What Women consider “Sexy”

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I have been seeing female patients for 27 years and we frequently discuss difficulties with intimacy. Topics can include decrease in libido, vaginal dryness causing pain, body image after childbirth or cancer treatment and the list goes on. I jokingly tell my patients that God messed up when he created sexuality since 90% of male libido is between the legs and 90% of female libido is between the ears.  We work together to try and problem solve both physical and emotional issues, sometimes with medication and other times with support and understanding. We discuss what it takes to “get in the mood” for intimacy. Which brings me to many of the revelations of male behavior that have appeared in news headlines over the past month. These are powerful men trying to create intimacy with co-workers and strangers.

Given my experience, I think I can speak for a great majority of women. We don’t find a picture of a man’s naked body or his genitalia sent to us via text “sexy”. We don’t appreciate sex toys given as gifts. We don’t find it “sexy” when more attention is paid to our bodies/clothing than to our work performance. We avoid friendly hugs that may turn into grabbing other body parts.

You may ask what is left? What do women consider sexy?  Here is my non-scientific report from what I hear from women ages 18-80.

  1. Love and Intimacy.  When a couple is having relationship difficulties outside the bedroom, low libido in the bedroom is often a side effect for women. We have a hard time separating our brain/emotions from intimacy.  Male libido can thrive despite relationship conflict, which often makes women even angrier.
  2. Contributions made to childcare and household chores. There is nothing better to kill a woman’s libido than doing 3 loads of laundry, cleaning up the kitchen and putting a few kids to bed while their partner watches a sporting event on tv, only to have that same partner try to initiate intimacy as she is falling asleep while brushing her teeth. A partner that volunteers to clean up the kitchen while the woman puts the children to bed stands a much better chance.
  3. Exercising with your partner increases endorphins, the feel good substances that the brain produces, which also increase libido.
  4. Taking the initiative to arrange a date night (planning childcare is a bonus). Women are better able to separate from their household duties when they are OUT of the house.

The majority of men in this country are much different from the men that have made headlines in the last few weeks. They may need a bit of guidance to improve their game, but they can learn from others mistakes and make life better for themselves and their partners.

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Why you need to check the donor box

In the past month I have had the opportunity to witness the incredible benefits that one person can make when they decide to donate their organs at the time of death. Most of us don’t like to think of the day when we will no longer be on this earth, much less consider that eventuality when we are standing in front of the drivers license registrar and asked if we would like to become an organ donor on our drivers license. As each of my children have completed drivers ed and then successfully passed the behind the wheel test, I have urged them to check that box on their forms. Just imagine your mother telling you what to do even when you are dead!

Last month one of my friends from medical residency received a new heart and kidney as hers had been slowly failing due to previous chemo and radiation from Hodgkins lymphoma. She was fortunate to find a match within a few months of being placed on the transplant list as her heart was tiring quickly and wouldn’t have lasted for the usual 8-10 month wait. Someone had to die for her to receive an extension on her life. She has always been a person who fights for the under-served and I would like to think that this life extension allows many more individuals to benefit from her new and improved heart.

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Marie one week post heart/kidney transplant

A short time later, my daughter had the misfortune to get tackled in the Homecoming powder-puff football game and tore one of the ligaments in her knee, the ACL She required surgery and the decision was made to use her hamstring tendon as her new ACL as it is stronger than a cadaver tendon. During surgery, it was discovered that she had very short and narrow hamstring tendons and they would not suffice to repair her ACL. Luckily, cadaver tendon was available and the surgeon was able to augment the repair to ensure that she has the strongest knee possible for skiing and soccer in the future. IMG_6154

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Torn knee ligament

While 95% of Americans support organ donation, only 54% sign up as donors. 117,000 people are currently waiting for a transplant and 20 people die each day while waiting. We can’t control when we lose our lives, but we can control how we want to be remembered.  Marie and Molly have a new heart, kidney and knee due to the generosity of others. Please consider signing up to be an organ donor.

Our Exotic Zoo Family

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One of my favorite TV shows growing up was The Waltons, the story of a large multigenerational family during the depression in a rural area of the SE US. Growing up in a rural part of  Minnesota, I could relate to the small town setting as well as the plight of the oldest son, who is the first in his family to leave the farm and go off to college. We never know what childhood experiences drive our adult decisions, but I think the relationships within this family of seven children may have something to do with my motivation to create a large family of my own.

My five children have slightly different takes than myself on what it means to be part of a large family at a time when most families consist of two children. My experiences drove the decision to create this family, but they are the ones who have lived it daily. This became even more apparent when I read my sr daughters college essay. She compared our family to a zoo of exotic animals that gets more than the average attention and has ever-changing relationships and dynamics. This may get her notice during the college application process, but made me step back and consider the dynamics of who we are and how we have changed with the addition of each child.

  1. Our first child was born in 1990, when parenting books were all the rage. We tried out the more permissive parenting routines, but with the addition of a second son threw away the books and used common sense. My child’s self-esteem became secondary to harmony between sibs and our ability to get out the door on time.
  2. We may live in Minnesota, which has cold weather for 4-5 months each year, but my kids were made to go outside and entertain themselves almost daily. It is much easier to tolerate yelling, shouting and crying when 4 walls don’t amplify the noise. I was that mom pulling a wagon full of toys and kids while trailing after boys skateboarding down the hill to the park.
  3. By child number 3, I had adopted the dog owner style of parenting. This involves using short, repeated commands to get your kids to do what you want. No explanations about why you need to get dressed in the morning, just do it. I could care less who started a fight between sibs, just stop hitting.
  4. Natural consequences. If you decide not to take a coat to school, you may need to sit in from recess because the teacher thinks you will be too cold (my kids were never cold).
  5. We are a multicultural family so our family was required to attend ethnic events. I agree that Chinese music can be shrill and grating, but we would have never learned that until we sat thru an hour-long performance. And the food is always better at these events than a typical Midwest potluck.
  6. When you have 4 siblings there are always changing alliances, just as with world nations. The older brother who always bossed you around can become the driver who gets you to your friend’s house. When you are on the outs with one sibling, there is always another in the wings waiting.
  7. Vacation memories are a kaleidoscope of stories. Everyone seems to remember different variations of a trip, even though we were all in the same place at the same time.
  8. There will always be one child who is not happy. Family harmony as depicted on social media never happened in our house. Most group pictures of my kids have one child pouting or standing off to the side not wanting to be there. Now these are my most treasured photos as they tell the real story of our lives. It was a hard lesson for me to learn – that it is not my job to make everyone happy.
  9. There is never a dull moment. The kids and their friends who frequented our house found this to be enjoyable – the parents could have sometimes used a break in the action.
  10. With two working parents our kids were called into action early on. Chore lists were the dreaded weekend routine and male/female roles were frequently shuffled. Girls can mow the lawn and boys can dust and vacuum.
  11. Meals were a one size fits all approach. No separate tastes allowed or individualized meals. If you didn’t like this meal, there was always tomorrow.
  12. With 5 kids within 10 years and 2 of those children being Asian, we always garnered stares and comments when out in public. Some of the kids loved the attention but not all. Over the years I have chosen to share less and less with strangers about our origins as I feel that it is time for the kids to take on that burden. It is their story now, not mine.

Our house will be a much quieter place by this time next year. I relish the memories of our zoo and hope that there will be some baby animals to care for in the future.

The Terrorists Within our Midst

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My heart was saddened when I read the headlines on Friday about another bomb incident in London. I thought of not only the 22 individuals that were affected by this violence but also the thousands of Brits that need to use the subway each day to get to their jobs and back home again. Going to work should not involve terror about what may happen before you start your job.  Soon after the news appeared it was listed as a “terrorist event” and further headlines contained the words travel ban, building a wall, immigrants and terrorists. If we can just prevent “those” people from coming to our country we will be so much safer.

But there is a more dangerous, violent and ruthless killer in our midst.  Post Hurricane Harvey, He appeared at a football party in Texas and killed his ex-girlfriend and eight others.  Last week, He walked into a school in Spokane, Washington and killed a classmate. Over Labor Day, He murdered his pregnant girlfriend and then appeared with her parents pleading for someone to find her. And these were only the high-profile events that made the national news in the last 2 weeks. On average, three or more women are murdered by their boyfriends or husbands every day in the US. All of the above killings were done with a gun.

Today, the President of the United States of America, someone who is supposed to be a role model for not only America but the rest of the free world, tweeted a video of himself hitting a golf ball that struck Hillary Clinton in the back and knocked her down. If you watch the video, you understand that the golf ball hit by Trump did not actually strike Clinton. THAT is not the point. The point is that we have an epidemic of male violence in this country and our President is signaling with this tweet that it is ok to physically strike down someone with whom you disagree.

I would challenge every American to think about the real terrorists in our midst – young men who believe that using violence and guns is a solution to their problems. These men are not being recruited over the internet by a religion, they are not recent immigrants from a country in the Middle East, they don’t have long beards or speak a different language. The terrorism that they create is much more prevalent and difficult to stop. They have almost unlimited and immediate access to firearms so that they can destroy before their temper cools down. No elaborate terrorist network is needed for their plans.

Many will brush off President Trump’s latest tweet as just a joke against his former running mate. Those of us who rush to pronounce judgment will be considered uptight liberals and not able to enjoy humor.  If you are a woman in this country, think about what tone is set when we can consider a woman being intentionally struck by a much physically larger man as humor. If the President can do it and Americans laugh it off, why isn’t it justified to put a woman in her place with a fist or threaten her with a gun?

Just imagine if we could use a small portion of the proposed funds for a wall on the southern border of our country and use the money to implement a school based program starting in middle school that addresses safe outlets for anger and treating each other equally. Because the terrorists aren’t across the ocean trying to get into the US …. they are already here.

The Parental Bond – birth vs adoption

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This past weekend I fulfilled a promise that I had made to my oldest daughter on the first day 18 years ago that I saw her olive skin and almond eyes in the far away land of Korea. We were traveling west to move her in for her first year of college 1600 miles away. Just like that first trip, my nerves were on edge for the entire time – anxious about having her so far away and excited for her sense of adventure and for the incredible experiences that she would have.  Remembering the first time that we held her, I was reminded of that long ago promise – to raise her for 18 years, pay for her college and then she would move out of our life.  Memories have a way of showing up at the most inopportune times. What a difference those 18 years have made.

Bonding to an infant or child is different for everyone. Sometimes it is instant and other times it takes days and months of care giving. When my biological children were born, I never thought too deeply about bonding. Nursing was a time when I allowed myself to slow down and focus on my love for their tiny bodies and connect thru their eyes. Bonding with an adopted child is a bit different – not bad, but different. They have already had time to be fed by someone else, to form a personality separate from their adoptive parent. Some adoptive parents bond instantly.  That was not me.

I realized when I first saw my daughter that we may have completed this adoption for the wrong reasons. Was wanting a daughter to complete our family of 3 boys an adequate reason to take a child out of her homeland of Korea and raise her in a predominately white culture?  Was I qualified to parent an Asian child? Was I doing a dis-service to my three boys by creating a family that would forever be viewed as different? And amidst all of those thoughts swirling in my head, I made the promise out of fear. Fear of the future. Fear of walking out of the room and telling everyone this had been a mistake and I was not up for the challenge. I thought I could fake the “bonding” for 18 years and then go back to my normal life. As we all know, life doesn’t work like that.

The process of caring for someone unrelated to you but who is wholly dependent on you for food and shelter eventually creates a bond just as strong as birth. I was able to fake being a loving parent for a few days and gradually the fear went away and was replaced by a steadily growing love. It may have taken a bit longer than a biological child but the eventual bond was no different. Now I have the same hopes, dreams and worries for my adopted children that I do for my biological children.

Within a day of leaving my daughter at college, she had her first stab of homesickness and questioning whether she had made the right choice by moving so far from home. I reminded her of my promise 18 years previous and how our lives would have been so different if I had decided to walk away from the unknowns. Now it was her turn to “fake it” for a few days or weeks or months until she grew to like this new phase of her life.

 

Why domestic violence needs to be a “guy” issue

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Although I have never been the victim of physical/sexual/verbal abuse, I see the consequences of these actions in many of my patients. I try to listen, not judge and provide resources for women who are either in an abusive relationship or suffering mental/physical repercussions of a previous relationship. But more than a few times I have thought, “Why doesn’t this woman just leave?”.

Over the past few weeks, two seemingly disparate articles have made me rethink this statement. The Star Tribune newspaper published an investigative article on sex trafficking, highlighting the customers of prostitution rather than the female victims. Efforts have succeeded in many states to prosecute the pimps and sex customers and not the female victims, as the majority of these young women are the victims of violence and feel enslaved and unable to leave. They often start as teenage runaways trying to escape an abusive home life, only to find themselves picked up by an older male who seems to provide safety and love. It doesn’t take long until these young women are enslaved in a different way – to drugs, sex work and physical violence from their pimps. Leaving is not an option as they have no family to go home to, no friends who can help and they carry the societal shame of what they have done. With this in mind, new initiatives have begun to educate and prosecute the male customers of the sex trade. If demand can be decreased, there will not be a need for supply.

The second article appeared on the blog  of a former neighbor and friend. This independent, opinionated, musically and athletically talented young woman had been the victim of domestic violence dealt by her boyfriend. Her story was horrifying as she came close to death a few times while also being  psychologically abused and estranged from her close and loving family.  Why didn’t she leave?  Why did she continue to make excuses for someone who left bruises on her body? But what if we changed the “blame” game? What if we asked, similar to the prostitution story above, why is the abuser abusive? What led him to believe that he has the right to choke and punch someone that he loves? Where has he learned the words that can systematically wear down a person’s self-esteem?  Why isn’t his family recognizing the bruises, put down words and unhealthy control he exerts?

The majority of our current resources around domestic violence are geared to protecting women once they leave an abusive relationship; providing a safe place to stay, legal services and job training. This is important but will never effectively change the behavior that led to the situation. We need research to find out what exists in our society that allows men to believe that this is acceptable behavior. Only when we understand that this is a “guy” issue and not a female victim issue, will we be able to effect change.

 

My Day of Confusion at Work as an Ob/Gyn

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During the delivery of a baby last week, the parents informed me that they had decided not to know the sex of the baby prior to delivery. I joked that I would need to watch a You Tube video prior to the momentous event so that I would be reminded of how to correctly identify the “parts” as either boy or girl. Luckily, I got it correct under pressure of both the delivery and the gender identification and disaster was averted. But it did allow me to reflect on how important this subject has become for the newest generation of parents.

When I first started in practice 25 years ago, routine ultrasound at 20 weeks gestation was not standard practice. The quality of ultrasound was far inferior to current imaging and even when looking for gender, you could be mistaken or not obtain a clear picture. Although not evidence based, routine ultrasound at 20 weeks gestation is now the norm and anticipated from the time of the first OB appointment. The purpose of the scan is to rule out major structural abnormalities but expectant moms see it as “finding out the sex of the baby”. Relatives and siblings are invited to view the unveiling and crowd into the small, darkened room for the 45 minute procedure.

Reveal events have now become the mid-pregnancy social occasion. The sex of the child is concealed in some way and the expectant parents “reveal” boy or girl status to invited guests. A competition seems to have started for favorite You Tube video/creativity with these events. Subsequently, our office has been swept up into the planning process for the Reveal. Following are just a few of the duties that our Ultrasound Techs have been asked to perform.
1. Call the Bakery and note boy or girl for the couple so that a cake can be baked with either a blue or pink interior frosting, revealed when the cake is cut.
2. Stuff the appropriate color golf balls into a box so that when the balls are hit they emit either a blue or pink cloud of dust.
3. Stuff a pinata with either blue or pink candy.
4. Write the sex of the baby on a piece of paper and fold in such a way that prying eyes can’t deduce the writing. That paper is then given to a favored family member to see, while everyone else stays in the dark until the day of arrival.

Studies have shown that parents bond better with their newborn when they are aware of the sex of the baby prior to delivery. It would also make sense that they would have a name for the baby at delivery, but this seldom seems to be the case. With the current generation of parents, planning how events will unfold during the delivery as well as in the first days post-partum is a priority so it only follows that knowing the sex of the baby would be part of the plan. It is only when they have parented for a few weeks or months, that they come to realize that this wonderful journey is full of detours and bends in the road and not a straight path.

Here’s hoping that I will get the sex correct the next time I am under pressure to perform. I have the You Tube video bookmarked for quick reference.