The new world situation caused by the coronavirus pandemic (COVID-19) requires special attention due to the confinement, social distance and hygiene measures recommended for its control, as well as the health, social and economic consequences after de-escalation of the measures mentioned to return to normalize life.

In each region of the world, the infection with COVID-19 has come at a different time, with a different incidence and with different governmental measures, but in society there will be significant social effects on sexual health, in couple relationships, in family relationships, in social relations and in mental health, as well as there will be economic difficulties due to the loss of many jobs, which will be the main sources of concern.
Sexual health and rights are an important public health problem that requires specific attention in times of pandemic and, therefore, the World Association for Sexual Health wants to focus our attention on their protection and on promoting gender equality and respect for sexual diversity.

We must remember that sexual health is defined as a state of physical, mental and social well-being in relation to sexuality that requires a positive and respectful approach to sexuality and sexual relations, as well as the possibility of having pleasant and safe sexual experiences, free from all coercion, discrimination and violence (WHO, 2002).

In the same way that diseases affect women and men differently, the pandemic situation increases existing inequalities between women and girls, as well as discrimination of minority population groups by any condition (functional diversity, LGTBIQ population, immigrants, etc.).
In times of crisis, such as the quarantine situation, women and girls are at increased risk of intimate partner violence, sexual abuse, and family violence as a result of increasing tensions in the home from confinement. They also face increased risks from other forms of gender violence, including sexual exploitation and abuse in these situations.

Women represent the largest workforce in the health and care sector in the world. Therefore, they are more exposed to having more health problems by being in the front line of action. Similarly, it is important to guarantee continuity of care in the event of an interruption or alteration of sexual health care services due to the diversion of resources to face the infection and the lack of health supplies due to shortages.

Providing mental and psychosocial health support for individuals, families, the community, and the staff who serve basic services is critical to maintaining health and rights. Surveillance and response systems must take into account aspects such as sex, gender, age, risk factors for health reasons, employment status and pregnancy status.

WAS collaboration and alliances with WHO, UNFPA and other United Nations agencies to support Ministries of Health and other Ministries related to pandemic control are essential to ensure correct information on precautions to avoid infection and potential risks associated with sexual activity and the risks of increased violence against women, children and the most vulnerable population groups. It is also important for WAS to advise on seeking health care and psychosocial aids.

It must be pointed out that individual protection protects others from getting sick, that life must go on and that sexuality is an inseparable and essential part of human beings.

Furthermore, the World Association for Sexual Health urges all states and nations to ensure that everyone’s human and sexual rights are recognized and respected, and that the rights and access to sexual and reproductive health services are not violated by new policies or measures to manage the pandemic. Human, sexual, and reproductive rights, equality, and a free and just society should not be sacrificed in the process.

Dr Sharmila Majumdar
MS Human Sexuality, PhD cbt
Fellowship from Ichan school of Medicine, Mount Sinai, USA
Director and Chief Sexologist
Sexual and mental health clinic , Avis Hospital

Consult Online – Click Here

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There is no cure, so the focus is on protecting children.
Pedophilia, the sexual attraction to children who have not yet reached puberty, remains a vexing challenge for clinicians. Classified as a paraphilia, an abnormal sexual behavior, researchers have found no effective treatment. Like other sexual orientations, pedophilia is unlikely to change. The goal of treatment, therefore, is to prevent someone from acting on pedophilic urges – either by decreasing sexual arousal around children or increasing the ability to manage that arousal. But neither is as effective for reducing harm as preventing access to children, or providing close supervision.

The exact causes of pedophilia have not been conclusively established. Some studies of pedophilia in child sex offenders have correlated it with various neurological abnormalities and psychological pathologies

• No intervention is likely to work on its own; outcomes may be better when the patient is motivated and treatment combines psychotherapy and medication.
• Parents should be aware that in most sexual abuse cases involving children, the perpetrator is someone the child knows.

Nearly all people with pedophilic tendencies are male. Studies of child molesters have reported that only 1% to 6% of perpetrators are female. Co-occurring disorders, such as personality disorders or mood disorders, are common in people with pedophilic tendencies. And about 50% to 70% of people with pedophilic tendencies are also diagnosed with another paraphilia, such as exhibitionism, voyeurism, or sadism.

Most psychotherapies used to treat pedophilia incorporate the principles and techniques of cognitive behavioral therapy. The focus of therapy is to enable the patient to recognize and overcome rationalizations about his behavior. In addition, therapy may involve empathy training and techniques in sexual impulse control. Most important behaviour therapy used is Relapse prevention

• Relapse prevention is intended to help the patient anticipate situations that increase the risk of sexually abusing or assaulting a child, and to find ways to avoid or more productively respond to them

• testosterone suppression offers advantages such as the need for follow-up visits (which aids in monitoring behavior). It may take 3 to 10 months for testosterone suppression to reduce sexual desire.

• SSRIs may be a useful adjunct to other treatments, because they not only subdue sexual ruminations and urges but also help with impulse control.

Finally I’m in favor of treatment to spare kids the physical and psychological trauma. It doesn’t matter whether it is nature or nurture unless it helps in quality treatment.

Dr Sharmila Majumdar
MS Human Sexuality, PhD cbt
Fellowship from Ichan school of Medicine, Mount Sinai, USA
Director and Chief Sexologist
Sexual and mental health clinic , Avis Hospital

Consult Online – Click Here

The post Pedophilia appeared first on Dr. Sharmila Majumdar - Sexologist Psychoanalyst in Hyderabad.

Q: Are we even wanting sex in these covid-19 days?
A: It’s hard to know yet. While some people may turn to sex for comfort or as a temporary distraction, these are unforeseen times and we don’t have much data. Depression and anxiety have a negative effect on libido. Some people are out of work, too, and unemployment can affect sexual desire. The kind of worry people are experiencing crosses so many domains: Job security, health, friends’ and family’s health, and the ability to have access to medical care, to name a few.

Q: What is considered ‘safe sex’ right now?
A: Your risk for infection with the coronavirus starts as soon as someone gets within 6 feet of you. (And of course, if you do have sex, your risk for pregnancy and sexually transmitted diseases remains the same, and the previous definition of “safe sex” still applies)
You’ve read this elsewhere: COVID-19 is transmitted by droplet nuclei, tiny specks of infectious material far too small to see. They are sprayed from the nose and mouth by breathing, talking, coughing and sneezing.
A person contracts the virus sharing the same airspace – a 6-foot radius, the distance droplet nuclei are believed to travel (although with coughing they may travel farther) — and inhaling the infectious particles. Or the droplet nuclei land on an object or surface, making it infectious. Touch that surface and then your face and the chain of transmission is complete.
If you do have sex with someone who is infected with the coronavirus, there is nothing we can recommend, be it showering head to toe with soap before and immediately after sex, or using condoms, to reduce your risk of infection. We don’t know if the coronavirus is present in vaginal secretions or ejaculate, but it has been identified in stool.

Q: Who are the safest partners?
A: It’s best to limit sex to your spouse who should also be following recommendations for hand hygiene and social distancing. The World Health Organization currently lists the risk of household transmission as 3% to 10%, but this is based on preliminary data. We don’t know what role kissing or sexual activity plays in transmission.
The idea of limiting sexual contact to your husband and social distancing in general is about ending the chain of transmission to your household should one person become infected.
If your Spouse is sick with symptoms of COVID-19, or has been exposed, definitely don’t have sex. They may be too fatigued anyway, but your risk of being infected will likely go up in close, intimate contact. Sleep in separate bedrooms if possible.
If you have more than one bathroom, designate one for the sick or exposed person. Try to stay 6 feet apart and be fastidious about disinfecting surfaces. If they were exposed, living as separate as possible in your home for 14 days is adviced.

Q: What if I’m in a new relationship and had planned to get other STD testing done?
A: Many labs are overwhelmed with coronavirus testing, so you may not get results for some STDs — like gonorrhea, chlamydia and herpes — as fast as before. Given the short supply of test kits for COVID-19, so sampling kits for genital infections may be in short supply.
Ask your doctor because workflows may vary locally and may change day to day. But if you are at risk of an STD, you should still seek out a test as soon as possible.

Q: What if I don’t have a Husband ? Am I now celibate?
A: Yes, I’m sorry to say, those are the recommendations. For now. But this doesn’t mean you can’t meet people online — start talking on the phone, have video chats, if that’s your thing.
And if someone you meet online is encouraging you to meet in person? That not only tells you how they view their own safety, but, even more important, how they view yours.

Q: What about sex toys?
A: Sex toys aren’t likely to be a method of coronavirus transmission if you have been using them alone. However, if you shared your toys within the past 72 hours, make sure they are disinfected and wash your hands afterward as the virus may stay active of some surfaces for up to three days.
And do not clean sex toys with hand sanitizer or use hand sanitizer immediately before masturbating, because it can be very irritating to the vagina or rectum.

Q: Is it safe to buy new sex toys?
A: it appears that a lot of vibrators are on sale. Is this a good time to take advantage of a deal and the extra time on your hands? Paying electronically is safer than an in-store purchase: Paying online means no one is physically handling a credit card or cash. Does your online purchase of a nonessential, a vibrator is a “want,” not a “need” put someone else at increased risk? Workers at large warehouses where social distancing isn’t possible may be at increased risk, especially if they don’t have sick pay, so taking time off if exposed isn’t possible

Q: What will safe sex look like in the future?
A: Right now the only safe sex is no sex with partners outside your household. If you or yours spouse are at high risk, should you take extra precautions to further reduce the risk of transmission — giving up sex and kissing, sleeping in separate bedrooms — in case one of you has an asymptomatic infection? Asking your doctor for guidance here is probably wise.
But what about when we emerge from our homes again — which may be some months away — and start thinking about in-person dating, and mating?
No one knows if we are all going to have the urge to have sex after this quasi-hibernation. One concern is a potential surge in risk-taking and STDs. in the immediate aftermath of this covid-19 pandemic. (After all, you can’t assume that if someone was celibate during the pandemic they don’t have an STD; most STDs don’t cause symptoms and could have predated the coronavirus.
If that all sounds bleak, well, it is. For now, the coronavirus probably means less sex overall, whether that’s because of no spouse or a drop in desire. Or both.
Hopefully, though, this is just for now. Because the more everyone commits to social distancing, physical distancing the faster we can all get back — and down — to business.

Dr. Sharmila Majumdar
Director and Chief Consultant
Sexual and Mental Health Clinic

Consult Online – Click Here

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