Ask Debby Herbenick | Anonymous STI testing in Chicago

Q My friends and I want your professional opinion. We have a friend who’s gone all Lindsay Lohan on us by hanging out (and having sex with) a girl who we’ve always known to be a lesbian. Our friend has always been into guys, though, and LOTS of them. Can she really be a lesbian now? Is this a phase? We’re still friends with her; we just don’t get it. Sometimes it seems like she’s doing it to be all avant-garde. But maybe it is for real? I guess we don’t know what she is anymore.

A It’s worth asking whether it even matters “what” she is, in terms of her sexuality. Quite a few celebrity magazines and websites (and even the Los Angeles police chief) have weighed in on Lindsay Lohan’s sexuality, but for what reason? Like Lohan, whether your friend identifies as lesbian, bisexual or straight is her call. When it comes to sexual attraction and behavior, research has often revealed a fluidity that is difficult (at best) to categorize. Even when certain sexual experiences or explorations last for a short period of time (like weeks or months), I sometimes worry that calling that time a “phase” doesn’t give it the credit it deserves. Most people try things out, whether the thing we are exploring is rough sex, phone sex, sleeping the whole night through with a partner, or being sexual with someone of a gender we’re usually not into. And whether or not we continue the thing we were exploring is often beside the point; we learn, we grow, we’re enriched, we pick up a few new skills. So her behavior is as “real” as anyone else’s—that’s true whether or not she keeps being sexual with other women. I think it’s great that your group is still friends; and if you have questions or curiosities, it’s usually fine to ask each other about one’s relationships and feelings—that’s what friends often do, right? If she doesn’t want to answer, she won’t.

Q I am a 21-year-old. My issue is sometimes when me and my woman are getting ready to make love, my dick doesn’t want to come up. I get so mad. Is it low levels of testosterone? Or is it that I masturbate too much? Why does it happen?

A For the sake of space, I deleted the 40 question marks at the end of “Why does it happen?,” but I get it: You want answers. Physical causes of erection problems are uncommon among young, healthy men. Have you gotten a checkup in the past year? Certain conditions can make erection problems more likely—diabetes is a common culprit, for instance. Erection problems are rarely caused by low testosterone. Assuming your health is good, it may be that performance anxiety is at the root of your erectile issues, as is the case for many men. Stress and anxiety about being good (or hard) enough can make it challenging to get or stay erect. The majority of men will occasionally have times when erections are hard to get (hard as in difficult, not hard as in throbbing). That’s okay. When it happens, try turning to other sexual activities like kissing, sensual touching, oral play (without the expectation for an erection or orgasm) or whatever else you and your partner find exciting or arousing. Keep in mind, too, that men rarely need rock-hard erections in order to have intercourse; it’s often possible to fit Part A into Part B with less stiffness than one might guess. As for masturbation, it’s not so much that frequent masturbation leads to erection problems; rather, the timing of masturbation might affect your ability to get the erection you want. After men ejaculate, they experience what’s called a “refractory period” during which having another solid erection that can end in ejaculation becomes impossible. The length of the refractory period varies among guys; it can last from minutes to days. That said, if you expect that you’ll be having sex with your partner on a certain day, you might try holding off on masturbation for the day or two beforehand. Some men find that holding off helps them to have firmer erections and sometimes more intense orgasms. Consider reading The New Male Sexuality (Bantam, $17) by Bernie Zilbergeld—perhaps my all-time favorite book about men’s sexuality—as it addresses common issues around erections and performance anxiety.

Q I hope you can provide some insights or direction on this one. I was just notified by a lovely lady whom I had a sexual encounter with several weeks ago. She informed me that she was just diagnosed with chlamydia and I should get tested. She indicated that she believes she caught it from her current partner but wanted to be honest and tell those she has been with about the situation. I have had no symptoms nor any discomfort. I want to get tested for chlamydia (and everything else they can test for) but do not want to go to my family doctor nor claim to my insurance company. Is there a place in Chicago (North Side is most convenient) that provides anonymous STI screening? Also, are there different kinds of tests or specific things I should ask for?

A I don’t know your lovely lady friend, and yet I’m completely enamored with her for being so good about informing her recent partners about her chlamydia diagnosis—and impressed with you, too, for seeking out testing. You can find a list of testing sites at gettestedchicago.org (which, although primarily about syphilis, also offers detailed information about general STI testing and clinics). Testing is also available at the Chicago Department of Public Health’s Lakeview Specialty Clinic (2861 N Clark St, 312-744-5507); you can call there to find clinics closer to you—or farther from you, if you’re trying to not run into anyone you know. Chlamydia often has no noticeable symptoms, so many women and men have no idea they have it. If left untreated, chlamydia can cause infertility. Quite a few clinics offer anonymous HIV testing, but it is less common to have anonymous testing available for the other STIs such as chlamydia and gonorrhea. Confidential testing (meaning you give a name, but they don’t report it to your insurance company) is more common. Then again, not everyone gives real names—I’ve seen more than a handful of people sign intake forms with fake presidential or celebrity names. If you’ve had unprotected sex, had a condom break or switched partners or come out of a sexual relationship, it is recommended—at minimum—to get tested for chlamydia, gonorrhea, syphilis and HIV. Health-care providers sometimes recommend testing for herpes, too; ask if that’s right for you. Men, at this time, cannot be tested for the human papillomavirus (HPV), though you can have a health-care provider examine your penis for genital warts (which are related to some, but not all, strains of HPV). I should note that urine tests are increasingly used to test men for chlamydia and gonorrhea, but some clinics are old-school about it and use a urethral swab (a Q-tip–like thing that is inserted into the urethra). Both tests are reliable, but the urine test is often preferred for comfort reasons (unless urethral play is your thing). If you have a preference, ask which test will be used prior to making an appointment.