“Ask Kai: Advice for the Apocalypse” is a column by Kai Cheng Thom to help you survive and thrive in a challenging world.
Have a question for Kai? Email firstname.lastname@example.org.
I am an assigned male at birth, non-binary person who has struggled my entire life with sexual and gender identity. I survived childhood sexual abuse (which I only acknowledged and accepted about five years ago through therapy). I explain this because I believe it all coalesced uncomfortable feelings about my body and sex in general.
I have always been conscientious about sexual health. I get tested regularly. So I was surprised to learn that I had contracted genital warts (HPV) at some point several years ago. This knowledge sent me into a huge shame spiral. I have always felt guilty and unworthy of love. This completely alienated me from years of hard work around my recovery. I have spoken to sex health experts who have had to calm me down from tears and begged me not to show myself such contempt over a very common thing.
I had my condition treated multiple times and was symptom free for over a year. I was finally feeling better about it when, over the last few months, a few new lesions appeared. I live with my partner, who is aware of my condition and has been supportive, but this has caused me to utterly curl inward about any sex or intimacy we share. I feel I can’t go to a doctor at the moment due to the pandemic, as obviously my neurosis shouldn’t take precedence over people with more “legitimate” health issues.
I’m asking for resources or tools to help me forgive myself—or at least to begin to show myself compassion. I am terrified of exposing my partner to this and honestly view myself as “ruined.”
As I read your letter, I am filled with a sense of compassion—of feeling connected to the guilt and unworthiness you have expressed. I want you to know that you are indeed worthy of love, N, though I can also imagine that this truth must at times feel at odds with your internal sense of yourself. Self-love and self-compassion are skills that take practice and slow growth, and making progress with them most often takes a spiral, rather than linear, path. That is, it’s easy to feel like we are right back where we started, even when we actually are getting somewhere.
If I’m understanding correctly, there are two intertwined issues that you are dealing with here: On the surface level, there is the situation you’re dealing with in regards to navigating the day-to-day complications of HPV in your intimate partnership. On a deeper level, there are the ways in which your experiences of trauma and recovery are triggered by dealing with HPV, which in turn seem to be impacting your sex life and the well-being of your erotic self.
Let’s begin with some of the practical considerations around managing HPV in a relationship. Based on your letter, it sounds like you may already be quite knowledgeable in this area, but I think it’s worth going over for the sake of thoroughness and for readers who may be less familiar with the topic.
HPV, as you mention, is indeed extremely common—in fact, the Society of Obstetricians and Gynecologists of Canada reports that 75 percent of sexually active adults will have at least one HPV infection in their lifetime. HPV is a virus that spreads through intimate skin-to-skin contact, which means that penetrative intercourse or fluid exchange are not necessary for transmission. This means that HPV is relatively difficult for sexually active individuals to prevent, even when common precautions (such as condoms and avoiding penetration) are used.
HPV is not currently curable, which means that there are no available treatments that can get rid of the virus once it’s in the body. However, in many cases, one’s immune system can clear the virus on its own. A symptom of HPV can be the appearance of warts, which can be medically removed. In a relatively small number of cases, certain strains of HPV can also result in various types of cancer. Vaccines are available in Canada for certain strains of HPV, though they are currently only approved for folks assigned female at birth aged 9 to 45 and folks assigned male at birth aged 9 to 26.
Managing HPV within a partnership requires communication (which it sounds like you are already doing, N) and good health information. Using safer sex products such as condoms, dental dams and gloves can help reduce the risk of transmission. Going for regular testing and check-ups can also be an important part of a sexual health plan. I think it’s important to note these are all strategies that would be helpful for people in any sexually active relationship, because navigating HPV and other sexually transmitted infections is a perfectly normal, healthy thing to do.
All this is to say, N, that HPV is an almost ubiquitous part of a sexually active person’s life—it’s not your “fault” that you contracted HPV, and it doesn’t make you a bad or unworthy sexual partner. I imagine that you know this on a cognitive level already, but perhaps have more difficulty integrating this fact emotionally.
Integration takes practice. As psychologists and neuroscientists like to say, “What fires together, wires together”—meaning, the neural pathways in our brains alter through repetition. It may take conscious, repeated effort for you to start believing that contracting HPV does not mean something bad about you. Dedicated meditation and self-affirmation practices (such as telling your reflection in the mirror every day that having a sexually transmitted infection does not make you a bad person) may be helpful for this.
When it comes to getting in touch with your doctor or other health care professionals, N, I’d like to gently push back against the idea that your “neurosis” is less legitimate than other people’s health issues. Both HPV and psychological distress are valid concerns that are worthy of care. While the pandemic does complicate accessing health care, the vast majority of providers have switched to phone and online services, which do not present a risk of spreading COVID-19.
If you are feeling any need to seek treatment, N, I’d suggest making a phone or virtual appointment and simply asking your doctor if they think it’s worth an in-person visit. It’s their professional responsibility (not yours) to screen patients and make the appropriate decisions to keep the public safe.
On the topic of seeking professional care, N, I’m also wondering whether revisiting psychotherapy or counselling might be important for you, especially since it seems you may have found it helpful in the past. Healing from the effects that childhood sexual abuse trauma can have on intimate relationships in adulthood is deep, complex work that usually can’t be fully addressed by reading articles or advice columns (not even mine, alas). In addition to mental health professionals, erotic bodywork practitioners such as somatic sex educators can be very helpful in working with sexual trauma and well-being.
Regardless of what type of professional you seek help from, however, it will likely be important for them to have a very strong grasp on working with both sexuality and trauma—a combination that can be a bit hard to find. You might also want to ask your partner to join you in seeing a healing professional as a couple, if you both feel comfortable doing so. Going slowly and giving yourself permission to shop around until you find the right match with the right healer is key.
If you are looking for reading material, I would highly recommend Staci Haines’ book Healing Sex: A Mind-Body Approach to Healing Sexual Trauma. Haines is a renowned practitioner of activist-oriented somatic coaching, and her contributions to the field of sexual and trauma healing are very significant. This book is quite readable and is full of practical information, strategies and exercises that the reader can adapt to their own situation.
In the meantime, N, I’d like to offer the thought—which you are free to take or leave—that both your desire for intimacy and your pain could be worthy, powerful emotions that serve an important survival purpose. The part of you that feels guilty and “ruined” may be trying to send you a very important message about what you need in order to feel safe when it comes to sexuality, even as we hold on to the belief (and I do) that you are indeed worthy of love and capable of loving.
It’s not my place as someone who doesn’t know you to conjecture about what that message might be. What I can suggest, however, is that when powerful, painful feelings start to surge up inside you, it is often helpful to slow down whatever you are doing, take some deep breaths and do something that helps you to feel safe. Safety can be a difficult concept for folks who have rarely or never felt safe, so I sometimes replace that word with comfortable. It may help to make a written list that you keep for reference: When you are feeling overwhelmed by powerful feelings about intimacy or sexuality, what are some things you can do that might make you feel more comfortable—even if just a little?
Slowing down and centring our own sense of safety can help us feel more capable of managing big emotions. Over time, it can also help us develop compassion for those painful parts of ourselves that hold guilt, shame, terror and desire, and figure out what we need to do in order to heal in the long term. And you are allowed to go slowly when it comes to healing and self-forgiveness, N. You are allowed to take your time, take breaks and ask for support, because you are worthy of care and love.
Remember, N: You are worthy of love and capable of loving. Every single part of you is worthy and capable of love.