Chat Questions: Oct 5, 2017

Chat Questions: Oct 5, 2017

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Our chats are usually around one hour and are held on Twitter. Start time is 8 pm Eastern – 7 Central – 6 Mountain – 5 Pacific. If you’re in another time zone, check the time zone converter. Make sure to use the hashtag #chronicsex to participate in the chat.

This week, we’re talking mental illness since it’s Mental Illness Awareness Week.

Q1: Please introduce yourself in whatever way you’re comfortable sharing

Q2: Do you have a mental illness?

  • Yes, diagnosed
  • Yes, undiagnosed
  • No
  • I don’t know

Q3: Do you know what effects your medications can have on your physical and/or mental health?

  • Yes
  • No
  • Unsure
  • I have a rare dx so it’s unresearched

Q4: Do you feel like your mental health care is being well taken care of?

  • Definitely
  • So-so
  • Not really

What we endure in childhood can contribute to (and maybe cause) both physical and mental illness: ACEs Study

While ACEs are important, they also currently leave out socioeconomic status and societal discrimination, so we’ll add those in

Q5: What ACEs do you think may have influenced your current illnesses the most?

  • Experiencing abuse/neglect
  • Poverty/food/health access
  • Systemic discrimination (racism, homomisia, etc)
  • Lack of support/isolation

Q6: What treatments have worked to help with your mental health?

  • Medications
  • Therapy
  • Pets
  • Other

Q7: What is the one thing that brings you the most comfort?

Pelvic Floor Therapy: Day 1

Pelvic Floor Therapy: Day 1

B&W photo of a person with long dark hair wrapped up in a sheet and hiding their face; white text: "Pelvic Floor Therapy: Day 1" and "Chronic Sex"

Earlier this year, I made an urgent appointment with my primary care doctor. She’s also an OB/GYN, which I love. I had a spot of seborrheic keratoses on my pubis that alarmed me. I didn’t know what it was before the appointment but, in prepping for my boudoir shoot, I found this giant mole-thing.

It was kinda scary.

While I was there, though, I also brought up something I’ve been dealing with for a few months. I will wake up with pain in my pelvic region. At times, it can be throbbing, stabbing, or spasmodic. I’ll usually need to pee, but have a hard time easing up muscles to let myself pee. Afterward, the pain is still so bad that I have to get in the fetal position and shove a pillow in my abdomen.

After an invasive and dysphoria-causing transvaginal ultrasound, everything was found to be normal. Two weeks later, I reached back out to my primary care doctor to see if pelvic therapy might help. So now, in addition to spine physical therapy for a bulging disc, I get to do pelvic floor therapy.


First appointment

Today was my first visit with my pelvic floor therapist. She is a little older and incredibly kind. I will admit, though, that I was a little nervous about the appointment.

Not only was I dealing with anxiety around having someone manipulate my vagina, but I also wound up dealing with some bowel incontinence earlier in the day.

a view of Kirsten's legs while she's on the toilet; her black boxer briefs from Tomboyx are visiable, as is a blue Ikea rug and while/beige tiles

Apparently, I’m not allowed to eat pineapple and drink juice anymore, says my GI tract.

I was worried about how this might affect things. Would we be able to do as much? Or, the more concerning question for me, was I going to just let loose everywhere?

Thankfully, I did not!

The first part of the appointment was spent talking about these spasms – when they happen, what might bring them on, etc. I mentioned my puzzling neurological stuff in addition to some rough abuse stuff I’ve been through.

It wasn’t exactly the easiest way to start a doctor-patient relationship.

Next, though, she pulled out a pelvis model and we talked through anatomy around the pelvic floor muscles.

pelvis model; the hip bones are visible along with the muscles that create the vaginal outside and the uterus poking out the top

Aside from the uterus popping out the top there, this is how a female pelvis looks. The hip bones are seen here in white with muscles in red. If you look closely, you can make out the urethra and vagina, too. One thing I always struggled to visualize was the different layers of muscles. This model comes apart so you can see the pelvic floor muscles both on the outside and inside.

The exam

It was really helpful to have a model to talk about the anatomy, but also for her to demonstrate what she was going to do with the exam.

The exam itself wasn’t horrible. I’m used to seeing my primary care doctor (who is also an OB/GYN) though, where I don’t have to make eye contact. That part got a little funky.

For those of you who haven’t had this type of therapy, the first thing is to switch from shorts to a hospital gown and lay on an exam table with a sheet over yourself. Next, the therapist feels around the outside of your pelvis – really, the outside of the labia and where it connects with your legs.

The exam moves to the inside, with the therapist using their fingers to check the muscles out. During different stages, they might ask you to clench or bulge/push out. This helps them to test the strength of your muscles.

My initial concern was that I might have loose muscles, but it’s the opposite! One thing we noticed quickly was that the left side of my pelvic floor was very tight. We then found the same at the bottom of my pelvic floor.

This isn’t super surprising. I tend to be tense in general. My left side is also the worst with every single health issue I have.

The treatment

For now, the first thing to do is start an at-home exercise. I mean, this is PT after all!

The one we decided to focus on for now is the submax:

This exercise is fitting for patients with pelvic floor tension or elevated baseline at rest. Begin at rest, contract your pelvic floor muscles gently, 70-80% effort. Hold the contraction for 5 seconds, then relax and release all tension for 5-10 seconds.

I am supposed to be mindful of my pelvic muscles, too. It’s easy to hold tension in pelvic muscles. Stress – ya know, like from begging Congress to not kill you – just makes that worse. Dealing with weakness in muscles can make them get tense trying to do their job, too.

There are some exercises that can help with pelvic floor tension as well. Right now, we’re avoiding those since I’ve got this bulging disc, but we will build up to them.

I’ll be seeing my pelvic floor therapist weekly before moving to biweekly. I’ll be documenting how things go here, too, because we need more resources on all this.

Have you ever tried pelvic floor therapy? What did you think?

Flogging Ended My Year-Long Fibro Flare #KinkySexTips

Flogging Ended My Year-Long Fibro Flare #KinkySexTips

a photo of a flogger (mixed medium of fluffy pink-purple and black leather) curled up against a grey couch; text "Flogging Ended My Year-Long Fibro Flare #KinkySexTips"

I’ve always been intrigued by BDSM and kink. I recently wrote a post about how the scene can bring useful things to anyone, especially in illness spaces. Naturally, when I attended the University of Guelph Sexuality Conference back in June, I hung out in their BDSM exploratorium.

The exploratorium was a very safe and respectful space, open to newbies and advanced kinksters to learn more about various kinds of play. It was great to be able to test out things, figure out what I was interested in, and talk with others about how my chronic pain might change things up.

I tried low-temp wax play and decided it wasn’t for me. Next, I had the same reaction with electrical play/e-stim, though I think that’s because of how much I utilize my TENS unit. I watched some rope play and hands-only impact play (punching, spanking, etc). Both were interesting to observe and I definitely want to do more with rope play in the future.

One station was set up for sensation play. It was so interesting. Scratchy, soft, leather, rough, hard, hands – we played with a wide variety of sensations on my forearms. Aside from being pleasurable, it was cool to be so present in my body for a positive reason.

The station I enjoyed the most was set up for impact play using instruments like floggers and paddles. My first go in the room, I spent time watching and observing. The second time, though, I offered to be a tester.

I got hit with a paddle, whip, flogger, and canes. During the negotiation process, I agreed to be hit just about anywhere, but the focus was on my back, butt, hips, and thighs. I had a few good bruises that lasted for a few weeks.

At one point, the person flogging me heard me go “Oooh!” My favorite thing is that they checked in, as did others watching, to make sure that was a good reaction – and it was.

After the event was over, I noticed that my pain was gone. I figured it would come back later in the day… but it didn’t. Now, I live with chronic pain, so it’s not that I was completely pain-free. However, the pain in my shoulders and neck was gone. It stayed that way for about a week despite a 15-hour drive back home.

Even after, though, my fibromyalgia pain was gone. I had been dealing with a fibro flare up for around a year – probably more – and it was finally gone. My rheumatologist and I had tried a bunch of stuff to get it to leave, but everything was basically a temporary solution.

Kirsten (short dark hair and black top) looks at a poster in a doctor office of the human anatomy/muscular system

Hell, even acupuncture – which worked at first – had lost efficacy.

It’s been just over two months since then. Despite the fact that I’m struggling to get adequate pain control and medical care for other things, my fibro is still cleared up. I have moments where it acts up more, but without a full flare – and mostly without the allodynia that was taking over my life.

I mentioned it to my rheumatologist at our latest appointment and she was ecstatic. When I told her how, she was really intrigued. We believe that, somehow, the BDSM play helped to rejigger the pain messages my body was sending. Researchers believe that mixed up pain signals are what fibro essentially is, after all.

In fact, ORCHIDS is going to do some research on BDSM and chronic pain to see what we can find! Stay tuned!

I can’t say that this will work for other people. What I can say is that I wish I had tried it a lot sooner instead of dealing with untreated pain.

If you’re interested in exploring BDSM tools more, I highly suggest checking out the collection Peepshow Toys has. SheVibe has some great stuff, too. In addition to being affiliates of ours, their shops are also just amazing.

This post is a part of the Kinky Sex Tips Blogfest ’17 run by Mona Darling. Mona is a former dominatrix who does sexual coaching for women. Make sure you check out her site because she’s running an amazing giveaway associated with these posts right now that includes coaching and great gifts!

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What BDSM Can Teach The Chronic Illness Community

What BDSM Can Teach The Chronic Illness Community

beige block on left side of square and right side has a photo of a feminine person with a black mask over their eyes and they are sticking their left pointer finger in their mouth, showing off their tongue and simple band on ring finger; on left, beige text in various black text boxes: "What BDSM Can Teach The Chronic Illness Community"; black text at middle "chronic sex"

BDSM (Bondage/Discipline and Dominance/Submission and Sadism/Masochism) winds up being very misunderstood.

People who don’t quite understand the whole scene think all sorts of things about those who are into it – it involves abuse, etc. Even health care professionals don’t get it, except some really great ones.

One of the things that many don’t know is how central consent is to the scene.

A LOT of conversation happens around these issues. People discuss sensations, actions, inactions, words, and more. Aftercare, which I’ll touch on later, is also discussed. These negotiations can take a few hours or a few minutes, depending on familiarity with each other, the scene, and other factors. It’s almost always longer when people first start playing together, though.

Checklists to go over what might be on your yes/no/maybe list are plenty and you can check out an example here.

Code words

Code words or safe words are something people usually know about BDSM. A safe word is a way to stop a scene/playtime. This can have varying stages, which is why I’ve written code words here.

You have words that can completely stop and mean we move right to aftercare. You may have words that ask for things to stop and for a check-in. You might also have words that signal you’re having a damn good time. It all depends on the negotiation process and those involved.

I use code words/phrases all the time. In fact, a lot of us do but don’t always call them that. We may say we are out of some unit of energy or running low on battery. When I was able to hike, the hubs and I came up with a term that would signal I needed to turn back. Since we’re history nerds, we used ‘bingo fuel’ which was the point where pilots only had enough fuel to get back to base and needed to turn around.

Even something as simple as saying “It needs to be a pizza night because I can’t cook right now” can be a code phrase.


BDSM can be very emotional, not unlike how some of the chronic illness/disability sexual experiences. Aftercare is a must.

It looks different for everyone but can include treating potential wounds, tea, snuggling, a check-in call the next day, and more.

Interested in learning more?

If you would like to explore what kinks may be right for you, you can take this test or check out the checklist I mentioned above. Before you get into the scene, you may want to check in with education-based sex shops in your area to see if they know of any events or classes. You can create an account on Fetlife to see what might be happening in your area as well.

I highly suggest reading more about BDSM before you get involved, though. It can be really great. Additionally, you may want to visit Lady Sophia, a dominatrix and sex educator in Chicago, who offers classes on various aspects of BDSM.

Am I *really* trans instead of cis?

TW: sexual assault/abuse, gender dysphoria. This originally appeared on our Medium page.

I have struggled with my gender for all of my life.

[1998–2000ish: Kirsten on a Ferris Wheel during a sunny day, holding the pole in the middle; she has long hair blowing in her face, round John Lennon-eque glasses, a striped white/blue/green shirt, and she is smiling]

As a pre-teen, I was very much a tomboy and began to wonder what I would look like as a male. I would dress up in my uncle’s clothing to see how I would look.

TBH, I was really fucking cute.

In high school, I learned to use my body for sexual attention. I got into clothing that showed off a lot of my body. Still, during any given school week, I would wear more tomboy-esque clothing two days and very feminine clothing two days. The remaining day was probably spent wearing my PJs to school if it wasn’t one of those two options.

[2005, high school senior picture: Kirsten sits on a stone bench with white pants and a teal/dark blue striped collared shirt; she is looking up towards the camera while smiling; she has long hair that goes from dark brown to blondeish at the ends]

When I was in college, I finally told my mother about some sexual abuse I had gone through years earlier. During that conversation, I brought up that I felt like a man trapped in a woman’s body often.

“Don’t you ever say that to me, ever again.”

Just in case you needed more proof of my family’s conservativeness, Ted Cruz and my mother follow each other on Twitter.

[2006/2007, Freshman in college: Kirsten is taking a selfie; she is wearing a white button up dress shirt with a grey waistcoat and white lacy bra; she has short dark hair and is standing in front of a dark blue wall with an abstract art poster]

It was really hard to share both of those things with my mother. When I came out as bi/pan on social media, she assumed it was because of my abuse and literally never talked to me about it. I never officially ‘came out’ to her about anything.

I never felt like I fully wanted to be a man, so I really didn’t bring it up to anyone again.

As I started learning more about gender identities and was exposed to them — thanks, Queer Ghost Hunters! — I realized I was genderqueer or genderfluid. I had fellow sex educators recognize this without it being verbally communicated and have had others pick up on this as well. When I began explaining my gender identity with these terms, people were fairly accepting. Overall, it was handled pretty well.

[2016: a photo of Kirsten holding her right arm up in front of her mouth with her hand in a fist, back of the hand facing out with the words “Weird Queer Fat” written on it in black sharpie; a rainbow bracelet is on her wrist; she is making a neutral, though kind of sad, face with her blue eyes staring out piercingly; she has on a grey tee and has dark brownish purpleish hair spiked into a faux hawk]

Like many people who are not cisgender, I face gender dysphoria. One of the biggest things that has helped me are videos from Chase. This one, on gender dysphoria, is one I especially like:

Chase documents criteria for a dysphoria diagnosis in adults (need 2/6):

  • Difference between assigned and expressed gender
  • Want to get rid of primary/secondary sex characteristics
  • Want primary/secondary sex characteristics of other gender
  • Want to be other gender
  • Want to be treated as other gender
  • Feel as though you have the typical feels/reactions of other gender

What’s interesting to me about this is I often wonder if I’m really and truly non-cis or if I’m somehow making things up. This is, no doubt, a result of being raised in a household full of abuse and gaslighting. I try to gaslight myself about what my experiences are, who I’m attracted to, and what I want to do with my life. Why would my gender identity be any different, right?

Do I really want to be male? Do I want to be treated as male? Do I act male? I don’t know.

After all, there are plenty of times when I can embrace my femme side.

[2017: color pic of Kirsten laying down tangled in sheets (which cover the good bits) on a white bed with short red hair; pic is taken from end of the bed so K is upside down, legs crossed and bent at the knees, right hand on sheet on chest, and left hand up beside her head; she’s smiling/laughing]

Being genderfluid doesn’t necessarily mean that I would do away with femme features for more non-binary ones. Sure, that’s part of why my hair is short. How I express my gender changes daily — and can change from moment to moment. In those respects, not much has changed since high school or college. The biggest thing is that I am finally embracing being a member of the LGBTQQIA+ community — and that winds up making me unapologetically queer.

You know, in addition to being unapologetically disabled and super justice/rights oriented… which then makes me concerned for my safety in this time of Cheeto-encrusted fascism.

I am certainly not cisgender and that’s permanent. With things changing for me all the time — especially how I feel about my body from an illness/disability perspective — I don’t feel like transitioning is something I can safely do or that I need to do at this point.

Some people don’t feel like that’s a valid trans identity, but it is.

[2017: pic of Kirsten from above, sitting on a dark wooden floor with white moulding and a blueish background; she has her legs bent criss-cross style, though not completely, and is looking down at/playing with her hands; she has on black jeans, a gray tee shirt with white text “Let’s talk about sex — Vibrant” and her white Converse are visible; her hair is reddish-purpleish]

I don’t know what the answer is to my struggles with my gender identity. Some days, I want shaved legs. Other days, having smooth legs just contributes to the dysphoria and anxiety I feel about not feel like I own my body (more than when my body causes itself pain and harm).

For right now, trans and genderfluid both fit me well. And that’s enough.