I've Had Just Enough Time

I can tell getting off birth control is fucking with me emotionally. I never realized how large of a role my hormones play in my emotional and mental health until I got on birth control at 18; it was a massive difference. It's not as bad as it was then, thankfully, but still a mess. In the last three weeks, I can cry at the drop of a hat. There's this song that comes on the radio every once in awhile (as if I need more reasons to hate the radio) about dying young, and every time I hear it, I think of Will and turn into a messy puddle. I second guess myself, constantly, and find that I'm struggling to talk about my feelings even more than usual, which means I don't. At all. I'm spending way, way too much time in my head lately, and not in a good way.

I find I spiral out often, letting conversations that made me upset or hurt or angry come back up, having the same debates in my head, even though I know I need to let it go. I find myself asking philosophical questions that put me nowhere but in a hole with a shovel, looking for answers I can't find. I held a focus group last week, that along with a culmination of other factors, left me in such an upset and angry state that I couldn't talk about it for two days. I find I still have some of that anger balled up. I realize some of it is very justified -- the anger isn't just me, it's a response to a lot of bullshit from my old job, frustration with the situation we're working with and my own concerns about the people involved -- but any time my anger becomes this powerful, I have to walk away. I have to step away and shut down and realize that my response is not productive, and at the end of the day, it's not hurting anyone but me. I find myself doing this a lot lately. Mentally checking out of conversations, putting up a wall around myself, censoring a lot of what I want to say. It must be a form of hell to be around. I hate how short-sighted and insular I can become. It's not a fun experience for anyone.

I'm taking a lot of this as a sign that I need to walk away from some of the LGBT work I've been doing in the past two years in NOLA. I do this. I wander away, let go and disappear underground for awhile, then when I feel called back, I return. Lately it's become overwhelming to realize I'm dating and playing and working in the same circles. Everyone's got an opinion on what queer activism and society and social responses should look like, because we're all personally invested. I get it. I find myself getting wedged often between my beliefs and convictions, the convictions of my closest friends, powerful institutions and organizations, and the often biting opinions of people I work with -- all at the expense of either a) myself and my mental health or b) the very people we're all working to help, who are often the most disenfranchised in the community. Eh. It's exhausting. I get tired of having to constantly justify who I work for, what I believe, what I'm doing to make things better, how I'm walking a thin line between opposing viewpoints... and realizing that, when I come home and go out with friends and just want to turn off, I can't. Because those issues are still very present for them, and it comes up often. I find I can't leave my frustrations and anger at work, because my work is my life. I find that I'm having to constantly justify my personal queer identity to strangers as a way of making my work legitimate to people who take one look at me and assume I'm not queer. It's a lot of fighting, at the end of the day, and it comes home with me. I need a break from it.

I'll come back. Queer advocacy and sexual health is my heart and soul, always will be, and I'm like a moth to the flame.

I don't know if it's right to blame my frustration and my sadness all on the birth control. Some of it is probably burn out from my last job. My new job is going fantastic, by the way, and I really believe it was the leap of faith I needed. It's unreal to step off a sinking ship, and turn around, only to find out it was sinking a lot faster than I realized. I didn't understand how much stress I felt from that job until I changed jobs and found that -- wow -- it's such a drastic difference. I actually enjoy going to work, the people I work with, and what I'm doing. I've been busier than ever, working 40 hour weeks and finishing this research contract and going to school and trying to fit a social life in there, too. It's not bad, but I'm guessing the stress of thirteen hour days -- I had four in a row last week, not counting going out on Tuesday and thursday night until 1am -- isn't really aiding anything. Eh. Self-care never was my specialty. It's no wonder I have high blood pressure.

I can blame it on the weather or on my birth control. I can blame it on stress or missing friends. I can blame it on a lack of sleep or living alone or the back pain that makes everything a little more difficult lately. I can say it's the pendulum effect of being so up and on from the last few months or maybe I have inherited bipolarity, though that one I'm doubtful of. But the truth is, I don't really know what it is. I just know I feel haunted, in a way I can't seem to wake up from, and I'm ready for it to end. I'd compare it to going through life under a veil, but that's just a little too close to the bell jar metaphor for me to really feel comfortable about saying that. It's probably the truth. But I'm scared to admit it. I keep telling myself that this will pass, that maybe after a month things will flatten out. I kind of hope so, because this kind of emotional intensity is absolutely exhausting. I imagine sensory integration sensitivity feels like this. My emotions are a little too raw, a little too exposed and easily overstimulated, always on. All the time.

I'll get back to writing about sex soon, I hope. I want to. I've got stories in my head that I need to let out, but unfortunately, they keep getting pushed to the back of the burner lately. I don't want this blog to feel like work, when so much of everything else in my life does. So I'll come back to it. I always do.

Sex-Positive, Part I: HIV Testing, Counseling, and Referral

I'm working on getting HIV Counseling, Testing, and Referral (CTR) certified by Louisiana so that I can conduct HIV testing. I've completed the training, and now I have to observe several individuals conduct HIV CTR before I can conduct the testing and receive my certification approval from the Regional Coordinator.

Tonight was my first observation. I watched three counselors provide the test for walk-in clients. In all honesty, I was a bit shocked by what I saw. Not because the counselors didn't follow the correct procedures and protocols -- they did. Not because of the results. Not because of the individuals who were tested or anything they said.

Let me back up.

It used to be, when you went in for an HIV test, the staff member would explain confidentiality and informed consent, take your blood or swab your mouth, and send you back to the waiting room (or, before the quick tests, on your way). After the test came back, a staff member would notify you with the results. Then, if you were lucky enough to test at an HIV service organization and not a doctor's office, the staff member would refer you for services if your results were positive.

Then someone intelligent dreamed up the concept of CTR. In CTR, you are tested. But while you're waiting the 20 minutes for the results to come back, the staff member ("counselor") has a one-shot chance at counseling and educating you on HIV. In other words, while you're nervous and captive and scared, the counselor asks you about why you came in, what your risk factors are, explains HIV transmission, helps you create a risk-reduction plan, explains how to use a condom and other barriers, and gives other information on prevention, where to get STD tested, and referrals for any other social services you may need. Considering the very minimal education most people in Louisiana receive on HIV and STDs, this method is kind of smart.

As a counselor, you're given a small window to talk with someone you've never met about their most intimate sexual habits, their drug use, their sex work, etc. You get a few minutes to get someone to trust you, listen to you, and most importantly, talk to you. You're often confronting all kinds of barriers -- social stigma about sex, homophobia, identity issues, gender, class gaps, race gaps, fear, misinformation, etc.

The most important lesson in CTR is that counseling is client-driven. It's not about the counselor. It's about empowering the client, helping him or her to identify their risks and identify ways to reduce those risks. It's about listening. It's about working in a partnership with the client, and making sure to meet the client on his or her level -- not above, not below. It's about leaving assumptions, values, and beliefs at the door as much as possible.

CTR takes some serious finesse.

So what shocked me the most about this process?

How incredibly negative the counselors were. Ugh.

One counselor would say, "You're negative, so that's good." The flip side of this, of course, is that people with HIV are "bad."

Another was telling me over and over again how he couldn't understand  why some clients will come in every month for testing. He was complaining that they obviously need to recognize and change their behavior instead of not using condoms and getting tested. Except... testing is a form of action toward prevention and knowledge. So while behavioral change is more pro-active, testing should not be condemned.

Another was clearly berating a client for not using a condom once. I could tell the client felt shamed.

One counselor doesn't ask the person's gender identity because he "can tell" if someone is trans. I'm sure I have several friends who could pass, and he would never know.

One counselor stated that "knowing the person you're having sex with" is a method of prevention. Not asking status, not asking about if they've been tested. But "knowing" them, which made really no sense to me.

Not one counselor talked about sex toys, BDSM, rimming, or any form of sex except oral and vaginal (for heterosexuals) and oral and anal (for gay men). Obviously, these sexual behaviors are common. They need to be discussed.

Two of the counselors did a half decent job talking about oral, but both treated the men as always receiving, never giving.

There was no mention or discussion of anal sex with a straight male client.

There was no mention of any barrier methods but condoms.

One counselor went on a tangent about how going out often is "bad." -- as if this somehow prevents HIV? Or helps a client feel anything but chastised...?

None of the counselors asked their clients to explain what they knew about HIV -- all of them assumed their clients knew basically nothing, and gave them only a cheap shot version.

All the language was gender-based around the partners the clients identified in the last 12 months -- which isn't always indicative of an individual's sexual actions.

All of the counselors quoted some form of inaccurate facts -- two counselors told clients that "New Orleans is #1 in new HIV cases in the country" and one counselor said "New Orleans is #1 in new HIV, gonorrhea, and chlamydia cases in the state." Nope.

(In 2009, Baton Rouge was #1 nationally in AIDS cases per 100,000 people. New Orleans was #3. 39% of people with HIV in Louisiana live in New Orleans. An estimated 4,500 people in Louisiana have HIV and are unaware of their status.)

Not one counselor used open-ended questions or allowed the clients to identify their own ideas on how to protect themselves.

There was a ton of value-based language -- that's "good" or that's "really bad." There is a place for this kind of language -- but "risky" is what should be used, not "bad." There's enough stigma around sex. Why put more?

I left the organization thinking a lot about what "sex-positive" means to me, and how clearly, the counselors whom I observed were not sex-positive. I felt like all of the clients left feeling like they'd just been given a verbal whipping on how bad they were at protecting themselves. It was definitely not about empowerment, nor was it about creating a space where clients could speak openly about any form of sexual behavior.


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It's incredibly difficult to get a stranger to open up about their sexuality and sexual practices. Stigma and fear can be insurmountable barriers, and that doesn't begin to crack the list of reasons why someone might not talk.

How can anyone counsel and educate about HIV without being completely, honestly open and nonjudgmental about sexuality and sexual practices?

Every time a counselor quoted a false statistic, I questioned the validity of every other statement he or she said.

Assumptions about gender and sexual practices create barriers and limitations.

Omitting questions about sexual practices that aren't vanilla and omitting questions because of assumptions linking sexual orientation and sexual practice means that conversation is never started -- and no information is shared or learned.

Making value judgments about individuals' actions shuts a client down faster than anything.


I watched these failures in language use, in education, in judgment, and in assumption create walls which prevented the counselors from successfully helping the clients assess and reduce their risk for HIV. I came to a conclusion.


I strongly believe that in HIV Counseling, Testing and Referral -- and in any sex education environment -- sex-positivity is vital.