San Francisco Sex Information

Q: I am a 57 year old female, straight, and have had MS for the last 3 years. I left a long-term relationship a few years ago because it wasn’t going to be able to weather the MS. He wasn’t the right partner to be with once I had a serious, chronic illness. It scared him and made him angry and desperate.

I have a particular set of symptoms that make me feel hopeless about ever having a partner again because of how this will interfere with sexual intimacy. I want to talk to someone who can reassure me and tell me I’m wrong. Maybe this someone knows solutions I haven’t heard about yet. I am doing some treatment at Kaiser, but I’m not making much progress.

I’ve tried to talk to conventional therapists, but they don’t have much to say or much real knowledge. Do you know someone who I can discuss this with?

A: We’re sorry to hear that you’re having to struggle with MS and that it’s put such strain on your intimacy. Chronic illnesses of all sorts can impose tremendous difficulties on people’s sex lives–whether directly due to symptoms or from the stress, fatigue and preoccupation that tend to come with the territory. It is possible to continue to have a hot and fulfilling sex life while dealing with chronic illness though, and some people do so successfully. Some of the common keys to success are self-knowledge, working around limitations, and self-advocacy.

Self-knowledge means learning what your body can and cannot do, which just has to be a process of trial and error along with thoughtful observation. Working around limitations means using that knowledge to create relationships and kinds of intimacy that work for you and your body. And self-advocacy means being ready to speak up for your needs with partners and potential partners and seek out partners who will meet them. In conditions like MS that tend to have “good days” and “bad days”, this might look like making clear to a potential partner that you might sometimes have to cancel or modify dates on short notice, and choosing partners who will be sympathetic and supportive of that.

Since you’ve found general therapists not to have the expertise to talk about your situation, you might try looking into MS support groups, where the people you were working with could be expected to know about the disease. You could also try some broader searching online for “chronic illness” or even “intimacy and disability” which might lead to resources from people dealing with similar issues. Also, if you haven’t seen it yet, the National Multiple Sclerosis Society has a pamphlet on their website devoted to MS and intimacy. You may also try the American Association of Sex Educators, Counselors and Therapists to find someone who will be able to talk comfortably about sexual issues.

Q: I am a woman with a question I don’t exactly know how to phrase. It has to do with what excites me, sexually. It doesn’t have to do with typical bondage/S&M type fetishes, which I have explored actively throughout my life and have come to accept as not inherently bad for me. This interest it seems, however, has just been a cover up for what I’m really interested in. I’ve had rape fantasies for a long time, which I have read is relatively common for women, so I never worried about it. I very much enjoy rape themed porn, the more believable and realistic, the better. What disturbs me, however, is the fact that I do not enjoy it from the submissive, women’s perspective, but from that of the male rapist. I find that I enjoy the objectification of women and imagine myself in the male’s role.

What I’m actually getting at is how this has evolved to more deeply disturbing sexual fantasies involving the violent deaths of women. After watching particularly violent, gory movies I feel very stimulated and usually masturbate. I have such fantasies on many nights. Now, I’d like to make it clear that I would never, ever hurt anyone, I can’t even kill bugs without a guilty conscious. No part of me wants to commit any of these acts in reality, but I get way too sexually excited thinking about it. I know that fantasies are just fantasies and most of what I’ve read tells me there’s no such thing as sexually “normal”, but I can’t help feeling this is wrong. It’s distressing to have these thoughts and it is to the point where I can’t just dismiss them by thinking about something else. It doesn’t interfere with my daily life, just haunts me anytime I’m alone with my thoughts.

I guess my actual question is… should I seek help, such as therapy? Is it ok just to fantasize about such bad things?

A: Your anxiety is understandable–having fantasies about acts that would horrify you in real life can be seriously disturbing. But it’s also not uncommon. For some people, the wrongness of the fantasy is a big part of what makes it so hot in the first place. From what you write, it’s clear that you have a solid understanding of the difference between fantasy and reality. You don’t seem at all worried that you might ever act out the acts you fantasize about, and you don’t seem to feel dissatisfied with keeping them in the realm of fantasy.

We can’t tell you what you should do–that’s your decision to make. We can say that talk therapy might be helpful in either diffusing the power of the fantasies or easing your distress over having them. But many people in similar situations also just go on having and enjoying violent fantasies without that ever becoming a problem for them.

Q: I was curious, what is my risk of contracting MRSA when I go to a sex club, provided that I use gloves when touching genital area and condoms for penetration (oral or other).

Is it a higher risk than the same kind of activity in a private setting because of contact with surfaces or towels (provided I’m not sharing a towel)? I’m very careful about always sitting on my towel, no kissing, and no genital contact without a barrier but one of my current partners believes that just my going to a sex club is putting him at risk for contracting MRSA.

I’m a gay ftm guy and just trying to get a realistic picture of what my risks are.

A: MRSA is not so much an STD as a bacteria that lives on surfaces (and people) and is very hard to kill. It lives anywhere there are a lot of people and a lot of moisture, such as hospitals, prisons and military barracks. It’s not just for bath houses! The other people could have MRSA places other than their genitals, and it could be spread through skin to skin contact. However, it sounds like you are taking a lot of the necessary precautions.

Some steps to reducing your chance of contact with MRSA are the following -

- wear shoes, even flip flops
- use a clean towel to sit on (check!)
- use condoms and other barriers (check!)
- wash your hands for 20 seconds or use Purell after touching people or surfaces. You can do this at the end of the night and each time you go to the toilet,
- sanitize surfaces and tools (dildo, clamps) with rubbing alcohol

Here is some more information on Wikipedia.
http://en.wikipedia.org/wiki/Methicillin-resistant_Staphylococcus_aureus