Podcast 11: Dr Mitchell Tepper, Sexuality Educator & Coach

It's our last podcast for this series! And we have the lovely Dr Mitchell Tepper from Atlanta in the U.S.  He has a PhD in human sexuality education. He did laboratory based research on pleasure and orgasm in women with spinal cord injury.  But anyone can benefit from his findings, and indeed this podcast - not just those who have SCI's.

Listen to Jennie and Dr Tepper discuss many areas of what sex may look like in your relationship.  It might not conform to society's perceptions of sex meaning penetrative sex.  Does that mean you've got a bad sex life? Definitely not!!!  

Dr Mitchell Tepper explains the importance of pleasure and intimacy within a relationship, and how they can be brought into a relationship even without a genital focus.  He explains how we are let down by sex education which ignores these factors, concentrating more on reproduction or orgasm.

A point to consider before listening to this podcast - is spontaneous sex the most planned sex event ever?!!!  Take a listen ......

Transcript

Audio recording: 0:09

Welcome to Enhance the UK's Undressing Disability Podcast, where we strip back all things taboo on sex and disability.

Jennie Williams: 0:19

Today we have a wonderful guest, Mitchell Tepper. He is a sexuality educator and coach and not based in the sunny UK. Mitchell, where are you right now?

Mitchell Tepper: 0:33

I'm in Atlanta, Georgia in the United States.

Jennie Williams: 0:36

And I'm going to ask you something very typically British, what is the weather like?

Mitchell Tepper: 0:41

It's a gorgeous day. It's springtime. Everything is in bloom here in the south of the United States. It's going to be 80 degrees. I don't know what that is in your centigrade, but it's going to be nice and warm.

Jennie Williams: 0:55

Well, whatever it is, it's nicer than what we've got. Now, I can tell you that it was snowing two days ago. And then the sun was out. It's very confusing at the moment, don't know what jacket to wear! all very, very confusing! But thank you so much for coming in and chatting to me today on the podcast. And we were both recently on panels, different panels on LoveAbility Festival a while ago, and I saw you talk and I was just really excited about us getting in touch via the Hub. So I'm going to hand it back to you really, rather than me just asking lots of questions, if you could just tell us a little bit about yourself.

Mitchell Tepper: 1:36

Alright, well, you already introduced me as a sexuality educator and a coach and I actually identify as a sexologist. And people ask, what's a sexologist, and I say, I'm a perpetual student of human sexuality. So I've always been curious about sex, even before my injury. I have a spinal cord injury, I broke my neck at age 20. And so that's nearly 39 years ago. And so at the time, I was really wanting to be a businessman, I was going to business school. And my dream was to go to Wall Street after I graduated, and I was the first in my family to go to college. And I was going to go to Wall Street and make a lot of money, buy myself a Porsche and buy my dad a Corvette. And then unfortunately, I was working as a lifeguard and broke my neck in the diving accident. And that changed my course. So I went, I finished my degree in business, went on not to be happy in banking, I went on to do durable medical equipment sales, selling wheelchairs, which I got involved with, through my involvement with, at the time was called the National Spinal Cord Injury Association, and now we call that United Spinal Association. But, you know, there were tears and people with disabilities who helped me along. And so I got very involved in the injuries specific organisation. And that led me into selling wheelchairs and eventually going back to Yale University to get a Master's in Public Health, where I had the intention of running a rehab hospital someday. So instead of business and banking, I thought I would do hospital administration and run a rehab hospital and I had some experience in internships in a hospital setting, and this was in the early 90s. And it was just like business, I wasn't really close to people. Hospitals were behaving like, in this country, like corporations. So it wasn't floating my boat. And I needed to do a Master's thesis. And I decided to do one, a national survey in the United States. And I surveyed the first 500 people from the National Spinal Cord Injury Association, that were identified in our database as being spinal cord injured. And I asked them about their experience with sexuality, education and counselling, in rehabilitation. And, as I suspected, which the literature made it seem like we were doing a good job, but that wasn't my sense on the ground. And I had an amazing response. And only about 50% of the people who responded got any type of sexuality education, and that could have been just a one hour class or a brochure and of the 50%, who got any kind of education, only half of those said they thought it met their needs. So there was a big need for sexuality education and counselling for people with spinal cord injuries. Now, for people not familiar with spinal cord injuries, those who actually make it to a rehab hospital, who are serious enough with their injuries, that they get paralysis, upwards to 90 plus percent of us have some kind of sexual issue, you know, whether it's problem lubricating or getting an erection or sensation, or orgasm, or being able to actually move. And so to really ignore sexuality and 75% of a population that needs it was was a problem that I thought needed addressing. So I, after that study, went on to get a PhD in human sexuality education at the University of Pennsylvania. So there were only a couple programmes in the United States where you could do that. And the one in Pennsylvania, fit fit me well. It was in the Graduate School of Education, and it's how I ended up as a sexuality educator versus a sex therapist or a psychologist because that's where the programme was, and they didn't have a counselling component. You know, I did take counselling courses. And for many years, I was a sex certified sexuality counsellor, which is the American Association of sexuality educators, counsellors and therapists. But I could never hold myself out as a licenced mental health professional. So I always let people know that I'm a sexuality educator. And I work in a context of coach, using an educational model. And what I learned, I have taken six therapy courses in my Ph. D. programme, is that 70% plus of people's sexual problems and concerns are addressed through education. You know, there are the people who have underlying issues, whether their mental health issues that are dealing with anxiety and depression and I work with plenty of people, most of the people I work with with disabilities have some kind of depression or anxiety or some other issue. But as long as they're being treated. Also, many of the people I work with have some kind of neglect or abuse history, whether it's physical or sexual, but if those issues are not resolved - the sex abuse, the negligence and the other kind of mental health issues - if they're not resolved, or at least treated well, I don't feel competent in treating the unresolved issues. But those people who are competent in treating those issues are so often not competent in treating the sexual issues, especially when they are a result from a disability or chronic condition. So, there are some well trained sex therapists with also education in disabilities and chronic conditions. So they exist. And always I'm referring back and forth for folks. So in my trajectory, I got a PhD in human sexuality education, and as a PhD, and it's a research degree, and I did actually research on laboratory based research on pleasure and orgasm in women with spinal cord injury. So, you know, as a sex researcher, that's what a sexologist is. So, as I said, I am curious, I've always been curious, I've stayed curious. I learned both from personal experience and from books. And I just feel specially suited. I felt like this was a calling. So it was my calling, I often identified as the prophet of pleasure, because I spread the word of pleasure. And I often avoided issues of sexually transmitted diseases or infections, unwanted pregnancies, abuse, because I thought there were plenty of people in the world out there trained to handle that. And they were very few people focused on helping people with disabilities find a pleasure in life that they deserve. So I felt this was my calling. I went out and I did that. I actually started a business in 1996, called the Sexual Health Network and I set up a website called sexualhealth.com, which unfortunately, is not in existence anymore, but I set it up to make information available at a click of a mouse, to end the silence around sexuality and disability. So that was my cry in 1996 was to end the silence around sexuality and disability. And I ran that sexual health.com for 15 years. In the beginning, we had eight people with disabilities, and also PhDs or MD's, so seven other people like me. And it grew to be over 60 experts from around the world. So not only United States, we had a good amount of people from India, Egypt, Australia, Israel. And so it really was a really international resource on sex and disability. Unfortunately, I sold it to a company hoping to grow it and do e-counselling but they took in a different direction. So like I said, I identified as a prophet of pleasure, because it's my calling, and often I don't get paid for it. More often than not, I'm doing what I'm doing voluntarily. So I had the website for 15 years that helped support me, I worked in academia and Morehouse School of Medicine for five years, and that also introduced me to working with injured veterans. So you know, the last several years, I've been focusing on making a documentary, which will be released this year called Love After War. So that's just extending my work that started in research and spinal cord injury, then went on to other disabilities and chronic conditions. And now, military combat related issues. But as we were talking before, I don't think that the the underlying condition, whether it be more with a disability, or acquiring it through trauma, or through disease or illness, really matters that much in helping people optimise their sexual response and pleasure. So I really think it's comes down to learning about sexuality in a holistic way. And when we understand the true essence of human sexuality, then we're able to express our sexuality in a very positive and a pleasurable way. So I think what people are not learning about sexuality education, or about sexuality, they're not getting good sexuality education.

Jennie Williams: 12:59

Certainly, it's really interesting, because certainly, in this country, people think about sex education, and I'm 42 and I think about sex education, and people think, putting a condom on a banana in their biology class, and everyone having a bit of a giggle. And in this country, there's more and more sex educators coming out. But actually, I tend to see this trend. They seem to be in their early 20s, most of them seem to be female. There's real lack of diversity, with sex education that I can see. And I certainly have not seen a male, disabled, somebody that's over the age of 30 working. And one of our team members, of all those three things, is training to be one. What does sex educator mean? Because most people are the mechanics of sex education and you know, penis and vagina, I guess that's what people think. So, what does it mean?

Mitchell Tepper: 14:06

That's that's a very universal but very limiting notion of sexuality education. So in the United States, when people think about sexuality education with with kids, they think about either the birds and the bees, right, so they're going to be talking about reproduction. I don't know if the birds and the bees is something in the UK that they talk about, but obviously we're using euphemisms, right, because we can't talk about penises and vaginas and sperm and ovum and sex, right? Or they talk about,'have you had the big talk'? And so there's this big scary talk you have to have with your kids at a certain age. You know, once you catch them basically masturbating or something? I don't know. But as a sexuality educator, you know, we think about many little talks. And they're little talks that start very early, and so they're age appropriate. So if you're pregnant, and your kid asked you, 'where do babies come from?', and the child is three years old. And you say, 'from mommy's uterus', so we're using real terms. We're not using womb or my belly. My son could tell you, when he was eight years old- he said, there was a picture of my wife pregnant, and he said that's me in mommy's uterus. I wouldn't be in her belly, else she would digest me and poop me out. So, you know, my son was the son of a sexuality educator, but we want to give them something that's age appropriate. And when they're a little bit older, they'll say, but how did the baby get in there? And then you'll say, Well, you know, there's a man in most cases, and you know, your penis, and he ejaculates and it goes into Mommy. So at each age based on appropriateness and the readiness of the kid, we provide information, but it's not just about reproduction. And it's not just about pregnancy prevention, when they're teens and STI or STD prevention. So that's really fear based - we're afraid of people getting pregnant, we're afraid of people getting an STD. But it's not focused on human relationships. So human sexuality, we have to look at first, and we're looking at a bio psychological, sociological, cultural, religious perspective, right? So sexuality has these multiple dimensions that affect how we express our sexuality. And we're looking at how we express gender. So you know, where the majority of people are born into a binary of male or female, there's intersex and intersex conditions but as a default, there's male and female, at birth. And then people learn how to express themselves as boys or girls, based on cultural influences of what's expected in that culture of males and females. I believe we all have masculine and feminine parts in us. And we express those differently - some of it we repress, some we express. And once again, your cultural upbringing determines that and over time, what's expected of men and women in many places are becoming the same, which is fine. So I don't know what that's going to mean for my definition of human sexuality. But I'm doing it from a basis of where people are born male and female, and they learn to express their masculine and feminine traits over their lifetime, in whatever way. And so traditionally, those have been in restricted ways, not allowing boys to express their feminine side, not allowing women to express their masculine side. So you know, we're working towards a world where we could express both, both males and females can express both, and people who are transgender can express their sexuality in any way they want. So we're looking at how we express our gender, we're looking at who we fall in love with, right? And who we're sexually attracted to. So that gets into orientation. So we're looking at gender, we're looking at orientation, we're looking at how we treat people who are of different genders, and have different orientations. So we want to teach about respect for other people. And we want to teach about all aspects of the body, not just sex as a form of expression of reproduction, but an expression of love, something that can bring us pleasure, something that could connect us and bond us with other people, something we could do for fun, stress relief, promoting the idea that we want to do things responsibly and safely. So all these things and what does our religious upbringing expect of us? A lot of people think that sexuality education is a dangerous thing, and we don't have any values. And that's not true. I mean, we value mutual respect, we value pleasure, we value safety. And I promote, and there's SIECUS - Sexual Information and Education Council of the United States, promotes what we call comprehensive sexuality education. So it comes from all these perspectives. And it will help people flourish, it will help people grow into healthy human beings. And now, I guess, in comprehensive sexuality education, in addition to all the reproductive issues, the safety issues, the relationship issues, and the pleasure issues, in the relationship issues I think more and more we're talking about consent. Consent is something hugely relevant nowadays, because we didn't speak openly that much. There was lack of education on both men and women parts. So we have people who are just very poor at relating with other people, people have done it in a way that is clumsy to say the least. Abusive on the other end of the spectrum and we all need to learn how to communicate, and ask for what we want. And also, importantly, to say, No. Because, on one side, you have men, generally, I mean, both men and women can be abusive and stuff, but more of the problems with the Me Too movement are with men. But when I hear the stories, women aren't given the tools they need to have the agency to say, No, you're making me uncomfortable, Stop. Not that it needs to be women's responsibility, just like men are sometimes doing stupid things, because they think it's what they're supposed to be doing. So good sexuality education is comprehensive. And it deals with all aspects of human relations between people, whether they're acting on their sexuality physically or not. So people can lose the ability to get an erection or ejaculate and have a child, that doesn't make you asexual, you still have feelings, you can still experience pleasure from other ways, you could still become a parent, you know, whether it's through assisted reproductive technology or adopting. So if you understand human sexuality, from multiple perspectives, and you know that it's not all based on genitals, then if you have a disability that affects movement, sensation, reproduction, you have other aspects of human sexuality to fall back on. And you always have the ability to love, to be loved and experience pleasure. And I think that's what the essence of human sexuality is in relationships. And, you know, the sex is, is just adding a really fun part.

Jennie Williams: 24:02

Yeah, I think it's really interesting, because, going back you said so much there that I was relating to all the way through and I think I'm a very liberal person, I talk really openly and honestly with my two year old and a three year old. And you know, we use vagina, we use vulva, and yet still, I say 'you were born in my tummy'. And actually, when you said that, I just thought, okay, yes, I still say that! And I live in one of the the gay capitals of the UK, in Brighton. And it's a very liberal place. I live in a bubble here. I take it for granted, you know, and then I go out, and then I realise that actually, it's not as liberal everywhere else that it is here. So it's very fluid, in gender you know, and I'm lucky. I'm really privileged that I get to bring my children up here. But really what I was relating to more than anything that you were saying, is a lot of people that we work with with our charity, myself included, through their impairments, conditions that has'caused' problems not being able to have what is seen as normal, penetrative, penis in vagina sex if you're heterosexual - and even if you're not, still having some kind of penetrative sex, whether that being using sex toys or whatever - is seen as a massive, massive problem. But what happens is that, hopefully, it's forcing people to communicate with their partner more. And actually, we're seeing people come in, and they're having conversations with each other, probably for the first time, especially if they've acquired their injury, or this condition has caused something, that they haven't had for years and years, about the simplicities of pleasure. And what actually they enjoy or their partner enjoys, it's just been kind of taken for granted that that's what happens. Even foreplay is a long forgotten thing for many people. And actually, then they realise that foreplay is also sex. And it's a very, very important part of sex. In fact, probably the best bit really of sex for a lot of people. Actively what we see through our charity, and the conversations and why people like yourself, are really important. And I think that there were people that were falling through the net, as it were, that don't know where to go to get this support; are frightened, are scared. And particularly a lot of men who think if I can't get an erection, then that's it, I'm not a man.

Mitchell Tepper: 26:51

It's very goal directed. And if I add what people don't realise is after 45-50 years old, where relationships like marriages and marriage relationships, when sex stops, it's usually the man who stops initiating because he has an event, or a couple events, of erectile dysfunction. He's humiliated, he's afraid to address it, he starts avoiding sex, and so if you have sexless marriages over 50, the one that perpetuates that is usually the man and it's usually because he can't get it up or keep it up or finish. And is just too humiliated or too embarrassed to face that. Instead of changing the way they interact sexually, they avoid it. And then people just quietly go on, without expressing, giving up on their on their sex lives. Physical sexual lives.

Jennie Williams: 27:57

Yeah, and let's face it, it's such an important thing. It's a part of people, being in a relationship. Without that you are essentially companions. And that's it and friends, and some people are fine with that. But most people aren't, and they want that. And I think that, again, we're really learning that there's this common misconception of impromptu sex, spontaneous sex. It just happens! It's passionate, and it's amazing! And that's what we go to in our heads don't we, when we fantasise and think about it, and that's really amazing. And those of us who have had that, it's brilliant. But the reality for most people, especially if you're in a relationship, and you've been in a relationship for a while, that doesn't really happen like that as much. And it's accepting that and learning that you have to think about it in a different way. And sometimes, it's really sexy, but you have to put it in the diary.

Mitchell Tepper: 28:57

We didn't even talk about the media's role in miseducation, and setting up the expectation that every sexual event is the spontaneous event, that happens instantaneously. You just walk in the door, you pick up your partner, you throw them against the wall, you throw them on a bed, you know, it's the same routine in every show. And, you know, I had a professor, he's my sex therapy teacher, Dr. Bill State (?), who said that, high school or whatever that spontaneous sex, was the most planned event in history, that you knew that you were going on a date Friday night, that you were getting the car, that you were going to dinner at this time, to movie at that time and a specific time before you drop her back home. That is going to be the time. So he said that spontaneous sex was really the most planned event in history. And you know, that's kind of more more realistic, that people do know that on Friday night or on Sunday morning, or, on this night for a couple that's together and you know, maybe one is working or both are working, and people have have lives. So yeah, maybe if you're living together as a couple and maybe work from home, you have some more spontaneity.

Jennie Williams: 30:34

No, a lot of people say during the pandemic, it's been quite a thing, because people are living together more, they're working from home, frankly, they're sick of the sight of each other. It's become even harder to do that for a lot of people. And that's why, you know, even saying, right, tonight, we're going to throw a cloth over the telly, I'm not going to put Netflix on, we're actually going to make an effort with each other. And then especially if you've got young children or whatever, and I sound like I'm talking about myself because I actually am talking about myself. I just think I'm really tired. And it's just easier to make that excuse. And then when you've got an added impairment on top of that, or condition or whatever it is, and you know there's a chance that it cause you pain, or I don't know, you're gonna get bladder pain, or whatever it is, from those things, that's even harder. So there's that mental block that a lot of the time, you've kind of got to get over anyway, regardless, if you've been together quite a long time. And then a double whammy if you think that it's also going to be potentially painful. And again, I guess this is why we've got to get away from this pressure of sex having to be something that is uncomfortable just to pleasure the other person, which I think a lot of people are still stuck in that mindset that they that they need to do.

Mitchell Tepper: 31:59

And I think one of the problems with avoiding sex, as in the kind of sex I talked about before; a man avoiding sex because you can't get it up or something, is that they then tend to avoid touching and kissing, caressing, because they believe it may lead to something. So I believe that, and certainly we know a relationship can without genital sex, without penetrative sex, if people are reinforcing each other and affirming their their love or caring for each other with hugging, touching, kissing, caressing, all of those things that show somebody you care and you love and gives you good feelings, right? Hugs, cuddling, I'm not saying do all that instead of sex, but I'm saying that those things can carry you a long time in between sex. So if you're not having sex, and you're not kissing, or touching, and you're not really communicating that much, see, a lot of people use sex instead of communicating, right? You know, physical sex. So when all that falls apart, you then feel distant from your partner.

Jennie Williams: 33:22

Absolutely. It's very easy and quick to get in that to get in that cycle. I feel like I could carry on talking to you for another hour. I know, I always do this with all my guests. I'm like, oh, my goodness, this is going too quickly. But we have been chatting for quite a long time. And I just don't know, with podcasts, we've got to keep it quite short. So to wrap this up, really, where and how can people get in touch with you if they want to hear more about what you do. And if you can support them.

Mitchell Tepper: 33:58

The best way to reach me is through DrMitchellTepper.com, and through the contact, I'm usually fairly responsive. And so I do offer coaching education online. I have a book called 'Regain that feeling; secrets to sexual self discovery'. And you could also find that through my website, Amazon, or regainthatfeeling.com. And so it's secrets that I've learned and from my research on pleasure and orgasm, it's from research on orgasm and people with spinal cord injury, but it's not just for people with spinal cord injuries. I think it gets into the true essence of pleasure and orgasm and puts people in a mindset so it's not a how to book. It's more of sharing people's stories of their process of sexual self discovery? You know what people go through overtime to find pleasure in their lives. So that's regainthatfeeling.com, DrMitchellTepper.com. Or if you just search Mitchell Tepper pleasure and orgasm on Google, you'll come up with loads of stuff I've written.

Jennie Williams: 35:25

You'll be found, there's no way to escape.

Mitchell Tepper: 35:29

Oh, yeah. And of course, very soon, go to loveafterwar.org for those who are interested in military or veteran populations and disabilities, and that type of physical, it's including PTSD and brain injury. And just sign up and we'll let you know when the movie is available.

Jennie Williams: 35:50

Oh, that's really exciting. And of course, you are also on our Undressing Disability Hub so people can connect with you directly on the hub.

Mitchell Tepper: 36:00

Yes and love the love abilities festival is again in October. So we welcome everybody to come. Pretty soon we'll have chosen our speakers, it's going to be three days in October. And so you know, keep an eye on loveabilities.org too.

Jennie Williams: 36:18

Brilliant, thank you so much again, for coming on and agreeing to chat to me and starting at 10 o'clock in the morning, even though it's meant to be 11 o'clock in the morning and I got the time difference wrong. So there we go! But you're in the sunshine, I'm not so there we go. But thank you so much. And please, anyone that wants to get in touch, please do and also you can get in touch with us at any point. Thank you very much.

Mitchell Tepper: 36:47

Love what you doing. Thank you.

Audio recording: 36:50

Thanks for listening. For more information or to have a chat with us, please visit enhancetheuk.org. From there, you can also sign up to our Undressing Disability Hub, a platform for professionals to connect and collaborate in the arena of sex and disability.