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Anorexia In Men

As we move into winter living, with the cold weather and dark nights upon us, for many of us our energies start to flag, and we look forward to the Christmas and New Year festivities. For some men, though, the festive season brings new challenges. With its emphasis on food and drink, men with eating disorders can feel particularly challenged. To mark this difficult time, I will focus my posts in the run-up to the New Year on eating disorders in men.

For many, “eating disorders” is synonymous with anorexia, but this is just one of several ways in which men experience eating distress. But what is anorexia in men?

The headline with anorexia is that the man restricts his intake of food to such an extent he becomes dangerously thin. When a man is this thin his brain is not sufficiently fuelled by nutrients, and this distorts his thinking further, and the illness can spiral out of control. If your body fat falls below 15% of your mass you are in the danger zone of anorexia. If you continue to restrict your intake of food, you may die.

Why do men get anorexia? The vulnerable time for men is in the teen years. It is during this period that we compare our physical capabilities and attractiveness with other boys. Not surprisingly, unlike girls, where our anorexia is motivated by the fear of fat, anorexia in men is often motivated by a desire to build a better physique. Anorexia in men is often associated with excessive exercise.

Trends in the media represent male beauty as involving a flat stomach with rippling abdominal muscles. For most men abdominal muscles are not visible until our body fat is at or below 14%. This is a dangerously low level to maintain our body fat. In fact professional models often “strip down” their body fat before a photo shoot and then allow it to creep up again after the shoot.

Representations of male beauty and what it means to be a man is only part of the story. For many men, they already have low self-worth before they started dieting and exercising excessively. In this sense anorexia might be a symptom of more complex underlying problems around feeling valued by family and friends. A proportion of anorexic men have had experiences of being bullied early in childhood for being overweight.

For many men with anorexia, their emotional world is extremely painful.  Anorexia, if anything, is a way of coping with that pain.  In a dark emotional world, sometimes controlling your weight is the only control you feel you have left.

For further information and support check out the Men Get Eating Disorders Too website.

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Book Review: Buddha’s Brain By Rick Hanson And Richard Mendius

If you are like me, you will be pretty suspicious of anything that sounds a bit cranky. Primal scream therapy, rebirthing and neuro linguistic programming all fall into that camp for me. But what about meditation?

Over the last decade what is interesting has been the way evidence-based therapies have taken meditation on board. It is as if no self-respecting new treatment approach can afford to ignore it. There is good reason for this; the evidence shows meditation is really helpful in conditions as diverse as borderline personality disorder to depression, and anxiety to chronic pain.

What most of these treatment approaches do, of course, is separate meditation from its Buddhist cultural heritage. It is as if by dropping the ‘religion’, it makes meditation more palatable to the Western practitioner/client. Although this is understandable, in a way it’s a shame. Buddhism’s raison d’être is the alleviation of human suffering, and has developed sophisticated psychological models of how to do just that.

What is great about this book is that Hanson and Mendius don’t drop the Buddhist heritage of meditation. Neither do they drop the scientific method. In fact Hanson and Mendius are deeply immersed in brain science, Rick Hanson as a neuropsychologist, and Richard Mendius as a neurologist. They draw on their scientific understanding of the brain to integrate Western science with Buddhist psychology.

This book isn’t a hard read though. The authors skilfully explain the intricate workings of the brain in straightforward language. If you are interested in the relationship between brain science and Buddhism and meditation, but don’t want something too taxing, this is the primer for you.

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Feckless Fathers … the Reality

I’ve watched with concern over the past year as a new phrase has emerged in the cultural zeitgeist … the “feckless father”. As a term, of course, it’s surely one of abuse. What man would welcome being described as “feckless”? But I detect a cultural double standard in the way it is used.

Of course we should all be concerned about children raised without a father. Such children are more likely to fail at school, engage in criminality, be the victims of sexual abuse, and even join gangs. There is a time bomb of fatherless children that is not only devastating for them, but also on the future of our society. Kids need their fathers.

By using the term “feckless fathers”, there is a very clear line being drawn. Fatherless children are created by the moral irresponsibility of men. Deciding to have and raise a child, however, is a decision of the woman. Feminism has long argued, correctly, for the “right to choose”: a woman’s right to control her own fertility. If a woman “chooses” to have eight children with eight different men, and discourage contact between the children and the father, is it not the woman who is being “feckless”?

Women can’t have it both ways. If they exercise the “right to choose”, and bring a child into either no relationship, or unstable one, they can’t then blame the man for not being there. My point is simple: the debate about “feckless fathers” focuses on the moral culpability of absent fathers, and does not pay sufficient attention to the moral culpability of single mothers.

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How Big Is Your Sexual Ornament?

According to Geoffrey Miller, author of The Mating Mind, in evolutionary terms, the mind “… makes most sense as an entertainment system designed to stimulate other brains …” (p. 155) … but what is he referring to?

Well all species develop what are called ‘sexual ornaments’ to display their fitness as a mate.  Take a peacock for example.  His elaborate display of feathers is a sexual ornament which demonstrates the health of his body and, by implication, his genes.

There are a couple of features to sexual ornaments worth mentioning.  First of all they display fitness because they invest excess resources in order to develop them.  If our male peacock was ill or unable to forage successfully, his plumage would not be so symmetrical or ornate.  He would be using all the resources he had available simply to survive.  So a sexual ornament, in evolutionary terms, demonstrates fitness over and above that which is simply needed to survive.

Second, it is usually the males who develop the most ornate sexual ornaments in order to attract the females to mate with.  In biology, the males are ‘the salesmen’ and females ‘sales resistant’.  But surely this is not true in humans? Think again.

Well according to Miller this might indeed be the case.  In fact it could be argued that the human mind itself is a sexual ornament designed simply for the seduction of a mate.  With the human mind we have the capacity to go beyond simple physical sensory appeal.  Our brains work with ideas and concepts, things that could, if developed, be used to display sexual fitness as a sexual ornament.

If you are struggling to survive you may have fewer spare resources available for the development of the intellect.  A man, who has the leisure to develop his interests, creativity and compete in a wide variety of activities, is demonstrating his excess of resources.  It is argued that such abilities and capacities can, in themselves, be seen as the human male equivalent of the peacock’s feathers.  Our minds, in other words, are there to develop and woo the opposite sex with a dazzling demonstration of competence in the higher pursuits.  Some activities perhaps, like being a pop musician, sportsman, or even stand up comedian, attract more competition from males for this reason.

So if I ask ‘how big is your sexual ornamentation’, don’t necessarily think below the belt, or size of your muscles, think of your successes in business, your profession, the arts, and even how you tell a joke or sing a song.  In evolutionary terms, the art of courtship in humans goes much further than the body beautiful.  In fact it can quickly transcend it.  Which is perhaps why good looking men develop no personality, and the best stand up comedians look like clowns?

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Do You Do 150 Minutes Of Exercise a Week?

The big question in sports science is how much exercise to do to get the health benefits, and how often?  The advice is often contradictory.  Some people have been suggesting you need to break it up into five slots over the week, others disagree.

workout exerciseFortunately there appears to be some consensus emerging.

First, 150 minutes of moderate exercise seems to be the figure we need to aim for.

Second, it doesn’t really matter how u split the time so long as you hit the 150 minutes over the week, and don’t do it all in one go.  As little as 10 minutes at a time may even be beneficial.

But what counts as ‘moderate exercise’?  The disappointing news is that most people underestimate it!  Walking, for example, counts as moderate exercise so long as your heart rate increases significantly, but you can still hold down a conversation.  About a 100 steps a minute should see you about right.  This isn’t a shopping trip down Market Street on a Saturday afternoon!

For many guys, 150 minutes of exercise seems a huge target to try and fit into their everyday lives.  Here’s my advice for getting into exercise.

1. Build Exercise Slots Into Your Daily Routine.

These slots need only be five minutes to start with.  In fact they shouldn’t be too adventurous.

2. Slowly Increase The Amount You Exercise.

Only consider increasing the length of time you exercise after 4 or 5 weeks – when the routine has starting to settle down.  The biggest mistake guys make is trying to do too much too soon.  You will only become demoralised and give yourself a ‘failure’ experience.  Exercise should be a lifestyle for the long run.  Not a quick fix.  So it makes sense to build up slowly.

3. Do Something You Enjoy.

Everybody is different.  Do something you enjoy … or feel you might cum to enjoy at the very least.  There is no reason not to find an activity you find fun.  It could be walking, jogging, weights, skiing at the indoor slope, football, swimming – you could even combine exercise with a social event, like dancing.

4. Do a Variety of Things.

150 minutes of the same thing every week will bore even the most committed.  Try and mix up your activities with some strength and some cardio activities.  It doesn’t really matter what you do, so long as you do something.  Down the line, when your routine is solid, you might want to fine tune your program.  Don’t worry about this too much at the start.

5. Keep a Record of Your Achievements.

Before you start, take a picture of yourself in your trunks, weigh yourself and take a measure of you waist and other body dimensions. Then repeat this every month.  There’s nothing better for building motivation than to keep a diary of how far you’ve come.

6. If all else fails … use a personal trainer.

Try Lewis Hughes, he’s starting an outdoor exercise ‘boot camp’ over the summer.  It will be a great introduction to exercise for men of all abilities.

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Heroes Of The Blue Sky Rebellion By Jack Kammer : A Review

As men we are not particularly good at political activism for our own wellbeing.  Too many of us have grown up believing the ‘feminist fallacy’ … that it is men that have all the power, and that we need to give it back.  As a consequence, it is women who now have the emotional, social, legal and cultural freedom to wander into traditional male domains, whereas men do not have the same freedom to wander so freely in women’s domains.

What this book attempts is nothing short of revolutionary.  Starting from the above premise, Kammer addresses the next generation directly: boys and young men between the ages of 13 to 23.  His message is one of hope and political engagement.

This book isn’t about turning the clock back.  That girls and young women have more choice then ever is a good thing.  What Kammer advocates is extending that choice and freedom to boys and young men.

In presenting his case, this is a refreshingly brief and easy to read book.  Yet its roots are deep.  Drawing on an understanding of all human rights campaigns, and a sensible critique of the way power is distributed in society, Kammer invites boys and young men to join “The Blue Sky Rebellion” … his term for the political reconnection of boys and young men.  In so doing he empowers boys and young men to address their very real alienation.

Kammers message is a tough one though.  In order to generate and embody choice for ourselves, we must feel empowered to go into traditional ‘female’ emotional, social, legal and cultural domains, and feel comfortable there.

I have long held the belief that women benefit politically from homophobia.  By setting men upon each other, they serve to ‘divide and conquer’.  Kammer suggests that this political ruse is finally transparent.

If boys and young men want to free of the hypocrisy of contemporary gender politics, then all boys and young men need to be free.  In this way ‘you’re gay’ and ‘you faggot’ should no longer serve both as terms of abuse for gay boys and young men, and as a way of controlling straight boys and young men.

Having laid out his store, Kammer then equips boys and young men with some of the tools they will need in their new political struggle.  He offers skills for addressing the main ‘feminist’ arguments against male freedom.  He shows how boys and young men need allies not enemies, and explains how to make friends with the world.  Finally, he emphases the need for political engagement and networking between like minded boys and young men.

In short Kammer not only defines his own take on win-win gender politics – ‘the Blue Sky Rebellion’, but shows boys and young men how to be truly heroic in their challenge of creating it.

This book deserves the widest possible audience.  Every boy or young man should have the opportunity to read it.

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The Indignity Of Producing a Sperm Sample – Is Home Testing The Way Forward?

The venue was an antiquated general hospital on the northern shores of the Welsh coastline.  The building looked like a prefabricated relic from the post war era from the early days of the NHS.  I was ushered by a matronly looking, stern but caring type of middle aged nurse, into a side room.  Her uniform, and the authority it represented, may have excited some men … but not me.

The room itself was painted in two shades of clinical green.  It contained a desk, an examination table, and various medical paraphernalia, including a stethoscope, a wound trolley, and x-ray viewing cabinet.

“Lie on there”, said Sister in a matter of fact sort of way, “and use this to collect the sample”, handing me a small jar on which had been written my name and hospital number.

With her instructions ringing in my ears, the ‘privacy curtain’ was pulled around me.  Sister apologised for not having any porn, and she was gone.

Like a ‘good patient’, I tried to ‘produce’ my sample.  Although a little embarrassed, I tried to be ‘grown up’ about the procedure.  These were professionals after all, and had asked many men to perform the same manoeuvre.

‘The sample’, of course, was of sperm … and it necessitated, as a precondition of its production, an erection.

I tried, as best conditions would allow, to make myself comfortable.  I took off my shoes, dropped my jeans to my ankles, and lay on my back with a heavy sense of duty.

I closed my eyes and withdrew into the deep recesses of my mind, you know, where the ‘really dirty’ fantasies reside … the ones that only come out when the need to cum outweighs the need masturbate in a morally responsible way.

Nothing happened … in fact the longer it took … the more difficult it became.

I wondered what NHS porn, should it have been available, would have looked like.  I came to the conclusion it probably wouldn’t have been of any help.  Any porn, so I reasoned, pre-screened and approved by Sister, wasn’t going to hit the spot.

I reflected that a more male friendly ‘masturbatory suite’ should have been pre-planned by managers for just these eventualities, and wondered what such a suite might contain.  A comfortable ‘bed’ was a must, as was subdued lighting, a DVD player of course, and perhaps solicitous décor.

Such thoughts, though pleasant, only served to impede my progress through my usual routine, and frustrated my ability to meet Sisters’ request.

As time moved on, I imagined the nurses talking amongst themselves, wondering why I was taking so long.  Perhaps it was the end of their shift, and they were waiting for me before going home.  The pressure was intense.

It was only when I was at the point of giving up that ‘things’ managed to stir in the right direction. Seizing my opportunity, I indulged with vigour – finally able to let inhibition retreat sufficiently to let necessity in.  I produced ‘my sample’.

Somewhat embarrassed by the three quarters of an hour I had been cocooned in this medico-sexual nightmare, I handed my sample to Sister with a sense of pride tapered with relief.  The ordeal was over.

“No” she said to my horror “you don’t give it to me, you have to take it to the lab”.

“The lab!” I exclaimed.

And so it was I was despatched to hand deliver the sample “as quickly as possible” to the counting facility for their attention.

I left the hospital feeling bruised and battered.  In producing ‘on command’, the very thing that defined me as a man, I had been emasculated by the process.


Perhaps because my memory of that day is etched indelibly into my consciousness, I read with considerable interest of the efforts of Loes Segerink and colleagues at the MESA and the Institute for Nanotechnology at the University of Twente in the Netherlands.  They have produced a 10 centimetre long ‘lab on a chip’ that, in principle, means that sperm counting could be done at home.

What a great idea!

In fact the technology is so ‘portable’, it may be possible to deliver it as an ‘off the shelf’ test similar to women’s pregnancy testing kits.

Of course there are ‘ethical’ issues about making such tests available to men without a medical consultation.  Given my experience, if any medical ethicists are reading this, you need to seriously consider the ethical benefits of the home test, against the reality of its alternative.  Trust me, it’s not pretty!

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Men And Menstruation

Menstruation is a difficult topic for blokes.  I remember travelling in India and meeting a young couple on a gap year after ‘A’ levels.  They had been travelling through some of the more isolated and impoverished parts of the sub continent.  Both were traumatised by the experience and took several days to settle down and start talking to people.  When I chatted to the bloke on his own, it was clear that he was not just traumatised by the poverty, but travelling in intimate proximity with a women menstruating in hot insanitary conditions.  It wasn’t just the hygiene he found difficult, but the pain she went through, and the emotional vulnerability she felt, which was exacerbated by being in an alien and unforgiving environment.

Like most blokes, this guy had been spared the harsh realities of menstruation until he was an adult.  Women, of course, don’t have this luxury.  They are catapulted into the reality of menstruation in their early teens, and for many, find it deeply traumatic.  The founder of The Samaritans, Chad Varah, had the idea for the telephone helpline because, as a priest, he had to conduct a funeral service of a young girl who had committed suicide at the onset of her first period.

The 28 day cycle, and women’s emotional reactions to it, then informs their psychology for the rest of their lives.  To truly know and connect with the women in our lives we need to make their menstrual cycle our business.

Given the ‘trauma’ of menstruation, it is little surprise that cultural and religious taboos have emerged to ‘manage’ the trauma, and shield it from public gaze.  It’s a little like ‘war trauma’ for men, something that is ‘managed’ and ‘contained’ … but not expressed.

Just because menstruation is a difficult topic for men, doesn’t mean to say it’s OK to ignore it.  The women in our lives need our understanding and compassion so they feel supported, validated and accepted.  Here are a few tips.

First, make it your business to get informed.  There are plenty of great web sites offering advice about menstruation and the problems women experience during their cycle.  Try NHS Direct or netdoctor.co.uk.  Possibly as many as a third of women could relieve some of their menstrual distress and pain with appropriate treatment.  You will only know if your loved one is suffering unnecessarily if you take the trouble to show an interest and offer her support.

If you want to understand, from a man’s perspective, what menstruation might feel like, try this great post.  It just might make you think twice about dismissing her moods and her cramps next time!

Second, get engaged.  Starting the conversation about her period is a difficult one for many guys.  A great way to start is to show an interest in the brand of tampons she uses.  Why does she use that brand? Why does she find it the most comfortable?  If you don’t live together, why not try buying her some, and just having them in the bathroom cabinet ‘just in case’.  It will show you care and are thinking about her.

Women, of course, are intimately connected to their monthly cycles.  It’s easy for men to forget this.  There is a great resource aimed at both men and women at PMSbuddy.com.  Here you can enter details of your partners, daughter or mother cycles, and it automatically sends you emails reminding you of when she is due, and offers tips about how to cope as well.  If you’re a women reading this and can’t wait for your fella to take the initiative, you can register too, and send the emails to up to five guys in your life.

Third, know what she needs.  Every woman is different and menstrual problems change throughout the life span.  Take time to know what she needs from you emotionally and physically.  Women often feel vulnerable, in pain, and unattractive during her period.  She needs you to support her through this.  Give her lots of love and understanding.

There are some things, though, best avoided.  One is asking ‘are you on’ or something even less sensitive.  Women often experience this as an accusation and become defensive.  It’s not hard to see why.  You are reducing their unique experiences in the moment to a ‘thing’ which is hardly respectful.  The second is avoiding humour as the only strategy to help you navigate her needs.  Humour is great from time to time, but if it’s your only strategy, you’ll be sending the message that what she is going through is not important to you.

I do understand this is a difficult topic for blokes to get to grips with.  But doing so will reap rewards in your relationship.  She will feel closer and more loved by you.  Do be sensitive to her needs for privacy and her own embarrassment talking about the subject.  This isn’t an easy conversation for both men and women, but if you love her, it’s a conversation worth engaging in.  Over time you will both become comfortable with it.

For me, the biggest benefit of blokes getting to grips with this is the help you can then extend to your daughters.  If you can engage with your partner, you will be more able to ‘be there’ for your daughter when the time comes.  Daughters need their fathers to be comfortable about menstruation, to normalise it for her, make her feel accepted, and to give her a good role model of how to manage this aspect of her life with other men.

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Do You Masturbate Too Much?

In the olden days, or so I am led to believe, it was considered wrong for boys and men to masturbate.  No doubt heavily influenced by Roman Catholicism, this view seemed to be received wisdom throughout much of the 19th and 20th Century’s.  Then came the 60’s.  With the sexual revolution, masturbation became good, almost compulsory.  Received scientific thinking, led by the great sexologist Kinsey, ‘normalised’ masturbation, so that it became, if not immoral, then at least acceptable.
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Of course boys and most men masturbate, but is there any reason to think you could be masturbating too much?  I think there is.

First, masturbation results in the emission of semen from the body.  In order to achieve this, the body’s nervous and endocrine system is activated which stimulates the acetylcholine/parasympathetic nervous system.  This, in turn, creates an excess of sex hormones and neurotransmitters which alters the body’s biochemistry and nerve function.  The emission of semen itself results in many vital nutrients being released from the body.

Research is beginning to suggest that this combination of endocrine/nervous system overstimulation, and emission of semen, can have negative impact on a man’s health.  The researchers found that the more men masturbate, the more they are likely to suffer from memory and concentration problems, fatigue, back pain, hair loss, a poor erection and even premature ejaculation.

Second, men who masturbate can begin to suffer from psychological problems.  In my experience of working with men, I have seen that excessive masturbation can reduce the ability to orgasm with a partner, encourage more elaborate and sometimes unhelpful sexual fantasy, and can lead to unrealistic expectations on sexual partners.  Sometimes this can even prevent men from finding and maintaining a sexual partner.  Furthermore, masturbation, especially over internet porn, is often a participatory factor in sexual addiction.

It seems, then, that excessive masturbation is not the neutral blank cheque that some people led us to believe. But what constitutes ‘excessive’.  Depending on your habits, you might be relieved or disappointed to learn that masturbation to completion more than three times a week is the threshold at which these negative side effects start to take hold.  This is a ball park figure, as every man is different, but it is a sobering statistic … at least for me!

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Homosexuality Can’t Be ‘Cured’ – But Can We Accept It?

Over the last 200 years or so, there has been ongoing debate about the relative role of psychology and biology in a range of human behaviours.  Autism and homosexuality are two good examples that research has placed firmly on the side of biology.  For many years professionals tried talking therapies to help people with autism and homosexuality overcome their ‘afflictions’.  In both cases all they served to do was increase the distress of the patient, and their families, by making them feel responsible for their behaviour.
With respect to homosexuality, the psychiatric profession for many years held it to be an illness.  This is no longer the case.  Although the causes of homosexuality are still debated in nuance, there is increasing consensus that it is biology that determines a person’s sexuality, not psychology, upbringing or indeed, personal choice.  Interestingly there are different biological reasons for male homosexuality and female homosexuality, rather than a unified reason that accounts for both.

Furthermore, a survey of all published research about therapies that have tried to change a person’s sexuality has shown that it has always failed to do so, and often causes harm.  This has recently led to the American Psychological Society issuing a declaration that therapy to change a person’s sexuality does not work, with the implication that it is unethical to try to do so.  Pressure is being put on the British Psychological Society and the Royal College of Psychiatry to issue a similar statement.

Given this backdrop it is alarming that a recent study in MBC Psychiatry found that as many as 1 in 6 therapists have attempted to change at least one person’s sexual orientation  in their professional career.  On the face of it this seems to go against the evidence.  I wonder, though, if something more subtle is going on – namely a difficulty knowing how to deal with gay clients who are unhappy about their sexuality.

In the life history of most gay men there is likely to be a period when they couldn’t accept their sexuality, and therefore really didn’t want to be gay.  The pressures of family and society to conform to a heterosexual norm seem insurmountable for many men.  It is clear that many gay clients have a lot of soul searching to do before they form an acceptance of their sexuality.  Indeed, it could be argued that many gay men, though superficially accepting and adopting a gay lifestyle, still suffer from a hangover of ‘internalised homophobia’ that continues to impact on their emotional wellbeing and ability to form meaningful relationships.

Given the very real unhappiness that finding oneself gay can bring to a person, it seems understandable, if ill advised, to try and help the person to lead a straight lifestyle.  I suspect this, rather than a real belief in its possibility, that has led so many of my colleagues to try and change a persons sexuality.

It is within this backdrop, however, that the real danger to gay men’s well-being lies – namely in those religious organisations that still offer ‘treatments’ for homosexuality. Against the grain of science but in the name of God, such organisations can only serve to enhance gay men’s unhappiness with their sexuality, and not in fact offer any real solution to it.  At best all they can hope to achieve is an asexual life where sex and relationships are sacrificed for a supposed ‘greater’ ideal of ‘what God wants’.  I can’t see this being beneficial to the individual, or, indeed, society.

Homosexuality will continue to be a contentious issue, not least because it raises tensions between individual behaviour and social and religious mores. All I can do as a therapist is help everybody, gay or straight alike, to be more accepting of homosexuality.  It is in accepting others how they really are, that we are best able to learn to accept ourselves as we really are.  Psychological health, after all, starts by seeing the world as it really is, rather than how we think it should be.

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