Holistic Wellness in Austin, TX

Sexual Health, Vitality, and Life Stages

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ExpressiveBody~~~~~

Most of my Book Corner entries are in annotated bibliography form.  This page, for its part, consists of a revision to material I put together and used for an academic presentation on sexuality, culture, and research so there is a bit of a change from the format you will see on the other entries.  I highly recommend all of the books that are included herein, either for practitioners of Chinese medicine, for people who are interested in their own sexual health, and for anyone who might want to learn more about culture and sexuality in general.  These are good books, so do enjoy!

–PB

Begin at the Beginning: History

“A history of sexuality runs the risk of confirming popular fears that academics are capable of ruining even the most simple of pleasures”

–Stephen Garton, preface.

Barnett, Richard. The Sick Rose or: Disease and the Art of Medical Illustration. London: Thames & Hudson, 2014. Print.

— and Mike Jay. Medical London: City of Diseases/City of Cures. London: Strange Attractor P, 2008. Print.

Bos, Gerrit, trans. and intro. Ibn-Al-Jazzar on Sexual Diseases and Their Treatment. London: Kegan Paul International, 1997. Print.

Garton, Stephen. Histories of Sexuality: Antiquity to Sexual Revolution. New York: Routledge, 2004. Print.

Tesh, Sylvia Noble. Hidden Arguments: Political Ideology and Disease Prevention Policy. New Brunswick: Rutgers UP, 1996. Print.

Locating “sex” within a cultural and historical continuum is a logical first step and Garton’s study is published by Routledge (thus of high theoretical caliber) and it is thorough. In reading this work, one will notice how much of a social construct sexuality is, and how it fits within a larger psychosocial framework. Of course, one will also wish to read the introduction to Ibn-Al-Jazzar on Sexual Diseases and Their Treatment given that Arabic medical knowledge is a cornerstone of traditional classical and Western models of medicine. Going beyond what Garton clearly labels as histories, plural, the British empire and its application of medical mores and treatments offers another cornerstone to the construction of what we, today, know of as medicine. As the two Barnett texts demonstrate, sickness is historically located within a woman’s body (if not just frankly and solely in the womb) but when and if there is not a convenient female receptacle, then poor people and those of color will do. Sylvia Tesh, a political scientist, articulates how narratives of sickness and blueprints for the eradication of illness are constructed. All together, the above books provide a solid grounding in what notions of illness are and how social groups frame, contain, and attempt to eradicate them.

But This is for TCM School, So Now What?

“As time marches by the Chinese will somehow become ‘just like us.’ This kind of thinking casts sexuality in late imperial China as both exotic and backward. It also impedes our understanding of sexual mores and practices in contemporary China, where—despite the hallmarks of modern sexuality that Western readers find reassuringly familiar—sexual culture differs in important ways from a Euro-North American model. […] At the same time, being attentive to cultural difference can also produce misreadings of the history of sexuality in China”

–Susan L. Mann (xvi)

Farquar, Judith. Appetites: Food and Sex in Post-Socialist China. Durham: Duke UP, 2002. Print.

Furth, Charlotte. A Flourishing Yin: Gender in China’s Medical History: 960-1665. Berkeley: U of California P, 1998. Print.

Heinrich, Larissa N. The Afterlife of Images: Translating the Pathological Body Between China and the West. Body, Commodity, and Text Studies of Objectifying Practice ser. Durham: Duke UP, 2008. Print.

Lloyd, Geoffrey, and Nathan Sivin. The Way and the Word: Science and Medicine in Early China and Greece. New Haven: Yale UP, 2002. Print.

Mann, Susan L. Gender and Sexuality in Modern Chinese History. New Approaches to Chinese History ser. Cambridge: Cambridge UP, 2014. Print.

As the previous section intends to highlight, “sex” is contingent and constructed. As a student and practitioner of traditional Chinese medicine (TCM), I want to be able to read the classic texts that inform my Chinese professors’ viewpoints as I deepen my knowledge of Chinese medical practice. I cannot do that adequately without some knowledge of Chinese cultural attitudes and history. The British Empire had a tremendous effect (and much of it detrimental) on Chinese medical history at the turn of the nineteenth century as we may learn by reading historian Larissa Heinrich’s account. There are convergences and divergences between Chinese and Greek medicine; knowing that they exist and how they mirror or oppose each other enriches the understanding of any scholar (cf. Lloyd and Sivin). Chinese medical history and women’s health seems a little colorless if one just reads Chinese medical classics such the Nei Jing and has no access to the rich cultural history that surrounds it; in effect, historian Charlotte Furth writes a compelling case for the vibrancy and depth of women’s health history in China. Anthropology and cultural studies inform the studies of modern sexuality that I list above.

Side note: The supervisor on the rotation where I treated my very first erectile dysfunction patient is a Chinese woman. When I first treated the patient, she complimented me and said that I was so calm, that I didn’t seem at all embarrassed. She, herself, seemed just a little bit uncomfortable with the patient. It might have been that she was concerned about my comfort level, of course.  I also wondered at the time if it was because he is somewhat older than his sixties, and according to Chinese precepts (at least the written ones) men in their sixties on forth should be a little more concerned with conserving their essence than with having a robust sex life. Reading about contemporary China and Chinese sexual attitudes made it easier and more interesting when I spoke to my Chinese supervisor about such matters.

Men and Their Penises: What About Them?

“We live in a moment of history when we have more information about sex at our fingertips than any time before, yet we know so little about male sexuality.”

–Abraham Morgentaler (5).

Bonnard, Marc. The Viagra Alternative: The Complete Guide to Overcoming Erectile Dysfunction Naturally. Rochester: Healing Arts P, 1999. Print.

Morgentaler, Abraham. Why Men Fake it: The Totally Unexpected Truth about Men and Sex. New York: Henry Holt & Co., 2013. Print.

Sionneau, Philippe, and Lü Gang. The Treatment of Disease in TCM Volume 6: Diseases of the Urogenital System & Proctology. Boulder: Blue Poppy P, 1998. Print.

As much as I could spend endless amounts of time reading social, cultural, and anthropological accounts of sexuality and health I am, now, dealing with actual human beings rather than works of literature. Consequently, I found some practical guides that either help me to educate patients or help me to educate myself. The Viagra Alternative: The Complete Guide to Overcoming Erectile Dysfunction Naturally was extremely gratifying because its author, a French therapist and men’s health specialist, advocates for all of the things that I thought would help my patients: TCM, herbs, diet change, yoga postures, and frank, positive self-talk and self-work to bolster confidence and self-esteem. Morgentaler is a major proponent of testosterone therapy and I have recommended his book to my patients with the caveat that this is a major aspect of his platform as a men’s sexual health expert and urologist. What makes his text so valuable, both for patient and for practitioner, is his honest and respectful depiction of men’s concerns. Men can be taught to fear and hate their bodies too, and I did not realize quite the degree to which this is so until I read this book. I think that any man with ED who read this would feel less alone and would become encouraged by the affirmative and kind attitude toward sexuality demonstrated by the book’s author.

The Treatment of Disease in TCM Volume 6: Diseases of the Urogenital System & Proctology is a most excellent resource for when one is sitting down to plan one’s points and strategy.  It is not for a non-professional audience, however.

Whores, Mothers, Vectors of Disease, and Crones: There is More to Being a Woman Than Diseased Wombs and Atrophied Vaginas

“Through public relations, direct-to-consumer advertising, and marketing disguised as epidemiology, the drug industry is capitalizing on—and exploiting—the public’s ignorance and embarrassment about sex, general sexual myths and misunderstandings, and doctors’ inadequate knowledge base.”

–Leonore Tiefer in Herdt, G., and C. Howard (95)

Herdt, Gilbert, and Cymene Howard, eds. 21st Century Sexualities: Contemporary Issues in Health, Education, and Rights. New York: Routledge, 2007. Print.

Kaschak, Ellyn, and Leonore Tiefer, eds. A New View of Women’s Sexual Problems. Birmingham: Haworth P, 2001. Print.

Nagoski, Emily. Come as You Are: The Surprising New Science that Will Transform Your Sex Life. New York: Simon & Schuster Paperbacks, 2015. Print.

The narrative of women’s health in my OB/GYN class made me laugh (albeit a bit angrily) at first. It reminded me so of literary realism and naturalism in its manifestation in late 19th century Spain.  The theme of a woman’s body as a vector for disease and decay, was (I suppose) logical in a gynecology class… but I also was left wondering when there would be some acknowledgement that men’s undercarriages decline with age too, even as a side note.

When the instructor taught the class that first one undergoes menopause, then one’s vagina gets dry, and then one’s vagina atrophies, I was horrified.  Surely, I thought, it’s like any other part of one’s body–aging muscles atrophy, aging skin gets thinner and drier, that’s normal and not specific to either women or to, in such a spot-specific way, vaginas.  But there is a real narrative structure about what happens to a woman’s body once her periods end and I wasn’t so sure I felt like buying it.

I checked several sources (webmd.com, mayoclinic.com, several print sources) my initial impression was confirmed: this exact progression is not a forgone conclusion in just this way for everyone.  Instead, I found that fear of menopause and distinctly unpleasant experiences with menopause is, in part, an American problem that is the result of cultural attitudes towards aging prevalent in the United States.  (And after being in student clinic, yes I do acknowledge and have seen that some women do have a very hard time with menopause….just as some men have a really challenging time as they age and their vitality begins to decline.  Bottom line: everyone is different, everyone has their own level of health, their genetics, their capacity to deal with things…in other words, aging genital organs–male or female–are like any other part of the body and we can all choose how we interpret, respond, and improve or ignore them, as we please.  And we are all going to atrophy from head to toe if we are lucky enough to live that long).

I am so glad that I spent my twenties in Spain and Italy because, being there, I missed the lesson that an older woman has nothing to look forward to other than to become dried up and atrophied. And apparently, not everyone in America is eager to embrace this notion anyhow. A New View of Women’s Sexual Problems is a collection of feminist psychologists’ working papers on women, sexuality, and social constructs. Another collected works text is 21st Century Sexualities: Contemporary Issues in Health, Education, and Rights. Both of these deconstruct received wisdom regarding women’s sexual health and the second includes considerable intervention into notions surrounding LGBQT sexuality and wellness also. These texts are challenging for a casual reader, but they are readable if one is sufficiently interested.  In addition, they are suitable for not only a literature scholar but also for anyone who is going to then turn around and read evidence-based laboratory studies. We are lazy scholars if we just look at what the rats do. What about the scientists themselves who write the textbooks that medical students read? They, like the doctors their work produces, are constructs of their milieu and their research is supported and paid for by someone. What ax is that scientist grinding?

When we parse narratives of intersectionality we may begin to answer these questions.

(Note: Chinese medicine can do a lot for women’s health at menopause.  It’s not my specialty area but there are practitioners who really love the topic and will do a lot for you, if that’s your focus at this time.  What matters is that you find someone who is on the same wavelength as you about your body and that you are kind and caring towards yourself as you undergo what happens to all of us if we are lucky: aka, aging, rather than the alternative).

Educating patients is an important part of the job and the above-cited texts might be a little more interesting to a professional audience rather than to a casual reader. However, an Indiana University/Kinsey Institute graduate who is now a sexual health educator at Smith College wrote Come as You Are: The Surprising New Science that Will Transform Your Sex Life. In my professional opinion, it seems that it was written for young, white, upper middle class college women (Smith College women, basically) and its go-on-girl peppiness is a annoying at times. However, it is very well written, extremely well researched, and it is eminently useful as a fine starting point for well-written, sex-positive inquiry into women’s health and sexual agency. Anyone who wants to learn about female sexuality that is framed in a positive, intelligent manner can read this book and get quite a lot out of it.

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Concluding note: This has been a longer essay than is the norm for my Book Corner but there is a lot to read and say if you want to discover some of our more significant narratives about what, let’s face it, is in one way or another a significant aspect of a healthy life.  If I update or add to it, I’ll probably go ahead and write a blog post.  Do keep up with my blog, and feel welcome to look around the rest of my web site at your leisure.  This essay, for its part, is intended as a gesture of goodwill towards the existence of interesting, no-clickbait content on the web and I never take money for advertising or sales from this page.  There is, of course, no medical advice implied herein, and my sole aim in sharing it is to educate and to inspire.

–PB

 

 

 

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