Welcome to Prep and Play, where we have conversations
about safer sexual pleasure. This podcast is
dedicated to empowering listeners through open,
honest discussions surrounding keeping our minds,
bodies, and spirits healthy while being sexually
active. My name is Danielle, and today we will
be continuing the conversation we started on
our last episode. So let's jump right back in
where we left off. What kind of toys and things
might be good for beginners and what should people
avoid with toys? Yes, I'm chuckling to myself
because someone I interviewed once was an anal
health specialist and he described how he had
a client who really wanted to engage in anal
sex, but felt like he couldn't relax. And so
he had introduced him to very small butt plugs.
And a butt plug is just, it looks like, how do
you describe a butt plug visually on a podcast?
Kind of like an acorn with a stem. Yeah, yeah,
yeah. An acorn with a stem, like a thick stem
at the bottom, like a wide base on the stem.
Yeah, perfect. It's kind of stubby. And it can
go inside of the anus and then rest inside of
there. And because it's kind of stubby and bulky
at the end of it, it can rest in there in the
base. stays outside of the body. And so anything
you introduce into the rectum, you want to make
sure it's got a flared bottom like that. So it
can't just migrate up into the rectum and then
pass the rectum into the sigmoid colon, then
further up. Again, this is what I mean by trial
and error, that people learn these things, unfortunately,
by trial and error. So it's got to have a flared
bottom. And one way you can kind of like get
yourself used to this experience is by getting
as this physician helped this client with, you
know, use a small butt plug at first, something
that's say the size of your pinky. And then as
you get comfortable with that and relaxed and
feel like you can enjoy the experience or at
least have a neutral experience, then you can
introduce something that's a little bit thicker
and wider and bulkier and with more girth. So
it's like a What are they called? Like Russian
nesting dolls, right? Like, you know, there's
a big one and then within there are much smaller
ones. So start with the smallest one and get
comfortable with that first. Same rule of thumb
goes for if you're having sex with someone, you
may not be ready for immediate penetration or
say whatever the toy is that's there or the penis
if it's a penis or hand or fist or fingers. You
may not be ready for the large Russian nesting
doll, but you can use your own fingers or someone
else's fingers, start with a pinky, then two
fingers, then three fingers and kind of, you
know, if it's a penis, for example, that you're
trying to get inside of yourself or inside of
someone else, you know, try to get let those
fingers, the girth of those fingers match the
girth of whatever is going inside first and let
someone be comfortable with that. Likewise, I
didn't mention this, but you might be thinking
of Daniel already is also like fingernails. to
be quite sharp. So you'd want to make sure your
fingers your fingernails are cut and buffed and
not sharp and your cuticles likewise. So this
is why some people use finger cuts or gloves
as well for that or just a condom to start with.
And then you did mention mentioned condoms. I
find that one of the I don't want to say issues
but a common thing that we see with anal sex
is that because there's no risk of pregnancy,
a lot of people will forego condoms in ways that
they wouldn't when they were thinking of vaginal
intercourse. But even though there's no risk
of pregnancy, there is still risk of STIs and
of HIV. So how do things like condoms and CREP
and DoxyPep fit into anal play? Yeah, I mean,
you said it. So there's there's still that chance
of contracting some other sexually transmitted
infection, HIV included, sexually transmitted,
even if you're not concerned about pregnancy.
So DoxyPep is available. PrEP is available. Well,
where it's available and for whom it's available
depends on where you live and that particular
context. But let's get back to like the one of
your early questions about like. How does the
brain and emotion influence people's experience
of sex? I'm of the generation of people who encountered
HIV really just before medications arrived. So
I was like a teenager, late teens when medications
arrived, which meant that there was always this
kind of like specter ghost of like the generation
of people who contracted HIV and then were gone
and we missed them. And HIV was kind of always
lingering around in my generation's head in that
way. And now we've got PrEP, we've got treatment
that really works, treatment that can really
eliminate the risk of HIV. And so what we were
hearing is that people can have sex and not worry
about that. Whereas before the idea of like,
having anal sex or anal play was always like,
always in some way linked to HIV or sexually
transmitted infections and something, something
bad is going to happen. And now people can experience
that and not have to have that same worry and
instead can connect with one another and experience
pleasure and life in a different way. So I'm
saying this because there is the biological benefit
of PrEP and DoxyPEP and antiretroviral treatment
to treat HIV and prevent the risk of transmission.
But there's also this huge emotional benefit.
to having those options now and being able to
be intimate with people in a way that, you know,
I wonder, sometimes I wonder if it's like similar
to when birth control arrived and people could
have, you know, penile vaginal sex, which sounds
very like mechanical, but they can just have
sex and it sounds weird to say it that way, right?
They could just have sex and not have to worry
about. an unwanted pregnancy and what to do about
that. They could just experience bodies together
and that, you know, lovely, pleasurable at times
can be spiritual experience of connecting with
another human being. And now that is something
that can be afforded to the people who can access
PrEP and DoxyPEP and HIV treatment. So it's pretty
amazing experience that we get to have now in
this later generations in this epidemic that
still continues. Yeah, that's awesome. And so
a lot of elimination of fear that we're seeing
with that. But there's so many options available
to people. And so I guess it's important really
to communicate both with partners and providers
here. And talking about anal sex can be awkward.
How can people bring it up with a partner? Yeah,
with a partner in particular, not in a health
care setting, but just with a partner. We'll
get to. A doctor. Previewing where we're going
with it. Yeah. So with a partner, you know, let's
just let's just validate that it can be difficult
to talk about sex in general, because we don't
model talking about sex very much in the world.
There's sex that happens in media, on TV and,
you know, books and other things. online in pornography
and just sort of seems as though people just
naturally have sex but they don't really talk
about what their curiosities are or what they
might want to experiment with or explore and
see if they like or dislike. So this is validate
that's sort of the baseline often for many people
and then to be able to talk about it with partner
I can imagine you know why that is difficult
but some strategies that I've heard from people
would be there's two things that come to mind.
One is, well, let me pause for a second, Danielle,
because it's not really my area of expertise
to help people talk about sex with their partners.
It's more for health care workers and help them
talk about sex with their partners. So because
I'm not a sexologist, I'm a little bit more cautious
about giving advice on it. And so I guess. Uh,
this is, it's not my current area of like research
or anything, but this is something that I've
had to explore a lot in, in, especially in a
previous podcast episode. Like we just did an
episode on conversations to have before, before
having sex. And so I guess I can talk a little
bit about my understanding of this. Um, and so
specifically one of the things that we discussed
in that episode was how important, not just for,
not just for safety and, um, like in a physical
sexual health, way, but also for connection and
consent, it can be to have these conversations
with partners about what you do and don't like.
And there were a few different varieties that
we explored discussing that in. So I had one
coworker who is typically engaging in. I would
say casual sex, meeting people through apps and
in the apps, it's actually really convenient
because apparently you just ask for a picture
and you're just like, what do you like? And then
you like send lists back and forth. I'm like,
that's so convenient because me personally engaging
in heterosexual sex with men, usually in a dating
capacity after trying to get to know these people.
I've found it a lot more difficult because being
a woman, it can be very, it can seem very brazen
to be the one to bring up sex. I've found that
it's it's honestly have been harder for me to
have conversations and say what I need to say.
I mentioned that sometimes I like throw out little
hints and this and that and then kind of just
like hope somebody drops through a hoop I'm holding
up or like things like that. But There are people
who do have conversations like that, especially
I think, I think it's more common within like
kink communities where they say, okay, what,
what's something you, what's your favorite thing
to do? Like what, what's your least favorite?
What's something you want to try? And conversations
like that, I feel like can be very valuable and
specifically for consent, especially with anal
sex because one of the specific things I talked
about is if My partner wants to try it and maybe
I'm not down with that. What happens when suddenly
I'm being penetrated that way and I'm very uncomfortable
with it without, you know, having a chance to
express that that would be uncomfortable for
me. So I'm a ton of actual advice on that. That's
one of those, you know, just just don't don't
be afraid of having. a conversation and asking
your partner. I think it's easier to ask your
partner what they like and then tell them what
you like than it is to just be like, hey, I would
like to try anal sex. Yeah, this is all so, so
well put. And part of the part of the struggle
with giving advice is that it's really like,
it's context dependent and culture dependent
and people dependent. And so like, you know,
just just to like, really spell it out. You know,
if you're someone who's meeting people on apps,
and it's pretty standard on apps, if you're on
apps where it's standard to talk about sex, you
know, that can be part of the culture of the
app, right? Or the culture of the sexual community
that you're part of. But if that's not your experience,
then you don't have that same opportunity. So,
you know, advice varies from person to person.
And you're reminding me of someone, a friend
of mine, I'm chuckling about this because I was
just so admiring that they did this. They were
reconnecting with an old partner they hadn't
had sex with in a while, like a decade. And,
you know, things had changed. So they came up
with a list. And I believe some of these lists
are online to like a list of sexual activities,
like really extensive lists, like we're talking,
you know, double digit list, if not triple digit.
And they printed it out and they gave one to
their partner and they got one and they said,
let's fill this out. And then let's see where
we overlap and see, you know, what we might want
to try with one another. So it's like a formal
way of doing what you're describing of like,
you know, being explicit and asking is saying
what you like or what you're interested in experiencing
or exploring. Because sometimes you can say what
you like, but you don't really know until you
meet. the person or people you're having sex
with might be different. And then going that
route. So I love your take on message of like,
people do this. People do communicate about sex.
It's okay to communicate about sex. It's okay
to ask for what you want because other people
have done it too. What about talking to a doctor?
What should people know about asking questions
or disclosing anal sex without shame? Yeah. So
This is the main area of my research. And my
goal with my research is to help people talk
about things that are uncomfortable in the world
of healthcare, where they need access to things
like DoxyPep and PrEP and PEP and antiretroviral
treatment and testing and things that are related
to sex, but because sex can be an uncomfortable
topic for people to talk about, including healthcare
workers, because healthcare workers often don't
get a lot of training on how to talk about sex.
That's like my bread and butter. That's what
I'm interested in sifting and changing. And so
one way that we've learned to do that is by changing
the physical environment in the healthcare setting.
I remember very early on in my work, I was doing
HIV counseling and testing. It was in San Francisco.
It was in a church. person who is the director
of the HIV counseling and testing program. His
name was Marcel. He's no longer with us, but
he's here in spirit. He was a really vivacious
person. And in his office, he had all these posters
around of different kinds of bodies and people
being erotic with one another. It wasn't explicitly
sex, but it was sexual and it was erotic. And
it was just so cool because you'd go in there
and you get the message that, oh, it's okay to
talk about sex. You know, I may be coming here
because I'm, you know, concerned about HIV or
syphilis or gonorrhea or chlamydia or something
else. But like, we can talk about sex here. And
that's always stood out to me. And, you know,
as you probably know, Danielle and anyone else
who works in healthcare has received healthcare
services. Most environments don't look like that.
They're not welcoming in that way. So what we've
learned in my research is If you can provide
a message, a cue, a poster, a palm card, something
in the waiting room on the screen that says it's
OK to talk about sex, and in particular, it's
OK to talk about anal sex, then that paves the
way for the clientele to feel like, oh, this
is a welcoming place. I can bring this up. So
that's the first thing I would think of. And
then, of course, If you're going to bring it
up, you want to make sure it lands with a healthcare
provider who's knowledgeable and educated and
skilled at communicating as well. So that's why
the workshop that you mentioned attending, that's
why that workshop exists to not only to change
the environment, but also to help healthcare
workers feel more confident and comfortable talking
about it when it does come up or to bring it
up themselves. Because often enough, even a poster
isn't maybe enough for a client to feel comfortable,
but If the provider brings it up themselves,
then the client can feel more comfortable. Yeah,
and I love that because we, you did give us posters
and little cards and stuff that we can place
in our agency in our clinic and have people feel
more comfortable bringing it up. And I think
that you mentioned there are. Healthcare providers
out there who are knowledgeable comfortable in
talking about these topics. And so I guess, from
my perspective, if. if you're encountering a
healthcare provider who isn't or who makes you
feel uncomfortable or ashamed, find a new healthcare
provider. Yes. Can I say one thing in addition
to on that same topic? Sure. It's just I'm going
to make another plug for this website that we've
created because it's a resource. All the posters
and all the other things that we created for
our project all link back to this website of
what we call credible, reliable, accurate information
about anal pleasure and health. And we haven't
created a lot of the information. What we've
done is we've combed the internet and looked
for resources that exist that we think are credible,
reliable, and accurate, and then put those resources
up there. So for example, the Queer Health podcast
about douching is up there. There's another,
there's a PDF that's about douching that we have
up there too. There's one about diet. for people
who are concerned about their fiber intake and
that sort of thing. There's one about sexual
positions and touchable sexual positions. There's
a lot of resources on there for people. So I
guess what I'm also saying is, we're saying if
your health care provider doesn't treat you right,
find another health care provider. And if you
can't or it's too difficult or you can't because
you know, there's only one healthcare provider
where you live, you still can get accurate, reliable,
credible information through the internet, through
this website, we hope. So that's also available
to people. And that's pleasureandhealth .org,
correct? That is correct. I will be linking that
in the show notes. Thank you. Awesome. And so
let's get into busting some myths. So some common
misconceptions around anal sex. You mentioned
one, it's supposed to hurt or it always hurts.
Yeah. There's really no reason for it to hurt.
The reason that people experience pain is because
they're feeling anxious and fearful and their
muscles are clenching, whether they realize it
or not. So sometimes we may be clenching, but
we may not be realizing that we're doing that.
And so the pathway there is to breathe deeply,
try to relax as much as possible, do other things
as well. Like you don't need to go from zero
to 60 as like nothing is inside of you to suddenly
a finger's inside of you. Instead, you can stimulate
the perineum, which is the area that's between
the vaginal opening or the scrotum and the anus.
Just rubbing that can be. very pleasurable, and
it can help relax the muscles of the pelvic floor,
which are also the muscles that extend into around
the anal opening. It can help relax those, some
lubricant, some saliva, something to rub around
the anal opening. Like I said, it's like the
palm of your hand, which means like, you know,
it can feel very pleasurable, but you know, it
takes the right kind of touch and I mean, right.
here in the sense of right for you in particular.
So that can help stimulating yourself and understanding
how you react to your own stimulation on your
own or with partners can also help. The message
here is that if you experience pain, it's an
indication that your body is saying, whoa, stop
what you're doing. Shift gears. Try something
different. back off from that thing, maybe change
your expectations that it should be a certain
way and instead listen to your body and how it's
reacting and then adjust and try something that's
more neutral and then see if you slowly can approach
things that are more pleasurable. I guess this
is also to say that like if the train leaves
the station, it doesn't have to arrive at that
particular destination. Like you can try something
and then back off from it. You've got freedom
to do that. You know, just because things start
moving in that direction doesn't mean that you
have to continue moving in that direction. You
can always change direction. There aren't actual
rails for the train. You're a human being. You
get to move around. You're fluid. You know, you
get to change and move in the direction that
you want to move in. I think that's such a great
piece of advice for all sex in general, like
any type of sex. So another one. Another misconception
is that anal sex will stretch a person out permanently.
Yeah, so every physician I've spoken to about
this has instead said, you know, if you're having
anal, if you're engaging in anal play, and I'll
also say like sometimes I've said anal play,
sometimes I've said anal sex, I think we've kind
of exchanged those terms. Sometimes people think
of anal sex as like, you know, a penis inside
of a butt. and sort of think of it very narrowly.
So anal play is broader than that. I really think
anal sex is really broader than that, too. But
just to be clear, it's really any stimulation,
like a tongue on an anus can also, it's rimming
or analingus, you know, that's also anal sex
or anal play, too. So there's lots of different
varieties of people, of what people can do. But
now I totally forgot your question, Danielle.
The misconception that anal anal sex will stretch
a person out permanently. Yes. Thank you. Okay.
So, um, there was a connection why I went there.
So the reason I went there is because there are
lots of varieties of how people can engage in
anal sex. So if we're talking about penetration,
particularly, uh, every physician I've spoken
to has said, well, you know, if you're enjoying
anal sex and it's pleasurable, you're not experiencing
any pain. What you're doing is you're, you're
stretching those muscles in the same way that,
you know, you would stretch I don't know, if
you stretch your arm or your hand or your hamstrings
or your calves. And when you do that, what you
do is you allow more blood flow into that tissue.
So as long as you're not experiencing any pain,
what should be happening physiologically is that
you are allowing more blood flow into that tissue
and allowing it to be healthier because more
blood flow in and out. is more healthy for your
muscles. So that's the message that I've always
been told. Now there have been a couple of studies
that have associated anal penetration with incontinence
or trouble keeping in gas or poop in life. But
the problem with those studies is that they're
not controlled for whether that anal sex was,
you know, consensual, pleasurable, relaxed, enjoyable.
So we don't really know that. And what we do
know is that there is, unfortunately, there are
times, you know, you mentioned this before, like,
you know, if a partner, you're having vaginal
sex with a partner, and suddenly, like, they
move from, you know, vaginal sex to anal sex,
and they haven't asked for permission, well,
you know, your body naturally is probably going
to tighten up in reaction, or feel something
in reaction, and those muscles may not be relaxed.
the pelvic floor muscles and the muscles of the
anus and the pure rectal muscle also, which is
responsible for being able to allow for entry
into the rectum too. So that's my answer. There's
like a little bit of science here, but the science
is in, I'm not saying that the approach of the
science is biased, but we're not able to control
and understand the full extent of human experience
just based on these two studies. And physicians
have all advised me that it should be kind of
the opposite. if you're really enjoying sex.
Awesome. That's good to know. And then the last
myth we'll do here is that only gay men have
anal sex, or even as a penetrative partner, enjoying
penetrating an anus is gay. Yeah, this is a sad,
sad myth. In part, because it inhibits people's
comfort. And we started out by talking about,
early on we were talking about shame and lack
of information. Well, like, you know, if you're,
if you're someone who is gay or bisexual and
is kind of is closeted and is concealing that,
you know, you're not going to go out of your
way to find that information if you feel like
you're going to be discovered. And if you're
someone who's not gay or bisexual or queer, but
you're curious about anal sex, you know, or you've
experienced pleasure just physiologically, you've
had a response. uh, to some kind of stimulation
and then you think, oh, does it mean that I'm
gay? It's just, it can be very confusing for
people unnecessarily. So it's really not about
people's identity. It's about just a physiological
response and connection to stimulation, you know,
by yourself, with other people really has nothing
to do with sexual orientation. And in fact, the
studies that have looked at who has anal sex
have found that there are far more women, then
there are men who've received anal penetration.
And if you think about it, actually, it does
make sense. 2 % to 4 % of men, for example, have
had sex with another man. And that generally
includes oral sex and anal sex. So we don't even
know exactly how many of them have had anal sex.
But say it's 4 % of men have had anal sex. But
then there are 50 % of the planet are women.
How many of them have had sex with a man? Quite
a bit. Quite a bit more than 4%, right? And of
those, what we see when people ask the question,
have you had anal penetration, it tends to be
much higher. So I'll give you an example of something.
I was just submitting a grant and doing some
research on this. And there is a study that was
done of electronic medical records in the United
States, about 5 ,000 women who received testing
for sexually transmitted infections. And when
you test for the sector transmitted infection,
Danielle, you know this, but maybe the audience
may not know this. You have to look in three
places. You have to look not only, say, if you're
someone who has a vagina, you look and look.
You've got to swab there or pee. You also have
to swab the back of the throat because there
could be an infection that's in the throat, but
that's not in the vagina. And then you also have
to swab the rectum. because there could be an
infection there that's not in the throat and
not in the vagina. So you really have to look
in three places. And of these 5 ,000 women who
definitely had had screening for sexually transmitted
infections, less than 0 .1 % of them had had
an anal rectal swab. Oh, wow. Less than 0 .1%,
right? But on average, about 36 % of women have
had anal sex at some point in their life. That
means we're really missing the boat in terms
of health care providers and the health care
system and taking care of people who have a vagina,
who identify as women and have a vagina. Or they
can identify however they want to. So it doesn't
really matter the identity, right? It's just
like as an example. So it's really not true that
anal play is something that's gay or that only
gay men have. And in fact, also not every gay
or bisexual man enjoys anal play, you know, just
because it's funny, right? It's like we somehow
assume, I guess, because of media that if you
have a mouth, you must enjoy kissing. If you
have a vagina, you must enjoy, you know, penetration
with the penis. If you have a butt and you're
having sex with other men who have penises, you
must enjoy having a penis inside of your butt.
It's like it's not true. We're just like part
of what's so cool about human beings is we're
like really diverse and we vary in what we like
and dislike and you know so we don't all have
to like or like the same thing we can all be
different and discover what it is that we like.
I love that and so in conclusion here what is
one thing you wish everyone knew about anal health
and or pleasure? I think the number one thing
is something you already touched on, which is
there's no reason to experience pain. There's
really really there's no there's no reason to
experience it. There's no you don't have to experience
pain. It really can be a purely pleasurable experience.
And when you start to feel pain or discomfort,
and I mean, emotional as well as physical, it's
just your body signaling to you to try something
different. And I guess coupling that with just
because other people enjoy anal sex doesn't mean
that you have to. It may not be your cup of tea
and that's fine too. Just because when I touch
the palm of my hand, I feel something there doesn't
mean that I forcibly have to make it pleasurable
or has to be pleasurable. Maybe it's not and
that's okay. You discover for yourself what you
like. That is awesome. I would like to encourage
everyone listening to have open conversations
and continue to seek education about these topics,
specifically through that, was it pleasureandhealth
.org? Because there are some great resources
there. And, you know, be open to trying things
if you want to try things. That's all I have
for today. Thank you so much, Brian, for talking
to me. Thank you, Danielle. I'm going to say
one more thing, which is you were saying, like,
how can people have these conversations? And
I'll just get kind of meta about this, which
is your podcast. Like, this is one way that it
happens. You change the typical conversation
by saying, hey, look, this is something we can
talk about. And it's OK to talk about it. That
changes the environment. It changes the opportunity
for people to realize, oh, huh. Daniel and Brian
just talked about this really openly and comfortably
and we're interested in it and excited about
it. And if other people are listening to this
too, then I may not be alone in what I'm curious
about too. So I think kudos for doing this. I
love that. I love that. And that was the goal
of this podcast to like encourage people to talk
about sex and sexual health. Awesome. Well, thank
you so much for joining me and thank you to anyone
listening and I. I will see all of my listeners
next time.