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Pressure to PrEP?

Boyfriend’s sexual requests raise deeper issues

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Truvada, Gilead, gay news, Washington Blade
Truvada, Gilead, gay news, Washington Blade, drug resistance

(Photo courtesy of Gilead)

Michael,

 

My boyfriend Tom wants me to start taking Truvada and I’m not sure I want to.

 

He says if we’re both taking PrEP, we can have better sex. He’d like us to stop using condoms so we can feel closer.

 

While I like the idea of unprotected sex with him, I’m also nervous about it because we recently opened up our relationship at Tom’s initiative and now he hooks up with other guys pretty frequently. He says that because he always uses a condom with them and is on Truvada, I don’t have to worry about either of us catching something. But I still worry, which is why I want to keep using condoms. It’s also why I don’t hook up with anyone.

 

The other reason he wants me to go on Truvada is because he thinks I’d be more comfortable having sex with other guys and we could play around together, which he’d like. I don’t really want to do this but I don’t want to say no to his fantasies.

 

Tom says I have an anxiety issue and I should have a more positive attitude about sex.

 

Am I being unreasonable? Should I listen to Tom? We get along very well but since he started bringing this up, I always have a feeling that he’s disappointed in our sex life.

 

Michael replies:

Are you being unreasonable about your safer-sex choices? A physician is the best person to answer this question, so please make an appointment with yours. But I can tell you that nothing is a guarantee against all STDs, except celibacy. PrEP can lower the chance of HIV transmission and condoms are useful against a range of STDs, but they aren’t foolproof and folks don’t always use them even when they intend to. You can also be exposed to a smorgasbord of diseases through oral sex (usually done without a condom), rimming and even kissing.

Clearly, there are varying degrees of risk and the decision of how much to take on should be yours. It sounds like your decision making is being clouded by your anxiety about making Tom unhappy. Wanting to please your partner should not be the sole criterion for a decision that involves your health. You can get into serious trouble by ignoring your own sense of what is right for you in order to please someone else.

Is Tom suggesting he’ll walk if you don’t start taking PrEP and joining him for hookups? Or are you only fearful that he will? If he’s threatening to leave, have a talk with him about this. Making threats to get your boyfriend to do what you want is toxic and destructive to a relationship.

Speaking of threats, how did the two of you decide to open your relationship? Was it a mutual decision, or due to pressure from Tom? I’m wondering how much you are saying yes to things you don’t want to do.

I also wonder if you want to keep using condoms because you don’t trust Tom. You don’t mention this, but when one person feels pressured by their partner as you describe, trust is often an issue.

If Tom is simply expressing his dissatisfaction, then if you decide not to do what he wants, you will have to learn to tolerate his unhappiness as he comes to terms with your choice.  Remember, while it’s important to be considerate of your partner, it’s not your job to keep him happy.

Actually, it’s not possible to make other people happy. Each of us is responsible for our own happiness, regardless of our partner’s actions.

Regarding your not having a positive attitude toward sex, this is a different issue from the level of sexual risk you are willing to take on.

Are you interested in being close to Tom and having a pleasurable sex life with him?  If so, why is Tom questioning your attitude? Being sex-positive does not mean being OK with doing anything and everything, and not setting boundaries that make you feel comfortable. This is another topic for discussion with Tom.

There are great opportunities here for you and Tom to improve your relationship skills. You have the chance to get better at clarifying how you want to conduct yourself, even if your boyfriend disapproves. And the two of you get to figure out how you can be a couple even when you want two different outcomes, which is the big challenge of all relationships.

 

Michael Radkowsky, Psy.D, licensed psychologist, counsels gay couples and individuals in Washington. He can be found online at personalgrowthzone.com. All identifying information has been changed for reasons of confidentiality. Have a question? Send it to [email protected].

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1 Comment

1 Comment

  1. Keith Cumbie

    February 27, 2016 at 6:00 pm

    What is the acceptable price for Prep? One life saved?5 lives saved? 1,000 lives saved?

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Advice

Working from home is taking over our lives

We need to create boundaries and return to offices

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working from home, gay news, Washington Blade

Back in the late 1980s when I was a young financial analyst at a New York bank, I’d leave the office at five and go home to my little Upper West Side studio. With no cable, internet, or cellphone, a landline was my only connection to the outside word till I went back to work the next day.

What was it like? Tranquility is the word. Surrounded by Manhattan, I was as isolated as a monk in a cell, with uninterrupted hours to read a book, cook, or listen to an album. And of course I could go out on the town without a work crisis reaching out to ruin my plans.

I’ve been thinking back to those days a lot, lately. Working as a psychologist, I’m hearing more and more clients complain lately about how much time they’re putting into their jobs. Folks have been working from home for a year now, and as the months have gone by, many of us are spending more and more hours on the job.

What’s going on? I hear a few justifications.

First, many people tell me that they don’t feel they have an excuse not to reply when they get a text or email from a boss or colleague after normal work hours. After all, what else would they be doing? This is especially true of my single clients who don’t have children. Even dinnertime isn’t off limits.

Second, as the pandemic drags on and most of us have so few sources of fun and stimulation, people are turning more and more to their jobs for something — anything — to keep them occupied.

And, of course, there’s the reality that we’re working from our homes. There’s no physical boundary keeping work at work.

So while it’s great not to have to commute or wear pants, working from home is making it even easier for our jobs to take over our lives than they already were. Put bluntly, this sucks.

We all need a break from work. Every day. Your job likely isn’t paying you for 16-hour days. Even if it is, you need to have some fun, rest, and recharge your brain.

Of course we can’t shut ourselves off from the world as completely as I did in those pre-internet/cellphone days. But we need to draw a boundary, even if it means disappointing our employers and colleagues by doing so. I’m not talking about not doing your job. I’m just talking about setting a limit on how much of your life you are willing to give to your work.

Standing up for your own well-being can be scary. There may be real risks in terms of job security and compensation. Only you can decide for yourself when it is vital to say “no.” But advocating for yourself is necessary at times. To quote Hillel, an ancient Jewish sage: “If I am not for myself, then who will be for me?”

Taking action on your own behalf is also a skill you want to develop, because it will help you in all areas of your life. If you can’t say “no” in order to eat dinner uninterrupted, watch a movie you’d like to see, spend time with someone you love or get a good night’s sleep, you’re going to get chewed up and spit out by others, quite a lot.

Recently, I’ve been reading that D.C.’s downtown is in danger of financial ruin. As many people may not be be returning to the office after the pandemic, some believe that the whole web of service businesses may collapse.

I’m hoping that the doomsdayers floating this theory are wrong, and that as the pandemic ends many of us will head back to the office, at least much of the time. We need to get back to setting a stronger boundary between work and the rest of our lives.

Yes, we’ll be helping our city rebound. And we’ll also be making a big step toward taking care of ourselves, by re-constructing a life that’s about way more than work.

Michael Radkowsky, Psy.D. is a licensed psychologist who works with gay couples and individuals in D.C. He can be found online at michaelradkowsky.com.

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Advice

ADVICE: Despair vs. resilience in trying times

Coronavirus lockdown has many down but you’re stronger than you think

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As the COVID-19 crisis goes on without our having any clarity about how or when this crazy situation will improve, most everyone I know is super-anxious about getting sick, fed up with being locked down or both. Is there a way for us to get through this any easier? 

Here’s a start: Acknowledge that there are no guarantees in life.

When we accept that life is going to throw all sorts of challenges at us and that there is sometimes nothing we can do to stop these challenges from coming, that leaves us with one great option: Work on becoming more resilient so we can better deal with the hard stuff, including the very hard stuff.

This is called resilience. Being able to pick ourselves up, dust ourselves off and keep going forward. Cliché, yes, but it’s what we need to do if we don’t want life to beat us down.

Good news: resilience is a trait we are born with. As I’m writing these words, I’m watching my 4-month-old, who recently learned to turn from his back onto his belly, trying to turn from his belly onto his back. He’s been at this for days, and has succeeded just once. He keeps crying and trying. He won’t give up. That’s resilience.

Further good news: If you’re LGBT, you likely have already done some work in this area. All the difficulties that we experience as we grow up — struggling to accept an identity that’s stigmatized, teasing, rejection and worse — and here we are. How? All of us found a way to keep moving forward in our lives rather than letting circumstances defeat us.

Of course, this is pretty much true of anyone who has been through tough times and survived. Many of our elders who experienced the Depression, wartime, or worse tell us that they aren’t fazed by the virus or having to stay at home. Having endured previous struggles, they know they can do their best to endure this one.

That’s what all of us must keep in mind now. Knowing that we have had the resilience to get through past difficulties can support us in getting through this new hard time.

Another important point to keep in mind: When we give our suffering meaning, it helps us endure the suffering. Reminding ourselves that striving to endure this tough period will make us even more resilient can actually help us to more easily endure it.

Other ways we can strengthen our own capacity for resilience: 

Do our best to take care of ourselves, of course. When we eat well, find a way to exercise, get adequate sleep and take breaks from virus-worrying through meditation or just focusing on something pleasant or uplifting, we’re less anxious and better able to keep calm. The ability to soothe ourselves is key to being resilient.

Stay connected to people around us so that we don’t wind up feeling isolated and alone, which can deepen feelings of hopelessness. We all need supportive friends and family whom we can ask for assistance when we really need it to survive. Knowing that they are there is part of feeling resilient. And if we’re able to help others in some way — dropping off groceries for an elderly relative or neighbor, or simply being willing to listen — we’re likely to feel stronger and more able to cope.

Appreciate what we have. This can include a roof over our head, food to eat, people and companion animals we love and simply being alive right now. Doing will serve us much better than lamenting.

While none of us will live forever, we all want to stay in the game as long as we can. Striving to be resilient can help us keep going forward through life with the belief that if it’s possible to survive, we have a good shot at doing so. And that belief can give us hope, determination and a positive outlook.

Michael Radkowsky, Psy.D. is a licensed psychologist who works with gay individuals and couples in D.C. He can be found online at michaelradkowsky.com

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Advice

ADVICE: Nerves easily fray while social distancing

Look within to avoid unnecessary tension with your significant other

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social distancing advice, gay news, Washington Blade

For many years, I’ve told couples I work with that being in long-term relationships is like taking a long journey by ship in a very small stateroom. You know, the kind where the couch unfolds to be a bed, you have to step over your partner’s legs to get to the bathroom and there’s no place to stow the suitcases. You have to find a way to stay calm, not drive each other crazy and enjoy the voyage.

I’d never actually traveled by boat, so this was just my theory. So when my husband and I were lucky enough to take a journey by ship up the Norwegian coast a few years back and had a cabin exactly as I’d envisioned (i.e. teeny), I discovered I was right. Despite the unbelievably gorgeous scenery right out our porthole, after a few days we could see how easy it would be to get irritable with each other.

Now here we all are in a much more difficult situation. We’re stuck at home, on top of each other, trying to do our jobs while taking care of companion animals and children, attempting to avoid an invisible enemy that could be anywhere.  We can’t go out on deck to watch Norway float by. Instead, we’ve got the television to look at, keeping us posted about all the bad and scary news.  

So it’s natural that as our nerves fray, we’re going to get irritated by our mates. They’re in the way. We don’t like their tone. They aren’t doing enough or responding when we ask a question. We feel like we’re the one doing everything.  

Sound familiar?

It makes sense that we react like this at such a stressful time, but when we do, it’s all downhill from there. In our current predicament, we don’t have the usual escape outlets that let us take a break and come back to our spouses calmer and with a refreshed attitude.  

What to do? Here are some simple strategies to help you, your significant other and your relationship through this extraordinarily miserable period:

Don’t point fingers: Think about what you can do to make the situation better rather than focusing on what your spouse should be doing. And then do it. This is a great strategy even in normal times. Remember, we have very little power to get another person to do something, but lots of power over our own behavior. So if we want things to change, we should look first to ourselves.

Be generous: Does your spouse feel strongly about something? Now is likely not the time to get into a struggle over whose say goes. Unless you have good reason to go in the other direction, be generous. Again, this is a policy worth adhering to when we get back to normal (soon, I hope!).

Take responsibility for soothing your own anxiety: This is always a great idea, but especially now. Yes, when we’re worried about something it feels great to get a hug and be told everything will be OK. But right now, your partner is just as anxious as you are and likely without the bandwidth to soothe you. Moreover, none of us really know that everything will be OK. 

So the best thing you can do when you’re anxious is look to yourself to find ways to keep as calm as you can, under the current circumstances: Meditation, slow deep breaths, whatever exercise you can find to do, striving to be in the present, working to accept uncertainty — these are all ways you may be able to help yourself feel even a little more calm.

And if you’re able to reach out and offer your spouse some loving reassurance — even if none of us know how this will end — so much the better.  Giving your partner emotional support is always a good move.

Michael Radkowsky, Psy.D. is a licensed psychologist who works with LGBT couples and individuals in D.C. He can be found online at michaelradkowsky.com. All identifying information has been changed for reasons of confidentiality. Have a question? Send it to [email protected].

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