agonyaunt | How To Do It: Swearing off PIV for awhile due to politics

Entry tags:

How To Do It: Swearing off PIV for awhile due to politics

|

My husband and I currently live in a relatively rural part of the Deep South in a state with a trigger law that will basically ban abortion entirely if Roe v. Wade is overturned. I have a medical issue that means I can’t take hormonal birth control, and we’re having a really hard time finding doctors who will do sterilization surgery for me or a vasectomy for him (we’re both childfree and in our mid-20s). We are certain we do not want any children. We live several hours from the nearest Planned Parenthood and only have one car that we need to share. Our goal is to move away (hopefully to New England where we have some friends) when we can, but we don’t make a lot of money, and saving for a big move will take time.

Our plan is to basically just stop having any penetrative sex/do anything that could result in pregnancy. I’m just not comfortable with the risk, and condoms are only 85% effective in real life without a backup. Could you give us some advice on ways to have satisfying sexual experiences without PIV sex? We’re relatively young, were both raised in purity culture, and feel a little out of our depth here with the exploration.

—Stuck in the South
Currently, Roe v. Wade has not yet been overturned. The situation does look pretty grim though, so let’s go ahead and talk about your options.

You said that you live several hours from the nearest Planned Parenthood. I’m still wondering whether they would be willing to give you or your husband a sterilization procedure. It’s worth calling to ask—if you haven’t yet—and considering how to make it happen. If they’re willing, and you’re able to figure out how to get there without jeopardizing your jobs or financial situation, that would help take a huge load of worry off of y’all’s shoulders.

Before you take penis-in-vagina activity off the table entirely, you might consider condoms (which are, yes, according to Planned Parenthood only effective 85% of the time) plus the pullout method—where your partner pulls out of your vagina long before he ejaculates. This does rely on your partner knowing when he’s close to orgasm with enough time to remove his—condom sheathed!—penis from the vicinity of your uterus.

One thing that might help is to define satisfying sex for the two of you. Dr. Ian Kerner’s So Tell Me About the Last Time You Had Sex is a great tool for thinking through the sex you have and fostering the qualities you value. The book has a whole chapter on outercourse, which is the term for all the rest of sex outside of PIV, that might give you some ideas. You also might give Barbara Carrellas’s Urban Tantra a read for her perspective on full-body sex, and a considerable amount of suggestions for how to touch each other.

Oral sex can be a great way to give each other orgasms, as can digital sex—also known as sex with fingers and hands. Take your time, and engage your sense of play. What feels like it might be fun to do? Will tickling his shaft with the backs of your fingernails tickle or turn him on? How about him incorporating his nose into cunnilingus? Would it be too silly? Does finding out sound exciting? Take note of what you each like, and continue to try new things. One important warning while you experiment; do not blow air into your vaginal canal.

You might explore areas you don’t immediately think of, too. Grinding against a thigh, or having an erection thrust against the back of your knee can be an experience. Get weird and laugh about it together.

Intimacy is another important factor in satisfaction, and while you’ll likely get some from non-penetrative sex, take care to spend time engaging in other forms of physical intimacy like cuddling, massaging, gently scratching, or anything else that works for the two of you. Good luck.

Flat | Top-Level Comments Only

1) This lovely couple is being failed by society. I'm glad they could write into HTDI (though I really didn't like the title HTDI gave this one)

2) I kind of want to write a story where this question gets answered in a more hands on way

3) You know what they call people who use the pulling-out method? Parents. I'm really not sure it improves the condom odds. But/and must do some research.

LMAO exactly @ your third point, to this day I don't get how the pullout method keeps getting recommended so often by sex ed handbooks and other people, it's super risky and in the case of the people who practice it without a condom it has been proved that pregnancy can occur from pre-seminal liquid alone.

I do appreciate how solid the alternatives to that are though, but still hope they just get themselves some form of permanent sterilization above anything else.

Done correctly, the pull-out method is surprisingly effective. The problem is that like every other form of birth control, people don't really do it correctly.

Edited 2022-06-01 22:32 (UTC)

True that! As you say, it's a method that needs to be practiced super carefully so I think that the factor itself should be taken into account.

I mean, that seems like a suboptimal time to make a guy think... talk about distracted and all that.

Especially birth control that requires *self-control*.

Okay so here's the thing with "perfect use" and "typical use" numbers for birth control effectiveness: perfect use means an average effectiveness for people who use a method exactly as directed (per year of use), while typical use is an average of the effectiveness for everyone who says they use that method (again, per year of use). Which means typical use for pulling out includes all the people who write on the form for the study that that's the birth control they use, no matter how they use it, whether they use it all the time or not. And so for every method where you have to do something every time you have sex that could result in a pregnancy, during the act--condoms, pulling out, diaphragms, spermicides--you see this big drop between perfect and typical use, because some people just don't use them every time. BUT, with these methods you can also tell if you're doing them close-to-perfect or not.

With a pill: are you taking it at about the same time every day, without missing a day? With a condom: Are you checking it's not expired? Do you know how to put it on correctly? Does it fit okay? Are you using lube? Are you putting it on before penetration and taking it off before losing an erection? Are you checking for breaking, slipping, or leaking? Are you using one every time? With pulling out: Has the person with sperm peed since their last ejacuation to reduce risk of sperm in precum? Are you pulling out well before ejaculation and ejaculating away from the other person's genitals? Are you doing it every time?

If yes, you're likely getting very close to the perfect use numbers.

And yeah, pulling out takes motivation and communication and body knowledge and judgment and trust and people need to be able to gauge whether they have those things to make it work. But honestly, I think society/the medical system devalues it because it doesn't trust people to use their bodies and their judgment (and there's no money in it for big pharma), the same way it devalues fertility awareness methods--you hear that same "you know what they call people who use x method" joke for the rhythm method all the time, right? But fertility tracking methods can be extremely effective for people who use them consistently, and fertility awareness methods and pulling out have a couple of other really important factors in common: they're free/cheap and available without medical intervention or equipment.

Edited 2022-06-03 05:06 (UTC)

You are not wrong about typical versus perfect use but I felt the need to add a couple of points here:

Point the first: the LW specifically mentioned that she and spouse both came out of "purity culture". Now, I am not an expert on all forms of purity culture, but one of the things I have noticed is that the forms of it that I have encountered in the wild seem to include the idea that, to put it really really mildly, cismen have little to no control over their sexuality. Like, we're talking about people who think that if a grown man sees, e.g., a woman in leggings, he's going to be uncontrollably aroused by that. So my point here is that depending on the particulars of LW and husband's form(s) of purity culture, getting a dude from that background to the point where he understands that he can control his body when he's actually at the point of orgasm, much less to the point where he can do it reliably, is... probably going to take a lot longer and a lot more work than doing things that involve sharing orgasms without PIV will, and in fact doing a lot more of those things will probably help with that. And your below comment seems to play well with that notion, in fact, so, yay.

Point the second, a lot of the aspects of "perfect use", whether it's using oral contraceptives or the rhythm method, involves people with occupiable uteruses having to... pretty much organize their lives around keeping that organ unoccupied. Whether it's making sure that you can always take the pill at the same point in the 24-hour-cycle, no matter what else is going on in your life or what your natural circadian rhythm is (not to mention that you have a whole entire rest of your endocrine system which can throw that all to hell no matter what you do), or having to fucking think about your uterus every goddamn day for the rhythm method, it's... making people with occupiable uteruses pay a lot of damn attention to the fact that they have occupiable uteruses and really, there are a lot of us for whom that is... varying degrees of very not okay. So some of us "devalue" that method because we feel devalued as people by having to expend constant effort on not reproducing that people who never had an occupiable uterus don't have to. And also the fact that no matter how much time and attention you spend on tracking your menstrual cycle (that you could have been using for literally anything else), that effort can all be undone by a person with a penis who ejaculates inside you, whether or not you had any say in whether that penis was inside you, at the wrong time.

I'm not saying these are necessarily good methods for the LW, my soap box is more general.

And yeah, birth control in general puts a disproportionate amount of work/expense/time commitment/mental capacity/scheduling/pain/side effects on people who can get pregnant. And society doesn't support people with sperm to take up a proportionate amount of responsibility nearly enough. And (possibly because of that) lots of people with sperm, let's be realistic, mostly cis men, are not reliable puller-outers, and are not incentivised to be good at it (because they are not the ones who are going to get pregnant, because they have insufficient empathy for what that means for their partners, because they are used to their pleasure being more important than consequences, whatever). We can totally talk about those things. But "lol what do you call people who use the pull our method? parents!" doesn't communicate any of those things, it just shames people who use the method and takes away people's knowledge of an option that may not be the best for everyone but is often one of the only options left where options are limited.

Thank you for a very thoughtful reply! I think your soapbox and one of my pet soapboxes had a bit of a soapbox derby there--- "the solution for people who don't want their uterus to be occupied is to spend a lot of time thinking about the possibility that their uterus could be occupied and arrange their lives around it" hits me in a place similar to your reaction to the jokes about the pull-out method , I think, so I appreciate your response all the more.

On the one hand, I'm kind of a poster child for that joke; Spouse and I were relying on fertility awareness methods, and both our kids were unplanned. On the other hand, I knew and told Spouse on both occasions that my fertility was in the risky zone, so it's not that the method failed per se, it's that we didn't use it properly. And on the third hand, if we hadn't even been using NFP, I'd likely have had at least three times as many pregnancies as I've actually had.

I'd still recommend that people who absolutely positively don't want children (at this time or at all) use other forms of birth control if possible. But if it's not possible, NFP and pulling out work better than doing nothing.

Yeah, that's the thing with FAMs. If you decide not to use a condom one time, there's no guarantee it's a fertile time anyway, so maybe there's a risk, maybe there isn't, your on-average odds of getting pregnant from that one time are low. If you're using FAM and you decide to not use it one time, you're by definition having pregnancy-risk sex during a fertile window and...well...

My personal experience was that Planned Parenthood was by far the most hostile to the idea of performing a permanent sterilization of anywhere I tried, so my first advice would be to look elsewhere for that (while acknowledging it’s hard—it took me nine doctors to find one who would do mind in my 20s).

I am surprised the columnist doesn’t mention copper IUDs.

don't all modern IUDs have a hormonal component?

Anyway if they can afford a trip I'd suggest finding a doctor in city, near their New England friends, perhaps, and ask them about vasectomy or tubal. (I'm shocked that nobody would do the vasectomy, tbh; they're mostly reversible and plenty of conservative deep south christians get them. Also people trust men to have bodily autonomy because patriarchy.)

I admit I held off on asking for my childfree tubal until I turned 30, because I didn't want to deal with their shit. But once I did ask, the ob/gyn outside of a major New England city gave me zero trouble, didn't ask for a man's approval, didn't make me jump through any hoops, etc. And even the tubal, which is more invasive, is a laparoscopic surgery with minimal recovery time; the vasectomy could be an outpatient thing scheduled on a weekend when they're visiting their friends.

But they might have to pay out of pocket, is the thing.

(ETA: Or, you know. Go to Memphis. Mobile. Nashville. New Orleans. Atlanta. Wherever you live in the rural deep south, if you can afford a few days in the city, you will find a doctor who'll do a vasectomy on a 25 year old. Maybe money is still an object even at that distance, but most of the deep south is not Maus-banning Quiverfull territory.)

Edited 2022-06-01 18:17 (UTC)

Nope. ParaGard is still on the market in the US, and I know several people who can’t do hormonal birth control who use it.

*raises hand* Yep! Hormonal bc doesn't play well with my other meds, but the copper IUD is effectively as reliable as the Mirena--there is a minuscule difference, but basically within the margin of error.

I actually got ParaGard instead of a tubal--they have about the same failure rate, but people discover that their tubal ligations have failed or reversed by getting pregnant. Most IUD failures (that don't happen because of incorrect insertion) happen because the IUD gets physically dislodged; if that happens you have a good chance of noticing it at the time. And correct placement can be verified visually with a speculum, while a tubal needs radioactive imaging. I have more day-to-day trust in my copper IUD than I would in surgical sterilization.

Okay, I need to figure out how to write HTDI to add this suggestion.

It may not be right for everyone, but it’s definitely a better suggestion than pulling out!

It's so wild to me every time I remember the US only has ONE brand of copper IUD.

It's a legacy of the Dalkon Shield fiasco, unfortunately. Here's an article that summarizes some of the issues.

I know, but I'm still surprised EVERY TIME I get an email from someone in Michigan who wants to DRIVE TO CANADA to get an IUD because we have a better selection.

I am surprised the columnist doesn’t mention copper IUDs.

Maybe they thought, as I did until this moment, that those were no longer being made. You have taught me something!

I was shocked recently when a gynecologist told me that diaphragms are no longer being prescribed, to the point that she had apparently never seen one and didn't know what I was talking about when I described the applicator used for extra spermicide. She said "there are better options" but taking one away seemed foolish to me.

Weirdly, I was talking about diaphragms the other day, but it took me a minute to come up with the word because it had been so long. Agree, all options should be available, especially because so many people have sensitivity to hormones.

Lots of places have stopped prescribing/fitting them but there's a non-fitted one you don't need a prescription for: https://www.caya.us.com/. It has a less irritating gel than the older versions too!

I'm glad, but wonder how well-known they are.
Also, it looks like the contraceptive sponge was a casualty of Covid hitting factories in India
http://www.todaysponge.com/

Maybe not super well-known, but gaining traction among "natural health" circles I think.

Re: "taking one away"--my understanding is that what keeps happening is pharmaceutical companies that make birth control pills keep buying up the companies that make diaphragms/cervical caps/etc. and then discontinuing the products through some combination of larger companies not prioritizing the smaller profit streams as much and not wanting competition for their hormonal birth control revenue streams.

They're in very common use worldwide, and increasing in popularity in the US as far as I know (both IUDs in general and specifically copper IUDs). I had copper IUDs and was very happy with them. It used to be difficult to get anyone to prescribe one if you hadn't had a baby (the insertion can be much easier if the cervix is still a bit open), but these days it's much more common for nonparous people to have them.

The columnist didn't mention anal sex (which I wouldn't consider "outercourse"). (Actually I think when I first heard the term "outercourse," some decades ago, it implied not only non-penetrative sex, but sexual contact that could be done clothed. But the definition may well vary.)

What irks me about the response here is LW says they and hubs have had a decision to not have PIV sex. They have clearly thought long and hard about it...so first thing this columnist does is try suggest ways to do it?

Ha! Yes!!! That got me too, but you said it better than any of what I was coming up with!

... I have a personal soapbox about this one, but I'll post it in a top-level comment in case you don't need the TL;DR in your inbox.

yeah, I thought that was very weird.

Okay, so as I said above, I'm irked that the columnist goes right to suggesting ways for LW and husband to have PIV sex. And this is a huge soapbox for me.

PIV sex is not the Holy Grail of how to do it, and in fact, especially for the receiving partner, risks pain and discomfort. And especially with the thing about both partners coming from purity culture, having kinds of sex that focus on exploring every part of each other's bodies and delighting in them and finding all spiffy new erogenous zones and things that are fun to do together, rather than focusing on how to get the guy's dick into his partner's orifices, sounds like a really good idea.

cheers in agreement

Why are they trying to put PIV back on the menu and then suggesting a book with only one chapter on outercourse? Why not: decentering PIV can actually be amazing for lots of people's sex lives because its centrality can overshadow creativity and pleasure, I'm so excited for you. AND, learn from the queers please, we're so good at this. AND, specific recs:

1. OMGYES: specific, approachable techniques to apply when using mouths, toys, or hands to pleasure vulvas and vaginas, a boon for all the straight men who, when having sex, seem to forget they have hands? (NOT THAT I'M STILL DISAPPOINTED ABOUT THAT GUITARIST OR ANYTHING.)

2. Do you like PIV, LW? Like, do you like getting fucked with a thing that's shaped like a dick? Does your partner like thrusting into you and grinding on you? Have you considered sex toys? Maybe a strapon harness he could wear? (Or one for you to wear, that's fun too!)

3. You live a few hours' drive from a Planned Parenthood, so maybe this is not available locally either, but is there a feminist or queer-positive or sex-positive sex toy shop near you? If not near you, is there a farther away one that started offering their workshops online during pandemic? A lot of sex toy shops will offer workshops on things like "how to give great head" or "erotic bondage for beginners" or an array of other things, so check them out and see if there are things that interest you and consider taking a couple, together or apart. They can be helpful with getting practice talking about sexual techniques and options even if the specific topics aren't your favourites.

4. Did you and your partner have a courtship period where you had fun sexy experiences without having PIV? Have you had other relationships where you had that? Are there things you remember fondly about it? Things you stopped doing once PIV was on the table? Do you feel like recreating some of it?

Flat | Top-Level Comments Only

How To Do It: Swearing off PIV for awhile due to politics

no subject

no subject

no subject

no subject

no subject

no subject

no subject

no subject

no subject

no subject

no subject

no subject

no subject

no subject

no subject

no subject

no subject

no subject

no subject

no subject

no subject

no subject

no subject

no subject

no subject

no subject

no subject

no subject

no subject

no subject

no subject

no subject

no subject

no subject