Q: Can my gyno tell if I've had sex before my Pap Smear? A: Probably. But whatever.

Dear Go-To Girl,
So I called Student Health this morning to get a Pap before I leave school and don't have health insurance for a while, and they gave me an appointment for this afternoon. The problem is, I just had sex with my boyfriend this morning and I've heard that if you've recently had sex it can mess up your Pap smear. Wtf?
Love,
Pap Gal
PS-We used a condom.
Dear Pap Gal,
Way to go using condoms. You're a good person. Your gyno will probably be able to tell that you've had sex recently, but as long as there's no semen inside you having recently had sex won't affect your Pap at all.
Go in peace.
Go-To Girl

The Go-To Guide to Getting Pegged

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By popular demand: The Rules of Queer Dating, Part 2

Apparently queers everywhere are so eager for me to tell them what to do about their relationships that I felt compelled to add a few more rules to The Rules. But the first and foremost Rule bears repeating: Be a creature unlike any other. Which leads nicely into my next rule:
14: "Resist the 'Urge to Merge.'" This applies particularly to gals: you shouldn't have the same haircut, borrow each other's clothes, or start looking alike. And don't wear matching outfits. Please.
15: "Don't get too intimate." Call me old fashioned, but I feel very strongly that all bathroom-oriented activities should be done privately, with the door closed. Even if you've just fucked someone senseless and seen every part of their body naked, allow them the dignity of doing their business alone. Same goes for using gendered, multi-stall bathrooms: for the love of god, don't stall up next to each other. That's just gross.
16: "Accept only one cancellation." I follow this religiously: just ask the [person] who cancelled on me twice in one week. S/he's dead to me now. Being queer doesn't make the repeated cancellation of previously made plans any less completely fucking rude. If someone you're dating keeps breaking dates with you, it's because they don't want to date you.
17: "Don't forget you don't have to settle down and move to the suburbs." Being queer used to be about not doing what everyone else did, mostly because queer people weren't allowed to. But nothing upsets me more than breeder gays and lesbians. I mean, live and let live, and if they want to get all HRC on us and pretend that nothing but gay marriage matters, so be it, but don't let them brainwash you into thinking that that's what a grown up queer life has to be like. You might be surprised to know that you can buy china and flatware if you're single. Crate & Barrel doesn't discriminate.
18: "Don't date someone who pressures you to have kids." Straight men know this; most of them will run away if a woman talks about babies too soon. This seems particularly intense with lesbians, perhaps because of what my dad calls "baby noises" that women begin to hear at some point. Some women hear them more loudly than others, and some (like me) only hear sirens. But if you're ambivalent about having children and you're dating someone who is not, say so. Children that endure gay and lesbian parental "divorce" suffer no less than those whose straight parents break up.
For further reading:
"The Rules: Time-Tested Secrets for Capturing the Heart of Mr. Right," by Ellen Fein and Sherrie Schneider
"He's Just Not that Into You: The No-Excuses Truth to Understanding Guys," by Greg Behrendt and Liz Tuccillo

Coming Soon to Health and Human Services: Looney Tunes PowerPoints

Thanks to Andrew Sullivan (www.andrewsullivan.com), for this powerpoint (http://www.abstinence.net/pdf/contentmgmt/EricKeroackPresentation2003.pdf) by newly-appointed HHS Deputy Secretary for Family Planning Eric Keroack that is called, and I am not making this up, "The Neuroendocrine and chemical Basics of Human Sexuality: The Results of Non-Marital Sexual Activity." In this presentation, he calls premaritial sex our generation's "Germ Warfare." He suggests that sex, because of its neurochemical processes, causes addiction to pleasure chemicals in a way that mimics drug abuse. The slides explaining this process are artfully illustrated with drawings that look like his 9-year old kid got a hold of a biology textbook and some markers. (see slide 19) Keroack suggests that the stress caused by non/pre/extramarital sexual activity acts as an opiate in the brain, increasing tolerance to oxytocin, the "bonding" brain chemical highly touted by conservatives as the chemical that proves women shouldn't have promiscuous sex lest they bond with every frat guy in sight. Besides Keroack disturbing overuse of Looney Tunes characters to illustrate his slides, his argument fails because it is basically this: the effects of oxytocin include an "airbrushing" of memory: for example, because of the oxytocin released during labor and delivery, women "forget" how painful childbirth really is and are usually willing to go through it again. So oxytocin in sex helps "airbrush" women's memories of fights or other upsets in relationships, which is apparently a reason why sex should be saved for marriage. So it lasts longer. Or something.

Good Catholics Use Condoms

I'm not making this up.

http://www.condoms4life.org/

The Rules of Queer Dating, part 1

1: "Be a creature unlike any other." Could anything be more appropriate for queers? "Creature" necessarily allows room for genderfucking, so this book is great for y'all. So get your drag on, dress up as that Asian gal from The Holograms, or a greaser mechanic, whatever.
2: "Don't stare at [people] or talk too much." Unless you're going to walk up to someone and tell them you want to take them home, don't stare. It's just not polite.
3: "Don't meet [them] halfway or go dutch on a date." Call me old fashioned, but I'm a femme and I expect to be taken out. Non-heteronormative of gender-binary-abiding people can figure this one out on their own, but somebody should just pay. There's nothing more gauche than talking about money.
4: "Don't call [them] and rarely return [their] calls." Again, this is classic hard to get. I believe that a ratio of 2 calls to 1 is good. And calls beget more calls, and I hate being on the phone.
5: "Always end phone calls first." Do this. Seriously.
6: "No more than casual kissing on the first date." This is playing hard to get with yourself. Do you really deserve to get laid right away? Doubtful.
7: "Don't expect to change a [person] or try to change [them]." This is especially key for readers of the bio-girl persuasion. For some reason, XX's make people believe that someone's "potential" is who they actually are, or that if they just quit smoking or just started listening to your favorite band, that they'll be perfect. Not so.
8: "DON'T TALK ABOUT YOUR FEELINGS." Seriously. Be mysterious. Unless there's a real reason to make "I feel..." statements, don't.
9: "Don't live with a [person] or leave your things at [their] apartment." There is one exception to this rule, and it involves coffee. No toothbrushes, no dildos, no scented candles.
10: "Don't buy collective sex toys." This is the same principle as living with someone: when you break up, you'll have the awkward situation of dividing custody of harnesses and dildos and, in the end, nobody ends up with a full set.
11: "Don't date a married [person]." Or date someone who's in an "open," "nonmonogamous," or "polyamorous" relationship. Those relationships are primary relationships with someone who is not you.
12: "Don't sleep together every day." Hello, U-Haul? Take a day off every now and then. Like two or three times a week at least.
13: "First dates (or hookups) should not last more than 48 hours." Party plus sleeping in plus brunch plus back to bed for round two plus sleeping over again equals just about 36 hours. Keep it at that.

I am vindicated

To the valiant men with whom I played Boggle this weekend, I submit the following four (count them: four) entries from dictionary.com:
---
lude  [lood] –noun Slang.
Quaalude.
[Origin: 1975–80; by shortening]
Dictionary.com Unabridged (v 1.0.1)
Based on the Random House Unabridged Dictionary, © Random House, Inc. 2006.
---
lude (ld) n. Slan.
A pill or tablet containing methaqualone.
[Short for Quaalude.]
The American Heritage® Dictionary of the English Language, Fourth Edition
---
lude (ld) n.
A pill or tablet that contains the drug methaqualone.
The American Heritage® Stedman's Medical Dictionary
---
Main Entry: lude
Pronunciation: 'lüd
Function: noun
: a pill of methaqualone —usually used in plural
Merriam-Webster's Medical Dictionary, © 2002 Merriam-Webster, Inc.

In conclusion, y'all can suck it.

Q: How do lesbians have sex? A: Watch this movie.

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Q: Blow job herpes? A: Yes

Dear Go-To Girl,
You're so great, I love you soooo much. Here's my question: is it possible to transmit oral herpes to genitals and vice versa?
Love,
Clark

Dear Clark,
The rumor is true: not only is it possible for oral herpes (Herpes Simplex 1) to be transmitted to the genitals, oral-to-genital transmission was shown to be the cause of 78% of all genital herpes infections.* Here's the rub: back in the old days, you know, when our parents were (not) having sex, people apparently didn't "go downtown" as much as we sluts do today. So Herpes Simplex 1 (oral) and Herpes Simplex 2 (genital) were relatively independent viruses. It should be noted that the viruses are not significantly different in their manifestation on the body, just that they happened to inhabit different regions. But since there's so much oral going on these days (and thank g-d for that) the viruses are getting completely crossed.
So what can you do? If you have a cold sore on your mouth, don't go around giving head to everyone you know. If you have a sore in your "area," well, keep it to yourself.

Love,
GTG



*Roberts, Craig M. PA-C, MS *; Pfister, John R. MS +; Spear, Scott J. MD, "Increasing Proportion of Herpes Simplex Virus Type 1 as a Cause of Genital Herpes Infection in College Students." Sexually Transmitted Diseases. 30(10):797-800, October 2003.

Hickeys are for hustlas

What's a gal to do if she winds up with one, two, or, say, nine hickeys on her neck? I've done some field research in this matter, and here are my conclusions based on available data:
1. Hickeys are not just for high school kids anymore. Few things are more effective at saying, 'Fuck all y'all, I got some last night' than a neckful of hickeys.
2. Covering them up, either by wearing a turtleneck or scarf, especially in non-winter weather, is totally lame. It says, 'I'm embarrassed that I got some last night,' which is not hot.
3. If you have, say, a job interview and really need to reduce the visibility of your partner's overzealousness, here's what you can do: put toothpaste on it. Really.
But hickeys are like the new 30; getting one says, 'I'm not embarrassed to be marked territory.' Or maybe just that you like to be bitten.

Don't listen to your classmates

Dear Go-To Girl,

I was in class the other day and heard several of my classmates talking about using citrus rinds as diaphrams for birth control! They said the acid kills the sperm. Is this true? Even if it is true, could it possibly be effective birth control? And even if it was effective, wouldn't it be painful or dangerous? What would be the advantage of the this natural method?

Thanks,

Brooklyn

Dear Brooklyn,

Unless they teach a class called "Secret 19th Century Birth Control Methods of the Stupid and Pregnant" at your school, don't listen to these classmates. While the rind of, say, an orange might from a great distance resemble a diaphragm, there are a few important differences between the two. First of all, a diaphragm is made of really flexible material; orange rinds are hard. Whether or not you could even put an orange rind in your cooch is an open question.

Here's the deal with acidity and the vagina: the vaginal environment is acidic, and sperm is relatively neutral but leans toward alkaline. So to change the pH of the vagina by using something acidic (citrus rinds, vinegar, battery acid, whatever) could make what is normally a hospitable environment for sperm hostile and, in theory, kill them. But the withdrawal method also theoretically prevents sperm from fertilizing an egg, so don't rely on a theoretical understanding to keep you from getting pregnant.
File this one under "WTF."

Sexiquette: 10-10-50 Revisited

After conversations last night about the validity and applicability of the original 10-10-50 rule, I have decided to provide some additional clarification on the rule.
10: The first 10 is the number of minutes necessary for sex. So if you are, say, a teenage guy and you're wondering how long you should really try to hold out when having sex with a girl, focus on making the 10 minutes you've got in you really solid. Some people (particularly drunks) can last forever, but, believe me, it gets boring. And yes, I have a clock on my bedside table. And yes, I look at it. I defy all you guys who really believe you last longer to look at the clock. 10 minutes is actually a really long time.
10: The second 10 does not apply to oral sex for girls. Sorry, girls and guys. I know your neck starts to hurt and whatnot. But if you're warming your girl up, you've got to put in the time. Girls, the same 30 minutes max rule should apply to you too. If your partner's neck is broken, you'll regret it.

I need to get into more messes like this one...

See today's Onion: "I Fucked My Way Into This Mess, And I'll Fuck My Way Out."
http://www.theonion.com/content/node/52981

Carcinogenic sex toys?

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Go-To Girl's Rules of Sexual Etiquette, part 1: 10-10-50

Those of you that were lucky enough to have been at the FGC-AYF-YF Fishbowl this summer already know about 10-10-50, but those of you who don't, allow me to elucidate. I'm a student, and I think in rules and theories. So, I have some theories. Ten-Ten-Fifty is a theory of how a sexual encounter should happen between two hypothetical people. Here's how it goes:

10: the number of minutes, from entry to exit, that sex* should take. Unless there's something remarkable going on (as in, alcohol-fueled anorgasmia, attempts at tantra, etc.) this is actually a pretty generous amount of time. Studies show that on average, men can go for about 5 minutes before coming. And I have heard from certain guys (who will remain nameless, but whose initials are S.D.), claims that "10 minutes isn't long enough" and whatever. Friends, guys, ladies, take a look at the bedside clock before you start doing it. I guarantee you that 10 minutes is plenty of time. And anything beyond 20 minutes is absolutely out of the question. We are all busy people.

10: the number of minutes a blowjob recipient can expect to get. There are exceptions to this rule, too, and they are as follows: if someone really likes giving blowjobs, they'll probably give you more than 10. Or if the blowjob is taking the place of sex then 10 minutes might be insufficient. But as far as blowjob-as-foreplay is concerned, anything longer than 10 minutes could cause serious neck strain and, c'mon, this isn't porno. *Ethical note: under the blowjob-as-substitute circumstance, it is unethical to stop giving the blowjob before orgasm and it is also unethical, guys, for the blowjob to continue longer than 30 minutes (at the risk of causing serious neck injury) if you know you are unable to come. This is particularly true if you are drunk. So keep it to 10 minutes. That bedside clock can again come in handy.

50: the maximum percentage of tongue that should be inserted into someone's mouth when kissing. There are no exceptions to this rule.

Go forth and fuck appropriately.

*this means penis to orifice; the rules of gay/lesbian/queer sex will be addressed in a different installment.

Best "Off Label" Use of NuvaRing Ever!

I'd like to thank Gavin, my F/friend and reader, for sharing the following fucking great idea.

"You say "nobody's partner has, um, felt it up in there" - by which I assume you mean that no man has reported to you, directly or via his partner (or, I suppose, via the grapevine), having felt the NuvaRing inside his partner during intercourse. I have.

It's not unpleasant, and can even be a little stimulating. This is, of course, easily avoided, in a playful move that turns NuvaRing into c**kring. Either partner can easily (and gently, guys!) reach "up in there", catch the ring with a finger, and (assuming the man in question is not monstrously huge - it's a slightly stretchy ring, and several inches in diameter) drop it over the top of a nearby penis. That can be as stimulating as you want it to be, or not. The guy is not likely to forget to return the ring, which is designed to be left out for some small number of hours per day. Hours. If you're sleeping with a man who might just leave without returning the ring, you need to a) go back to condoms, b) ditch the loser, and c) get tested for STDs and pregnancy."

Way to go, Gavin.

OTC Woes: Emergency Contraception on the Cheap

I've long been trying to make clear to people that one doesn't need Preven or Plan B for morning after contraception. I'm pasting below a table from Planned Parenthood's website that shows dosages of regular birth control pills to be used for emergency contraception purposes. It is my opinion that routine use of the MAP is going to end up being really, really bad for a woman's health, so don't do this regularly. But if you find yourself in a bind and have a pack of pills (or a friend's pack of pills, or whatever) here's how you can solve your problem. And then see my response to 'WTF' below. (PS-If you take Yasmin or another pill that isn't listed, just take a bunch of pills, like 5 and 5. But don't tell anyone I told you that. Oh, and you can't sue me.)

Pill Brand Manufacturer 1st Dose 2nd Dose (12 hrs later)

Progestin-only Pills
Plan B® Barr 1 white pill 1 white pil or 2 white pills in one dose
Ovrette® Wyeth-Ayerst 20 yellow pills 20 yellow pills
or 40 yellow pills in one dose

Combination Hormone Pills
Alesse® Wyeth-Ayerst 5 pink pills 5 pink pills
Aviane® Duramed 5 orange pills 5 orange pills
Cryselle® Barr 4 white pills 4 white pills
Enpresse® Barr 4 orange pills 4 orange pills
Lessina® Barr 5 pink pills 5 pink pills
Levlen® Berlex 4 light orange pills 4 light orange pills
Levlite® Berlex 5 pink pills 5 pink pills
Levora® Watson 4 white pills 4 white pills
Lo/Ovral® Wyeth-Ayerst 4 white pills 4 white pills
LowOgestrel® Watson 4 white pills 4 white pills
LuteraTM Watson 5 white pills 5 white pills
Nordette® Wyeth-Ayerst 4 light orange pills 4 light orange pills
Ogestrel® Watson 2 white pills 2 white pills
Ovral® Wyeth-Ayerst 2 white pills 2 white pills
Portia® Barr 4 pink pills 4 pink pills
Seasonale® Barr 4 pink pills 4 pink pills
Seasonique® Barr 4 light blue-green pills 4 light blue-green pills
Tri-Levlen® Berlex 4 yellow pills 4 yellow pills
Triphasil® Wyeth-Ayerst 4 yellow pills 4 yellow pills
Trivora® Watson 4 pink pills 4 pink pills

With a regular 28-pill birth control pack, use any of the first 21 pills for emergency contraception. Don't use the last seven pills in a 28-day pack. They are only reminder pills that contain no hormones. With Enpresse, use only the orange ones. With Triphasil or Tri-Levlen, use only the yellow ones. With Trivora, use only the pink ones.
(from http://www.plannedparenthood.org/birth-control-pregnancy/emergency-contraception/how-to-take.htm)

Advice: I hate condoms! (Who doesn't?)

Hey Go-To Girl:
My partner and I have just started to have sex without condoms, but I'm not on birth control. I'm
wondering what my options are, because I'd like to continue not using condoms, but am also under the impression that unless I want a baby that using nothing is about the dumbest thing EVER (any thoughts on that are appreciated, too, because for some reason he's not as worried about me getting pregnant...and I'm definitely open to the possibility that I just don't know too much about this).
Anyway, I'm really NOT wanting to use highly hormonal birthcontrol, and a midwife friend of mine mentioned a few weeks ago about a kind that is mild but effective, and that you insert/replace once a month.
Does that sound familiar?
Whatchu got for me gal?
Love,
Wants Total Freedom

Dear WTF,
You're right: using nothing is the dumbest thing ever. I won't address my feelings about your partner who seems unconcerned about you accidentally winding up pregnant (but where I come from, we have a word for a guy like that...) but here's the lowdown on condoms and nonhormonal methods.
a) Have you been vigilantly tracking your menstrual cycle for the past year and found that you have a predictable, regular cycle?
If the answer is "no," don't pretend that you understand the Rhythm Method and can decline to use condoms at certain times of the month. While the chances of getting pregnant during certain phases of the cycle are remote, finding out you're pregnant is a bad way to retrospectively predict when you ovulate.
b) Have you and the guy had the STD conversation?
If the answer is "no," you should be using condoms even if you're sure you can't get pregnant.
c) I hate condoms, too. A lot. That's why I got a ParaGard IUD.
The upside: It's nonhormonal and more effective than sterilization (seriously). It lasts 10 years (seriously). None of that weight gain/depression/moodiness/lack of libido/generally hating everything that you get with the Pill. It's the most popular contraceptive method both worldwide and among women OB/GYNs.
The downside: Cramps are worse, and my period lasts a bit longer. If you have bad cramps now, getting an IUD will make them worse, perhaps even debilitating. But if you don't (I had no cramps before my IUD) then it won't be that bad.
d) The once-a-month method your friend mentioned is the NuvaRing, which is a ring that you insert into the vagina each month. It releases a lower dose of hormones inside the body, so the side effects are supposed to be milder than with other hormonal methods. From people I know who have used it, they report high levels of satisfaction and nobody's partner has, um, felt it up in there. But if you're anti-hormones over all (as I am) then it's a no-go.

If you've used hormonal methods before, any side effects you experienced are likely to return. Some MDs are hesitant to give IUDs to women who haven't had children, but I've done the research and, trust me, if you're STD free you can get one.
If you have any STDs, you shouldn't get an IUD, because having an IUD and an STD can blow up your risk of pelvic inflammatory disease, which can cause infertility and death. But the IUD by itself DOES NOT cause PID or infertility. Nurse Midwives are also able to insert IUDs as long as they've been trained to do so and I prefer them for Gyn care in general.

To sum up: buy a box of condoms, and use them until you get your shit together. My favorite are Kimono MicroThin.

Love,
GTG

For more:
http://www.condom.com/kimono.html
www.paragard.com
www.nuvaring.com

It's up!

Ladies and Gentlemen, my article on Glamour and condoms is up. It's the lead feature. Suffice it to say, even though I wrote this article 2 years ago, it's still timely. Glamour continues to publish anti-condom articles (as does Marie Claire), but my subsequent monitoring of women's magazine condom coverage has shown that, of all of the magazines, Cosmopolitan does a fantastic job. Each year they recycle the same article that describes, in detail, how to use condoms perfectly, how to make sex with condoms more fun, and how to stay protected. Even though the tone of the magazine makes me want to beat myself over the head with it, as far as truth and balance are concerned, Cosmo wins.

Read my article:
www.americansexuality.org

Monogamophobia? Here's the cure

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Tell Someone! "Don't bother with the HPV vaccine"

HPV is incredibly common, sometimes it causes warts, sometimes it causes cancer, but mostly it causes nothing and goes away on its own. (see http://www.cancer.gov/clinicaltrials/results/cervical-cancer-vaccine1102)

Chances are, unless you're a virgin, you've already been exposed to HPV. The big deal about the vaccine is that it does prevent the persistent infection of the body with the particular type of HPV that causes cervical cancer, which, they think, will actually prevent cancer. So that's why you've seen the commercials that say "A vaccine! For a virus! That causes Cancer!"

But here's the thing: the vaccine costs about $350, it does nothing to stop an already present HPV infection, and the vast majority of cervical cancer in this country is caught early by annual Pap smears. The places in the world where cervical cancer is a prevalent killer among women are resource-poor countries, and it's anybody's guess how they will be able to afford to spend $350 on a vaccine. And speaking of resource-poor, the following groups within the United States have the highest diagnostic rate of cervical cancer: "Black women in the South, women living along the Texas-Mexico border, white women in Appalachia, American Indians in the Northern Plains, Vietnamese-American women and Alaska Natives are among the U.S. women who are most likely to die of cervical cancer." (http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=31646) These are populations who also have disproportionately bad access to health care services (to say nothing of specialized women's health services like Paps).

So, here's what you need to know: approximately 4,000 women in the U.S. die of cervical cancer each year, and the majority of untreatable cases are found in women who have not had a Pap in at least 5 years. Almost all cases caught by annual Paps are highly treatable. And the vaccine probably won't help you if you've already had sex. And it only prevents one of the several strains of HPV that can cause cancer. So perhaps this vaccine will be added to the litany of shots given to little kids, but it will probably not cause a steep decline in cervical cancer. And it costs $350. Just get a Pap.

For More:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=31646
http://www.cancer.gov/clinicaltrials/results/cervical-cancer-vaccine1102
www.tell-someone.com (Merck's website for the vaccine)

Reggie and the Full Effect Fall Tour!!

Words cannot describe how excited I am to inform you that I will not.miss.the.show.this.year. October 30th and 31st, Irving Plaza, New York City, Julie Sunday, front and center. James, I said it once and I'll say it again: you look better in Skittles. If you don't know Reggie, go, right now, to www.reggieandthefulleffect.com. You won't be sorry.

Introductory remarks

Hello, Friends. I'm caving to peer pressure and starting a blog and a MySpace page. My Simplicity Place is all aflutter, but I feel the need to provide some unified place where friends and associates can come to a) ask sexual health questions; b) ask theological questions, particularly of the Quaker variety; c) ask questions about destination weddings and honeymoon planning (really, I'm an expert); and d) find out what I'm reading (and writing), and what I think you should be reading.

Here are a few things to get you started:

American Sexuality magazine, www.americansexuality.org
--I will have an article up about how Glamour magazine inaccurately portrays condom efficacy and the relationship between their condom coverage and the large amount of birth control pill advertising in the mag. But AmSex is good all around.

Sex Herald, www.sexherald.com
--I write for them too. Here's an article I wrote on sex toy safety:
http://www.sexherald.com/healthy-sex/playing_it_safe_with_sex_toys.html

Here's my interview with anal sex expert Tristan Taormino:
http://www.sexherald.com/sex-and-health/index.php?section=21&item=5

Go Ask Alice!, www.goaskalice.com
--I used to write for this website but in spite of my absence it continues to be the best sexual health Q & A site out there.

Brides Magazine, www.brides.com
--Yes, I wrote for Brides.