Winter 2018 Update

This past semester, we at Sexual Literacy have been taking time to reflect on and critically examine our work and our mission--specifically, how well we’ve been reaching and connecting with our desired audiences in the Harvard community. We wanted to step back and get an understanding of how we’ve been utilizing the resources we have, and who our content was actually reaching. It’s been a very helpful process for us, and we’ve come away from it with whole bunch of exciting new ideas.

Next semester, we’ll be taking some of those ideas and using them to inform how we engage with the Harvard community. Our primary goal is to interact on a more personal level with our audiences than we have in the past, so we’ll be developing some new initiatives, outreach, and educational opportunities. Keep an eye out for pilots of some of these programs—we hope to see you in the spring!

❤ 

The Sexual Literacy Team

An Update from the SL Team

We here at Sexual Literacy are excited to share that we are taking this semester to intentionally reflect about how to best utilize this platform. We will be revisiting our best-practice frameworks, assessing what has and hasn't worked so far, and thinking creatively and strategically about how we can use Sexual Literacy to the greatest benefit of our community. We are constantly looking for feedback and will be asking folx to join us for focus groups later this semester. If you have any thoughts, suggestions, or want to check in, please email us at harvardsexualliteracy@gmail.com!

We are happy to continue replying to questions directly, so please continue to reach out.

Thank you for being members of our community and for all that you do to make our community a better place!

❤ 

The Sexual Literacy Team

I’m about to graduate! There’s been a ton of resources available while I’m at Harvard. Do you have any tips about how to find things once I’m out of the college bubble?

RC: Building off last week’s post, this week we are going to speak to some national resources that folks might find of interest when thinking about sexual and interpersonal wellbeing.  We will start with a quick run-through of resources that address sexual health and then look at some that address interpersonal wellbeing.

AG: One awesome thing about the digital world we live in today is that there are an amazing array of great online informational resources. Of course, that means that there’s also a lot of not-so-great information online, but some websites that we recommend if you are looking for sexual health information include:

Many of these have Q&A boards similar to our website, as well as informational articles. None of these offer direct healthcare services, which we talked a bit about last week. But just a reminder that places like Planned Parenthood or community health clinics can be a good first stop for accessing health care.

RC: When thinking about interpersonal wellbeing, it’s really important to note that there is no set formula or map that will define relationships.  We try to stress that understanding interpersonal wellbeing is less about understanding objective symptomatology and more about understanding the felt- and lived- impact of the interpersonal dynamics.  Because of this, interpersonal practices that might help me thrive might really not work for someone else, and vice versa. That being said, there are some important resources for folks who are interested in learning more about interpersonal harm, health, and how to be a mutual and equitable person.

AG: You can also find even more resources, broken down by category, via OSAPR’s website! Navigating this world of information can be overwhelming but there are definitely a ton of amazing organizations out there doing great work and publishing really useful content. Good luck!

RC:  Wow, we made it through a whirlwind academic year!  For those of you who are graduating, including the person who wrote in with this question, we wish you nothing but the best as you move into the next phase of your lives.  For those of you who we will see around campus in the Fall, have a great summer, and we will see you soon! Thanks for reading!

I’m about to graduate! There’s been a ton of free resources available while I’m at Harvard. Do you have any tips about how to find things once I’m out of the college bubble?

RC:  That’s a great and complicated question!  For anyone who has been in a workshop with me, y’all will know that my whole way of thinking is organized around access to resources and this is a shining example of that.  Depending on employment status, access to health insurance, income level, geographical location, and a number of other contextual factors, a person’s access to free and/or reduced-cost health and wellness resources will likely vary.

AG: A benefit to being employed in some organizations is access to employee assistance programs. These are programs that can “offer free and confidential assessments, short-term counseling, referrals, and follow-up services to employees who have personal and/or work-related problems.” This can include things like childcare access, mental health counseling, interpersonal violence resources, substance use resources and more. If you are employed, it is worth checking in with someone from Human Resources to see if you have access to a program like this.  

RC: Building off that, some health insurance providers offer incentives for preventative health initiatives, which might include things like defraying the cost of a gym membership, supporting exercise classes and/or weight-management programs, or subsidizing the cost of massage, acupuncture, etc…  

AG: Again, check in with your insurance provider to see what kinds of incentives you may have access to. We recognize that these types of programs are not common across all sectors and regions; in addition, if you are not employed they are inaccessible. However, there are often still community-based resources that may be available to you. Some examples of these may be: Planned Parenthood, community health clinics, and other mobile clinics.

RC: In many smaller towns, the Chamber of Commerce maintains a list of (generally) reduced-cost health resources that may be useful.  It’s really important to reiterate here that the availability of resources is very much based on the the community in which you find yourself.  It can feel onerous to navigate when moving to a new community; often people find that word-of-mouth and/or connecting with trusted resources for recommendations.  Finally, it may be worth googling and then following up to vet free health resources in your community.

AG: Next week we will give an overview of some national resources and will focus on post-grad interpersonal health! Congrats on graduation!!

 

I’m trying to buy condoms but am a little overwhelmed by the options. How do I know which condom is right for me?

ML: Thanks for asking this important question! Absolutely—when purchasing condoms, there are a multitude of options from which you can choose. From various sizes to ribbed vs. unribbed, flavored vs. glow-in-the-dark, this decision may feel like a daunting one. In this post, we are going to talk through a number of the factors that impact efficacy, comfort, and personal preference that will allow for the best experience at the end of the day.

AG: One straightforward way to start getting a sense of what condoms might be right for you is to measure your erect penis. You’ll want to measure both the length (from the pubic bone to the tip) and the girth (the width of the penis which you can get by dividing the circumference by 3.14). Condom manufacturers sell snugger fit, regular fit, and larger fit condoms which will fit different penises depending on these two measurements.  

ML: In addition to the fit of the condom, there are other things to consider when finding a condom that’s best for you and your partner(s). Some of these may include: ribbing, or texturization of the condom, flavor, color, material, thickness/thinness, added sensation, and amount of lubricant on the condom or in the packaging.

AG: A lot of variation! It’s worth remembering too that though most condoms come with some lubricant in the packaging this is generally just to prevent the condom from tearing as it is unrolled and so more lube can always be added! Again, we know this list can feel overwhelming. Finding the perfect condom isn’t always super quick, and can really just be more of a process of experimentation. It can be worth trying on the condom before the sex act to ensure that it fits well enough to be effective and comfortable, but you’ll get the best sense of what works the best for you with time and through trying different options.  

ML: Here on campus, there are multiple locations at which you can pick up a variety of condoms and other safer sex supplies for free. Feel free to stop by the sixth floor of HUHS in the Center for Wellness & Health Promotion, the Women’s Center, the BGLTQ Office, or at SHARC Office Hours in house dhalls where you can also ask any additional questions as it pertains to sex and sexual health. Here’s a map that points out these places!

AG: We wanted to end by briefly noting some of the pressures and expectations that may come with buying condoms. Many people may feel that they need to use larger sized condoms. In fact, studies show that 25% of men have tried magnums (extra-large condoms) when in reality these are really not necessary for most people. The average penis size is 5.16” long while a magnum condom is made for penises that are 8.07” long...so a big difference! The truth is that sex will feel better and that the condoms will work the best when they fit your penis appropriately. For some people it can feel that others may judge their condom choices however, picking something that fits well will really result in the best and safest experience for you and your partner(s). If picking up or buying condoms in public is nerve wracking, there are also certainly ways to buy them discreetly online!

April is Sexual Assault Awareness Month!

RC: Hello! This week’s post is not going to be a Q&A; instead, we are going to give a brief description of why Sexual Assault Awareness Month (SAAM) matters and write a shameless plug for April’s Sexual Assault Awareness Month events.

AG: Yes! The tough reality is that sexual assault happens and that it happens frequently. National statistics show that 1 in 5 women and 1 in 4 LGBTQ+ individuals experience sexual assault during college. However, we also want to stress that it’s not just women and LGBTQ people that experience sexual violence. Recent research from Columbia University indicates that 12.5% of men will experience sexual assault throughout college. Rates were noticeably higher for members of single gender organizations (like fraternities or sororities) regardless of gender.

RC: These statistics generally map onto lifetime prevalence data as well; national data indicate that 1 in 5 women and 1 in 6 men are likely to experience sexual assault throughout their lifetime. It’s really important to highlight that folks who have identities at the margins often experience much higher rates of sexual violence and often face significant barriers to reporting and accessing resources; for instance, 27.5% of Native American/Alaska Native women report experiencing sexual assault in their lifetime, compared to 20% of white women, and the Human Rights Campaign reports that “among people of color, American Indian (65%), multiracial (59%), Middle Eastern (58%), and Black (53%) respondents of the 2015 U.S. Transgender Survey were most likely to have been sexually assaulted in their lifetime.”

AG: Though of course, consideration and conversation about sexual violence ought to happen throughout the year, SAAM is an opportunity for us to come together in solidarity. We can use this month to think about ways to support people who have experienced or been impacted by sexual violence, to educate ourselves about the ways in which sexual violence shows up within our communities, and to hold ourselves accountable for change.

RC: The original SAAM awareness events began with Take Back the Night marches in the late 1970’s. These started in England and quickly spread.  In the 1980’s, while October was already recognized as Domestic Violence Awareness Month, activists identified a week in April for sexual violence awareness-raising, which quickly turned into the Month. Since then, advocacy organizations, coalitions, and states have had varying levels of SAAM engagement. Notably, in 2001, the U.S. observed its first National SAAM. To learn more about the history of SAAM, please visit: https://www.nsvrc.org/saam/history.

AG: One piece of SAAM that we hope people begin to embrace is working to reframe our conversations about sexual violence. Historically, we have used rhetoric that dichotomizes victims and perpetrators. We find that it is more accessible to frame conversations about interpersonal harm in a way that is reflective of how harm can be complex and dynamic.  In service of that, we try to use language like: person who experienced harm, person who caused harm, etc.

RC: Ok, events!  To learn more about SAAM programs, please visit the OSAPR website.  For all undergraduates, there will be a weekly Yoga for Restoration class offered in the Dunster JCR on Wednesdays at 7.  Hear Me Now: A Take Back the Night event will be hosted in the Dudley Lounge on April 19th at 6pm. Our Voices, a student production, will be in the Leverett Library Theater on April 20th and 21st.  And, as always, Harvard Wears Denim will take over the Science Center Plaza from 12-2:30 on April 25th. We hope to see y’all there!

 

I’m in a new monogamous sexual relationship. I heard you should get tested regularly for STIs, and I want us to but I’m worried my partner will be offended. How do I navigate this conversation?

AA: Thanks so much for sending in this question. It’s great that you’re wanting to be open and communicate with your partner your desire for the both of you to get tested for STIs (sexually transmitted infections). These conversations can bring up a lot and it’s great to think through in advance how you want to navigate given what you know of you and your partner.

LM: Communication is a really important part of any relationship, and having a conversation about STI testing can be a great way to normalize open and mutual communication in your relationship. You mentioned that this is a new relationship, too, and beginning to have these conversations early can create relational practices that support ongoing dialogue.

AA: The CDC recommends that sexually active individuals get tested between every three months to every year depending on your sexual activity and partners. More detailed testing recommendations can be found here. As we’ve mentioned in previous posts, the most common symptom of most STIs is actually no symptoms at all. Thus, getting tested in accordance with the recommendations is worthwhile even if you aren’t experiencing any symptoms.

LM: These could be some useful facts to bring up in your conversation with your partner. Since it’s recommended to get tested every so often, even if you don’t have symptoms, this can show your partner that your desire tcalo get STI tested may not stem from any particular concern about them, but rather that it’s a positive healthcare practice.

AA: It’s important to note that each relationship has its own communication style; only you can fully determine how to navigate conversations that might be loaded with your partner. That being said, there are some ways to engage in these conversations that others have found helpful. For instance, as LM mentioned, starting with the medical recommendations can be a low-threshold way to begin a conversation about STI testing with your partner. Generally people find that these conversations are more effective when they are framed using “I” language. The more each one of us can make our relational requests about our own needs rather than about the relationship itself, the more folks tend to be able to engage. When I think about a potential way to do that, it might look like: “I have decided to make STI tested a part of my preventive healthcare routine. I would like to have a conversation about whether this can become a practice in our relationship.”

LM: If you and your partner do decide to get STI tested, we at SL have previously written about getting STI tested at HUHS if you’re interested in finding out what the process looks like. Again, I want to emphasize how productive it can be to have conversations like these right off the bat. Like AA said, it can be helpful to communicate your own needs to your partner, and this can apply not just to STI testing but to the relationship as a whole.

AA:  I want to make sure that all Harvard students know that they can receive free STI testing at HUHS. You can schedule a STI test online via the HUHS patient portal, you don’t even need to call. First head the HUHS website and log into your patient portal. Once you are logged in fully, click on “appointments” and then “schedule an appointment.” When the next choices appear you’ll need to select Primary Care and choose the location option that corresponds to your PCP's name, then type in STI testing and complete the rest of the form. Appointment time options will pop up and you will be able to choose the time that is best for you.

If the clinician orders a test that requires a blood sample they will most likely send you to Quest Diagnostics which is in the basement of HUHS. Since Quest is a separate company, who does their own billing, it is important for you to remind them to bill HUHS for this blood sample. HUHS pays for all student STI testing, including any tests done through a blood draw. Sometimes, but rarely, there is a small margin of error as billing is done by humans. If a bill is sent to your insurance it will generally just say “lab test” and not the specific type of test. If this is still of concern to you we recommend that students call their insurance company (most phone numbers can be found on the back of your insurance card) and ask that their Explanation of Benefits (EOBs) be sent to their address on campus.

Amanda Ayers
Health Educator

LM
Student

I’m a Harvard undergraduate and just found out that I’m pregnant. I haven’t decided what I want to do yet and was wondering, what options are available for me?

AKG: Thanks so much for sharing your question! While SL is often a forum to talk about sex, sexuality, and relationships, we get that this aspect of reproductive health is sometimes left out of the conversation. Seeking information about options is a big step, and only the person experiencing the pregnancy is able to say what will work best for them and their wellbeing. Very generally, there are three choices you can make:

  • Abortion: ending the pregnancy

  • Adoption: continuing the pregnancy but placing the child(ren) with someone else permanently

  • Parenting: giving birth and raising the child(ren)

Depending on your identities, background, experiences, and future goals, any of these may be an option.

ML: Thanks for submitting this question! As college students, we are often inundated with information about preventative sexual health, but rarely talk about what happens when these events occur. While pregnancy may or may not have been a part of your plan here at Harvard, there are a multitude of services to help you through this experience regardless of the option you choose.

AKG: I agree, ML. Unintended pregnancies account for about 45% of all pregnancies in the US. Because this is a common experience, there are many places to get support and information out there to help folks walk through the decision-making process. A favorite service would be the All Options hotline (1-888-493-0092), which provides “unconditional, judgment-free support for people in all of their decisions, feelings, and experiences with pregnancy, parenting, abortion, and adoption.”

ML: Each state has different laws, policies, timelines, and procedure options. Because of this variety, we’re only going to take a bird’s eye view of methods. For more information about what may be available in your state, please check out the websites at the end.

AKG: Thanks, ML! So, let’s talk about one option: abortion. According to data from 2014, about one in four women will have an abortion by the age of 45. While it is a common procedure, the decision is personal.

The two ways to end a pregnancy in Massachusetts are medical abortion and surgical abortion. Medical abortion is available the first 10 weeks after the first day of a missed period. It’s a two step process where someone would take the first dosage generally at a medical provider’s office, and then they are able to take the second medication at home, usually within two days of the first one. Many folks report feeling severe menstrual cramps and experiencing bleeding or spotting that can be heavier than their normal period. This means that it may be helpful to have support with you including a friend or someone from Boston Abortion Support Collective (BASC) and/or take a break from your normal routine.

Surgical abortion in Massachusetts is available generally until 23 weeks after conception, though there are select instances where abortion may be performed past this point. There are two types of surgical abortions; both are in-clinic procedures that happen at Planned Parenthood League of Massachusetts in Boston, Women’s Health Services in Brookline, and at some area hospitals. Some clinics require that someone else picks you up from the appointment, so know that it may be necessary to have a friend or a member of BASC with you.

At Harvard, if you are covered through the Student Health Insurance Plan, and electing for a surgical abortion, you will be expected to pay a $75 copayment. A medical abortion should be entirely covered. If you have private insurance, but it will not cover an abortion or you do not wish to ask your insurance company if they’ll cover it, the student health fee (which all undergraduates pay) will provide a $350 voucher. The Eastern Massachusetts Abortion (EMA) Fund is also available should you require additional financial or additional support.

ML: Thank you, AKG. It’s very important to understand the different routes one can take should pregnancy not be a choice you want to make. If abortion is not an option or not the right choice for you, adoption is another route you can take. Through either a private or public adoption agency, you will be guided through the process of choosing caregivers. You will want to speak with an adoption counselor that you can find through your medical provider to learn more about agency-specific procedures and state particular rights; however, a broad overview is that you can choose to have an open or closed adoption. An open adoption is where you can choose to receive some information about the child and their family as they grow up, whereas a closed adoption would involve receiving little to no information post-delivery.

One option for talking to an adoption counselor is the National Pro-Choice Adoption Collaborative, a non-discriminatory, secular, non-profit agency that aims to provide unbiased information about adoption and services related to adoption nationwide. Like All Options, it’s another place to have a conversation with someone outside of your immediate environment to talk through the options that you have.

AKG: If you will be going through the birth process, HUHS can provide OB/GYN services to you, and the birth will take place at Mount Auburn Hospital. Undergraduates are able to live in the Harvard dorms while pregnant. However, if you choose to carry out the pregnancy and parent the child(ren) then you will not be permitted to remain in the dorms. In Cambridge, there are a number of resources and daycares that offer services, although pricing and availability may vary.

ML: While the breadth of information presented above provides a snapshot of your options should you find out that you’re pregnant, there is more information available about each option. It is important to note that each person’s experience will be different, and that there is no one right choice or answer to this question.

Mentioned Services:

My partner and I are considering pregnancy; I’m nervous about the process of giving birth. What does it usually look like to go through a labor and delivery?

RC: That is a great question!  For each person/process, it may go differently.  In this post, unlike most, I am actually going to be writing as the IRL or Context Expert and will speak from my own experience delivering two babies.  As AG mentioned in a prior week’s post, 45% of pregnancies in the United States are unplanned.  That was certainly true of both of mine.  One of the most important things that my partner and I had to consider upon finding out that we were pregnant was where we hoped to deliver.

AG: There are many different options when thinking about the birthing process that you want to have. First, you may decide where you would like to give birth: in a hospital, at home, or in some other location (for example, a birthing suite). Depending on the state, home births are generally attended by midwives; some people choose to include doulas, pets, children, relatives, and/or friends in the process as well. If you choose to give birth in the hospital, you can either give birth vaginally or via a caesarian section. People will make these decisions for many different reasons and it’s important to consult with a healthcare provider in the process.

RC:  Many providers offer the option of completing a birth plan, which lays out the ideal labor and delivery and often includes details about back-up preferences.  These may include questions about epidurals, c-sections, music, choice of lighting, people in the room.  I did write one for the birth of my first child--many of the elements I named went somewhat as I had hoped; some did not.  With my second labor and delivery, I made sure that I had clearly communicated about my wants, needs, and non-negotiables with my partner and birth team in advance, so felt that my process would be honored without a formal birth plan.  Again, for each person and each process, it may look different.  Please note, if, at any point, complications arise, your birthing team will be able to advise you regarding the best ways to ensure the safety of you and your baby(ies).

AG: Typically during the third trimester of pregnancy (and as early as the second trimester), people may experience something called Braxton Hicks contractions, which are basically the uterus “practicing” for the birthing process. They are generally infrequent/irregular in pattern (unlike actual labor), and for some the sensation may be intense.

RC:  One of my favorite takeaways from one of the books about mindful birthing that I read before my first child was born offered a different framework for thinking about contractions and the accompanying sensations.  Rather than describing the muscular contractions as painful or not painful, the book offered that we use the language of strong versus less strong sensation.  This does not add a value judgement or prime our brains to anticipate the physical sensation as anything other that whatever it is in the moment.  I found this really helpful; as an athletic person who really enjoys noticing what’s happening in my body, this reframe allowed me to observe and delight in the activation of a muscle I had never used in that way before.

AG: The process of actual labor can be mapped onto several stages, which correlate with the dilation of the cervix (it is considered fully dilated at 10 centimeters) and what is happening with the baby. The first stage of labor can be broken into early (the cervix is 0-3 cm dilated), active (3-7 cm), and transitional phases (7-10 cm). As these phases progress, contractions often become more frequent and more intense. The water may (or may not) break anytime within this first stage of labor.

RC:  With my first child, born on January 1st, we were celebrating New Year’s when my contractions began.  A friend actually decided he wanted to be responsible for tracking them, which was great!  They began around 8:30 pm on December 31st and after ringing in the new year, everyone left, my partner and I went to sleep, and I slept until 5:30 am, at which point the intensity and frequency of the contractions kept me from sleeping.  I don’t think I called any of our birth team until 8:30 or 9 that morning.  It’s important to note that there is no set timeline for the duration of a labor and delivery.  In both mine, my water didn’t break until much later in the process.  With my second, my water broke as I delivered. Some people report that they didn’t notice their water breaking at all, later to discover that it had.

AG: After the cervix is dilated to 10 cm the “active” stage of labor begins. In this stage, the person generally feels compelled to push so that the baby(ies) can move from the uterus through the vaginal canal, in the cases of vaginal birth. You may have heard people talk about episiotomies; routine episiotomies are no longer recommended, although they may be medically necessary in some cases.

RC: After the (last) baby moves through the vaginal canal, which is often called delivery, the last stage of the birth process begins: the delivery of the placenta.  In some cultures, people eat some of their placenta, other folks may choose to get it encapsulated in pill form, others may choose to bury it under a beloved plant, and still others may dispose of it.   

AG: At this point the delivery is complete! It’s often really helpful to ensure that the baby and the delivering parent have enough support to navigate a new phase of life. It’s also important to note that both parents (in a two parent dynamic) may experience a range of emotions and likely both will benefit from screening for depression and anxiety during this time.

RC:  While we have outlined a lot of technical information in a linear manner, it’s really important to note that everyone’s experiences of labor and delivery are different and may include a number of factors, people, babies, etc. that aren’t explicitly named in this post.  I also want to make sure that, as the IRL writer, I note that each labor and delivery involves risk and may not go as intended.  That was certainly true for me; there are risk factors for different populations that are really important to note and consider as one goes through this process.  It’s especially important to call out in this space the health disparities that women of color face when growing and delivering babies in America.  Serena Williams’s experience is a high-profile example of exactly that.