September 2018 SexLab Update

SexLab has been very busy during the 2017-18 academic year. Our blog is celebrating its third anniversary and with that we have some exciting news to share.

Our research associate, Shannon Coyle, spent the summer revamping our website and blog. Check out sexlab.ca for our fully redesigned lab page!

Over the last year, our Lab Director, Dr. Caroline Pukall—with invaluable input from her fantastic team and wonderful collaborators—has been incredibly productive, with over 20 new publications. She and her team members have attended numerous conferences in order to get the word out on their cutting-edge research via many well-received presentations. In addition, Caroline, along with co-editors Drs. Andrew Goldstein and Irwin Goldstein, are working on the second edition of their successful book, Female Sexual Pain Disorders: Evaluation and Management. They have lined up authors with unique expertise in order to provide healthcare professionals with state-of-the-art content related to all aspects of genitopelvic pain (expected publication date: 2020).

In terms of teaching, Caroline completely overhauled her online human sexuality course, and taught it in the Winter term 2018. It was popular and highly rated by students. The on campus course has also seen significant changes and enrolment continues to be at its maximum. Caroline is using the second edition of her Human Sexuality: A Contemporary Introduction (Oxford University Press, 2017) textbook for these courses, and she is grateful to all the contributors to this successful text.

Caroline has also been involved in successful grant applications from CIHR (with Dr. Linda McLean from the University of Ottawa), SSHRC (with Dr. Jordan Poppenk from Queen’s University), the Catherine Oxenberg Foundation (with Dr. Meredith Chivers from Queen’s University) and ISSWSH (with her student, Robyn Jackowich). Currently, she is working on numerous projects with students and collaborators on different topics, including: persistent genital arousal disorder (PGAD), diverse relationships, prostate cancer, penile pain, a vulvar pain questionnaire, and a clitoral MRI study! In addition, she is co-chair of the Consensus Meeting on PGAD (with Drs. Irwin Goldstein and Barry Komisaruk) to be held in March 2019 prior to the ISSWSH meeting. This academic year is sure to be another busy, yet productive, one!

We also have a new (and familiar!) recruit who recently (re)joined the SexLab team, Dr. Stéphanie Boyer. Stéphanie completed her Master’s and Doctoral degrees in SexLab, after which she spent several years practicing psychology in Boston, with appointments at McLean Hospital and Harvard Medical School. She has returned to us after 5 years to lend her expertise to a number of projects in the lab related to women’s sexual health, ranging from sexual psychophysiological research to healthcare experiences in women with sexual dysfunction and genital pain. We are VERY excited to have her back!

This past year, our senior PhD students, Jackie Cappell and Katrina Bouchard, have been busy applying for internship and wrapping up their dissertations.

Over the past year, Katrina applied for a pre-doctoral internship in clinical psychology and worked on her dissertation on women's sexual arousal. She successfully matched to St. Joseph’s Healthcare in Hamilton and started a year-long psychology residency in September 2018. This academic year, Katrina will finalize her dissertation and submit the associated manuscripts for publication. She plans to defend her dissertation in the coming months. 

Jackie also applied for a clinical psychology doctoral residency position last year. She successfully matched to Eastern Health in St. John’s, Newfoundland and just started this year-long position in September 2018. Jackie’s first study from her dissertation—which focuses on postpartum sexuality—was published in Birth, and several media outlets covered the novel findings. Data collection and analyses are complete for her two in-lab studies and she has presented her findings at national and international conferences, including the Society for Sex Therapy and Research (SSTAR) and the International Academy of Sex Research (IASR). Jackie is currently in the process of writing her dissertation and submitting the manuscripts for publication. She plans to defend her dissertation in the coming months. 

Our two 2nd year PhD students had a full summer with successfully completing their comprehensive exams while still managing to contribute a wealth of knowledge to the field of sexuality research via conferences and publications

This fall, Robyn Jackowich is entering the third year of her PhD in clinical psychology. The focus of her doctoral research is on a biopsychosocial investigation of persistent genital arousal disorder (PGAD) in women, examining psychosocial, sensory, and vascular factors. She was awarded a 2018 ISSWSH Scholars in Women’s Sexual Health Research Grant to support this research. During the past academic year, she published articles on PGAD in the Journal of Sexual Medicine and Sexual Medicine Reviews.

This past summer, Robyn completed her comprehensive exam and project (Developing a Self-Report Measure of Genital Arousal Sensations and Perceptions), and looks forward to sharing the results of this project at the upcoming 2018 Canadian Sex Research Forum in Toronto, ON.

Robyn also received the 2017 Routledge Young Investigator Award in Human Sexuality from the Journal of Sex and Marital Therapy, for her article titled Symptom Characteristics and Medical History of an Online Sample of Women Who Experience Symptoms of Persistent Genital Arousal. She accepted the award and presented these findings at the 2018 SSTAR meeting in Philadelphia, PA.

Stéphanie Gauvin received an Ontario Women’s Health Scholar Award and Ontario Graduate Scholarship for her doctoral dissertation which explores how chemically-induced menopause affects sexual and relationship functioning in women who have undergone cancer treatments for breast cancer.

She was recently awarded a Canadian Institutes of Health Research (Institute of Gender and Health) Hacking the Knowledge Gap: Trainee Award for Innovative Thinking to Support LGBTQI2S Health and Wellness. Part of this award funded a trip to Vancouver to attend the two-day Design Jam event. At the design jam, she worked with team members Philip Joy and Matthew Lee from Dalhousie University to create a pitch for a comic book anthology created in collaboration with queer artists, called Queer Bodies in Confidence, that highlights the challenges that queer men experience in relation to their body image. Her team was awarded with having the best pitch at the event.

Stéphanie also published the SexFlex Scale from her master’s thesis in the Journal of Sex & Marital therapy and the Handbook of Sexuality-Related Measures. In addition, she published a review paper on sexual problems and sexual scripts of individuals who self-identify as bisexual and co-authored a textbook chapter with Drs. Pukall and Eccles.

She attended the Canadian Sex Research Forum’s 2017 conference and won an award for the best data blitz for her presentation on measurement invariance. Stephanie is working on a paper with labmate Lindsey on how discrepancies in vibrator usage relates to sexual well-being, and they are working on a project examining biopsychosocial factors of idiopathic anal pain.

Our Masters students have been writing this past year in preparation for defending their theses and a thesis proposal.

Meghan McInnis has spent the last several months wrapping up her Master’s thesis study, which is an investigation of prostate cancer patient experiences. Over the summer, she has been writing up her thesis, which she will be defending later in September.

Along with Stéphanie G., Meghan was awarded a Canadian Institutes of Health Research (Institute of Gender and Health) Hacking the Knowledge Gap: Trainee Award for Innovative Thinking to Support LGBTQI2S Health and Wellness. Part of this award funded Meghan’s attendance at the Design Jam event in Vancouver this past February. For two days, she worked with other cancer researchers (Amanda Bolderston from the University of Alberta and Evan Taylor from the University of British Columbia) to develop an initiative to support LGBTQ+ cancer patients. Meghan and the rest of her team will be working with Bird Communications to develop a web site that will include video testimonials from patients and survivors and other targeted resources.

Meghan attended the annual meeting of the Society for Sex Therapy and Research in Philadelphia in April. She presented a poster on Canadian healthcare professional students’ self-reported competence and confidence with working with transgender patients and clients. Currently, Meghan is co-authoring a paper with Stéphanie G. based on these data.

Lindsey Yessick has spent her summer analyzing data and writing her Master’s thesis, which uses functional magnetic resonance imaging to examining pain processing in the spinal cord/brain of women with provoked vestibulodynia. She will defend her thesis on September 24th.

Many of her studies have been ongoing while her thesis was in preparation, including a collaboration with Stéphanie G. to examine biopsychosocial factors of idiopathic anal pain. Lindsey also launched a study validating a new fMRI paradigm to assess clitoral arousal (finded by the Catherine Oxenberg Foundation).

Lindsey attended the SSTAR meeting in Philadelphia as well. Her poster was on the impact of a discrepancy between solitary and partnered vibrator use on sexual well-being. In addition, she will also be presenting the results of her thesis at the 2018 International Association for the Study of Pain conference in Boston this week.

Our newest student, Kayla Mooney, completed the majority of her required coursework for her Master’s degree. During the winter, she also assisted with an 8-week online educational program for women with persistent genital arousal disorder (PGAD). She will be presenting a poster at the upcoming Canadian Sex Research Forum in Toronto on some data collected from this program.

In the spring, Caroline, Robyn, and Kayla co-authored a review paper that proposed a model of “genitopelvic dysesthesias” to conceptualize conditions characterized by unpleasant genitopelvic sensations, which will appear in the next edition of Sexual Medicine Reviews. Kayla and Caroline are also co-authoring a paper with collaborators at Dalhousie University on experiences of pain during intercourse during pregnancy.

Kayla has spent the last several months preparing her Master’s proposal, which she defended at the end of August. Her Master’s thesis will be an investigation of how PGAD affects the relational, sexual, and psychological well-being of couples, and how intimate partners respond to their significant others’ PGAD symptoms. She is hoping to begin data collection for her thesis in October.

So as you have read, SexLab has been incredibly productive this past year! In 2018-19, we look forward to wrapping up several important research projects, publishing new findings, and continuing our research in the field of human sexuality.

Shannon Coyle, Research Associate

Discussions of Pleasure: How Ontario’s New SEX EDUCATION Curriculum has Failed to Live Up to the Hype

Tweet In 2017, a 23 year old woman left a date with celebrity comedian and self-described feminist, Aziz Ansari, in tears. In an article by Katie Way for babe.net, and under the pseudonym Grace, she recounts in vivid detail Ansari’s not-quite-illegal but nevertheless non-consensual sexual conduct over the course of the evening. It is a story that is unsettlingly familiar for women in our society; Ansari repeatedly and forcefully asked for sexual activity until Grace felt she had no option other than resign her consent; Ansari continued to engage in activities with an unenthusiastic and visibly distressed partner; and after the fact, Ansari claimed that at the time, he was unaware that his actions were inappropriate (Way, 2018). Ansari clearly disregarded or was unaware of the necessity of willingly given, enthusiastic consent. He also prioritized his own pleasure over a mutually respectful experience and approached sex in a combative manner by attempting to take what he wanted from Grace and impose his expectations for the night on her, regardless of how she felt.

In the midst of movements like Time’s Up and Me Too, for which Ansari himself has been a vocal advocate, there have been two main responses to Grace’s story in mainstream discourse. The first suggests that Grace does not belong to these movements and that she is overreacting or ‘crying wolf’-she gave consent and therefore Ansari should not be penalized as he did not break any laws. The second is that Grace’s consent was incomplete and unwillingly given, therefore Ansari’s actions were a violation and he should be called out or shamed in a manner similar to Harvey Weinstein and Kevin Spacey. I would suggest a third response, that Grace’s story is representative of a systemic injustice that starts with the way we frame discussions of sexuality in our society. Too often, the importance of mutual pleasure and informed, ongoing, enthusiastic consent are overlooked, and experiences like Grace’s dismissed as merely bad sex. However, it is often much more, it is disrespectful sex, and it disproportionately effects women. Rather than impose further guilt on Grace or penalize Ansari, I would argue that we have an obligation to the the next generation to reshape our understanding of sexual experiences and include not only the legal framework of consent, but also expectations of thorough communication and discussions of mutual pleasure. Without these, consent is a weak legal construct with limited benefit to individuals and their lived experiences of sex.

In my opinion, discussions about the importance of mutually pleasurable sex should take place before adolescents are sexually active, in order to establish it as a norm to which every sexually active individual is entitled. They should be included in sexual education classes alongside discussions of consent and healthy relationships. In 2015, the government of Ontario had the opportunity to enact a great deal of change in this area when they released the updated provincial sexual education curriculum. However, the updates fell short and among the gaps that remain in the curriculum is a failure to address pleasure as a priority or reality of sexual activity.

This omission is clearly intentional, and the reasoning for it understandable. Many stakeholders, particularly parents and religious groups, fear that addressing pleasure in the context of sexual activity is an endorsement that will encourage students to have sex. However, these students likely will engage in sexual activity eventually, and by avoiding discussions of pleasure out of fear, we rob students of the tools they need to engage in healthy sexual relationships throughout their lives. They may not have another opportunity to learn these skills as it takes immense courage, as well as a certain level of health and internet literacy and research skills to seek out accurate sexual health information outside of school.

Another reason not to allow parents’ fears to dictate the sexual education curriculum is that Ontario students are already highly exposed to sexuality, through various forms of media, from a young age. However, this exposure is biased in favour of heteronormative and sexist notions of sexuality that are rooted in dominant discourse. These norms perpetuate unrealistic and often unhealthy ideals about sexuality, such as the double standard that exists between women and men regarding masturbation. This double standard has had devastating consequences on women’s feelings and expressions of sexuality, and often results in associating sexual experiences with guilt and shame. These ideals also contribute to the competitive approach to sexual activity that has become normalized in our culture. People like Aziz Ansari have been socialized to believe that in order to have a satisfying sexual experience, they must take from their partner something which they do not want to give, rather than work together to create a mutually pleasurable experience.

Furthermore, adolescents are exposed to sexually explicit material that is contributing to their perception and expectations of sexuality. If sexual education does not adequately address the realties of sex, including pleasure and appropriate behaviour, students may not understand that the lens through which they view sexuality is distorted and will likely develop unattainable expectations of themselves, their partners, and their sexual experiences.

Although the Ontario sexual education curriculum is unlikely to address these concerns in the near future, they are being tackled in other ways. Pornhub, one of the largest websites for sexually explicit content in the world, has recognized that their material contributes to problems which are exacerbated by the inadequate sexual education that most North American youth receive. As such, they have chosen to use their platform to promote healthy, inclusive, sex-positive sexual education through the Pornhub Sexual Wellness Centre, a branch of their main website. Although the site is not perfect, it is challenging to navigate and not as well marketed as had been hoped for, it does approach this issue in a potentially revolutionary way. It was developed by a clinical sexologist and is one of the first websites to provide accurate, inclusive, and easily accessible sexual information internationally, to people who would otherwise not be exposed to it. Though Ontario’s new sexual education curriculum has not lived up to expectations and has failed to address pleasure as a reality of sexuality, exciting alternatives such as the Pornhub sexual wellness centre may engage students with this information in new and exciting ways.

Sophia Christopher, BSc, Queen’s University

References

Pornhub Sexual Wellness Centre. (2018). https://www.pornhub.com/sex/

Ontario Ministry of Education. (2018). Sexual health education by grade. https://www.ontario.ca/page/sex-education-ontario.

Way, K. (2018). I went on a date with Aziz Ansari. It turned into the worst night of my life. Babe.net. Retrieved from https://babe.net/2018/01/13/aziz-ansari-28355