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The genderless and infinite soul

Tamsin Wu writes about how the concept of reincarnation can be crucial in understanding and accepting the natural existence of LGBTQ in our lives.

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Souls pertain to the immortal force that drives the human being. Being immortal and immaterial, it never perishes, but rather gets to be incarnated time after time. Reincarnations are used to explain away the amazing talents of child prodigies, the unexplainable connection between soulmates, as well as the countless events and karma we experience. The concept of reincarnation can be crucial in understanding and accepting the natural existence of LGBTQ in our lives.

In a nutshell, reincarnation is about infinite souls going through different existential forms and lives. Souls live through this world again and again in order to fulfill spiritual contracts, learn further and face karma. A lot of our current experiences depend on the good and bad deeds we’ve made in our lifetimes before. In enlightenment, souls would be able to go to higher consciousness and realms away from the world we know of today.

While some philosophies or spiritual beliefs – such as those found in Buddhism, Hinduism and Plato’s philosophy – talk about the rebirth and ascension of the soul throughout many lives before and after, other more popular religions discredit it. Some people are closed off from reincarnation thinking it’s too much of a foreign idea in our conventional belief system for it to be real. This is unsurprisingly so considering the widespread indoctrination of mainstream Christian religion on people since the time they were born. They wouldn’t be able to grasp the concept of reincarnation without the fear of punishment for compromising their devotedness in the typical Biblical interpretations they’re accustomed to. However, in these modern days, more Christians or Catholics are showing an open-mindedness to spiritual activities and beliefs that have been considered unholy by tradition. Besides psychic reading and feng shui, the belief in reincarnation is one of them.

Religious talks aside, it is refreshing to know that psychology and science is progressing in their studies of the possibility of reincarnation. From pro-LGBTQ arguments that gay people are just born that way to interesting explanations about how homosexuality exists naturally in the animal kingdom, perhaps we can put reincarnation into the mix.

In order to blow away the cancerous notion that LGBTQ is something abnormal, demonic or out of the ordinary, we have to comprehend nonheterosexuality from a standpoint higher than the limiting characteristics of anatomy our souls are moving in.

There are two things that need to be clarified in understanding LGBTQ – sexual orientation and sexual identity. Lesbian, gay, bisexual, straight belong to sexual orientation. For many years, most societies have been heteronormative – a romantic relationship should only be between a guy and girl. Homosexuality has been feared, derided and punished. In some parts of the globe, this is still the dangerous scenario. But, as the world works, there’s always a Yang (good) to the Yin (bad). Gradually, marriage equality has been sprouting in some countries and LGBTQ is being celebrated. Humanity is starting to understand that as long as something comes out of love, there is no evil when two people of the same gender enter into a relationship. There is no harm done when a person wants to express him/herself in a way that deviates from the social constructs of masculinity and femininity. In actuality, humans fall in one or more spectrum within the Kinsey Scale in their lifetime. Eventually, they find the point that rings true to them, which brings them a step closer to fulfillment. This sexuality scale is useful to understand attraction between humans because it goes beyond the binary concept of gender, which is not inherent in souls. It shows that people cannot be labeled as only either-or, black-and-white.

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Sexual identity, as the name implies, refers to which gender a person sees oneself as. Sexual identity doesn’t immediately determine sexual orientation, which is same as the fact that biological gender doesn’t determine sexual orientation.

This brings us to the topic of transgender. Why do transgendered people identify as a certain gender that’s the opposite of the biological gender they have been born with? Doesn’t this show that the soul does have a gender? Aside from the explanation of the complexity of gender development, we can also attribute this to the reincarnation concept. As has been said, souls have gone through different lifetimes, and none of us know what stories and experiences other people’s souls have gone through (unless you’re a legit past life reader, or you have remnants of past life memories in your brain which have been testified by some). Those past lifetimes may have left some deeply felt characteristics in some people’s current human existence that had them to believe that they must be a certain gender. Past experiences and karma comes into the picture. Whatever it is, we should not judge them because it is part of their own journey. The best that we can do to understand is to see pass the material and physical essence. We should not allow our consciousness to get stuck in this dimension of materialism. Otherwise, we will always follow a limited way of thinking that bars us from embracing the beautiful infiniteness and grandness of our existence in this universe.

All of us face different joys and struggles in our lives that pave the path towards growth, strength and wisdom. For the LGBTQ community, the struggle of simply being comfortable in our own skin can already be seen as a political stance and challenging towards the status quo, even though we’re just being our authentic selves. But what is the “self’? The self is the so-called “ego” that has been painted layers upon layers of physical characteristics, social engineering and labeling, consumerist inclinations, media and political propaganda. Peel away all those thick layers and we are just left with this profound life force called the soul, with energies derived from multiples lives. Hence, the soul’s ego is molded and re-molded depending on such layers presently dealt with by the soul. Contrary to what a lot of people have been thinking their whole lives, the soul is not defined by the body. It doesn’t have a ghostly, feather-light appearance of our physical body which has been portrayed countless times on the screen. The soul is without the imposing characteristics and behavior of a human gender. The soul is unisex, devoid of such human concept. That is why regardless of race, class, religion, gender, sexual expression and orientation, we are all the same at the core of our existence. This is a universal truth that holds all of us together. It is only with layers of physical limitations, lies, fabricated truths and distorted facts that we have been differentiated and pitted against each other, as well as blinded from the true nature of our being.

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To elucidate further the difference between the soul and ego, let me share with you a recent past life reading I’ve had with my girlfriend at a The Third Eye Wellness party. The past life reader gave me a feeling of certainty that her readings were true because of the things she said about my girlfriend and I even before I’ve divulged any information to her. Anyway, on to the past life…

I honestly couldn’t remember anymore if she asked us to pick cards when she was reading a part of our past (love)life. I can only remember the details she saw. According to her reading, I was a thin, frail-looking man and my girlfriend was the woman. I was a man of wealth who held a silent dignity and substance. The woman’s face looked a lot like my girlfriend’s face, and she was someone who loved to socialize and who wore big dresses. We both mutually loved each other, albeit discreetly, since she was already married to an off-putting man with a moustache. Although they didn’t have a happy marriage, she stayed poised and positive in her life. On the other hand, the past life reader told me that she could see a plump woman with a high-pitched voice, but she couldn’t tell if that was my wife or my mother. That plump woman was dominating me in that toxic relationship as I chose to keep mum whenever she scolds. However, there were times that she showed loving ways towards me. The past life reader added that the man whom my girlfriend was married to is a male relative of hers in this lifetime. It is someone whom she dislikes very much. (We know who that is..)

The past life reader told us that we never did anything unfaithful. We just loved each other without harming anyone else. After that lifetime, she said that perhaps our souls made a contract to be women in this lifetime (and, might I add, in a country wherein LGBTQ rights are still being largely fought for) to keep in tune with the kind of discreet relationship we had before.

However, as the past life reader also said, the lifetime she described to us isn’t necessarily the previous lifetime. There were probably a few lifetimes in-between that and this current lifetime. What is important, anyhow, is the learning and growth we’ve gained, and to continue to gain.

The read was indeed interesting and just goes to show how our egos change from one lifetime to another. However, there are some things that stay the same wherever lifetime your soul goes to. Parts of your personality and relationships repeat, albeit in different situations, from one lifetime to another.

As we go through life, the soul needs to be nurtured despite the obstacles put forth in our earthly existence. Pure intentions of love, compassion, helping and learning add positivity to the soul and the environment. Hate, ignorance and violence, on the other hand, add negativity. Therefore, attacking someone based on sexual orientation and gender is obviously wrong, and would definitely reap bad karma. This is done from a consciousness of ill and uninformed thoughts. Ultimately, the goal is to rid the soul, and on a grander scale, this world, of such impurities.

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In the words of Scarlet Johannson’s character Lucy, “We never really die”. Our bodies or selves gradually morph into death, but our souls surpass it. Souls will go from one lifetime to the next, and perhaps beyond this planet we call Earth. This isn’t a new radical way of existential thinking. Old centuries have recognized that there are higher spiritual planes and dimensions than our human mind can reach. It is only with the constant pursuit of noble values, such as wisdom and love, will we transcend this lowly, materialistic existence we’ve been held to. All souls – young and old – go through this worldly life to grow and break free from negativity and oppression. Eventually, we can all attain the spiritual height that sends us back to our source, or to God, as others would say.

In the meantime, let us enjoy discovering what learning the universe has to offer us, as well as what purposes our situations and relationships want us to fulfill.

A sure-footed wanderer. A shy, but strong personality. Hot-headed but cool. A critic of this propaganda-filled, often brainwashed society. A lover of nature, creativity and intellectual pursuits. Femme in all the right places. Breaking down stereotypical perspectives and narrow-mindedness. A writer with a pen name and no face. I'm a private person, but not closeted. Stay true!

Health & Wellness

Trouble sleeping? Insomnia symptoms linked to increased risk of stroke, heart attack

The results suggest that if we can target people who are having trouble sleeping with behavioral therapies, it’s possible that we could reduce the number of cases of stroke, heart attack and other diseases later down the line.

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People who have trouble sleeping may be more likely to have a stroke, heart attack or other cerebrovascular or cardiovascular diseases, according to a study published in the November 6, 2019, online issue of Neurology, the medical journal of the American Academy of Neurology.

“These results suggest that if we can target people who are having trouble sleeping with behavioral therapies, it’s possible that we could reduce the number of cases of stroke, heart attack and other diseases later down the line,” said study author Liming Li, MD, of Peking University in Beijing, China.

The study involved 487,200 people in China with an average age of 51. Participants had no history of stroke or heart disease at the beginning of the study.

Participants were asked if they had any of three symptoms of insomnia at least three days per week: trouble falling asleep or staying asleep; waking up too early in the morning; or trouble staying focused during the day due to poor sleep. A total of 11 percent of the people had difficulty falling asleep or staying asleep; 10 percent reported waking up too early; and 2 percent had trouble staying focused during the day due to poor sleep. The researchers did not determine if the people met the full definition of insomnia.

The people were then followed for an average of about 10 years. During that time, there were 130,032 cases of stroke, heart attack and other similar diseases.

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People who had all three symptoms of insomnia were 18 percent more likely to develop these diseases than people who did not have any symptoms. The researchers adjusted for other factors that could affect the risk of stroke or heart disease including alcohol use, smoking, and level of physical activity.

People who had trouble falling asleep or staying asleep were 9 percent more likely to develop stroke or heart disease than people who did not have this trouble. Of the 55,127 people who had this symptom, 17,650, or 32 percent, had a stroke or heart disease, compared to 112,382, or 26 percent, of the 432,073 people who did not have this symptom of insomnia.

People who woke up too early in the morning and could not get back to sleep were 7 percent more likely to develop these diseases than people who did not have that problem. And people who reported that they had trouble staying focused during the day due to poor sleep were 13 percent more likely to develop these diseases than people who did not have that symptom.

“The link between insomnia symptoms and these diseases was even stronger in younger adults and people who did not have high blood pressure at the start of the study, so future research should look especially at early detection and interventions aimed at these groups,” Li said.

Li noted that the study does not show cause and effect between the insomnia symptoms and stroke and heart disease. It only shows an association.

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A limitation of the study was that people reported their own symptoms of insomnia, so the information may not have been accurate.

Also, the researchers did not ask participants about having sleep that was not refreshing; this is another common symptom of insomnia.

The question that needs to be asked: How is this relevant particularly to the LGBTQIA community?

Sleep may be fundamental to health, but a study found that lesbian, gay and bisexual adults reported more sleep problems than their heterosexual counterparts. This suggests that sleep difficulties may underlie a number of mental and physical health problems experienced by sexual minorities.

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Improved support after self-harm needed to reduce suicide risk

To reduce the high risk of suicide after hospital attendance for self-harm, improved clinical management is needed for all patients – including comprehensive assessment of the patients’ mental state, needs, and risks, as well as implementation of risk reduction strategies, including safety planning.

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Risk of suicide following hospital presentation for self-harm is very high immediately following hospital discharge, emphasising the need for provision of early follow-up care and attention to risk reduction strategies

To reduce the high risk of suicide after hospital attendance for self-harm, improved clinical management is needed for all patients – including comprehensive assessment of the patients’ mental state, needs, and risks, as well as implementation of risk reduction strategies, including safety planning.

The results are from an observational study spanning 16 years and including almost 50,000 people from five English hospitals, published in The Lancet Psychiatry journal.

“The peak in risk of suicide which follows immediately after discharge from hospital underscores the need for provision of early and effective follow-up care. Presentation to hospital for self-harm offers an opportunity for intervention, yet people in are often discharged from hospital having not received a formal assessment of their problems and needs, and without specific aftercare arrangements. As specified in national guidance, a comprehensive assessment of the patients’ mental state, needs, and risks is essential to devise an effective plan for their follow-up care,” says study author Dr. Galit Geulayov, Centre for Suicide Research, Department of Psychiatry, University of Oxford, UK.

It has been estimated that every year there are approximately 200,000 presentations to emergency departments in hospitals across England following acts of non-fatal self-harm. Self-harm is associated with increased mortality, especially by suicide. Approximately 50% of individuals who die by suicide have a history of self-harm, with hospital presentation for self-harm often occurring shortly before suicide.

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The new study compared the risk of suicide following hospital presentation for self-harm according to patient characteristics, method of self-harm, and socioeconomic deprivation. It also estimated the incidence of suicide by time after hospital attendance, adjusting for gender, age, previous self-harm, and psychiatric treatment.

The study included 49,783 people aged over 15 years who presented to hospital after non-fatal self-harm a total of 90,614 times between 2000-2013. The authors followed these patients for 16 years (until the end of 2015), and the study included five hospitals (one in Oxford, three in Manchester and one in Derby).

Within the 16 year follow up, 703 out of 49,783 people died by suicide – with the incidence of suicide being 163 per 100,000 people per year.

Around a third of these deaths occurred within a year of the patient attending hospital for non-fatal self-harm (36%, 252/703 deaths), and the study confirmed the high risk of suicide in the first year after presentation to hospital for self-harm (the incidence of suicide in the year following discharge from hospital was 511 suicides per 100,000 people per year – 55.5 times higher than that of the general population).

The authors found that risk was particularly elevated in the first month (the incidence of suicide in the month following discharge from hospital was 1,787 per 100,000 people per year – close to 200 times higher than in the general population) – with 74 out of 703 people in the study dying by suicide within a month.

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The authors note that men were more likely to die by suicide following hospital presentation of self-harm than women, people who attended hospital more than once for non-fatal self-harm were more likely to die by suicide than those with a single presentation, and age was associated with risk (with risk increasing 3% with each year of age).

In addition, those who lived in less deprived areas had a higher risk of death by suicide than those who lived in the most deprived areas, but this contrasts with a large body of evidence and might be explained by higher rates of psychiatric disorders in this group in this study – more research is needed. The authors also note that some forms of self-harm were more strongly linked to subsequent suicide, but advise against including detail of this kind in media reporting.

Suicide is a big issue in the LGBTQIA community. In 2018, for instance, a study found that a total of 37% of trans respondents reported having seriously considered suicide during the past 12 months and 32% had ever attempted a suicide. Offensive treatment during the past three months and lifetime exposure to trans-related violence were significantly associated with suicidality.

A study published in LGBT Health in 2016, meanwhile, emphasized the importance of strengthening family support and acceptance as part of a positive intervention.

The authors of this newer study note that holistic assessment of risk factors is required, and warn that no single characteristic will help predict later suicide.

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“While awareness of characteristics which increase the risk of subsequent suicide can assist as part of this assessment, previous studies indicate that individual factors related to self-harm are a poor means to evaluate the risk of future suicide. These factors need to be considered together, followed by risk reduction strategies, including safety planning, for all patients,” says Professor Hawton, Centre for Suicide Research, Department of Psychiatry, University of Oxford, UK.

The authors note that their study focuses on three cities in England and the findings may not necessarily apply to the whole of the country.

Writing in a linked comment, Dr. Annette Erlangsen, Danish Research Institute for Suicide Prevention, Denmark, notes that there is a range of treatment options available following presentation of self-harm in emergency departments (including referrals to psychiatric wards after psychosocial assessments, outpatient treatment for patients not under immediate risk of self-harming, and – in some countries – specialized suicide prevention clinics) but many countries send patients home with a referral to their GP or do not refer at all.

She says: “The bottom line is–while the body of evidence of effective intervention is growing, we need to help people who present with self-harm. Operating in such a scenario is challenging but the numbers are clear; we need to ensure that patients receive support immediately when presenting and implement a continuation of care after discharge.”

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Study finds normal body weight can hide eating disorder in teens

In 2013, a new category of eating disorder was formally recognized: atypical anorexia nervosa. Individuals with this condition meet all other diagnostic criteria for anorexia nervosa but have a normal body weight.

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Teens and young adults with atypical anorexia nervosa can have normal body weights and still be dangerously ill, according to a new study led by researchers at the Stanford University School of Medicine and the University of California-San Francisco.

The research is the largest, most comprehensive assessment to date of normal-weight adolescents with atypical anorexia.

Traditionally, individuals had to be below 85% of their ideal body weight to receive a diagnosis of anorexia nervosa, a disorder characterized by restrictive eating, over-exercising, distorted body image and intense fear of weight gain. But in 2013, a new category of eating disorder was formally recognized: atypical anorexia nervosa. Individuals with this condition meet all other diagnostic criteria for anorexia nervosa but have a normal body weight.

“This group of patients is underrecognized and undertreated,” said the study’s senior author, Neville Golden, MD, professor of pediatrics at the Stanford School of Medicine. “Our study showed that they can be just as sick medically and psychologically as anorexia nervosa patients who are underweight.”

The study, publishing online Nov. 5 in Pediatrics, shows that large, rapid weight loss is the best predictor of medical and psychological problems in patients with atypical anorexia, not their body weight at diagnosis. Dangerously low heart rate and blood pressure, as well as serious electrolyte imbalances and psychological problems, are common in patients with atypical anorexia whose weight is within a normal range, the study found.

The study’s lead author is registered dietitian Andrea Garber, PhD, adjunct professor of pediatrics at UCSF.

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“The bigger context is that, over the past 30 years, the prevalence of adolescent obesity has quadrupled, and teens are being told to lose weight without being given tools to do so in a healthy way,” Golden said. Obese teens who adopt unhealthy behaviors — such as severe food restriction and extreme exercise — may initially be praised for weight loss or told not to worry about eating-disorder concerns because they aren’t underweight.

“By the time they get to see us, they’ve lost a tremendous amount of weight, their vital signs are unstable and they need to be hospitalized,” Golden said.

The study compared 50 patients with atypical anorexia nervosa with 66 patients who met traditional diagnostic criteria, including being underweight. Participants were 12-24 years old, and 91% were female. All participants received eating-disorder treatment as part of the study, the results of which will be reported in a future publication.

Before developing an eating disorder, patients with atypical anorexia had higher weight-to-height ratios than typical patients. During their illness, patients in both groups lost the same amount of weight, an average of 30 pounds over 15.9 months. The two groups had equally poor vital signs, including low heart rate and low electrolytes. Cessation of menstruation, a side effect of the disease, was equally common in the two groups. Some members of both groups also had very low blood pressure, although this was more common in the patients with typical anorexia. Atypical patients had worse psychological symptoms, on average.

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The researchers used statistical modeling to determine which factors best predicted illness severity. The amount, speed and duration of weight loss were linked with worse illness; body weight at the time of diagnosis was not, they found.

More research is needed to identify what constitutes healthy weight for adolescents recovering from atypical anorexia nervosa, Golden said.

“If a patient was obese, the goal is not to have them regain all the lost weight,” Golden said, adding that a mixture of metabolic, hormonal and psychological measures may be needed to define a healthy weight instead.

“If someone gains a bit of weight, regains menses, and is doing well socially, emotionally and cognitively, that might indicate that they are in a place of recovery,” he said.

Other Stanford co-authors on the study are Cynthia Kapphahn, MD, clinical professor of pediatrics; research coordinators Anna Kreiter and Kristina Saffran; and clinical dietitian Allyson Sy. Scientists at UCSF, UCLA and the University of Chicago also contributed to the study.

Weight issues also affect the LGBTQIA community, with 44% to 70% of LGBTQ teens reported weight-based teasing from family members, 41% to 57% reported weight-based teasing from peers, and as many as 44% reported weight-based teasing from both family members and peers.

Meanwhile, specific to the gay community, a study found that Grindr, the most popular dating app for gay, bisexual, two-spirit and queer men, had a negative effect on men’s body image, especially when it came to weight. The study also found that apart from weight stigma, body dissatisfaction stemmed from sexual objectification and appearance comparison. With three out of four gay men reported to have used Grindr, this issue affects a big chunk of the gay population.

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How too much porn causes erectile dysfunction

Here we list the ways watching too much porn causes erectile dysfunction (ED) and the spill-over effects it can have on everyday sexual interactions.

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It’s a slippery slope. At the beginning, it might not take much to get aroused. However over-consumption of pornography may lead the user to seek out more extreme content as they become desensitised to the things that once turned them on. Not only can this have an impact on erectile function, but it can also have unintended consequences when it comes to real-world sexual relationships.

Here we list the ways watching too much porn causes erectile dysfunction (ED) and the spill-over effects it can have on everyday sexual interactions. 

Desensitisation 

Watching too much hardocre porn can make it harder to get an erection because repeated viewing of extreme content may render normal, everyday sexual encounters unfulfilling. 

This is because as people watch more porn, their viewing habits tend to change. As porn users watch more x-rated flicks, they begin to develop a tolerance to the things that used to excite them. As a result, they branch out to more extreme content to fulfil their sexual desires and fantasies. 

However, this kind of extreme content is rarely replicated in real life. After being desensitised by porn, people may find it difficult to become aroused by real life – and comparatively “mundane” – sexual experiences. 

This was certainly the case for Alexander Rhodes, the founder of NoFap – a movement that supports men who have experienced relationship difficulties, erectile dysfunction, and other conditions as a result of their porn consumption. He began watching porn at the age of 11 or 12, and by the time he started having sex at 19 he “couldn’t maintain an erection without imagining porn”. 

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The desensitising effect porn can have is compounded by the fact that it is highly addictive. Research has shown that out of all the varieties of online entertainment (e.g. gambling, gaming, and social networking) “adult entertainment” is the most common reason for compulsive internet use.

Porn triggers the same reward centre in the brain that other addictive substances (such as sugar and drugs) do. This, in turn, floods the brain with dopamine and makes the brain crave the source of the pleasure more. 

The brain attempts to combat this dopamine overload with another chemical called CREB (cyclic adenosine monophosphate response element binding protein). CREB helps to limit the pleasure response generated by dopamine. However if the brain is repeatedly exposed to dopamine (and thus excessive amounts of CREB), the user can become desensitised to the stimulus that initially gave them pleasure. 

In fact, it can make the user desensitised to other things in life that once gave them pleasure – such as socialising with friends or even sex. This may make it harder for the affected person to get an erection because they do not get the same feelings of pleasure they once did from real-life sexual interactions. 

Performance anxiety isn’t always caused by porn. Sometimes it can be caused by general feelings of nervousness, or the fear of not being able to get an erection before sexual intercourse. However, porn can exacerbate feelings of anxiety by making regular porn watchers insecure about their bodies and/or performance.

Unrealistic expectations

Some people may experience erectile dysfunction (ED) after being over-exposed to porn because it gives them unrealistic expectations about what sex “should be like” in real life. The immaculately shaven bodies, exaggerated moans, and extreme positions exhibited in porn portray sex in way that is rarely recreated in everyday life. 

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If a person is repeatedly exposed to porn – particularly at a young, impressionable age – then they may begin to believe that the depiction of sex in porn is representative of sex in real life. When their expectations are not met, it may be hard for them to get aroused because real sex doen’t normally involve the same extreme positions, ear-splitting shrieks, and surgically enhanced bodies as porn does. 

Further, watching porn is a very individual experience. If a person is used to deriving their sexual pleasure from porn, they could find it difficult (and nerve-wracking) to make the transition over to a real-life sexual relationship in which two people need sexual satisfaction. The anxiety this could cause may result in the inability to achieve an erection. This is known as performance anxiety, and it is very common.  

Performance anxiety 

The infinite stamina and notoriously large appendages displayed in porn videos make many men feel anxious about their ability to please their sexual partners in the real world. Many men see sex as a performance and put themselves under immense pressure to “get it right”. 

But by putting themselves under such stress, men can experience anxiety-induced erectile dysfunction. The nervousness, worry, and fear that arises from feeling as though they need to perform “like a pornstar” can induce a “fight or flight” response and kick the sympathetic nervous system (SNS) into action. 

When this happens, the heart beats faster and pumps blood to the areas of the body that need them most in a “fight or flight” situation (such as the muscles). As a result, less blood is supplied to the penis – making it harder to achieve an erection. 

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Performance anxiety is relatively common. A survey by men’s wellness brand Numan revealed that 79% of men who had experienced ED had also suffered from anxiety. Performance anxiety isn’t always caused by porn. Sometimes it can be caused by general feelings of nervousness, or the fear of not being able to get an erection before sexual intercourse. However, porn can exacerbate feelings of anxiety by making regular porn watchers insecure about their bodies and/or performance. 

There is evidence to suggest that sildenafil (the active ingredient in Viagra) can indirectly help to alleviate performance anxiety by improving confidence. Erectile dysfunction can have a profoundly negative effect on a man’s self confidence. However, sildenafil may help to improve confidence in men affected by ED because it allows them to generate harder erections. This, in turn, may help to relieve performance anxiety, as men treated with sildenafil might be less likely to worry about their ability to perform in the bedroom.  Like most other medicines, though, sildenafil does have its side effects (although not everyone gets them). Therefore, it’s best to consult a doctor before taking sildenafil to ensure it is safe to take and does not conflict with any medication you are on. 

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Long-term mental health benefits of gender-affirming surgery for transgender individuals

A study found that among transgender individuals with gender incongruence, undergoing gender-affirming surgery was significantly associated with a decrease in mental health treatment over time.

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For transgender individuals, gender-affirming surgery can lead to long-term mental health benefits, according to new research published in the American Journal of Psychiatry. The study found that among transgender individuals with gender incongruence, undergoing gender-affirming surgery was significantly associated with a decrease in mental health treatment over time.

Researchers Richard Branstrom, Ph.D., and John E. Pachankis, Ph.D., with the Yale School of Public Health, New Haven, Connecticut, used the Swedish Total Population Register to identify more than 2.500 individuals who received a diagnosis of gender incongruence (i.e., transsexualism or gender identity disorder) between 2005 and 2015. Among individuals with gender incongruence, just more than 70% had received hormone treatment and nearly half (48%) had undergone gender-affirming surgical treatment during the 10-year follow-up period. Nearly all (97%) of those who had undergone surgery also received hormone treatment. Less than one-third had received neither treatment.

They analyzed mental health treatment in 2015 in relation to the length of time since gender-affirming hormone and surgical treatment, including distinguishing the potentially interrelated effects of the two treatments. The mental health measures included health care visits for mood and anxiety disorder, antidepressant and anti-anxiety prescriptions, and hospitalization after a suicide attempt.

Increased time since last gender-affirming surgery was associated with reduced likelihood of use of mental health treatment. The study found the odds of receiving mental health treatment were reduced by 8% for every year since receiving gender-affirming surgery over the 10-year follow-up period. They did not find the same association for hormone treatment.

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The study also found that compared with the general population, transgender individuals with a gender incongruence were

  • about six times as likely to have had a mood or anxiety disorder health care visit;
  • more than three times as likely to have received prescriptions for antidepressants and anti-anxiety medication; and
  • more than six times as likely to have been hospitalized after a suicide attempt.

Despite the reduced mental health treatment use after gender-affirming surgery, treatment use among transgender individuals continued to exceed that of the general population.

The authors conclude that “in this first total population study of transgender individuals with a gender incongruence diagnosis, the longitudinal association between gender-affirming surgery and reduced likelihood of mental health treatment lends support to the decision to provide gender-affirming surgeries to transgender individuals who seek them.”

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How do ketogenic diets affect skin inflammation?

Ketogenic diets containing high amounts of MCTs especially in combination with omega-3 fatty acids, should be used with caution since they may aggravate preexisting skin inflammatory conditions.

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Not all fats are equal in how they affect our skin, according to a new study in the Journal of Investigative Dermatology, published by Elsevier. The investigators found that different ketogenic diets impacted skin inflammation differently in psoriasiform-like skin inflammation in mice. Ketogenic diets heavy in medium-chain triglycerides (MCTs) such as coconut, especially in combination with omega-3 fatty acids from fish oil and plant sources like nuts and seeds, exacerbated psoriasis.

‘This study leads to a broader understanding of possible effects of ketogenic diets with a very high fat content on skin inflammation and underlines the importance of the composition of fatty acids in the diet,” explained co-lead investigator, Barbara Kofler, PhD, Research Program for Receptor Biochemistry and Tumor Metabolism, Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria. “We found that a well-balanced ketogenic diet, limited primarily to long-chain triglycerides (LCTs) like olive oil, soybean oil, fish, nuts, avocado, and meats, does not exacerbate skin inflammation. However, ketogenic diets containing high amounts of MCTs especially in combination with omega-3 fatty acids, should be used with caution since they may aggravate preexisting skin inflammatory conditions.”

Ketogenic diets are increasingly popular because of their promise to treat a number of diseases and promote weight loss. They are currently being evaluated as a potential therapy in a variety of diseases and have been suggested to act as an anti-inflammatory in certain conditions. Dietary products containing coconut oil (high in MCTs) or fish oil (high in omega-3 fatty acids), consumed as part of a ketogenic diet, are marketed and used by the general population because of their reported health promoting effects.

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Previous studies have indicated that high-fat diets with a substantial amount of carbohydrates promote the progression of psoriasiform-like skin inflammation and development of spontaneous dermatitis in mice. The investigators therefore hypothesized that high-fat ketogenic diets would dampen psoriasiform-like skin inflammation progression and that partial supplementation of LCT with MCT and/or omega-3 fatty acids would further enhance these effects. Although the study did not confirm that hypothesis, it showed that an LCT-based ketogenic diet does not worsen skin inflammation.

Co-lead investigator Roland Lang, PhD, Department of Dermatology, Paracelsus Medical University, Salzburg, Austria, elaborated on the study’s results, “Ketogenic diets supplemented with MCTs not only induce the expression of pro-inflammatory cytokines, but also lead to an accumulation of neutrophils in the skin resulting in a worse clinical appearance of the skin of the mice. Neutrophils are of particular interest since they are known to express a receptor for MCTs and therefore a ketogenic diet containing MCTs may have an impact on other neutrophil-mediated diseases not limited to the skin.”

Mice used in the study were fed an extremely high-fat (77 percent) ketogenic diet, which is uncommon except for patients following a strict regime for medical conditions like drug-resistant epilepsy. “I think most people following a ketogenic diet don’t need to worry about unwanted skin inflammation side effects. However, patients with psoriasis should not consider a ketogenic diet an adjuvant therapeutic option, noted Dr. Kofler.”

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