Causes and Treatment of Hypoactive Sexual Desire Disorder

Hypoactive Sexual Desire Disorder (HSDD) is by far the most frequent problem occurring in female sexual dysfunctions. It is generally characterized by persistent or recurrent absence of sexual fantasies or desires. In other words, the woman is rarely in the mood for any form of sexual activity; she neither initiates sex nor seek sexual stimulation. This condition is also referred to as inhibited sexual desire, low sexual desire, impaired sexual interest, and low libido, among others.

Causes of Hypoactive Sexual Desire Disorder

Hypoactive sexual desire disorder may occur in a woman at any age. It may be present in adolescence and can persist throughout a woman’s life. However, HSDD often occurs during a woman’s adulthood, often times following a period of stress. The source of hypoactive sexual desire disorder may be multi-factorial illness, medications, and psychological issues.

Menopause

HSDD in women is more common as a result of menopause. Reduced estrogen to post-menopausal levels can lead to dryness of the vagina making sex painful which reduces motivation. The gradual decline of the hormones estrogen, progesterone and testosterone together serve to decrease drive.

Physical Problems

Physical ailments such as diabetes, heart diseases, vaginal yeast and urinary tract infections, neurological disorders, pelvic surgery, chronic liver disease and kidney diseases can all lead decreased or low sexual desire.

Psychological Problems

Psychological causes such as stress from work and family, relationship communication problems, anxiety, depression, and previous traumatic sexual experiences can also contribute to the development of this disorder.

Physical abuse

A lifelong or primary HSDD where a woman has never felt any sexual desire not exhibited interest in sex could be as a possible result of incest, sexual abuse or rape.

Repressive Cultures/Belief Systems

Certain repressive family attitudes towards sex which are often enhanced by rigid religious trainings can force individuals to think of sex as an immoral activity.

Unpleasant Initial Sexual Experience

Initial failed attempts at sexual intercourse or pains from first sexual experiences could also lead to HSDD.

Insufficient Sexual Hormone Levels

Low levels of testosterone may cause HSDD in males and females. However, while some argue that increasing testosterone levels even in those without low levels may also serve to increase sex drive; others are of the opinion that HSDD in males and females rarely results from insufficient levels of the male sex hormone, testosterone.

Relationship Boredom

A woman experiencing stagnation or boredom in a relationship can develop an acquired HSDD.

Medication Side Effects

The usage of antidepressants for depression, antihypertensive medication, and oral birth control pills may interfere with sex drive, arousal, and orgasm leading to the development of HSDD.

Sexual Function Impairment

Impairment of sexual functions such as vaginismus (an involuntary contraction or spasm of the pelvic floor muscles and outer third of the vagina resulting from an unconscious desire to prevent vaginal penetration thus making it impossible or very painful) can develop into HSDD. This may be due to incompatibility in sexual interest between the sexual partners. This can also occur in the presence of a sexually demanding partner.

Dyspareunia

Dyspareunia or painful intercourse due to surgery, injury or infection may also cause HSDD. Also inadequate lubrication at the time of penetration from insufficient foreplay can also cause painful intercourse.

General symptoms of HSDD in patients include infrequent and eventual absence of sexual activity; less enjoyment of sexual activities than she used to; avoidance of sex; and have fewer or no erotic dreams and sexual fantasies. In a selective and focused HSDD, there might be zero interest in having sex with their partners but have normal or increased real/fantasized sexual desires toward other men.

Treatment options for Hypoactive Sexual Desire Disorder

Treat of HSDD is typically directed at removing or alleviating the underlying cause e.g. relationship misunderstanding, depression, and other sexual dysfunction (especially arousal or orgasm difficulties). When the problems causing HSDD arise from issues with sexual arousal or performance, then these dysfunctions will need to be directly addressed. It is acknowledged that majority of HSDD cases are situational in nature arising from dissatisfaction and loss of interest in the sexual partner. Thus there will be need for treatment to be within the context of the relationship itself and as such, it is common for both partners to be involved in therapy.

The use of antidepressants like Prozac and Paxil of which women are major consumers, has been known to be a major cause of decrease in libido in as much as 60 percent of patients. Where possible, it is advisable to switch to a lower dosage or to one that has less of a sexual side effect, like Celexa, Effexor, or Wellbutrin.

On the pharmaceutical side, testosterone supplementation in individuals with testosterone levels below the normal range (20 nanograms per deciliter) seems to be the treatment of choice. Although testosterone has not been approved for the treatment of HSDD by the FDA, studies have shown that several women who have used the testosterone patch have reported significant increase in the frequency of sexual activity and satisfying desire.

However, it should be noted that there is very limited data on the effectiveness of various forms of medication and therapy for female HSDD.

Protecting Children From Sexual Predators – Some Useful Parenting Tips to End Childhood Sexual Abuse

Every day, we hear more reports of child abduction and/or sexual abuse by sexual predators. These predators can be strangers. However, as statistics below show, most times your children will know the perpetrators of such harmful crimes. What are some useful parenting tips to end childhood sexual abuse, protecting children from both known and unknown sexual predators?

National Statistics

RAINN (the Rape Abuse & Incest National Network) provides the following statistics. However, since childhood sexual abuse is often hidden and it is generally estimated that approximately 88% of sexual abuse cases are never reported, national statistics can vary broadly. Therefore, it is likely the crime is more extensive than these figures reflect.

1 in 6 women and 1 in 33 men have been sexually abused in their lifetimes in the United States
44% of sexual abuse victims are under the age of 18
93% of juvenile sexual assault victims know their attacker
Childhood sexual abuse occurs everywhere, regardless of social, economic or ethnic backgrounds
In addition, domestic violence accounts for a great amount of sexual abuse, even among children, as many domestic violence perpetrators also abuse children in the household. The strongest risk factor for the same violent behavior occurs in homes where children witness violence with and among their caregivers. In fact, boys who observe or who may be forced to participate in domestic violence, including inappropriate sexual behavior, are twice as likely to abuse both their partners and their own children when they have reached adulthood.

Cost to Society

Whether you have children or not, the problem affects everyone, as the Center for Sex Offender Management estimates that 30% to 60% of children sexually abused as children later become adult sex offenders. Furthermore, there is a definitive economic impact on society, most notably a loss of health due to the physical and emotional distress of such crimes. As victims reach adulthood, those untreated problems are further exacerbated by loss of work. Even incarceration of sentenced sex offenders attributes to a strain on the prison system and loss of revenue. Currently in the United States, almost 8 million paid workdays and 5.6 million days of household productivity are lost per year due to such destructive crimes, equivalent to 32,000 full-time jobs. The cost for loss of health, work and imprisonment translates to annual lost revenues of approximately $5.8 billion.

Look for Signs of Abuse

Many people ignore the signs of childhood sexual and physical abuse. It is important to investigate further if your child displays any of the following:

Change in Behavior and Health
Those children who fall victim to sexual perpetrators may exhibit poor physical and mental health. They could also begin having social difficulties. Furthermore, cognitive dysfunction and behavioral problems may suddenly manifest.
Keeping Secrets
Sexual predators do not want to be caught. They will instruct the child to keep the ‘secret’ about any inappropriate behavior. Sexual perpetrators rely on the fact that children ‘do as they are told’ by someone older. In addition, although most people think that only adults are sexual and/or physical abusers, as the vicious cycle of abuse continues more people under the age of 18 become abusers themselves. Therefore, be cognizant of any secrets you discover being kept from you from ANYONE older than your child’s age.
Withdrawing from Other Friends – Spending Time with Someone Older Than Your Child
Children can become confused about their bodies if they are violated inappropriately. The sexual acts performed can be pleasurable and many times sexual predators will tell your child that their sexual escapades are not wrong. Therefore, your child, although they may feel guilty about what is happening, may incorrectly believe that what they are doing is not improper since it feels good. Beware if you notice your child has withdrawn from others, wishing to spend alone time with another older person.
Receiving Unexplained Gifts from Others
Inappropriate sexual behavior is about control, not sex. This is one reason children are such easy targets. Sexual predators will often give gifts to your child as another way to reinforce their control over them. Always ask and investigate any unexplained gifts to your child.
Discovery of Spending Time Alone with Older Person in Isolated or Unique Locations
Sexual predators love to isolate their victims. They oftentimes will set up ‘special meeting’ places, away from suspicious eyes. Therefore, if you discover your child is spending time alone with someone older in any isolated or unique location, it is wise to probe further.
Ways to Protect Your Child

Trust Your Instincts
Sexual predators choose their crime victims based upon availability. Therefore, it makes sense that most victims personally know their perpetrators since they may be already easily acquainted with them in their circle of family, friends and community. Therefore, dealing with sexual abuse with someone your child may know could present additional challenges. First, the chances you will know your child’s sexual predator is very high. Be open to this fact. No matter how much you may trust your spouse, your family, your friends, and members of your community, such as teachers, counselors and spiritual support, do not ignore any of the above signs of abuse. Furthermore, oftentimes a parent’s instincts will alert them to a problem, but they ignore it because they already know the person. We think sexual predators look like monsters. However, they look like everyone else. Never ignore your instincts. It is better to be safe than sorry.

Communicate Early and OftenOpen a line of communication about inappropriate sexual behavior early. Establish trust with your child so that they will feel free to share anything with you. Teach your child:
Reinforce ‘Stranger Danger’ Rules
Many schools provide education on staying away from strangers. However, please reinforce those warnings and advice. Tell your children to stay away from strangers, do not get into their car and do not offer assistant to lone strangers, etc. If addition, travel with buddies when possible.

Saying ‘No’ is OK
Children are taught to do as they are told and respect adults. However, be sure they are aware that it is OK to say no when they feel uncomfortable, regardless of whom they are confronting.

Some Secrets are Bad
Instruct your child between the difference between harmless secrets shared with friends and inappropriate ones. Anything having to do with sexual behavior or physical abuse in any way needs to be shared with a child’s parent.

Communicate Differences Between Different Types of Touch
Touching is a wonderful part of life. However, it is most beneficial to educate your children about the differences between different types of touching with regard to discerning the differences between ‘real love’ and ‘fake love.’ For instance, if another person speaks of love as allowing your child access to put their hands down inside your child’s clothing in those areas normally covered by a bathing suit, there may be some cause for concern and evaluation. In addition, you do not want your child afraid of your doctor who may need to explore these areas. Therefore, relating touching to ‘real love’ and ‘fake love’ may help with trips to the doctor since he normally does not relate touching to love. Regardless, reiterate that sexual touching done ALONE with an older person needs to be thwarted. The best suggestion is to open the lines of communication and education. It may also be beneficial to accompany your child to the doctor.

Warn of Sexual Predators on the Internet
The internet, although a valuable source of education and information, can also be very dangerous. Be vigilant about knowing to whom your child may be communicating. Instruct them never to give out personal information online and to report to you anyone discussing keeping ‘secrets’ or talking about ‘private’ areas of the body.

Teach Your Children to Trust Their Instincts
Although there are numerous programs and parents who utilize the above tactics, there still is an overwhelming incidence of childhood sexual and physical abuse. What is lacking? If you teach children to listen to their own gut in any situation, harm can be averted. Instruct your child to listen and act on the spirit that is within them guiding them to a constructive path. If their intuition makes them uncomfortable with a certain situation, teach them to run away and get help.

Listen to Your Child
Finally, please listen to your child no matter how outrageous you may feel about their story. Once you have told your child to tell you their ‘secrets’ and to share whatever they are feeling and then you discount their story, you simply destroy trust. Take everything they say as truth, no matter the other person involved. Investigate further anything they tell you. After all, as a parent, it is your job to protect your child, not another adult. Listening to your child could stop harm.
Sexual predators destroy lives. However, if we all implement these useful parenting tips, childhood sexual abuse could end. Our children and society can be protected more successfully from known and unknown sexual predators. Is it not worth a try?

Sacred Sexuality

Sitting with my friend Roseanne in the darkening twilight, I ask her a question I’ve been asking many people lately: “What does sacred sexuality mean to you?” Roseanne hesitates, searching for the right words. “It’s not something you can force… but once in a while, you pass through into something beyond, something transcendent…. It’s like a great light… Life comes pouring into existence, and for just a second, you get a chance to look at it and see it happening.”

Roseanne, a mother and housewife in her early fifties, is neither a student of Tantra, nor is she versed in New Age thought. In fact, she seems an unlikely source for information on sacred sexuality, raised as she was in a strict Mormon family where sex was equated with sin. Yet the long overlooked truth is that countless “ordinary” men and women feel a natural, intuitive reverence for sex as the place where “life comes pouring into existence.”

At the same time, millions of Americans also carry a heavy legacy of sexual guilt and shame which blocks their ability to appreciate sex as a divine gift. Over and over, people tell me that their parents rarely or never talked about sex, and pretended to be asexual. “In my family,” one woman told me, “there were no words for sexual parts or sexual acts…. When I was eight or nine, I got out a mirror and looked at my vagina and wondered if there was something wrong with me. “Is this okay?’ I thought. ‘Is this how it’s supposed to be?'”

Many of us were raised in religious traditions that considered sex “unspiritual” if not downright sinful. In contrast, most indigenous people revere sex as an encounter with the spirit worlds. Sobonfu Some, a teacher from the African Dagara tribe, says that her language has no words for “having sex.” The equivalent Dagara phrase translates as “going on a journey together”-a journey guided, according to Dagara belief, by the spirits of the ancestors.

Moreover, the Dagara believe that though this journey is taken in private, it benefits the entire community because in the process, the human and the spirit worlds are brought into alignment. Such ideas may seem a far cry from our own. Yet I have heard hundreds of women, as well as many men, describing sex as a mysterious, profoundly sacred power.

Janet, for example, responded without a moment’s hesitation to my question about the nature of sex: “Sex is the light that streams from the body.” “Sex is magic,” said another woman, “it’s a field of magic.” And yet another told me in a tone of awe, “It’s the primal creative force. It moves through you, but it doesn’t belong to you; you can’t possess it.”

Sex is not a genital activity; in fact, it is not an activity at all, but rather an aspect of the creative life force also known as Kundalini, which can enliven and electrify us at every stage of life. For Cindy, a sculptor in her seventies, the moment of her sexual awakening coincided with her birth as an artist. “In that moment, I understood that this vibrant aliveness was me. That’s who I am. All the creative work I have done since then comes out of that state.”

Cindy has had several deeply satisfying relationships, but today, she is happily single. Grinning, she tells me, “I felt so empowered when I realized that I would always be a sexual woman, and that I didn’t have to depend on a partner. The older I get, the more I feel turned on to spirit, to my own creativity, and most of all to the crazy, magical rush of life.”

Naomi, a woman in her forties, made the exhilarating discovery of her own sexual power during a women’s ritual at which each participant took off her clothes and offered a nude dance. Years of childhood abuse had taught Naomi to equate sex with humiliation. And so, she entered into her dance shaking with terror. Soon however, fear gave way to a mounting surge of ecstasy that coursed through her body and intensified until it exploded into orgasm. “This joy started coursing through my body until I was rolling around on the floor like a little animal, kicking my legs and laughing. It wasn’t dignified or beautiful. It was a joyful, ecstatic exuberance exploding through my body.”

Sacred sexuality can be etheric and gentle, or it can be bawdy, raucous, and funny. Cutting through the ego’s pretentiousness, it reconnects us with the innocent joy of our animal bodies and gifts us with the medicine of wild, liberating laughter. Therefore, the ancient Greeks called Aphrodite the “laughter-loving” goddess who was always surrounded by children.

We all need to find our access to ecstasy, for the soul’s hunger for ecstasy is as real and urgent as the body’s hunger for food. When people become obsessed with sex they are in fact starving for ecstasy. Our society will not have a healthy attitude to sex as long as it fails to acknowledge ecstasy as a basic human need which people will try to satisfy by any means, including alcohol, drugs, and self-destructive sex. Modern Western civilization is probably the first that has no ecstatic rituals. Creating our own version of the Sufi Zikrs, the Pagan spring festivals, or the ancient Greek mysteries could address the longing that drug-prevention programs and sex education cannot fulfill.

As an energy that transports the soul back and forth between the unmanifest and the manifest dimensions, sex has always been of special interest to healers, shamans, priests and priestesses who felt called to serve as go-betweens between the worlds. In the past, only very few, select individuals were called to this path. Today however, the urgent evolutionary need of the planet is causing a mass spiritual awakening. Most of the men and women I counsel are as deeply dedicated to the spiritual path as any nun or priest, yet they are also regular people with regular jobs and families.

For some, sexuality has served as a catalyst that forced them to abandon the path of organized religion and find their own way through difficult, uncharted terrain. Richard, now happily partnered with another gay man, was formerly a highly respected Zen Buddhist teacher and monk. “I saw desire as a big no-no,” he told me. “The Buddha taught that attachment to impermanent objects causes suffering. In my order, that was interpreted as meaning that personal attachments were bad, and sex was definitely bad.” Like many religious institutions, Richard’s order considered celibacy a spiritually superior way of life.

In theory, Richard agreed. Yet as the years went by, he became more and more frustrated. “I felt dry and shriveled. I started wondering, ‘Where’s the juice in my life? I need to find that juice.'” Soon after, Richard made the choice to leave his order, a choice he has not regretted. “Now,” he told me, “I believe that the purpose of the spiritual path is not to avoid suffering but to grow in love. And the only way I can walk the path of love is by following my heart’s deepest desire. I still feel that celibacy is a valid choice, but it should be an option, not an ideal. So much hypocrisy and deceit are the direct result of idealizing celibacy.”

As Richard has discovered, the path of sacred relationship is at least as demanding as the monastic path because it forces us to develop and transform the ego in ways monastic life does not. Nonetheless, Richard is not alone in his determination to integrate sexuality and spirituality, human and divine love. For many centuries, the way of the monk or nun has seemed incompatible with the way of the householder.

Yet in the last fifty years, a radical-and still little understood-transformation in the function of our sexual relationships has been occurring. Poised as we are on the brink of global disaster, communion with spirit is no longer a luxury but an absolute necessity. Consequently, more and more couples are finding themselves equally committed to one another, to the spiritual journey, and to the process of inner transformation.

“What people like us are trying to do has never been done before,” a married friend told me. “Certainly our parents were not trying to achieve that level honesty and consciousness and intimacy.” Marriage (in which I include any long-term, committed sexual relationship) is perhaps the most radical voyage of personal transformation a spiritual seeker could embark on. But short sexual involvements, too, deserve to be honored as spiritual teachers. Every sexual attraction carries a message from spirit which we will fail to hear if we simply chalk it up to random “chemistry”.

Of course, this does not mean we should act on every impulse. Hannah told me of a night she and a monk spent sharing a small room, both madly in lust with each other. “Neither of us slept a wink,” Hannah remembered. “Every cell in my body was trembling with desire. But I did nothing.” Ironically, she remembers this night as one of her deepest experiences of sexuality, and has never regretted her choice.

“I couldn’t pretend to myself that this was love,” she told me. I don’t believe that sex and love necessarily have to go together, but in this case, they were in conflict, and I chose love.”

Those wanting to improve the quality of their sex life will find no lack of books, workshops and teachers. At the same time, even the most refined sexual techniques cannot unlock the door to the sacred. The key lies elsewhere-not in our actions, but in our perceptions. If we would experience sex as a luminous, light-filled miracle, we must approach it with eyes of reverence and with a mind free of judgment and shame.

Among the many manifestations of divine light, few are more beautiful than sex with its rich amber glow, its red-hot sparks, and its sweet honey flavor. Sex carried us all into life, and every now and then, it affords us a glimpse of paradise and of the radiance that is our true home. Sex is one of the most potent spiritual teachers we will ever encounter. It’s high time to give it credit for the inner growth it triggers and to gratefully acknowledge the vast generosity of a gift that connects us with the ecstasy of creation.

Ten Steps Towards Sexual Wholeness

1. Tell your story in sacred space. Telling your story is a powerful way of coming out of sexual isolation, owning and integrating your experience. Sometimes, it can even be a lifesaver. Words carry power, and naming your truth in the presence of compassionate, attentive witnesses is tremendously empowering. However, this deeply intimate process should always be contained in a sanctuary space of sorts, which might be a therapist’s office or a trusted friend’s living room.

I do not recommend telling your story outside of sacred space, which I define as an environment where your story will be received with attention, compassion and reverence, where you will not be judged or shamed, and where your request for confidentiality will be respected. Like the body, so the psyche too has its “private parts” where a person holds their deepest, most intimate secrets, as well as their most vulnerable feelings, memories, hopes and fears. Your story is sacred, and you would no more want to share it with an inappropriate audience that you would want to have sex with inappropriate partners.

2. Embrace pleasure as a friend. Wilhelm Reich was one of the first to realize how much we fear pleasure. When Joanna had an orgasm that left her, in her own words, “at the center of the universe, totally at one with everything,” she reacted not with elation but with terror. Perversely, we often view pain as safe, even virtuous, while associating pleasure with decadence and sin.

“In Catholic school, I learned that suffering was good,” one man told me. “Jesus suffered, and so did the martyrs. Nobody went to heaven for having a good time.” Provided our pleasure does not harm ourselves or others, we should consider it healthy, healing, and holy. Sacred sexuality honors pleasure as a gift from God, and as nature’s way of letting us know what is good for us. Welcome pleasure into every moment of your life, and embrace it as a friend, guide, and teacher.

3. Find time and space to open to your sexuality by yourself. Masturbation, or self-pleasuring, to use a more positive word, can be a voyage of self-discovery and an experience of truly making love to yourself. It’s just one way, though-remember that there are a million ways to “turn on” to yourself. Get naked, wrap a shawl around your hips, and do an erotic dance. Go out on a warm summer night and lie on the damp grass, letting your body commune with the earth’. A good lover is a priceless gift, but please don’t buy into the belief that without a lover, you can’t be sexual!

3. Take responsibility for the partners you attract. The foundation of sacred sexuality is love, and love begins with self love. If you have a history of choosing inappropriate partners, you can safely assume that in some way, you still feel unworthy or undeserving of the love you want.

4. Learn as much as possible about where and why you go astray. Watch out for patterns of “making do,” condoning abuse, or settling for relationships that are ultimately destructive and undermining. Sacred sex involves not only physical nakedness but also emotional and spiritual nakedness. Take a good hard look at who you are getting naked with.

5. Learn to express your sexual desires and needs. Good sex requires honest communication. Don’t expect your partner to read your mind. Unfortunately, fear and shame cause many otherwise articulate men and women to become mute in bed. Alexandra spent ten years in a sexually frustrating marriage before she finally found the courage to ask her husband for what she wanted. “As a good, red-blooded American girl, I was brought up to believe that the man had to give you sexual pleasure, and that if he didn’t give it to you, there was no way to get it.” As it turned out, Alexandra’s husband was more than happy to oblige her. Yet one wonders how many relationships fail because partners dare not express their desires.

6. Slow down and relax. We all know that stress is the number one killer in our society. Besides felling thousands of people every year, it also cripples our sexuality. Slowing down-way down-is essential to sacred sexuality. Ecstatic lovemaking occurs only within sacred time, time out of time; it cannot tolerate being cramped into tight schedules. “Quickies” can be wonderful. Still, they are the sexual equivalent of fast food. Give yourself the gift of a gourmet meal now and then!

7. Relax while aroused. As we get aroused, we tend to tense up. Practice doing the opposite. Instead of tensing, relax and allow pleasure to spread throughout your body. This runs against our grain because we generally want to reach orgasm as quickly as possible. To do so, we tense, thereby concentrating our excitement in the genital area. Often, we unconsciously hold our breath at the same time. Try breathing deeply and allowing yourself to relax into increasing levels of sexual arousal, without rushing toward orgasm. If and when orgasm occurs, it will release a healing flood of pleasure throughout your entire body.

8. Be brave. Understand that even with the best partner, sacred sex is bound to be somewhat scary. Why? Because as in any encounter with the divine, you will have to let go of control and surrender to a power greater than your own. Sacred sex is loving sex, and love is not for cowards; it takes courage to plunge into that purifying blaze. The ego may balk, yet our body and soul live for that crazy, exhilarating plunge. There is nothing more noxious to the body than being inhabited by an ego that refuses to let go. Our body yearns to reconnect with the eternal source of its being, and grieves when we becomes so fearful that we refuse the healing medicine of ecstatic pleasure. A body deprived of ecstasy and of the cleansing, purifying stream of bliss is never a happy body.

9. Open to God as your lover. Meditate on a divine Being who blesses your sexuality and desires you with as much passion as you desire Him or Her. Mystics of all spiritual traditions have invoked God as a lover who led them into states of rapture and orgasmic pleasure. By accepting God as our lover, we invite sacredness into our sexual experience. On the other hand, opening to the divine lover will also transform our spiritual practice. In the presence of the God the lover, worship becomes lovemaking, and lovemaking becomes worship.

10. Take the next step. Ask yourself, “What is the next step in my sexual life?” Taking the next step can mean telling your lover about your sexual fantasies, writing erotica, or choosing to be celibate. For one woman, taking the next step meant visiting a local sex shop. “I was scared,” she remembers. “Decent people just didn’t do that kind of thing. Then I thought, ‘Okay. It’s time for you to admit to the world that you are interested in sex.'” What’s the next step for you?