Sunday, October 16, 2011

Why I Keep the Focus on Self-Pleasuring and on the Importance of the Relationship with Ourselves

Many people have said that if we really want a good relationship with another person, we have to like ourselves. We need to be our own best friend and enjoy spending time alone in order to have a healthy and fulfilling friendship or sexual relationship with another person.

Many other people have said that it is difficult for someone else to give us pleasure if we don’t know how to pleasure ourselves.

When I started doing sexuality education over twenty years ago, I began with the topic of unlearning homophobia. I quickly expanded the subject to include unlearning biphobia and sexphobia. In seeing people grapple with these prejudices, I decided their root is a general discomfort with sexuality. I have come to believe that if we want to have positive change around sexuality, we need to unravel some of its bigger taboos, one of them being masturbation or self-pleasuring.

So I keep the focus right there on self-pleasuring and the importance of the relationship with ourselves. When people talk about sexual practices, I remind them that self-pleasuring is one of them. When people talk about relationships, I remind them about the importance of the relationship with ourselves. I celebrate every chance I get the brave work of individuals like Dr. Betty Dodson and Dr. Joycelyn Elders.

But the issues of importance are much broader than a focus on self-pleasuring, sex or even the relationship we may have with ourselves or another person. I want a world where we honor pleasure in all forms. When I see how we do work, pay bills, buy stuff and use petroleum products and how little we rest, relax or enjoy simple pleasures, I know I want to live in a different kind of world. When I see people not being able to be alone or settling for unfulfilling or unhealthy relationships, including the relationship with themselves, I know I want to live in a world that honors human connection and needs and values human development and growth. While I want the world to change, I keep the focus on our own self-love and self-pleasure first because even if we live in a world where there is peace and love, it won’t matter if we don’t feel them within ourselves. So when I see people struggle with self-acceptance, body acceptance and self-esteem, I know I need to keep talking about the importance of the relationship with ourselves and loving our bodies. No matter how much someone else loves us or thinks positive thoughts about any aspect of us, whether physical, emotional or otherwise, it won’t make a difference unless we believe those things about ourselves as well.

I want to live in a world where there is more compassion for ourselves and each other, and I think we need to start with ourselves in order to get to each other. We cannot own other people, our children, our pets or the earth. We cannot own our best friendships or relationships, and yes, I believe our friends are as important as any sexual relationship we may have. While we cannot own other living beings around us, we can and should own our thoughts, ideas, interests, loves, likes and time. The sense of empowerment we can feel from claiming our authentic selves is far more rewarding than trying to control or own someone else, and that includes our most intimate partners.

The greatest love is unconditional: when we truly allow individuals to be free in every way, knowing we can only receive love if it is freely given. Ultimately, we come into the world alone, and we die alone. So while we can relate and have community, family, friends and all kinds of other relationships, ultimately we are still alone. The most important relationship that affects all other relationships is our relationship with ourselves.

While we cannot own anyone else, we can take ownership of our body, sexuality, identities, history and cultures. We can own our uniqueness and imagination. By truly connecting to self, we can offer another person play, touch, love and sensuality—but only if we can give them to ourselves.

One of my favorite topics is the topic of letting go. I’m intrigued and awed with how it is such a common denominator in so many human experiences, pleasurable and painful. We have to let go to experience orgasm. We have to let go of our worries about what people think in order to really enjoy life as our authentic selves and how we choose to be in this world. We have to let go when someone dies and let go of fear to experience the moments of our lives fully.

Let’s enjoy the person we spend the most time with: ourselves. Let’s live in each moment as fully as we can, knowing there is no guarantee we will get another moment with ourselves or another we love. In addition to taking action with our words, time, energy and money, we can change the world with self-love, self-esteem, self-compassion and self-pleasure. We cannot give to someone else what we cannot give to ourselves.

First Published on Good Vibrations Magazine,  October 11, 2011

Copyright 2011 by Susan Miranda.  All rights reserved.  No part of this writing may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright holder. For reprint permission, email

Tuesday, July 12, 2011

Consent in the Doctor's Office

When I was in my late teens, I had barely formed friendships with other youth, much less developed a sexual relationship with anyone, male or female. So I had little awareness of sexuality, much less any need for birth control, and had never had a pelvic exam. Once I entered college, my parents pressured me to get a job. I had a female friend who was in the National Guard Army Reserves and popular and extroverted enough to do well with its male-dominated atmosphere. Her example combined with the appeal of making money for college convinced me to follow her into the National Guard. Before I knew it, I was in a Guard-arranged doctor’s appointment having my very first pelvic exam.

Twenty years later, I worked as a reproductive health counselor in a women’s health clinic. I explained to countless girls and women what happens in a pelvic exam and the necessity of relaxing the opening to the vagina to minimize any potential discomfort. Twenty years later, I was also paid to be a gynecological teaching associate, letting hundreds of men and women, future health care professionals, practice pelvic exams on my body and giving my consent and taking responsibility to relax my vaginal muscles to avoid pain. I explained to those future providers how they could help any woman—not just me—feel comfortable, safe, in control of the exam and able to stop it if needed. But twenty years earlier, as a young woman who knew little about my body and sexuality or anything about pelvic exams, I lay on the exam table in the doctor’s office without any idea what was going to be done to me.

I can’t recall the doctor’s face. He never looked up, slowed down, or stopped as I screamed out in pain when the speculum, which felt like a steel rod, opened up inside of me. But I do remember the look on the face of the nurse in the corner of the room: she was expressionless. I have no idea what was going through her mind, but certainly there was no compassion to speak of.

I compare that experience to how, as a reproductive health counselor, I held the hand or touched the shoulder of each woman, coached her about breathing and reminded her to relax the muscles at the opening of the vagina. With my eye contact, I would show all the compassion I felt for her. When the pelvic exam or inserting the speculum didn’t go painlessly, I was the first to say, “I am so sorry that it hurt,” and I often tried to talk it over with the woman after the exam, explaining that I knew it could be difficult to relax sometimes but there was hope that the next time could be painless.

During one patient visit, I knew the doctor was ready to insert the speculum, but I could tell the woman was not ready. I put my hand between the speculum and the woman’s vulva and said, “She’s not ready.”

Today, as a sexuality educator, I believe that if consent in the doctor’s office is not important, then it makes it less likely that it will be taken seriously in every other part of our lives. Consent is not just important when our genitals are being touched. It is important when we are being touched anywhere on our bodies. I’ve worked for over five years as a caregiver for individuals with HIV/AIDS, and it has always been my belief that any touch—touching someone’s arm or putting lotion on a resident’s legs or helping clean someone’s entire body with a shower or bed bath—is a significant intimacy to pay close attention to, in order to ensure respect and consent. I also believe in the potential sacredness of interactions that involve no touch—whether talking to or just being silently present with someone during a moment of their living or dying.

I have explored touch, intimacies and healing modalities of all kinds with a deep desire to embrace all aspects of myself (sexuality, emotions, thoughts and spirit) as part of my own personal healing as well as to facilitate my writing and sexuality education activities. I can say unequivocally that it matters less where we are touched than how we are touched. I will also go on record to say that my experience in that doctor’s office decades ago felt like rape. Being an advocate for consent in our sexuality, relationships and all parts of living and dying, I affirm that consent matters everywhere and every time in our interactions at work, at home, in the street and in the doctor’s office.

First Published on Good Vibration Magazine, July 11, 2011

Copyright 2011 by Susan Miranda.  All rights reserved.  No part of this writing may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright holder. For reprint permission, email

Friday, May 6, 2011

Willingness, Desire, Wanting, and Consent

About twenty years ago, I was at a sexuality conference in San Francisco. I met someone I found to be attractive and was interested in physically. She invited me to her home for dinner. Being fairly direct and upfront about most things, I told her I was interested in being physically intimate. Her response was “What I am willing to do is…” This was a long time ago, and I can’t remember exactly what she was willing to do. I believe it was something along the lines of holding or cuddling. My response to her was: Rather than telling me what you are willing to do, what do you want to do?

I use this example a lot in my sexuality education seminars and workshops when talking about consent. Had she and I done any holding or cuddling or whatever she was willing to do, it would have looked on the outside as if she had consented; after all, she did say she was willing. But that is not the kind of consent I wanted. She and I ended up not doing anything physical. I enjoyed the dinner time I had with her and the people she was sharing a house with, and then I left to go back to where I was staying.

The nuance of willing versus wanting is not just about sex and sexuality. I believe that how we treat people in all parts of our lives and in all parts of our society—at work, in the street and at home—is important. Consent is always important and not just in situations that involve touch, sex or sexuality. Respect, consent and consciousness in our words and interactions are all needed if we are going to reduce violence.

These are some of the questions I ask routinely. Do we treat people poorly because we are paying them money and we consider ourselves to be the customer? Do we get treated poorly because we’re paid to do a job?  Are we rude to the person sitting next to us on the bus or the driver in the car next to ours? Does it ever feel good to have someone do something that they don’t really want to do?

Some of these interactions may not appear to be about consent and certainly are different from a sexual interaction, but I believe that the core causes of sexual violence in the United States are the more general violence, disrespect and lack of compassion that exist in many contexts in our society, not only sexual ones. We need to address these core causes to fully undo sexual violence.

There are significant violations and more minor violations in relationships. There are large ways to show a lack of compassion and respect and smaller ways that do the same thing. We have to ask ourselves in every moment, “How do I feel about this interaction?” It would be easy to say that we should be doing this out of concern for the other person or people involved, but I think we should do this for our own sake as well. Do we participate in situations in which there is some semblance of willingness but the other person does not really want the situation to happen? I believe that doing so would, on the deepest level, not feel good to us if we were paying attention.

Getting back to my example of the woman in San Francisco: I could have said yes to her willingness to cuddle or hold, but I doubt that it would have been a positive and meaningful interaction unless something changed to help create a stronger desire for the exchange rather than just a willingness to have something happen.

Of course, large violations also occur, whether sexual or physical violence.  When I hear of these instances, it makes me sick to know such pain can be caused. Those situations are different from what I am describing, and we need to hold the perpetrators responsible. Nevertheless, to get at the root of this violence, I believe we all need to take a look at how we contribute to a culture of disrespect through humiliation, ridicule, or making fun of people. While some of these behaviors may be part of being human, like gossip or making fun of someone  in reaction to something hurtful they did or said, we also need to look at how some of these behaviors contribute to a climate where bullying in schools, disrespect and harassment become all too common in our day-to-day lives.

We cannot control or take responsibility for other people. We cannot read other people’s minds or communicate for them. But we do need to take responsibility for our own participation, and our silence or lack of sensitivity and awareness can have a significant impact. We can honor another person’s truth if something goes wrong in a sexual interaction, and we can look at our part in it. For example, if something had happened with this woman in San Francisco and the end result was that she regretted what happened, I could have (and would like to think that I would have) listened to her experience with empathy and not minimized it or blamed her because she said she was willing. Had we allowed something to happen and it had not gone well, I could have recognized that I didn’t pay attention to what my instincts told me about her level of consent.

It is no compliment to have someone say yes just because they can’t say no. It is no compliment to have someone do something with me because they are willing. It would be a compliment to know that a person feels comfortable enough with me to say no or to say yes and really mean it. And it certainly is not a compliment to have someone do something they would not have done otherwise because they are intoxicated or in some other way vulnerable to making a choice they would not really want to be making. While they may be responsible for becoming intoxicated, we would be responsible for taking advantage of that fact and/or not following our instinct that it was best not to go forward in that situation. And if we had actually not cared what the outcome for the other person would be, we would have to take responsibility for not having that concern.

We need to be intentional in the big and the small ways if we want the best relationships in our lives. Our goal should be to pay attention and make sure all of our interactions are mutually positive as best we can. I say this knowing that we are not perfect and relationships and communication can be messy even when all is going well. If we see the value of not wanting to participate in harm, we should be actively working to reduce the chances of it. I am open minded as to what kinds of interactions people can negotiate and choose consensually, but I would say that a bottom-line necessity is an intention to promote the good of all involved.

It never feels good to have people doing something halfheartedly and certainly not when it comes to how we experience, receive, give or participate in touch, love, intimacy or sexuality. So we need to ask ourselves: Do we want what someone else is willing to do or what someone wants to do?

First Published on Good Vibrations Magazine, May 3rd, 2011

Copyright 2011 by Susan Miranda.  All rights reserved.  No part of this writing may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright holder. For reprint permission, email

Sunday, January 23, 2011

Healing the Entire Body. Why would we exclude the genitals?

About twenty years ago I participated in a workshop that explored how being fat-negative as a society was connected to being woman-negative. In the workshop we talked about how the fat on many women’s bodies is different from the fat on many men’s bodies. We looked at where fat is on many bodies (not just bodies of people who identify as women), i.e., breasts, hips, thighs. After hours of sitting and listening in this workshop, I finally raised my hand and asked, What about the genital area? It was noticeably missing: it was the only part of the body not discussed in the workshop. Years later, I came across sexuality and anatomy books that show clearly that there is fat in the genital area. There was no reason why it should have been excluded from the conversation other than, perhaps, the workshop leader was too uncomfortable to include it.

One of the things I have done for money is being what in Minneapolis is called a patient instructor. Elsewhere across the country, it is called other titles such as “gynecological teaching associate.” As a patient instructor for the medical community, I have let future doctors, nurses and even chiropractors practice breast and pelvic exams on my body over a period of five years. I have written and published on this topic and the importance of teaching medical students how to do these exams with sensitivity and respect. I don’t minimize the discomfort that can exist in our culture when dealing with the genital area: I have observed many students sweating in nervousness prior to practicing these exams on me. I acknowledge that a health care practitioner touching the genital area is different from, for instance, a health care practitioner touching an arm. However, my experiences doing this work confirmed what I as a sexuality educator believed all along: the genital area is just one part of the body—not less or more important than another part. And the more comfortable we can be with all parts of our bodies including our genitals, the better we can take care of ourselves and communicate effectively whether with a health care practitioner or with a sexual partner.

I have a neck injury from a car accident that happened over twelve years ago. While the initial recovery right after the accident involved dealing with the acute injury, over the last ten years I have found that the muscles in my neck can still tighten and cause severe pain. I spend much of my day, every day, doing rehabilitation exercises, stretches and yoga. I have spent much of the past ten years learning what makes my neck injury worse and what can help it. While learning how to swim for the first time as an adult, I incidentally discovered that swimming helps my neck injury. Shoveling snow hurts. Heat helps. Minnesota winters make it worse. In the process of dealing with this severe neck injury, I have often wondered if the principles of what happens in my neck would not also hold true for the rest of my body. Why wouldn’t the same principles of muscles tightening and what we can do to help them relax hold true for all parts of the body, including the genital area?

There can be all kinds of reasons why we tense certain muscles in our bodies. Injury from an accident is one. Other reasons could be the impact of sexual abuse, desk work in an office or just living in a society that is negative towards sexuality and all bodies generally. Our emotions can come into play. Fear, anger and anxiety can all contribute to contracting muscles. Relaxation and blood flow are important to the entire body. A major focus of my sexuality education work in the past five to ten years has been to talk about the concept that blood flow is important everywhere in the body and about how massage, pressure and touch can be important to enhance blood flow and relaxation everywhere in the body including the genitals. I’ve made clear that we have options for how to do this important healing bodywork for ourselves. We can massage ourselves, have a friend, partner or lover do genital massage or perhaps pay someone to do this intentional healing touch. I do not view this as being necessarily sexual any more than I view the hundreds of pelvic exams I have received from medical students as being sexual.

I’ve asked this question in the workshops I’ve led: What if every time I went for a massage, my left arm was never massaged? What if every time I had a professional massage or received massage from a friend or partner, the rest of my body was massaged but not my left arm? After some time, would my left arm feel different from the rest of my body? I don’t ask this question because I think my arm is exactly like my genitals or that these issues are simplistic. But I insist on asking the question because I advocate for a holistic approach to healing, whether sexual healing or other kinds of healing. Being holistic means addressing all of the nonphysical aspects of ourselves, i.e., emotional, spiritual, mental, as well as all of the physical aspects of ourselves. The physical aspects of healing include every cell and part of the body, including the genital area.

What I seem to say more often than anything else in my education work is that it is not what we do or say, but how we do or say something that is most important. So it is not whether the genital area is included but how it is included that matters the most.

What makes touch intimate? Touch and intimacy are not so simplistic to me that we can assume that the genital area is the most intimate part of the body. After having hundreds of people practice breast and pelvic exams on me, I can say I stayed present for every exam so I could give feedback to the students and make sure I was not hurt. Those are not the experiences in my life in which I felt vulnerable or had a sense of deep intimacy in a body contact situation that involved an exchange of money. While those situations were certainly respectfully intimate or I would probably not have done that work over all those years, I’ve often thought that because of the intense pain from the injury, my neck is the more intimate area for me to have a practitioner work on. Of course, every person is unique, and what is a vulnerable area could be different for the same person from one time to another.

Again, I am not suggesting that the genital area is not important and unique. But I would not say it is more important or even more sexual than other parts of the body or other parts of our whole selves, including our minds, emotions and spirits. Often it is said that our brains are our most sexual organ, and perhaps our skin, considered as one organ, has as high a potential to be erotic as our genitals have. So the idea that we can keep something nonsexual by excluding certain body parts misses the point of the complexity of touch, sensuality and sexuality. It is fine that our genitals are included in sexuality at a very basic and primal level. However, I view touching anywhere on the body, eye contact, sharing breath with another person and a whole host of other activities to be potentially as intimate and sexual as anything genital, depending on the circumstances. Moreover, an interaction involving the genitals can be nonsexual if that is the intention for that particular interaction.

I can’t think of anything more important than consent and respect. However, it is not so easy to clearly label something as respectful or not respectful by what is visible or what part of the body is being touched. Respect is a subjective factor. In my writings about doing patient instructor work, I’ve described how a student could do everything technically correct and still something wouldn’t feel right to me. Conversely, a student could do something that, generally, I would advise them not to do in terms of their touch or the language they used while doing a pelvic exam, but somehow their touch or language did not feel bad to me. In both instances, I could not know the intent or thoughts of the students without asking, but I could trust myself. We each have the right to identify what feels respectful to us in every instance of our lives whether it involves touch or not. What I advocate more than anything else is for us to trust ourselves as to what feels respectful and acceptable to us in every interaction we have and certainly any that would include touch.

Healing is about healing our entire being—body, emotions and spirit. Nothing should be excluded in the healing we do for ourselves, and we all should follow our unique, authentic path that includes all aspects of ourselves in the healing we seek.

First Published on Good Vibrations Magazine, January 21, 2011

Copyright 2011 by Susan Miranda.  All rights reserved.  No part of this writing may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright holder. For reprint permission, email