81

Sex and Breast, Brain & Ball Cancer

A
fter seeing the title of this chapter, you are probably thinking, “Just the upper I’ve been wanting to read!” Actually, you might be surprised.

When we have sent questions about sex to cancer experts, their responses have been along the lines of, “People with cancer are more concerned about living than orgasms!” You would think we had walked into an AA meeting with a twelve-pack of
Anchor Steam.
So if you are wondering about the subject of sex and cancer, the following account of a 37-year-old reader with breast cancer might be helpful. The readers’ experiences that fill this chapter tend to be long, but they contain tips and suggestions that are far better than what’s in much of the professional literature.

I hate cancer, hate having lost a breast. I went through a horrid jealous phase, envying other women their whole breasts, their health, their fertility (treatments put me into early menopause). But that’s a draining response, so I don’t dwell on it. Now, I just try to appreciate beauty when I see it.

Treatments for cancer can cause discomfort, fatigue and intense pain. Still, it’s possible to be sexual throughout treatment, just differently than before. Self-pleasure through masturbation is easiest because you set the pace. Try masturbating even if you have a partner because then you can guide them as to what feels best. I started with self-pleasure for sleep and pain relief a few days after surgery. Later, masturbating in front of my partner also helped be a turn-on at times when I didn’t feel up to active sex.

Relaxing with a bath set the stage, lighting a few candles in the bathroom for mood, then a warm tub filled with epsom salts to relieve aches and detox skin. I used lots of lube for self pleasure. I started this bath ritual about a week after surgery, keeping water away from the scar area and drainage tubes until healed.

I talked with my best friend about sex and body image. She said, “You know, no man has ever pursued us for our fabulous cleavage. We both have small breasts, so we are beautiful and desirable for other reasons,” and then she gave this wonderful dirty chuckle.

Imagination helps create sexuality beyond what your body is actually capable of expressing at the moment. Erotic talk and guided fantasies help me meet my partner’s sexual needs. Often, I put my head on his chest and cup his balls and tell erotic tales when I don’t have energy to do more. He touches himself and is happy because we are close.

Tenderness is now more important to me than carnality. My former enjoyment of raw fucking just faded away. I think my partner misses the erotic she-beast who morphed into a cuddle-kitten.

During treatment, I started using light taps and code words to signal when I needed to move, stop or pull away due to pain or discomfort. My favorite position became the couvade, or twisting my pelvis to rest on one hip for side entry, legs sandwiched around his, and supported by lots of folded towels and an extra sheet. The extra towels served another purpose. Nausea and incontinence are common responses to chemo and radiation. Having the towels there to wrap around made me feel more confident about bed play.

Lube is hugely important. Drink extra water a few hours before sex. All mucous membranes (especially the mouth) get sore with chemo and radiation, so during treatment, I added plastic condoms, even for oral sex, to help prevent any infections while my immune system was down and out. Semen made my skin burn and get rashy, so I cleaned up fast. I learned that I liked not having a bush of pubic hair so I continue to trim it even after it started growing back. Being bare makes me more responsive.

Alcohol upset my stomach, but pot soothed my nausea and made me feel relaxed enough to be sexual. I think medical marijuana should be legal for cancer patients to help sexual healing and getting a groove on as well as combatting nausea.

Lace is itchy against the scars on my chest and under my arms where lymph nodes were removed. I won’t wear underwire bras anymore because they are too constricting. But I do put on cute camisoles that are soft and stretchy enough to take off without tugging.

Sexual confidence comes and goes more readily. Sometimes, I don’t like being exposed, and will drape a sheet over me during sex to cover my scars. My partner has to be patient with that. If I have a hot flash during sex, I’ll ask for oral sex instead, so there is a lot of back-and-forth during sex. Continuing joint pain makes me move positions a lot, so I use small pillows and bolsters for support. Yoga helps with pain management, too.

Interestingly enough, I now get aroused through massage of my inner foot arches. It’s nice to have discovered a new erogenous zone to take the place of lost nipple sensation. A foot massage is a sweet way to get started relaxing and wiggling around in my partner’s lap; it’s fun.

My lover is an amazing partner who helped me do all the hard stuff: shaving my head when my hair began to fall out, going with me to meet the doctors when I felt afraid, or offering a helping hand to steady me as I stepped into the tub or shower. I am lucky to have such love and care.

The following is from another reader who was diagnosed with breast cancer at a very young age:

I was diagnosed with breast cancer at the age of 31. My boyfriend asked me to marry him ten days after that. Knowing that he still loved me and wanted to marry me after hearing such devastating news was so incredible to me.

I elected to have a double mastectomy which was a scary thing to do because the thing that defines you the most about being a woman is your breasts. It was strange thinking that the thing that I had criticized the most about my body was now feeling like the most precious part of it. I immediately had reconstructive surgery after my double mastectomy so I never experienced life without breasts, but the ones I woke up with were made of silicone and had no nipples. My skin was ultra sensitive, and at first I didn’t want to wear a shirt let alone be touched. After a few days I had no sensation in my breast area at all.

Before my surgery I had LOVED having my nipples played with and I used nipple clamps frequently. It was so devastating to lose such an important part of my sexuality to cancer. It was hard to imagine enjoying sex as much without my nipples and the sensations they had produced in my whole body – a tingle that goes from your head all the way to your toes. I felt so ugly and disfigured. I really couldn’t fathom that my fiancé would even want to have sex with me. Proving to me yet again what a wonderful man he is, we ended up having sex just a few days after I was discharged from the hospital. It was one of the most therapeutic parts of my sexual healing. Just seeing the devilish sparkle in his eyes as he looked at me with so much love and longing warmed me from the inside out!

It’s been almost two years since my surgery and I feel sexy despite my cancer and reconstructed breasts. My husband has continued to be turned on by me and we’ve found other areas of my body that are as sensitive (if not more sensitive) than my nipples used to be. It really goes to show that being sexy is more a mental attitude than a physical trait and that facing your fears about sex after such trauma can be a very positive experience.”

Dating Someone Who Has Cancer

One of the things that’s different about dating someone who has had cancer is that you are with someone who has had to fight hard to be alive. Outside of combat veterans, not a lot of us know what having to fight to stay alive is like, and how it changes your perspective on a lot of things that we ordinarily take for granted.

If you are dating someone who has had cancer, they will most likely want you to know as soon as possible. This is not for some perverse kind of bragging rights, but because they don’t want to have to deal with starting a relationship only to find you suddenly bailing once you find out about the cancer. This is especially important to people who can no longer have kids because of the cancer treatment or who have surgical scars or other cancer-related challenges to cope with. We live in a society where even models and athletes can be wickedly self-conscious—imagine someone who’s got scars or something missing.