Hi everyone! We're Dr. Lori Brotto and her graduate students Silvain Dang, MA, and Natalie Brown, MA, from UBC Sexual Health Research out of The University of British Columbia. Our research covers topics ranging from mindfulness and sexual health, to cultural differences in sexual response, to asexuality, to sexual dysfunctions, and now to COVID-19 and sex, and more! We're very excited to be here with you all today to answer your questions about our research, and sexual health and sexuality in general! A little more about us and our research...

Dr. Lori Brotto is a Professor in the UBC Department of Obstetrics and Gynaecology, and a Registered Psychologist in Vancouver, Canada. She is the Executive Director of the Women's Health Research Institute of BC located at BC Women’s Hospital. Dr. Brotto holds a Canada Research Chair in Women's Sexual Health. She is the director of the UBC Sexual Health Laboratory where research primarily focuses on developing and testing psychological and mindfulness-based interventions for women with sexual desire and arousal difficulties and women with chronic genital pain. Dr. Brotto is an Associate Editor for the Archives of Sexual Behavior, has >170 peer-reviewed publications, and is frequently featured in the media on topics related to sexuality. Her book, Better Sex Through Mindfulness: How Women Can Cultivate Desire (2018) is a trade book of her research demonstrating the benefits of mindfulness for women’s sexual concerns. Proof: https://imgur.com/a/dnRmcES

Silvain Dang is a PhD candidate in clinical psychology at the University of British Columbia, Vancouver, Canada. He completed his Master of Arts in clinical psychology from UBC in 2014. His specialization is in sexuality, culture, and perfectionism. He also has a research background in behavioural neuroscience. He practices interpersonal, psychodynamic, and cognitive-behavioural approaches to psychotherapy. Proof: https://imgur.com/a/6TUL6NI

Natalie Brown is a PhD student in the UBC Clinical Psychology program, working under the supervision of Drs. Lori Brotto and Alan Kingstone. She completed her MA in Clinical Psychology at UBC, and her thesis explored the cognitive mechanisms underlying sexual attraction and desire, with a specific focus on asexuality and Sexual Interest/Arousal Disorder. She is also involved with IMMERSIVE, a study investigating women's subjective sexual responses to virtual reality (VR) erotica, and she plans to evaluate VR as a clinical tool for the treatment of genito-pelvic pain/penetration disorder (GPPPD) in her PhD. Natalie is also one of the coordinators of the COVERS study, which investigates the short- and long-term impacts of COVID-19 related social changes on sexual and reproductive health. Overall, her research program aims to improve our understanding of sexual difficulties and develop evidence-based interventions for individuals with distressing sexual concerns. Proof: https://imgur.com/a/AEhFOdX

If you'd like to read more about our research and our publications, or see some of our research featured in the media, you can check us out at brottolab.com

EDIT: And we're done! We'll try to get to a few last questions here, but we want to say a huge thank you to everyone who took the time to engage with us about sexual health! If you want to find out more about us, please go to our website at www.brottolab.com, or follow us on social media @UBCSHR

Comments: 878 • Responses: 25  • Date: 

RedLMR56551 karma

Okay this is going to sound odd. How do you communicate sexual attraction and desire without being creepy?

ubcshl821 karma

Natalie here - I don’t think this question is odd at all, and I wish we talked about it more. So, I would say the first thing to do is to initiate communication and then read social cues.

If you’re having a conversation in person, see how engaged this individual is in the conversation, whether they move closer to you when you speak, and what their body language is saying. Are they gazing at you? Are they repetitively touching their hair? Are they moving their eyebrows in certain ways? If you’re getting a sense that they might reciprocate your feelings, you could always say something like, “I find you attractive and was wondering if you wanted to hang out sometime?” However, context is key.

Now that we are in the era of COVID-19, online conversation might be the medium of choice. I would advise starting a conversation with them through text, Facebook chat, etc., and see how they respond back. Are you getting a lively conversation going, or do the messages go unanswered for days? Now, a caution, a lot can be misconstrued over text/chat. So, if you’re unsure I would ask about their feelings in a direct but respectful way. Similar to above, you could say something like, “I find you attractive/I really enjoy talking to you, would you be into doing activity X”? Activity X could be a date of your choice.

Important - if they indicate that they are not interested, do not continue to express your sexual/romantic feelings.

justlookingaround-341 karma

Hi researchers!

What are a the top few things you’ve discovered in your research you/we may not have known before? What information is new that the general public doesn’t already know?

And since you are on Reddit, many of us are single and not mingling. What is the best way to check if our single lives are sexually healthy?


ubcshl472 karma

Lori: Great question! Since my research focuses largely on sexual desire, I think one of the most important findings from our research is that psychological interventions are very effective for cultivating desire, and although we have not directly evaluated them against medications, what we know regarding the data on medications for women’s low desire is that their benefits are modest, at best, and a third of women experience negative side effects. Mindfulness meditation, which other research tells us changes how the brain functions and also the structure of the brain, can be very effective for improving sexual response, and making people feel overall more satisfied about sex. It is surprising to me how many people engage in sexual activity without actually “showing up” for it! What I mean by that is that they can be distracted or having thoughts that are not relevant to the sex that they are having. One other intriguing finding is that people can benefit from these kinds of interventions regardless of their age. Thus, the belief that sex ends at a certain age is purely a myth!

ubcshl369 karma

Silvain: One of the (among many) surprising things I learned about people’s sexualities is the huge range of reasons people give for having sex, or for not having sex. There was one group of researchers which found that people gave 200+ reasons for having sex! And there’s lots of reasons people don’t have sex as well, ranging from because of painful past experiences to they’re simply not interested. For single folks, I think the biggest way to check if your single lives are “sexually healthy” is checking in with yourself. Are your current sexual experiences consistent with your values, and do they make you feel good or okay at the end of the day? Or do you feel dissatisfied and things seem really different from what you want in life? Ultimately, we each get to decide what place sex has in our lives and what is right for ourselves.

f6c6233 karma

Is a woman’s squirt actually just pee?

ubcshl655 karma

Lori here: great question. Researchers (and the public) have been fascinated with this question for decades. The research has gone back and forth as to whether the contents of female ejaculation (aka the squirt) is urine or fluid from the “female prostate” or peri-urethral gland. The most scientifically sound study confirmed that yes, indeed, most of the contents of the female ejaculation is indeed urine.

NoAppointment6026194 karma

If you are experiencing sexual dysfunction/low sex drive and it is clearly not related to mental illness or medication, what can you do about it? I've generally found the advice from health care practitioners to be "you're out of luck" or "wait it out", but surely there's a better answer.

ubcshl223 karma

Silvain: I’m really glad this question came up, and I’m really sorry to hear that the advice you’ve gotten is mostly “you’re out luck” or “wait it out”. Lori talked about the usefulness of a mindfulness-based approach for enhancing sexual desire and arousal. A lot of sex therapists also use cognitive-behavioural therapy (CBT) to treat sexual dysfunctions, which can be quite effective for some people. Low sex drive and sexual dysfunctions can be caused by a variety of things though, and a thorough assessment is often needed to figure out exactly what is the cause and what might be the best treatment. I generally recommend folks try to find a sexual health service, or a sex therapist, in their local community for a more complete assessment and to discuss treatment options. I realize that this may not be open to everyone unfortunately, depending on your financial means and the availability of services in your part of the world. Accessibility of sexual health services to all people is a hugely important area of advocacy in our field.

ubcshl127 karma

Lori: great answer, Silvain! The only thing I might add is that good, accurate information about sexual health can also really help sexual dysfunction. I recommend www.sexualityandu.ca as a good resource. Also, Emily Nagoski’s book, Come As You Are.

LinkifyBot34 karma

I found links in your comment that were not hyperlinked:

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ubcshl112 karma

Good bot!

tonoocala188 karma

is there any truth to the the myth about consuming pineapples?

ubcshl356 karma

Natalie here - In short, there doesn’t seem to be any solid empirical evidence directly linking the consumption of pineapples to the improved taste of semen.

Lori: I agree with Natalie. There have also been myths about pineapple reducing the taste and odor of vaginal secretions. While pineapples are certainly delicious and beautiful, and I recommend consuming them for their general health benefits, there is NO evidence that consuming them will alter the quality of vaginal secretions.

Gingerchaun172 karma

Should I be using glory holes during the pandemic?

ubcshl386 karma

Lori: Interestingly, the BC Centre for Disease Control actually recommended glory holes, and other barrier methods, as a means of reducing the transmission of COVID-19 during sex, especially with unfamiliar partners. http://www.bccdc.ca/health-info/diseases-conditions/covid-19/prevention-risks/covid-19-and-sex

bman_78134 karma

Is watching pornogaphy unhealthy? if not how much you would consider to be unhealthy?

ubcshl265 karma

Natalie here - This is a great question and one that comes up often! So, I do not consider pornography consumption in itself to be unhealthy, and I’m skeptical of the term “porn addiction”. Let’s start with the downsides. Whether pornography consumption is harmful for an individual depends on a few different factors. First, if an individual finds that their pornography consumption is negatively affecting their sexual relationship with a partner, and this is causing the individual distress, it could be an issue. Second, if one is consuming types of pornography that are propagating sexual myths (e.g., lubricant is not required for anal penetration), and this person internalizes these myths, it could also be a problem. An example that comes to mind is the idea that cisgender women often orgasm from around 5-10 minutes of vaginal penetration without any clitoral stimulation (often seen in mainstream pornography). Research suggests that very few cisgender women orgasm reliably from penile-vaginal intercourse alone, and many require (and prefer) clitoral stimulation. So, in short, many types of pornography can instill ideas about sexuality that don’t translate into fulfilling sex!

Let’s now shift to the positive aspects of pornography. First, you can use pornography to fulfill your sexual desires solo (if your partner isn’t up for sexual activity or you don’t have a sexual partner). Also, you can watch pornography to experience something that you fantasize about (e.g., BDSM activities) but you might not want to enact with your sexual partner. Also, you could watch pornography with your partner! I would highly suggest erotica for this (a type of pornography) which has more of a story line than mainstream pornography, focuses on consent, and is less “cisgender man” centred (i.e., focuses on women’s pleasure).

As for the “right amount” of pornography to watch - it’s tough to say. I think the key question about “how much is too much” relates more to functional impairment. Is the amount of porn you’re watching interfering with your ability to do other things you care about - have fulfilling sexual relationships, spend time with friends, meet deadlines at work? If the answer is no, you’re probably okay. If the answer is yes, perhaps seek counsel from a sex therapist.

rd213498 karma

I live in a pretty religious household and the main idea that gets pushed is a very strict one. Being a teenager i have obviously explored my body and all but i just wanted to ask if i should masturbate while living in such strict conditions or if i should feel bad while doing it, and what i could do to overcome these bad feelings?


ubcshl174 karma

Silvain - Thank you for raising this important question. As I’ve mentioned in a few other response, I don’t know the details of your living situation or your own religious beliefs, so I can’t give super specific advice. What I can say is that masturbation is very common in teens, and wanting to explore your body in your teenage years makes a lot of sense. Exploring our body is also a really important part of growing up. We need to know our bodies, including what does and does not feel good in our body. It’s a really important part of being able to make effective decisions for ourselves. It can be a big part of how we keep ourselves safe. I also understand that it’s really easy to feel scared, ashamed, or guilty about masturbating and exploring our bodies, especially if we grow up in a very strict religious household. I just want to repeat that masturbation and exploring one’s body is a normal and common experience for many teens.

Lori here: Thank you for your honesty and I am certain that many others have the same question. I am sorry to hear that you might be made to feel like masturbation is harmful. In fact, the research suggests that masturbation is a very healthy and helpful way of getting to know your body and what kinds of sexual touches are arousing for you. In sex therapy, we often recommend that people engage in self-touch as a way of exploring different types of arousing feelings. However, I do understand that in your home environment, it could be stressful, and as such, why you might consider not masturbating while people are around. I might be inclined to suggest that you try to masturbate when no one is in the home and really focus your attention on the physical feelings. Try to “let be” any thoughts or worries about others in the home and what they might be thinking. We do not want to “pair” masturbation with fearful thoughts, worries, and anxiety. We want to pair masturbation with positive thoughts and an awareness of good pleasurable feelings. I hope that this works for you and feel free to report back!

Thediciplematt94 karma

Any research on promoting male sperm health? Recommended diets, etc?

ubcshl173 karma

Lori here: There is a great resource from the Mayo Clinic: https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/fertility/art-20047584 Here is what they say:

  1. Maintain a healthy weight. Some research suggests that increasing body mass index (BMI) is linked with decreasing sperm count and sperm movement.

  2. Eat a healthy diet. Choose plenty of fruits and vegetables, which are rich in antioxidants — and might help improve sperm health.

  3. Prevent sexually transmitted infections (STIs). Sexually transmitted infections — such as chlamydia and gonorrhea — can cause infertility in men. To protect yourself, limit your number of sexual partners and use a condom each time you have sex — or stay in a mutually monogamous relationship with a partner who isn't infected.

  4. Manage stress. Stress can decrease sexual function and interfere with the hormones needed to produce sperm.

  5. Get moving. Moderate physical activity can increase levels of powerful antioxidant enzymes, which can help protect sperm.

olderthanbefore83 karma

To be more sexually attractive, what parts of their physique should men and women improve? Or is it all about the face? Thanks

ubcshl267 karma

Natalie here - It might seem cliche for me to say “beauty is in the eye of the beholder”, but it does seem to hold up in the literature. Specifically, the physical qualities that one finds attractive is affected by a multitude of factors, culture among them. However, facial symmetry does seem to matter - the more symmetrical your face is, the more attractive you are to others irrespective of gender. Interestingly, cisgender women’s preferences for men’s facial structure varies across the menstrual cycle. In terms of other specific physical features, I’m not sure there’s anything one can “improve”. However, studies have linked a few other factors to perceived attractiveness: kindness and repeated exposure. In short, if someone is described as kind you are more likely to rate them as physically attractive, and the more often you see someone the more attractive they appear.

kittymmeow50 karma

During your education or careers have you ever experienced pushback for your choice of field of study? I have heard that sexuality and sexual health has been traditionally under-studied, do you think that is improving over time or is it still somewhat of a taboo topic even in research settings?

ubcshl129 karma

Natalie here - I wish I could tell you that I have never received pushback from friends, family, and colleagues, but that would be untrue. When I first decided to pursue graduate school for sex research, my parents would tell others that I “hadn’t figured out my career yet”. They did come around and they now support what I do. However, when my sister and I ask for gifts around Christmas/birthdays related to our work, she receives books about medicine (she’s a physician), and they usually give me a biography by a female politician. So, we’re still working on it.

In terms of colleagues, it is true that some researchers have not taken my research seriously, but I find that the majority of folks at the University of British Columbia where I attend graduate school are open-minded and curious. I did receive some rather shocking questions/suggestions during the interview process, but I have been able to do some pretty cool work there (e.g., research related to virtual reality erotica) that definitely would not be accepted elsewhere.

So, it’s a mixed bag. BUT - I have never once regretted my decision to pursue this career. I wake up everyday excited to do sex research. It’s an incredible opportunity to do research that has the potential to improve others’ quality of life.

ubcshl81 karma

Lori here - I do find that I often have to legitimize to people that sex research is an incredibly important and legitimate area of study. Because people often have preconceived and illformed ideas of what being a sex researcher entails (they always assume that we study people having sex in our labs!), it means that I spend time first linking sexual health to overall quality of life, and explaining that when sexual function declines, many other aspects of health and wellbeing suffer too. Then from there I explain our methods, how we study sexuality, and our methods of analysis. In this way, it is no different than studying other aspects of health like diabetes or asthma.

vichn46 karma

Hi there. If a woman or a man experience chronic congenital or acquired conditions that do not respond to medication or can only be cured by surgical intervention (not desirable by many), how do they: a) normalize their attitude to the condition; b) communicate it to a partner properly; c) remove shame and fear of rejection from their mind as it's not their fault?

Thank you!

ubcshl56 karma

Lori here: Thank you for asking this question. I am certain that many readers can appreciate it. Each of the things you list: normalizing your own condition + communication about it + removing shame require important work done, and for some people, it is work that has to happen one at a time. In my practice I often work with individuals with congenital conditions that impact their (internal or external) genital anatomy, and they come to me because it interferes with their wish to date. In our work, we must do the foundational work of practicing acceptance. As you point out, when the medications and surgeries have reached their limit, it is imperative that we practice self-compassion for the things we cannot change.This is hard work, and I often rely on the self-compassion practices of people like Tara Brach (https://www.tarabrach.com/) to cultivate this practice. Before we try to share this kind of personal information with a partner, we need to know ourselves and stay true to that. In therapy, I then practice role playing conversations with individuals trying out different ways to tell a person about the congenital or acquired issue. Importantly, you need to understand that the other person’s negative reaction says nothing about you, and a lot about them. I find that one of the best ways to eliminate shame is to normalize. Sometimes getting into the facts (like a mini education session) can demystify the condition and results in reduced shame. We also know that uncertainty can breed anxiety, so the more you can share accurate information with the other person, the less uncertainty they will have, and the less anxiety there will be. Good luck!

redlion49635 karma

How totally misunderstood is the work that you do?

ubcshl43 karma

Lori here - Because we evaluate the effects of mindfulness on sexuality and genital pain, and we find that it works, sometimes people conclude, therefore that sexual dysfunction and genital pain are “all in your head”. This is received negatively by those with sexual dysfunction and/or genital pain as implying that their symptoms are in some way made up, or a byproduct of psychological issues. This is not true. In fact, mindfulness can directly reduce sensations of pain, and this does not mean that the origin of the chronic pain is psychological! That said, mindfulness does work by changing our brain. Repeated practice of mindfulness results in structural changes in the brain anatomy, and also functional changes in how the brain operates in the moment. Therefore, mindfulness is indeed a brain therapy. We ran an entire social media campaign 2 years ago called #ItsNotInYourHead which sought to educate the public about the causes and treatments for genital pain in women, and to debunk the harmful myths that genital pain was “all in women’s heads”.

ubcshl40 karma

Silvain: Great question! And hard one to answer because it’s hard to know exactly what everyone or any one person thinks about our work! I think there is a really big range. Some people I’ve met in my teaching or clinical work have been really well informed about sexuality and the work of sex therapists, researchers, and educators. But there is also a lot of misinformation out there as well, about human sexuality if not about our work specifically. I think the biggest take-away is that lots of people don’t realize how much good, useful information is out there. There is lots of great research being done about sexuality in the scientific community, it’s a thriving topic. There are lots of well trained sex therapist who can help with sexual difficulties in people’s personal lives or relationships. And there is lots of good information out there as well (although there is a lot of not so good information too). I know this also depends a lot on where you are living in the world, but at least this is the case in Vancouver/Canada.

tonoocala28 karma

what maximizes sexual performance and durability of the act? (Exercise, meditation, is it just pure passion, being horny, a diet of healthy foods [fruits, vegetables, non-salted nuts...], or anything else you may think of)

ubcshl69 karma

Natalie here - It really depends on how you define “sexual performance”. My personal definition is the ability to provide pleasure to a partner and myself, but I know that the term is more widely used to refer to the length of time that one is able to maintain an erection. So, initiating and maintaining an erection:

Anxiety is the enemy of sexual arousal. So, for the maintenance of an erection I would suggest engaging in activities that maximize anxiety reduction and present-moment awareness. You’ve mentioned meditation - which is great - and I would say practicing mindfulness (non-judgmental awareness of the present moment) during sexual activity is key. I would also encourage being with a sexual partner that you feel comfortable with, communicating openly, and taking your time. The more pressure you put on yourself, the harder it is to maintain an erection.

Silvain here - I agree with Natalie that anxiety is a really common cause of sexual difficulties, in the absence of a medical issue. One type of anxiety that can be common when we think about sexual performance is, ironically enough, performance anxiety. Most people, when they have sex, are looking for some combination of pleasure and connection. However, when we get too focused on sexual performance, our brains are no longer focused on feeling pleasure or connecting with our partners. Gently reshifting our focus to what feels good physically or emotionally in the moment can be really helpful.

Communication is another huge part. Talking to your partner about what they like, what you like, and what you/they don’t like is really important. We can’t read each other’s minds - talking things out lets us focus on doing the things that bring the most enjoyment to yourself and your partners.

tonoocala13 karma

thanks for the reply and taking the time to educate here!

ubcshl19 karma

Of course! Thanks for your interesting question!

ricardo950517 karma

I was looking fwd to visiting the museums again for Greek and Messopotamian art and it had me thinking of sexuality in Greece when my daughter asked (she's playing a video game based in like 350BC. Like a woman having a sexual relationship with another woman then marrying months later and it wasn't a huge thing it seems. How would sexuality be described back then? I'm trying to understand this to better explain it. As well as the fact that so many of her friends think they're gay and they're like 12-13. (I assume body changes, understanding their weird emotions they feel that are new). Thanks!

ubcshl54 karma

Silvain here - For the first part about sexuality in ancient Greece: A lot of what we think is or is not acceptable when it comes to sexuality depends a lot on the messages we are exposed to in our society. This can be very different in different places of the world and in different times in history. The culture that we are raised in can have a big impact on what we think is right and wrong. It’s even more complicated when we are talking about a video game made by modern people about what they think ancient Greece was like, or trying to portray ancient Greece in a certain way. Sexuality in the other times in history is a big topic and a really interesting one - I recommend asking about it in the r/AskHistorians subreddit, where you might get some more detailed information from historians who study sexuality in ancient Greece and ancient Mesopotamia.

Natalie here - For the second part of the question, given that 12-13 years is around the time when a lot of changes relating to puberty are taking place, as you’ve noted, feelings of sexual attraction towards others can (but do not always) emerge. It is definitely possible that some of her friends are experiencing sexual attraction to their same-gender peers, and valid if they identify as gay/lesbian. We could also note that sexual attraction can be fluid, and its direction can change over the lifespan (e.g., in adolescence/young adulthood one might experience attractions to the opposite gender, and then later in life they experience attraction to someone of the same gender).

samuelrv025314 karma

What made you want to start researching sex?

ubcshl43 karma

Silvain here - I grew up in an environment where talking about sex was very taboo, and there was not a lot of chances to learn more about this topic for better or worse - only a lot of silence. At the same time, I was also never personally scared or ashamed of the topic, even though I knew it was something that made a lot of adults uncomfortable. Maybe it’s because I was really interested in animals and biology as a kid so learning about animals “mating” was just a normal part of nature documentaries and books I read. When I began to learn more about the psychology and neuroscience of sexuality in university, it just felt like a good fit - that I can use my comfort talking about this topic to help other people feel less shame or guilt, and to help educate rather than hide everything in silence.

ubcshl37 karma

Natalie here - I took an amazing course during my undergraduate degree on the Psychology of Human Sexuality and I was hooked after the first lecture. I’ve always been interested in relationships between people, and studying sexuality presented a unique opportunity to explore an aspect of human connection that is not well understood. Also, I couldn’t think of a cooler title than sex scientist.

ubcshl42 karma

Lori here: Like Silvain, I grew up in a home where sex was not to be talked about and myths pervaded about what would happen if we (my two sisters and I) engaged in premarital sex. Therefore, it was surprising and perhaps serendipitous that I landed a volunteer job in a sex research lab where I observed the impact of stress and different medications on the sexual behaviour of rats! It triggered an interest in sex research because as I was contributing to new findings in sex research, it simultaneously reshaped my world view and beliefs about sexuality. Then when Viagra was approved (1999 in Canada) and I learned: (1) how common sexual concerns are in women - 1 in 3 women; and (2) that there was no female counterpart to Viagra, it fueled my passion for my now 20 year research career in women’s sexual health.