Florida Agenda

By Sam Knew

In the mental health field, there’s a practice of not labeling things “right” or “wrong”.  So much so, it’s given birth to the phase, “What do you think?” The idea is that the client will assign these labels to their options, which can actually act as self-motivating factor. This process, however, can leave so many of us feeling overwhelmed or stuck. Why is it that some people seem to be able to make decisions, with little wavering, and others seem to toddle back and forth on the proverbial fence?

It makes sense to weigh all the options when making big decisions. But for some, even the small decisions in life can seem like major obstacles. Many who find themselves obsessively teetering between what movie to see or where to go to dinner aren’t able to see the self-destructive effects. For example, one issue is the obvious time lost. Another is missing out on opportunities, such as deadlines. Additionally, indecisive people also tend to regret and worry even after they made a decision, concerned if they have made the right choice.

So, where does all this panic over right and wrong come from? One theory is a lack of self-confidence. People tend to focus more on their limitations or the losses.

Additionally, they may be concerned with what others think – a process that could irrationally or irrelevantly hinder one’s judgment. The process is also perpetuated by self-doubt and anxiety (mental and physical).

This continual overwhelming array of emotions can reach a boiling point. Indecisive individuals may shut down (opting not to participate), subsequently placing themselves in a “victim-like” mode, which can develop indecisiveness into a compulsive behavior, making the cycle more difficult to break.

One thing to keep in mind is how we make choices. It would seem logical that one would want to take in all the information available before making a decision. But oddly enough, one study actually shows that people who are decisive are selective with much of the information they look at. Primarily, they create a hierarchy of characteristics (deal breakers) and assign positive or negative attributes to related options. This allows them to spend less time reviewing options that are irrelevant. Indecisive individuals attempt to review all the details. In one study that looked at individual’s decision-making process through their eye movement, it discovered that indecisive individuals even spend a significant amount of time actively reviewing “nothing,” that is the blank space on a page.

You can relieve some of the pressure of make decisions. Start by cutting yourself some slack and avoiding negative labels, such as “indecisive”
or “wishy-washy.” Identifying your priorities is another step. This will help you know the difference between your needs and wants. Choices in regards to “wants” may feel less overwhelming. It’s also helpful to setup routines, minimizing the need to make decisions. And, most importantly, accept that you’re the only one that can determine what’s right and wrong in your life.

Sam Knew, MSW is an educator and a local counselor. He can be reached at samknewmsw@gmail.com

By Sam Knew, MSW

If you go to the Apple store to look at pornography, you may have a problem

The internet is everywhere – our homes, work, phone, even free of charge at public libraries. That is why the nearly 4 million online users who identify themselves as online sexual addicts face a daily battle. It’s the internet’s accessibility and affordability that enables this form of addiction. This over-exposure of graphic and gratuitous sexual material can generate such an unhealthy attitude towards sex. And like most addicts, these individuals are capable of acting out with life-altering consequences.

Users compulsively access the “net” to download sexual images, visit sexually oriented chartrooms and participate in live sexual video acts – usually involving some form of masturbation. Many become isolated by shame, which  perpetuates the addiction.

Although defining this form of addiction may be challenging due to the degrees of use, most professionals will identify it as an addiction when it becomes unmanageable or all-consuming, costing users their own reality. Cyber addicts have been known to go online for hours or literally days at a time, risking their relationships, job and health.

The book In the Shadows of the Net: Breaking Free of Compulsive Online Sexual Behavior outlines five groups of users. The groups range from appropriate to inappropriate. Appropriate users include those who are capable of accessing sexual material online, even using it to enhance their real sex lives, and maintain a healthy, expressive sex life in their real world. Inappropriate groups include those who are at risk of becoming addicts, using the internet for exhibitionism or illegal sexual acts, such as meeting under-age sex partners. They tend to lack the ability to express their sexual desires in the real world, yet they are still in control of the image they project to the world (much like a functioning alcoholic).

The most severe group is made up of individuals who have some form of sexual addiction, and the internet is simply a tool in that addiction. They are detached from the real world and put themselves in numerous forms of high-risk situations in all aspects of their life. These users risk their jobs by viewing pornography at work. In addition, they jeopardize relationships, carrying on online fantasy relationships, some actually coming to fruition. This compulsion also takes its toll on the users’ physical and mental health, resulting in forms of depression and anxiety.

As with most addicts of any other addiction, users must learn to live with their disorder, as they are never truly cured. The goal is to create an environment where addicts can communicate their desires, and even fulfill them in healthy ways. Users need to understand the drive of their compulsion and learn to reconstruct their perception of sexual expression. Most importantly, they need to spend less time in their virtual world and more learning to cope in their reality.

Sam Knew, MSW is an educator and a local counselor. He can be reached at samknewmsw@gmail.com

Most of us think that yeast infections (Candida) are primarily a female problem; however, it may surprise you that men can also contract or develop yeast infections. Penile, anal and yes, oral, are all types of yeast infections in men. Most commonly, penile yeast infections among men are transmitted sexually, after sex with a carrier female, which makes it even more surprising that yeast infections are not considered a sexually transmitted disease (STD).

Men who engage in vaginal sex with an infected female partner can pass the infection to anyone (male or female) that his penis comes in contact with, which is one means of the spread (anally and orally). The rate of infection is higher among uncircumcised men since the foreskin can trap in moisture. General symptoms of penile infection are identified as itching (similar to jock itch), burning during sex and urination, soreness, and redness of the tip of the penis. Some men may also experience a white, clumpy discharge (not to be mistaken for semen).

Anal infection symptoms are usually isolated to itchiness and redness. Men who also engage in unprotected anal sex (even with an uninfected partner), may develop an infection. This can occur when bacteria in feces comes into contact with the penis, (another reason to avoid that “not so fresh” feeling).

Oral infection (thrush) is usually recognized by white patches covering the inside of the mouth. Patches may be on the insides of the cheeks, tongue, roof of the mouth, and lips and gums as it spreads. Partners performing oral sex on uncircumcised men are at greater risk, again due an increased likelihood of trapped bacteria.

Additional means of infection among men include the prolonged use of antibiotics and men with compromised immune systems. Reason being, antibiotics do not discriminate between bad and good bacteria, thus creating an ideal environment for the infection to cultivate. In addition, diabetic individuals are also likely to develop yeast infections due to high levels of sugar in the body, specifically in urine.

Fortunately, prevention and treatment for all these types of yeast infections are fairly simple. Your own personal hygiene is always a good place to start. Also, try being mindful to wash any areas of the body that can trap moisture (foreskin) and remember to completely dry them. Severe cases in partners can be identified easily, especially if you are taking the time to playfully “inspect” your partner(s). Usually treatment includes a week-long regimen of topical cream and abstinence, the latter perhaps being the most difficult of the two.

Sam Knew, MSW is an educator and a local counselor.

When it comes to life, there are some moments permanently engraved in our minds: Our first kiss, our first love, our first pair of Prada navy suede logo penny loafers. There are also some memories, however, we could spend a lifetime trying to forget. In some cases, these memories can leave profound scars, hindering our journey toward self-healing and forgiveness.

This can leave many of us trapped in the numbing, powerless role of “the victim”. But somehow many of us take the small crucial steps toward survival and even learn to thrive in spite of it all.

As a rule of thumb, most mental health counselors avoid the word “victim.” This may even include those who have experienced traumatic, life changing events (sexual abuse, health diagnoses, loss of a loved one, etc.). The word victim implies a lack of choices or a sense of helplessness. This perspective could leave individuals preoccupied with the past, creating a barrier towards progress. As an alternative, we prefer them to self-identify as “survivors”.

Survivors see the world differently from victims. They still struggle to find reasons for their problems, but seek out help to overcome them. Survivors also tend to not be as isolated and can see their own negative patterns. This path from victim to survivor is paved with patience, hard work and a unique inner strength that can only be described as heroic. Make no mistake: Their evolution is to be envied and celebrated. These individuals push to pick themselves up and attempt to create a healthier life in spite of their past experiences, even when they have trouble believing it for themselves.

In some cases, the process challenges them to relive the trauma in hopes of escaping its suffocating and paralyzing power. This process is as individual as the people themselves. The process can’t be rushed, as so many loving bystanders naively may hope – and even express. Survivors are also not expected to ignore o r deny t h a t t h e y have been v i c t imi z e d ; rather, come to a point of acceptance and understanding to allow them to take control of their life. What most come to discover is that there is no magic wand that can erase the memories or undo the past. They learn to cope with negative and distracting feelings and thoughts. And, although they realize they may never be “cured” or “freed” of these traumas, they strive each day to move forward.

The eventual goal is to commit to this healing process, and thrive. Survivors who move into the “thriver” role become more satisfied with life, create long-term goals and revive feelings of empowerment, compassion, joy and love. One way they do this is by connecting with others, sharing their story and acting as a source of strength for others. Thrivers, more than anyone, echo the sentiment: This too shall pass.

Sam Knew, MSW is an educator and a local counselor. He can be reached at samknewmsw@gmail.com

Who Knew?

By Sam Knew

Most of us spend our lives avoiding contracting even the slightest germ, much less an infective virus. We live in a world of hand sanitizer stations at shopping centers and medicine cabinets filled with multi-vitamins and some sort of natural tea product. So, it may be unimaginable that there are individuals intentionally seeking out diseases, hoping they will be lucky enough to get bitten by “the bug”. They are called bug chasers. This term usually refers to a sub-culture of gay men that intentionally seek to get infected with Human Immunodeficiency Virus (HIV), the virus that causes Acquired Immune Deficiency Syndrome (AIDS).

It is still not understood what motivates these individuals, but many theorize it may be the desire for a sense of belonging. Bug chasers may long to be part of a nurturing and compassionate part of a community, as found within the HIV+ population. Others conclude some people feel so overwhelmed by the possibility of contracting HIV, they prefer to “get it over with.” The short film The Gift explores this rare phenomenon, documenting a young man’s sense of relief after being diagnosed HIV+. The Gift’s director, Louise Hogarth, adds the increasing false sense of the lack severity in contracting the virus may also be a contributing factor. Some believe the disease has become more of a manageable illness, controllable with just a pill. This school of thought has encouraged individuals to let down their guard, being less disciplined in their safe sex practices.

This fringe population of bug chasers is accommodated by “gift givers.” These are individuals that are willing to infect bug chasers.

This pairing of bug chasers and gift givers usually comes together online. Though the compilation of these two groups is a very small subset of the population, they have developed a culture of their own, including “conversion parties.” This is one means by which HIV+ men and those looking to be infected can meet.

Usually only one individual is HIV+ (known only to the individual himself and the host); the other members of the party participate in unprotected sex in hopes of being infected, commonly referred to as  getting “pozzed up”.

The question of these individual’s mental health and legal responsibility are just beginning to be examined. There is still little research or actual statistics on how many people are purposefully seeking sero-conversion, and less  on people who have sero-converted  intentionally. Additionally, nearly half the states have laws against infecting individuals, but even most of those laws are not prepared to address the consensual transmission of HIV.

Sam Knew, MSW is an educator and a local counselor. He can be reached at samknewmsw@gmail.com

Photo: (top) This graphic image is being used in a French HIV/AIDS?awareness campaign.

BY Sam Knew, MSW

It seems week after week we read about one three letter acronym after another that can affect our health, but here’s
one you may now be as familiar with – HPV (human papillomavirus). For gay and bisexual men, it can be a secret killer. There are 6.2 millions cases in the U.S each year and over one hundred strains of the virus, forty of which are transmitted sexually. In previous years there have been studies linking HPV to cervical cancer, which encouraged the Food and Drug Administration (FDA) to approve a vaccine for women. Recently, the FDA has also approved a vaccine for young males (9-26). But now there is talk about protecting the rest of our population, seeing as studies have linked HPV to genital infections – as well as some forms of cancers.

The virus in men can typically go undetected and untreated for a lifetime, or until more severe infections and diseases develop. In some cases the virus can develop into genital warts, in areas of the penis, testicles, groin, thigh and anus. These cauliflower like warts tend not to be painful and disappear shortly after they appear, creating a misguided sense of recovery. Genital warts affect about one percent of sexually active men. And although symptoms may disappear or the warts can be treated and removed, they can always reappear – making treatment a life-long process. However, you may have bigger problems than warts to deal with in the long run.

Gay and bisexual men are 17% more likely to develop anal cancer. In addition, HPV increases those risks, especially for individuals with weakened immune systems, such as men with HIV. Individuals with anal cancer can experience bleeding, pain, itching or discharge. Other symptoms include swelling of the lymph nodes in the groin and anus area. Penile cancer is also a risk factor linked to HPV. In the early stages, individuals might notice discoloration, toughing skin texture and build up of tissue on the penis. This could be followed by painful sores and bleeding; however, in some cases there may be no symptoms until the cancer has advanced.

Fortunately, science has kept up with times. Unfortunately, insurance companies still have some catching up to do. The FDA has approved the vaccine for young women and men, primarily focusing on the pre-sexually active population. One reason for the age restriction is the belief that nearly half of sexually active people already have acquired an HPV infection; which is why some older individuals (anyone over 26) might find it more difficult to cover the $375.00 cost of the vaccine. That hasn’t seemed to stop some doctors from encouraging clients to get vaccinated; arguing it can’t hurt – and it’ s a lot cheaper than the co

st of battling cancer.

Sam Knew, MSW is an educator and a local counselor. He can be reached at samknewmsw@gmail.com

By Sam Knew, MSW

It has been nearly 40 years since the American Psychiatric Association (APA) removed homosexuality from its official Diagnostic and Statistical Manual of Mental Disorders (DSM). Yet the question still lingers in the minds of some, “Is being gay a disorder?” It is a question some members of the gay, lesbian,  bisexual, transgender, and questioning (GLBTQ) community have even asked themselves at some point. But is it  possible that being gay is making us crazy? Incredibly enough, our own hang-ups about our sexuality may actually be driving us to the edge.

Studies have found that many members of the GLBTQ community are at a higher risk of disorders such as anxiety, substance abuse, and suicide. In fact, GLBTQ individuals are six times more likely to attempt suicide. However, it should be noted that the majority of GLBTQ individuals never attempt  suicide. Rates are higher however with individuals who have more trouble
fitting into both the GLBTQ community and straight

community. For example, one study showed 83% of transgender
people had considered suicide, and 54% had actually attempted it. Complicating matters more, those who have attempted to take their life may also be suffering from one or more other mental health disorders, including anxiety and depression. Not surprising, how one struggles to understand and accept their sexual identity plays a large role in their mental health.

So how exactly do all these negative thoughts and feelings lead to depression? Well in short, neurotransmitters, a chemical in the brain, relay a series of specialized messages among brain cells. Levels of norepinephrine or serotonin (types of neurotransmitters) affect a  person’s mood. For example, increased levels could stimulate feelings of motivation or self-confidence. But as far as
science can tell, it is still a chicken and egg theory. Is it the chemical imbalance that causes depression, or vice versa? Either way, it is known that individuals suffering from depression have this chemical imbalance – and GLBTQ individuals are six times more at risk of being clinical depressed.

One way many of these feelings of depression and anxiety can manifest themselves is through substance use and abuse. Although there are an array of substances abused by members of the GLBTQ population, alcohol and crystal methamphetamine seem to be the two most common – more so among gay men. And although these substances, among others are commonly abused throughout most communities, it seems in the GLBTQ community alcohol consumption rates do not decrease over time as with most. Additionally, multiple studies report nearly one-third of all homosexuals will struggle with substance abuse as means of coping with acceptance.

Gay men are also at an increased risk of developing other disorders. Eating disorders, such as anorexia (self-starvation), bulimia (purging), compulsive overeating and binging can become life threatening. Much of the time these kinds of disorders revolve around issues of self-worth and control. These forms of compulsive disorders can take other  various forms of obsessive-compulsive disorders (OCD). OCDs can manifest in various forms, from obsessive fears of contracting infections to compulsively repeating rituals, such as hand washing.

Perhaps it’s the unique stressors many members of the GLBTQ community undergo – as early as pre-adolescence that place us at higher risk. From our fears and struggles of self-acceptance to social-acceptance, our thoughts and experiences shape us into the people we are – for better or worse.

Sam Knew, MSW is an educator and a local counselor. He can be reached at samknewmsw@gmail.com

By Sam Knew, MSW

Share and share alike may be a good philosophy in general, but when it comes to the bedroom it may benefit you to be a little selfish with your toys. The rate of transmission for sexually transmitted infections (STI) with the use of sex toys varies, and there are numerous contributing factors – but without question – you are at risk.

Depending on how sex toys are used, they come into contact with bodily fluids such as semen, vaginal secretions, blood and feces. Each of these carries its own risk of transmitting STIs and other types of infections. Even if your sex toy party is a party of one, you run similar risks. Using the same toy from one orifice to the other without proper sanitation can lead to numerous types of self-inflicted infections. Hepatitis A is an infection one can contract when using a sexual toy that is contaminated with fecal matter, even if it’s the users own fecal matter.

One option to reducing your risk is choosing the right sex toy. The Coalition Against Toxic Toys (CATT) suggests, “Sex toys should be non-porous. Examples of safe, non-porous materials include: high-quality silicone, glass, surgical steel, ceramic and medical grade plastics.” These types of toys are also easier to clean and less likely to trap bacteria.

There has been an increasing trend to avoid toys made of phthalates (FAY-lates), also known as jelly rubber, a chemical used to make plastics.

Phthalate chemicals are used today in perfumes, hair sprays, plastic raincoats, nail polish, carpets, furniture and medical devices. They are even responsible for that “new car smell” MSNBC recently reported. The main concern with phthalates products is the lack of regulations – and in high concentration it can be toxic. Studies also report linking phthalates to infertility and other reproductive problems, cancer and liver and kidney damage.

In addition, keeping your toys clean is critical. Toys made of more porous materials may be harder to keep clean, and allow bacteria to be trapped and transmitted. These types of types of toys are also more vulnerable when cleaned improperly. Some studies have concluded that using harsh cleaning chemicals and excessive heat, as found when one uses a dishwasher to clean his/her toys, can compromise the protective layers of some toys.

Condoms are also widely recommended when using sex toys. An advantage to using condoms is fast, easier clean up. Especially during sex, they allow partners to safely share sex toys. Maintaining your toys is also just as important. Allowing them to dry completely, storing away from direct sunlight and following any suggested maintenance by the manufacturer. This includes using the proper lubricants, so not to damage your toys – or your health.

 



Sam Knew, MSW is an educator and a local counselor.

He can be reached at samknewmsw@gmail.com

by Sam Knew, MSW

For years our biggest concern when it came to testosterone was related to tales of roid rage. After school specials warned us on the dangers of beefed-up gym bunnies going into uncontrollable fits, throwing people through walls, and of course, there was the additional fear of acne and a diminishing penis. But these days there seems to be more talk about the dangers of low testosterone, or “Low-T.” Testosterone is a steroid hormone. It’s the principal male sex hormone and it’s also responsible for healthy mental and physical development. Testosterone, along with a few other vital components, can make the difference between how lucky you feel, look and get.

As so many of us do, we try so hard to turn back the clock, but as we all come to learn “time is the one thing that does not forgive.” And it seems our bodies, at least internally, keep pretty good track of time. As we age, our production of testosterone decreases and our metabolism begins to slow down. That slowed metabolism encourages the production of fat cells in our body, producing aromatase, “which is responsible for converting testosterone into estrogen,” according to the Science Daily. Estrogen in small amounts actually has some benefits. However, with our already decreasing testosterone levels and continuing increasing estrogen levels, the results can be less than flattering.

Elevated estrogen levels are also correlated with heart attack, stroke, blood clot, diabetes, thyroid problems and even types of cancers, such as prostate and male breast cancer.

But, as I’ve stated many times, it really is all about the sex. The combination of Low-T, increased estrogen levels and an increase in body fat can have a detrimental effect on one’s sex drive. It’s known as “hypogonadism,” a decreased libido. Fortunately, the condition is treatable, and there are a variety of options.

Changes in your diet and exercise may do just the trick.  By decreasing the chances of fat cells transforming your already dimensioning testosterone hormones into estrogen you can derail the cycle. “This is especially true of fat around the abdomen, because belly fat absorbs testosterone more efficiently than any other fat cells in the body. To raise libido, the challenge is not so much to reduce weight as to reduce waist size” according to one MSN report. For those of us who are a little less disciplined, there are some medical options. Testosterone replacement therapies and anti-estrogen therapy are common medical treatments. Low testosterone treatments can be prescribed. One option is as an intramuscular injection, taken as needed (usually biweekly). There is also a patch or gel, which is placed on the skin. Each form of treatment has its risks and benefits.

And with benefits like a healthier heart, gut and sex life, you’ll feel better. Really … you’ll actually feel better. Testosterone levels may also influence the level of serotonin (a chemical that influences a variety of brain cells).   Increased serotonin levels could stimulate feelings of motivation or self-confidence – and what’s sexier than that?

Sam Knew, MSW is an educator and a local counselor. He can be reached at samknewmsw@gmail.com

Sam Knew, MSW

For many men society has dictated their roles in life.

We take out the garbage, kill the big bugs and are handy with a hammer. As gay men, we have the additional responsibility of looking fabulous while doing so. Now, I know what some of you are thinking, “What’s a hammer?” Nonetheless, based on gender, we (and the world), see men in a certain stereotypical light. This limited view of males in our society has had its benefits historically; however, it has also created a perpetual state of denial, shame and injustice for some.

It is estimated that one in six men are victims of sexual assault (rape). White heterosexual males commit the majority of cases; however, perpetrators can include women, friends and social acquaintances. In some cases victims are drugged or taken advantage of while under the influence of alcohol. An estimated 12% of case victims are in the age range of 25 and older. And similar to other cases of sexual assault, “sexual desire nor sexual deprivation is the primary motivating force behind sexual assault. It is not about sexual gratification, but rather a sexual aggressor using somebody else as a means of expressing their own power and control,” according to the National Center for Victims of Crimes (NCVC).

Unfortunately, male victims are less likely to report cases of sexual assault. One major factor with male victims, especially heterosexual victims, is the fear of how they will be portrayed publically. One study found that people place more blame and have less sympathy for male victims. Those reactions magnify when the victim is a gay man. In addition, there is the misguided notion that men should be able to fend off any form of sexual assault, which leads to the perception that male victims secretly desire the attack. There is also the negative stigma that gay men are more sexually promiscuous and fantasize about sexual assault – which makes them willing participants.

More so, men (straight or gay) who are sexually assaulted may not consider themselves victims if they become sexually aroused during the attack. The NCVC reports that, “Since ejaculation is not always within conscious control, but rather an involuntary physiological reaction, rapists frequently succeed at getting their male victims to ejaculate.” For this reason, many victims blame themselves, which prevents them from reporting the crime – and seeking help. This misdirected blame may also be compounded with feelings of depression, sexual confusion and dysfunction, anger, guilt and suicide.

Survivors, more than anything, need support and justice. Communities and laws are rapidly gaining awareness and shedding light on this disturbing crime. More information and preventative measures are available through local police departments and/or community centers. Community centers, like our own The Pride Center at equality Park, will be holding an informational session in collaboration with the Wilton Manors Police Department on March 17th at 6pm. It is the goal of this meeting to provide the information necessary to help potential victims and help current victims become survivors.

Sam Knew, MSW is an educator and
local councelor. He can be reached
at SamKnewMSW@gmail.com