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Sick from Sucking

Yes, you can get sick from sucking (err, oral sex), including be infected by HIV and AIDS. But how big is the risk, really?

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Hector A.*, 25, insists he never had unsafe anal sex – at least not since his first one, “which would be over 10 years ago,” he recalls, “and I’ve had tests after that that showed my (negative) status.” He, however, had “numerous sexual encounters, mainly oral, since then.” The oral sexual experiences were done in, among others, sex clubs and bath houses (“I’ve been in all of them – those that already closed, and those that are still operational,” he says), pick-ups from clubs (“Meat markets”), sex parties (“Check schedules in G4M and LifeOut.com, among others”), movie houses (“Even SM MegaMall is a sex area”), and encounters in sex beats (“Largely unrecognized, but we do have many in Metro Manila alone”).

“So numerous (the oral sexual encounters), in fact, that I’ve lost count, actually stopped counting, already,” he says. “I guess you can say I’ve been around.”

It was, therefore, with mixed feelings that he met the news not a few months ago that he is HIV positive. “There was this acknowledgment that, yes, mainly because I have been sexually active, getting (HIV) is probable,” he says. “But there was this disbelief, too, that I am (positive), since my sexual practices were limited to what I, and many people I know, believe to be a somewhat safer sexual practices – I was just giving heads, not taking it up the ass.”

Hector A.’s case brings to light, yet again, the link between oral sex with HIV and AIDS, which is actually not a new issue, even if it is only starting to widely get the attention it deserves. After all, as many like Hector A. believe, “who would have thought you can get HIV and AIDS from sucking, too!”

UNINFORMATIVE INFORMATION?

The lack of urgency to stress the link between fellatio and HIV and AIDS may be understandable, even if it’s unforgivable. After all, even if the claim that HIV and AIDS, and other sexually transmitted infections (STIs) for that matter, can be transmitted orogenitally (mouth to genitalia), studies actually fail to prove the veracity of the claim.

A study by NATAP.org and HIVREALTALK.com involving 239 men who have sex with men (MSM) who exclusively practiced fellatio in the past six months (50% had three partners, 98% unprotected; and 28% had an HIV-positive partner), no HIV was detected, making the researchers admit that “the risk of HIV attributable to fellatio is extremely low.”

“(We) acknowledge that fellatio, although not an efficient route of infection, nonetheless appear(s) to carry a small risk. (Other) studies provided quantitative estimates of the low risk among men who have sex with men (MSM), with one (estimating that) the per-contact risk of unprotected fellatio with an HIV-positive or unknown HIV status partner [4/10 000; 95% confidence interval (CI) 0.01%, 0.17%] to be lower than the per-contact risk of acquiring HIV from protected receptive anal intercourse (RAI) (0.18%; 95% CI 0.10%, 0.28%),” the groups say.

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Understandably, in a survey of teens conducted for The Kaiser Family Foundation, 26% of the sexually active 15 to 17 year olds surveyed responded that one “cannot become infected with HIV by having unprotected oral sex.” An additional 15% were not certain if one can be infected with HIV through oral sex.

This is not to say that the position of those advocating safer sexual practices even when “just” sucking is not without merit. NATAP.org and HIVREALTALK.com note a study done on the primary modes of transmission in San Francisco in the US, where 8% of HIV-positive participants acquired HIV from fellatio (Though this is not to say that 8% of people with HIV and AIDS were only infected through oral sex, which is a generalization Outrage Magazine is not claiming – Ed ).

Adds the CDC HIV/STD/TB Prevention News Update in a fact sheet (What You Should Know about Oral Sex: Oral Sex Is Not Considered Safe Sex): “Because anal and vaginal sex are much riskier, and because most individuals who engage in unprotected (i.e. without a condom) oral sex also engage in unprotected anal and/or vaginal sex, the exact proportion of HIV infections attributable to oral sex alone is unknown, but is likely to be very small. This has led some people to believe that oral sex is completely safe. It is not.”

One study cited by the Public Health Agency of Canada (PHAC, phac-aspc.gc.ca) in Oral Sex and HIV Transmission calculates the per-sex-act probability of HIV transmission in a cohort of men who have sex with men (MSM) and determined that for unprotected receptive anal intercourse, the probability was 0.82% per act, for unprotected insertive anal intercourse 0.06%, and for unprotected receptive oral intercourse with ejaculation 0.04%.

Still another study, still cited by PHAC, calculates the “population-attributable risk percentage (PAR%, which refers to the incidence of a disease (in this case, HIV) in a population that can be attributed to a certain risk behavior, e.g. fellatio) at 0.18% for MSM who had had one partner in the previous six months, 0.25% for two partners, and 0.31% for three partners.”

The PHAC insists that “oral sex between MSMs is not as safe as once perceived (since) several epidemiological studies have examined the risk of HIV infection through unprotected receptive oral intercourse (receptive fellatio).”

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Among others, there’s a 1996 to 1999 study of MSMs with recent diagnosis of HIV infection, and it was found that 7.8% of subjects (eight of 102) were probably infected through receptive oral sex. In a 1986 to 1988 study of HIV infection and AIDS among MSMs in the Netherlands, “four of 102 cases of seroconversion (3.9%) likely occurred as a result of receptive oral intercourse.” And in the UK, 13 cases of HIV transmission through orogenital contact had been reported to the public health authorities up to December 1998.

So, yes, HIV and AIDS CAN be transmitted through sucking.

HERE COMES THE CUM

According to the French POSITIFS Association (positifs.org), “concerning fellatio, the risk of HIV transmission is possible in case of a bleeding lesion, like gingivitis, or even just after a teeth brushing.” The big catch is that a “lesion may be microscopic, causing a non-visible bleeding, so a rapid rinsing of the mouth is not sufficient to avoid the risk of transmission. Indeed, if there is a bleeding lesion, the virus may instantaneously penetrate in this opening.”

The CDC HIV/STD/TB Prevention News Update notes that “although the risk is many times smaller than anal or vaginal sex, HIV has been transmitted to receptive partners through fellatio, even in cases when insertive partners didn’t ejaculate (cum).”

“The risk of contamination from a male sex without ejaculation exists. It is possible because of ‘internal micro-ejaculations.’ It mustn’t be forgotten that even during a very short penetration, the risk of HIV transmission exists, because of the presence of seminal liquid just at the extremity of the urethra. Furthermore, an early ejaculation may always occur, as it is difficult to always control the state of excitation,” the PHAC adds.

Fortunately, if it can be considered fortunate at all, “saliva that does not contain blood presents no potential for transmission, as research has shown that an enzyme in saliva inhibits HIV. In general, the mouth and throat are well defended against HIV: the oral mucosal lining contains few of the cells that are the most susceptible to HIV. Other research notes that saliva contains several HIV inhibitors, such as peroxidases and thrombospondin-1, and that the hypotonicity of saliva disrupts the transmission of infected leukocytes (white blood cells),” the PHAC states.

Other factors potentially associated with increased risk of HIV transmission through oral sex include oral trauma, sores, inflammation, concomitant STIs, ejaculation in the mouth, and systemic immune suppression. For receptive fellatio, poor oral health and taking cum in the mouth is a “hazardous combination” that multiplies the risk of HIV transmission.

For safer sex advocates, HIV isn’t the only one that can be transmitted through oral sex. “Scientists have documented a number of other sexually transmitted (infections, or STIs) that have also been transmitted through oral sex. Herpes, syphilis, gonorrhea, genital warts (HPV), intestinal parasites (amoebiasis), and Hepatitis A are examples of STIs that can be transmitted during oral sex with an infected partner,” the CDC HIV/STD/TB Prevention News Update states.

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Adds the POSITIFS Association: “We know for instance that a Chlamydia infection may be localized in the pharynx. Pyogenic germs (like streptococcus or staphylococcus) are known to give mouth infections, but also genital infections. And some germs can also be transmitted by oral contact, such as the Epstein-Barr virus, responsible for the infectious mononucleosis.”

FOR THE LOVE OF SUCKING

There is no call to stop sucking – certainly not! But according to the PHAC, there is a need to realize that “while oral sex is a lower risk activity than unprotected anal or vaginal intercourse, repeated exposures may increase the risk. And although the risk of acquiring HIV through oral sex is low, the higher rates of practicing oral sex indicate that it may contribute to significant numbers of HIV cases among MSMs. Safer sex practices should consider oral sex, particularly unprotected receptive fellatio with ejaculation, as a potential risk behavior for HIV transmission.”

For the CDC HIV/STD/TB Prevention News Update, “you can lower any already low risk of getting HIV from oral sex by using latex condoms each and every time. For cunnilingus or anilingus, plastic food wrap, a condom cut open, or a dental dam can serve as a physical barrier to prevent transmission of HIV and many other STDs.”

When in doubt, see a doctor.

Hector A. is still coming to terms with his new seropositive status. No longer in shock, “in my head, I am, however, still coming to terms with getting infected by sucking – an act I never thought would (enable HIV) to affect my life this way,” he says.

He has already “mended my ways,” he says, foregoing (what I used to do before).” The big plan for him is to “help spread the word out there that, yes, you can get HIV and AIDS from a head job,” he says, although admitting he is, at the moment, “not yet ready to come out in the open.” “The message is important, though, even if it may seem farfetched (for many for now). Here’s the thing: I never thought it could happen, too, until it happened to me. If anything, that should serve as a lesson that needs to be really, really learned.”

*NAME CHANGED UPON REQUEST TO PROTECT INTERVIEWEE’S PRIVACY

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Phl votes for LGBTQIA rights at UN Human Rights Council

The UNHRC adopted a resolution to renew the mandate of the Independent Expert focusing on the protection against violence and discrimination on the basis of sexual orientation and gender identity.

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ALL PHOTOS TAKEN DURING METRO MANILA PRIDE PARADE 2019

The United Nations Human Rights Council (UNHRC) adopted a resolution to renew the mandate of the Independent Expert focusing on the protection against violence and discrimination on the basis of sexual orientation and gender identity (SOGI).

The resolution was adopted by a vote of 27 in favor, with 12 voting against and seven abstentions.

Now this is worth highlighting: The Philippines voted in favor of the resolution.

The Philippines’ UN voting history vis-à-vis LGBTQIA people has been inconsistent. In 2016, when the UNHRC adopted the resolution on “protection against violence and discrimination based on SOGI (which created the post for the Independent Expert), the Philippines abstained from voting for the resolution. It was then under the presidency of Benign Aquino III.

Also to date, the country still does not have a national anti-discrimination policy protecting the human rights of LGBTQIA Filipinos, even if various versions of the anti-discrimination bill (ADB) have been filed in the Upper and Lower Houses of Congress for 20 years now. In 2017, during the last – 17th – Congress, it passed the House of Representatives; but its counterpart version in the Senate failed to gain traction.

Created in 2016, the UN Independent Expert on SOGI has been supported by a growing number of States from all over the world. This new resolution to create and renew the mandate was presented by a Core Group of seven Latin American countries – Argentina, Brazil, Chile, Colombia, Costa Rica, Mexico and Uruguay.

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The UN Independent Expert on SOGI is tasked with assessing implementation of existing international human rights law, by talking to States, and working collaboratively with other UN and regional mechanisms to address violence and discrimination. Through the work of this mandate since 2016, the impact of criminalization of same-sex relations and lack of legal gender recognition, the importance of data-collection specific to SOGI communities, and examples of good practices to prevent discrimination have been highlighted globally, with visits to Argentina, Georgia, Mozambique and Ukraine.

As a top-to-bottom approach, however, the immediate impact of the UN Independent Expert on SOGI on grassroots LGBTQIA activism remains a sore issue for those critical of its.

The renewal process of the mandate had to overcome 10 hostile amendments, but the core of the resolution in affirming the universal nature of international human rights law stands firm.

RESULTS OF THE VOTE

Voting in favor of the resolution

Argentina, Australia, Austria, Bahamas, Brazil, Bulgaria, Chile, Croatia, Cuba, Czech Republic, Denmark, Fiji, Iceland, Italy, Japan, Mexico, Nepal, Peru, Philippines, Rwanda, Slovakia, South Africa, Spain, Tunisia, Ukraine, UK, Uruguay

Voting against the resolution

Afghanistan, Bahrain, Bangladesh, China, Egypt, Eritrea, Iraq, Nigeria, Pakistan, Qatar, Saudi Arabia, Somalia

Abstaining on the resolution

Angola, Burkina Faso, Democratic Republic of Congo, Hungary, India, Senegal, Togo

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SOGIE Equality Bill filed anew in 18th Congress

In the Lower House, Lumad leader-turned-Bayan Muna Rep. Eufemia Cullamat has refiled the SOGIE Equality Bill as House Bill 258. Meanwhile, in the Upper House, Akbayan Sen. Risa Hontiveros refiled the bill as Senate Bill 159, one of her priority measures.

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ALL PHOTOS TAKEN DURING METRO MANILA PRIDE PARADE 2019

We continue to #ResistTogether.

Versions of the Sexual Orientation, Gender Identity and Gender Expression (SOGIE) Equality Bill have been re-filed in the Lower and Upper Houses of Congress.

In the Lower House, Lumad leader-turned-Bayan Muna Rep. Eufemia Cullamat has refiled the SOGIE Equality Bill as House Bill 258. Co-authors are Bayan Muna Reps. Karlos Ysagani Zarate and Ferdinand Gaite.

Meanwhile, in the Upper House, Akbayan Sen. Risa Hontiveros refiled the bill as Senate Bill 159, one of her priority measures.

The explanatory note of HB 258 talks about intersectionality, stating that “LGBT (people) often find it difficult to exercise their rights as persons, laborers, professionals, and ordinary citizens.”

For instance, “LGBT students are denied admission or expelled from school due to their sexual orientation or gender identity. Companies block the promotion and stymie the career advancement of gay or lesbian employees due to the deeply embedded notion that homosexuality denotes weakness. Laws such as the current anti-vagrancy law are also abused by the law enforcement agencies to harass gay men.”

Incidentally, the latter – i.e. anti-vagrancy law – was repealed in March 2012 (via Republic Act 10158), but members of the LGBTQIA community (particularly gay and bisexual men) often still fall prey victim to harassment by law enforcers.

“It is therefore imperative to define and penalize practices that discriminate against LGBT (people),” continued the explanatory note of HB 258.

Hontiveros, for her part, said the time has come for the enactment of the SOGIE Bill; even vowing that the incoming Congress will be a “massive victory against hate and discrimination.”

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“If the Senate’s 17th Congress was a big win for women and health, the 18th Congress will be a massive victory against hate and discrimination. The SOGIE Equality Bill will pass. It is a measure whose time has come,” Hontiveros said.

In 2017, the House of Representatives actually passed the SOGIE Equality Bill. The Senate’s version, however, did not gain the final approval of the 17th Congress.

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Over 50,000 parade for Pride in Metro Manila

The Pride-goers gathered not just to show force and then party, but also to highlight the need to create safe spaces for LGBTQIA Filipinos.

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Growing rainbow number.

Over 50,000 people gathered in Marikina City to attend the annual LGBTQIA Pride parade in a largely disorganized event affected by sporadic downpours and marred by event planning/execution issues. The Pride-goers gathered not just to show force and then party, but also to highlight the need to create safe spaces for LGBTQIA Filipinos.

While confusion continued to exist even during Pride day about what revelers were supposed to #ResistTogether – this year’s catchy theme – there was at least a call to recognize the sector (particularly with the number) by passing the anti-discrimination bill (ADB) that has been pending in Congress for two decades now.

And despite the numbers fascination, the total number of attendees is still undetermined even with the mandatory/forced registration of all participants (else not be allowed entry into the premises), with the information desk “told to say it’s 52,000” while a host inconsistently bragged figures reaching 70,000. All the same, this year’s number easily eclipsed last year’s estimated 25,000 revelers.

Notably, this year’s gathering attempted to “return” the format to the older Pride parades in Metro Manila by allowing various groups/organizations to speak onstage, as opposed to only those affiliated with the political party/leaning of the organizing Metro Manila Pride.

According to Regie Pasion, who helms LGBTbus, the Marikina-based LGBTQIA organization that helped in organizing this year’s Pride (and the gatherings in 2017 and 2018), “at it’s core, Pride remains a protest” and “will remain so until LGBTQIA human rights are recognized”.

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Locally, for Marikina, while the ADB continues to languish, the city’s mayor Marcy R. Teodoro signed the local anti-discrimination ordinance (ADO), passed ahead of the Pride parade. In signing, Teodoroo said that the ADO will “nagbibigay sa lahat ng pantay at parehong karapatan sa trabaho, edukasyon, tirahan, at mga serbisyo ng pamahalaan (give everyone equal right to access education, work, accommodation and government services).”

The same ADO was passed after Marikina hosted the Pride parade for three years; pushed exclusively by the local LGBTQIA community.

Coming from Lucena City to attend the 2019 Pride parade, Aaron Moises Bonette of QZN Pride and Bahaghari QZN said that the challenge remains “for us to utilize this same number to take the same streets to fight for our actual rights (and not just to parade),” he said.

Last year’s Pride parade, for instance, may have gathered over 20,000 revelers, but when it came to rally for the ADB, the organizers were not able to attract 50 participants.

“Don’t get me wrong: Reaching this big number is admirable. But Pride shouldn’t start and end in June. It should be done every day (hopefully by as many, or even by more) people until we are treated as equals. Otherwise, this thing we call ‘pride’ is but an ideal,” Bonette ended.

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Now illegal to discriminate against LGBTQIA people in Marikina

Marikina City joins the list of local government units (LGUs) that now has an anti-discrimination policy that eyes to protect the human rights of its LGBTQIA constituents. Offenders may be penalized from P1,000 (first offense) to P2,000/P5,000 (second and third-time offenders), along with imprisonment of up to 15 days.

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The rainbow cometh.

Marikina City has joined the list of local government units (LGUs) that now has an anti-discrimination policy that eyes to protect the human rights of its LGBTQIA constituents.

The host of Metro Manila Pride parade since 2017, the city was also – for a while – under scrutiny for claiming to be pro-LGBTQIA but with (seemingly) limited LGBTQIA-related efforts topped by the once-a-year parade held in June.

But the ordinance introduced by councilors Paul Dayao, Mario de Leon, Manuel Sarmiento and Zifred Ancheta eyes to make it a policy of the city to hold non-discrimination of LGBTQIA people (at least there).

Discriminatory acts included in the ADO include: employment- and school-related discrimination; refusal to provide goods/services/accommodation because of a person’s SOGIE; and by subjecting (verbally or by writing) people to ridicule because of their SOGIE.

Offenders may be penalized from P1,000 (first offense) to P2,000/P5,000 (second and third-time offenders), along with imprisonment of up to 15 days.

The ordinance introduced by councilors Paul Dayao, Mario de Leon, Manuel Sarmiento and Zifred Ancheta eyes to make it a policy of the city to hold non-discrimination of LGBTQIA people (at least there).

Surprisingly, while the ADO is creating an Anti-discrimination Mediation and Conciliation Board to deal with ADO-related violations, no LGBTQIA organization/party will be among the board members.

The ADO is awaiting the signature of Marikina Mayor Marcy R. Teodoro, though this is already expected. In 2018, Teodoro told Outrage Magazine that hosting Pride is a way to show the city’s support to Metro Manila’s LGBTQI community, particularly since his office in particular supports this community’s push for a nationally enacted anti-discrimination policy. In the end, Teodoro said, “we want to be known as an inclusive community. We can only do that by recognizing everybody as all equal to each other.”

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Sexuality continues to change and develop well into adulthood – study

Substantial changes in attractions, partners, and sexual identity are common from late adolescence to the early 20s, and from the early 20s to the late 20s, indicating that sexual orientation development continues long past adolescence into adulthood. The results also show distinct development pathways for men and women, with female sexuality being more fluid over time.

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Photo by Sharon McCutcheon from Unsplash.com

Traditional labels of ‘gay’, ‘bisexual’ and ‘straight’ do not capture the full range of human sexuality, and whether a person is attracted to the same, or opposite sex can change over time.

This is according to a study, published in the Journal of Sex Research, which analyzed surveys from around 12,000 students, and found that substantial changes in attractions, partners, and sexual identity are common from late adolescence to the early 20s, and from the early 20s to the late 20s, indicating that sexual orientation development continues long past adolescence into adulthood. The results also show distinct development pathways for men and women, with female sexuality being more fluid over time.

“Sexual orientation involves many aspects of life, such as who we feel attracted to, who we have sex with, and how we self-identify,” said Christine Kaestle, a professor of developmental health at Virginia Tech. “Until recently, researchers have tended to focus on just one of these aspects, or dimensions, to measure and categorize people. However, that may oversimplify the situation. For example, someone may self-identify as heterosexual while also reporting relationships with same-sex partners.”

In order to take all of the dimensions of sexuality into account over time, Kaestle used data from the National Longitudinal Study of Adolescent to Adult Health, which tracked American students from the ages of 16-18 into their late twenties and early thirties. At regular points in time, participants were questioned about what gender/s they were attracted to, the gender of their partners, and whether they identified as ‘straight’, ‘gay’ or ‘bisexual’.

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The results showed that some people’s sexual orientation experiences vary over time, and the traditional three categories of ‘straight’, ‘bisexual’ and ‘gay’ are insufficient to describe the diverse patterns of attraction, partners, and identity over time. The results indicated that such developmental patterns are better described in nine categories – differing for both men and women.

For young men these patterns have been categorized as:

    null
  • ‘straight’ (87%),
  • ‘mostly straight or bi'(3.8%),
  • ’emerging gay’ (2.4%)
  • minimal sexual expression’ (6.5%).

Young women on the other hand were better described by five categories:

    null
  • ‘straight’ (73.8%),
  • ‘mostly straight discontinuous’ (10.1%),
  • ’emerging bi’ (7.5%),
  • ’emerging lesbian’ (1.5%)
  • ‘minimal sexual expression’ (7%).

Straight people made up the largest group and showed the least change in sexual preferences over time. Interestingly, men were more likely than women to be straight – almost nine out of 10 men, compared to less than three-quarters of women.

Men and women in the middle of the sexuality spectrum, as well as those in the ’emerging’ gay and lesbian groups showed the most changes over time.

For example, 67% of women in the ‘mostly straight discontinuous’ group were attracted to both sexes in their early 20s. However, this number dropped to almost zero by their late 20s, by which time the women reported only being attracted to the opposite sex.

Overall, women showed greater fluidity in sexual preference over time. They were more likely (one in six) to be located in the middle of the sexuality continuum and to be bisexual.

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Fewer than one in 25 men fell in the middle of the spectrum; they were more likely to be at either end of the spectrum, as either ‘straight’ or ’emerging gay’. Relatively few women were classed as ’emerging lesbian’.

“In the emerging groups, those who have sex in their teens mostly start with other-sex partners and many report other-sex attractions during their teens,” Kaestle said of her findings. “Then they gradually develop and progress through adjacent categories on the continuum through the early 20s to ultimately reach the point in the late 20s when almost all Emerging Bi females report both-sex attractions, almost all Emerging Gay males report male-only attractions, and almost all Emerging Lesbian females report female-only attractions.”

Kaestle said that the study demonstrates young adulthood is still a very dynamic time for sexual orientation development.

“The early 20s are a time of increased independence and often include greater access to more liberal environments that can make the exploration, questioning, or acknowledging of same-sex attractions more acceptable and comfortable at that age. At the same time – as more people pair up in longer term committed relationships as young adulthood progresses – this could lead to fewer identities and attractions being expressed that do not match the sex of the long-term partner, leading to a kind of bi-invisibility,” said Kaestle.

For Kaestle, “we will always struggle with imposing categories onto sexual orientation. Because sexual orientation involves a set of various life experiences over time, categories will always feel artificial and static.”

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Importantly, although the study found nine categories of sexual orientation development, limitations in the statistical methods used mean that more categories could exist.

The names of the categories are also in no way meant to replace or contradict any person’s current self-labelled identity. Rather, Kaestle hopes that these findings will help researchers in the future to better understand how a range of sexual orientation experiences and patterns over time can shape sexual minorities’ experience of distinct health disadvantages, and the effects of discrimination.

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Transgender people are not mentally ill, says WHO

The new classification is not expected to affect the healthcare provision to respond to the needs of transgender people, but – all the same – it’s expected to improve social acceptance among transgender people while still making important health resources available.

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Photo by Cecilie Johnsen from Unsplash.com

The World Health Organization (WHO) has decreed that transgender people are not mentally ill, with the WHO’s legislative body voting to move the term used to describe transgender people – “gender incongruence” – to the panel’s sexual health chapter from its mental disorders chapter.

The new standard of classification appears in the 11th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-11); but will go into effect on January 1, 2022.

The WHO uses “gender incongruence” to describe people whose gender identity is different from the gender they were assigned at birth.

The new classification is not expected to affect the healthcare provision to respond to the needs of transgender people, but – all the same – it’s expected to improve social acceptance among transgender people while still making important health resources available, according to the United Nations health agency last year when it announced the intended change.

Dr. Jack Drescher, a member of the ICD-11 working group, wrote: “There is substantial evidence that the stigma associated with the intersection of transgender status and mental disorders contributes to precarious legal status [and] human rights violations”.

It is worth noting that the WHO still classifies intersex traits as “disorders of sex development”.

This is not the first time the ICD changed a classification related to sexuality. In 1990, the WHO declared that “sexual orientation alone is not to be regarded as a disorder.”

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