Defining Digital Health with Dr. Markie Twist & Dr. Neil McArthur - Securing Sexuality Podcast Episode 28
Securing Sexuality is the podcast and conference promoting sex positive, science based, and secure interpersonal relationships. We give people tips for safer sex in a digital age. We help sextech innovators and toy designers produce safer products. And we educate mental health and medical professionals on these topics so they can better advise their clients. Securing Sexuality provides sex therapists with continuing education (CEs) for AASECT, SSTAR, and SASH around cyber sexuality and social media, and more.
Links from this week’s episode:
Exploring Sexuality in the Age of Technology; Impact of Second Wave Technologies and Understanding Sexuality and Consent in a Digital Worl
As technology continues to evolve and become more integrated into our lives, it is important to consider the impact it has on our sexuality and consent. In a digital age, technology has changed the way we interact with each other, how we express ourselves sexually, and how we navigate consent.
Here we explore the implications of technology on sexuality and consent in a digital age. The first way that technology has impacted sexuality is through its influence on communication. Technology has made it easier for people to connect with each other from anywhere in the world.
This can be both positive and negative; while it can facilitate meaningful connections between people who may not have been able to communicate before, it can also lead to unwanted advances or harassment online. While social media platforms like Twitter and Instagram may tout inclusivity, they have also been quick to limit and ban the accounts of those speaking about sexuality online.
This open dialogue around sex can be beneficial for those looking for advice or support but can also lead to confusion or misunderstanding if not used responsibly. Technology has also had an impact on sexual expression. With the rise of virtual reality (VR) technologies such as Oculus Rift and HTC Vive, users are now able to explore new forms of sexual expression in a safe environment without physical contact with another person.
VR technologies have opened up new possibilities for exploring one’s own sexuality as well as engaging in consensual activities with others online without any risk of physical harm or STIs.
Finally, technology has had an impact on consent in a digital age by making it easier for individuals to give explicit permission before engaging in any kind of sexual activity with another person – whether that’s online or offline.
Apps like We-Consent allow users to record verbal agreements before engaging in any kind of sexual activity which provides evidence that both parties were aware of what was happening at all times and agreed upon it beforehand – thus eliminating any potential misunderstandings later down the line if something goes wrong during the encounter itself.
In conclusion, technology has had a profound effect on our understanding of sexuality and consent in a digital age by changing how we communicate about sex, providing new ways for us to express ourselves sexually through virtual reality technologies, and making it easier than ever before for us to give explicit permission when engaging in any kind of sexual activity with another person – either online or offline.
As technology continues to evolve at an ever-increasing rate, so too must our understanding of these issues so that everyone involved is kept safe from harm while still being able enjoy themselves fully within their own boundaries when engaging sexually with others either digitally or physically.
Online Dating Apps
Hello and welcome to Securing Sexuality, the podcast where we discuss the intersection of intimacy and information security.
I'm Wolf Goerlich. You say hacker and I'm Stefani Goerlich. She is a sex therapist and together we're going to discuss what safe sex looks like in a digital age. And today we are talking to two people that I've been dying to get on the show since literally the very beginning.
Neil McArthur is the director of the Center for Professional and Applied Ethics at the University of Manitoba. You have probably seen his writing on digital health and sexuality, particularly he's been in Vice and Fast Company and The Guardian. Or maybe you've got his most recent book, The Ethics of Sexual Health, which was published by Routledge, my home publisher. And along with Neil, we have the amazing Dr. Markie Twist.
She's a licensed marriage and family therapist, an AAMFT designated clinical fellow and approved supervisor and an AASECT certified sexuality educator. Dr. Markie works with doctoral and master's level couples and family therapy students in the Applied Psychology program in her role as teaching faculty at Antioch University, New England and, and, and, and serves as the editor in chief of the journal Sexual and Relationship Therapy.
So individually, they are crazy busy and together, Markie and Neil have been working together for years on issues related to sex and technology. They co-authored the paper that first defined the mix of sexuality and digital health, respectively. And they have co-edited the special issues of the Journal of Sexual and Relational Therapy devoted to both Digi-sexuality and digital health.
So now you can see why I have been so excited to talk to them. Welcome you two. Thank you. Thank you so much. It is so good to have you here. We have so many questions.
But first, Digi-sexual, the term, the idea, what, what is its genesis and what does it tell us about ourselves?
Go for it, Neil. It was originally your baby. And so it emerged from work that we were doing on, on technology and the way it was really starting, we were starting to see it really impact people's sexual identities.
So I think one of the really interesting things that's happened in the last couple decades is you're seeing the emergence of, I guess, or the, the, the coming to visibility of various kinds of sexual identities and sexual identity has become really part of the conversation and become important to people in a way that I don't think was, was as, as salient in the past.
And we were starting to see that the way in which people's, people's technology, people were using their technology, it was starting to actually shape and impact their sexual identity.
And we could sort of, in a somewhat speculative way, I think, trace that forward to a, to a point where what we were starting to see was people who saw technology as being essential to their sexual identity, to be a really integral part of their sexual identity and not necessarily at the expense of human partners, but human partners were becoming, becoming a variable rather than a prerequisite.
And it was the technology that was really the prerequisite. So the idea of digital sexuality is just people for whom technology is at the essence of their sexual identity and it does not necessarily require human partners. And we were especially expecting, and I think that's played out, that that would, that would start to become more prevalent as technology advances, as you're seeing VR, robots are still, I guess, a ways off.
It's funny because my research on this started on robots and robots have started, have ended up being the sort of the slow horse in all this. And what you're really seeing is chatbots and VR experiences and so on. And those are what are now really shaping people's sexual identity. So those are what we call second wave technologies. And we're really tracing the impact of those technologies on people's sexual identity.
I used to build robots and I can tell you robots are hard. They're clunky, they don't work, they oftentimes go awry. And if it's one thing that I wouldn't want a robot to go awry during, it's probably exactly what we're talking about here.
Couldn't you make a robot that found its way by repeatedly slamming itself against a wall?
Oh, yeah. I'm picturing that in sort of a foreplay romantic context and it feels painful to imagine.
So what kind of technologies are people bringing into their sexual lives or sexual identity?
If we're not necessarily talking about, you know, real dolls per se, what are the things that are out there?
One of the things that has been really interesting is this chatbot replica, which I'm sure you've heard of. It's a companion bot. I think one of the really interesting things, because one of the things that I'm sure you've noticed is that so many of these technology companies really hamstring their technologies when it comes to anything to do with sex.
I mean, they really try to purge. There's a robot named Pepper you may have seen that is probably the least sexy robot you've ever seen. So if you buy Pepper, you have to sign a user agreement saying you will not have sex with Pepper.
So, you know, so many of these companies are just trying to forbid any suggestion that they're sexual at all. But Replica, they created this chatbot and they actually allowed up until very recently users to have quite explicit conversations and Replica would be basically willing to be your boyfriend or girlfriend if you wanted it to be. And this company suddenly disabled that functionality a couple of weeks ago.
It was pretty dramatic and pretty hard on its users. But that was really, I thought, cutting edge technology, not necessarily in terms of the level of the tech, although it was pretty good, but in terms of just what sort of functionality it enabled and how people responded to that. That brings up a question because I hadn't heard that they killed the algorithm.
And I know we're going to talk about frameworks for exploring space and for making it comfortable, humane, safe, protective, enjoyable. I'm shocked at this idea that someone and many people were falling in love with this robot. I was reading about this in the news over and over, like men are having relationships. The Cut had an article about women falling in love with this.
And then just one day they woke up and it was gone.
Yep, pretty, pretty awful. So I take it that what drove it was there was an Italian regulator that decided that this was exposing children to inappropriate content. And so to avoid a legal battle in Italy, the company just basically stripped all, I guess you could say, sexual functionality from its app just overnight. And so people woke up.
And I think in many cases they got quite harsh messages from their replicas saying, I cannot have these kinds of conversations with you anymore. I cannot be, I don't even know if they even said like, I can't be your companion like this anymore or something.
I mean, pretty, pretty, pretty harsh stuff actually. That reminds me of last year at Circle CityCon at one of Wolf's hacker conferences, I gave a talk I called 10,000 years of cyber sex. And I talked about a case where somebody had a hologram girlfriend that this person got locked out of his account during a soft or a systems update, a software update and effectively lost his girlfriend.
I have to imagine it would be even worse to have your replica girlfriend or boyfriend or partner break up with you effectively to just not even lose them, but to have that element just taken away. That would have to be devastating. I would think so. And I mean, unfortunately, this is something we've seen.
I mean, these technology companies, we've seen it with Tumblr, we've seen it with OnlyFans. These technologies have the power to just able or disable these kinds of functionalities and they wield it.
I mean, maybe not just completely at will, but under all sorts of pressures, internal and external. And users have no protections.
I mean, all right. So something like Tumblr or whatnot, I mean, a lot of that was organic.
But in this case, I mean, the founder of Replica was quoted as saying we want to build her, right?
The Scarlett Johansson AI from that movie. If that is the intent in your starting point to yank that, I am just, I don't want to rabbit hole in this, but I'm just blown away and sad for these people.
Yeah, it's really sad. But I think it brings up a whole other concept which Neil and I didn't originally write about, which is digital attachment, which is the idea that it isn't always sexual. The issue is, I think, that people become very uncomfortable with humans transcending relationships with other humans in all sorts of ways. And technology is just another example of that discomfort.
And I think they were probably comfortable with, well, what if they're not just having loving conversations with Replica, this her creature?
What if they're also having sexual conversations?
And that makes me very uncomfortable to think about. So I think there was that layer. But I think there is the discomfort that comes from humans forming attachment bonds with technology, which is not new. Humans have had attachment relationships with items.
I always like to tell people or ask people, didn't you have a security blanket or a lovey when you were a kid?
Okay. And some of us still know where it is.
So it isn't like that blanket could love you back, but it didn't change how much it meant to you. And it also certainly wasn't harming you.
And I think this is that perfect example of like, who was this hurting?
It was making people feel connected to a technology that made them feel like they had a loving attachment bond. And then it was ripped away from them. And for some people, they might've been digi sexual about it. They might've also been having sexual dynamics. But for many of them, it was just this loving type relationship. So that's kind of yucky.
Yeah, it is. And I mean, and unnecessary. People form all sorts of attachments to all sorts of things. I remember all the stories about Roomba. And occasionally you'll still hear them about people naming the Roomba or pack bonding with their Roomba, trying to comfort the Roomba when there's a storm. The comparison to a lovey or a stuffed animal is really apt.
Years ago, I don't think Wolf, I don't think even you know the story. Years and years ago, I was moving and had a friend helping and I told her I love to use moves to purge. So you know, if I leave a room, it's yours, go in, rip it apart, I'm done with it. And we went to get lunch. And so I had left the room, but I hadn't finished the room.
And we came back with lunch for everybody. And the room was empty.
And I said, where was the bear that was in there?
And she goes, I threw it away. You left the room, the room was done. And that was how in my mid 20s, I lost my teddy bear that I'd had since babyhood. And at that point, I was parenting myself, but it had, you know, traveled with me to Michigan, it had traveled into parenting. And then you leave the house and it's gone. And I can't imagine a romantic connection feeling that way.
Yeah, I still have my first Blackberry. So because I loved her so much.
Yeah, she's in a drawer. I still love it. I've moved tons of times. And certainly, I can't use her. But I still have a strong connection to her. I can't tell you when I lost my childhood stuffed animal, which was a mouse for the record, that's probably outed me on some security question. But I can tell you when I gave up on my first Blackberry, because that was a very hard choice.
Yeah. Right. I still miss the keyboard.
Anyway, I'm pretty sure if you look across your desk and into your closet, that mouse is actually in the room you're in right now. I wasn't going to say that, but it probably is. So you know where it is.
So obviously, we are all empathizing, we are able to connect this even if somebody listening isn't necessarily a huge like early tech adopter, we're able to connect this to things that make it make sense for people.
How does this impact the emotional lives, the emotional health of the folks that are bringing these technologies into their lives?
What does that look like for them?
And I'm sure somebody is going to ask, is that a healthy thing for them to be doing?
One of the things that we were motivated when we started doing this work on digital health was the fact that we were starting to see sort of a kind of abstinence only education approach creeping into how people were approaching technology that the reaction of teachers and so on was starting to be, well, just get off it or whatever.
I mean, that's just not realistic.
And also, not only is it not realistic, but I think our view has always been that even if we could just completely unplug ourselves, we'd actually be depriving ourselves of quite a lot of things that are really beneficial. I think that technology can really add a lot to our relationships and it can add a lot to our lives.
So I think that, yeah, so I think our approach with digital health has always been not how we do, because I think, again, even people who talk about digital health, sometimes their approach is, well, we've got this awful thing and how do we make it less awful?
And I think our approach has always been, this is a thing that has risks, but it also has huge benefits. So let's first of all, not freak out. And second of all, let's try to figure out actually starting from the positive end, what a healthy relationship looks like. That's absolutely accurate.
And a big part of why we originally with Digi sexuality, we're so concerned about, you know, as Neil was saying, not just the abstinence approach that started to get encouraged with technology for all sorts of reasons, but certainly an abstinence approach that was being promoted around sexuality and technology.
And that sort of, you know, this is all bad or all good way of thinking about technology with really leaning towards it's all bad, especially when it comes to sexuality stuff. That started to lead to a lot of stigmatization. Like you mentioned, Stefani, the person who was dating a hologram, there's somebody who married a hologram based out of Japan.
And you know, I mean, he got quite a bit of support, but also the modern society and the comments on those stories are awful.
And who is he hurting?
Once again, I just always want to ask this question. It's a hologram. He's choosing to date a hologram. It's not hurting anyone. Right. And so the big concern was stigma. Right. And so how do we help people who are going through stigmatization simply for having relationships with technology that maybe people at the time aren't having or won't have yet. But someday these might seem like very normative things. Right.
And so we very much had the thought of like, let's get ahead. Let's have an identity that's a helpful way of thinking about this for people. And let's talk about what technophobia is and what sexual phobia is and all of these stigmas.
And I know people get concerned, like, is technology good or bad for you?
And I would actually just argue it's not the technology itself. It's what you do with it. And I think people in terms of my therapy practice, they either go to one of two extremes. They either make everything technology is the problem. Right. Or they don't pay attention to it at all. And then it becomes sort of some sort of issue in their life. And so I think, again, it's not the technology.
It's what you do with it. And I think technology is best thought of as a member of someone's relational system. Right. As you grow and change, it's going to grow and change with you. And I think that to say that technology is like this, oh, it's all bad, really dismisses a whole bunch of people who benefit, like us right now just having this conversation.
We're benefiting from technology, like the people who are homebound and don't have access to people outside of this setting. The people who don't, I know Neil talks about this, hold as much sexual privilege. Right.
Do they not get to have partners and enjoy sex if they don't have access to humans?
Right. They should still have those opportunities.
What about people whose bodies are experienced as disabled in modern society?
What about people who are aging?
I mean, consent becomes a huge issue. As you age around sexuality with other humans, maybe there's a way to ameliorate that more with technology. So I think there are lots of advantages to technology. I think people just have to be thoughtful with it. When Stefani did her 10,000 years of cyber sex, one of the points she made was every time we've come up with a technology, practically immediately we sexualize it.
Like from stone to clay to everything. Now my side of thinking is every time we come up with technology, practically immediately we turn into a weapon. Right.
Oh, I figured out how to open up these clamshells.
Hey, this would be really handy to hit the tribe over the head next door and take their clamshells.
In digit sexuality, I know you guys are broken up into waves and I like to understand what those waves are, but I wondered within those waves, are you seeing any differences in stigma and any differences in the ways that these technologies are both offering benefit and perhaps putting people in harm's way?
Briefly, maybe we can come back to this, but briefly when we talk about first wave and second wave digital technology, the first wave are the things that basically we're familiar with that use us to connect to other people, whether it's everything from Tinder to FaceTime to any technologies that we're familiar with now that involve helping us connect to human partners.
The idea of the second wave is that there are immersive kinds of technologies that make human partners less important as part of the equation. I think what we've seen in the last 20 years is sort of a cycle with regards to the first wave technologies where they get introduced, they get stigmatized, then they get normalized. I think the clearest example you can see with that is internet dating.
I think we can all remember a time, it was not that long ago when it was really weird to bring someone home to your parents that you had met online. You would never tell them how you'd met. Even your friends would think it was weird. It was even right at the beginning at least seen as something for losers. And we've completely now normalized that.
I think our view of the second wave of technology is all like, if we go through this introduction, stigmatization, normalization cycle, it's like, couldn't we just preempt that whole cycle and skip the stigmatization part?
Why do we have to stigmatize every new wave of technology that comes along?
Which is exactly what I think we're doing now with people who use VR or have relationships with their chatbots or whatever.
It's like, let's just go ahead and normalize it from the beginning.
Yeah, Neil, I think those are really excellent observations. I do want to note that the queer community, more specifically the gay community, started online dating and hooking up at least 10 to 15 years before the straights. And so it was actually relatively normalized within those communities.
This is actually sort of some of the stigma and shame that comes along, right?
Because a lot of first wave technologies were definitely used within queer groups, which are minoritized by dominant society already and then shamed.
And then on top of that, sex workers used a lot of the first wave technologies, right?
And when you look at just online porn, that is the whole first wave of digi sexuality as well, right?
And so things might have been normalized or less stigmatized within groups that were already minoritized and stigmatized by dominant society.
And then once the rest of dominant society caught up, then they were like, OK, it's normal now to date online, right?
But you still get people who have this digi sexual phobia, which is this combination between having technophobia, fear of technology mixed with just having fear, right?
Fear, human fears of people having relationships that aren't with humans, which brings us to the second wave and Neil's right. That's where people are really uncomfortable still.
Like I, Neil and I've talked about this, like I'll be teaching students and I'll ask them anonymously online. I'll ask them anonymously in a poll question.
You know, have you ever used first wave technology?
And almost every student now is like, yes.
Whereas five years ago when I would ask this, hardly no one had, right?
Or like would at least admit it. Now in the second wave, there's a handful of people, if it's a room of 45, 50 students, one or two of them will anonymously say that they engage in second wave, which is VR porn, robots, you know, dolls, artificial agents, things of this nature.
Only a handful, two or three will say they have, right?
It's a small number, but that's more than it was five years ago when it was nothing, right?
Because as the technology grows and changes and we grow and change, then I think hopefully, cross fingers, some of the digisexual phobia and stigma will hopefully diminish. Having said that, I don't think it'll ever be gone completely. And what you're describing makes so much sense in thinking about how erotic minorities, how sexual minorities find each other.
You know, there is a privilege that comes with being able to walk into a bar and be like, hey, baby, and know that that person aligns with what you're looking for.
And so, you know, for as long as there have been any kind of technology, the written word, for example, there have been people using that to try and connect with a community that they can't just find by walking into a room. We see that with, you know, with kinksters, with kinky people and queer people, and that sizable then overlap, were the early adopters of technology.
They were the ones placing ads in the back of the penny press. They were the ones starting usenet groups in the early days of the internet. They were the ones who figured out how to access the back rooms and the AOL chat days, all sorts of innovation that is necessary simply when it's not safe to walk into a room and say, this is who I am.
Is there anybody here like me?
And I think that being aware of that and recognizing when somebody has the privilege to opt out of it and to acknowledge the discomfort that people experience as a recognition of their own privilege. This feels weird to me because I have the luxury to not need it. It's not a framework that a lot of folks think about.
And I know, you know, as our podcast audience has grown, we started out literally just talking to our friends. We started out talking to hackers and sex therapists. And now we get a lot of different people. And I suspect at points of this conversation, there have been folks who have been like, that's weird.
Why are they marrying holograms?
Like, why is she acting like that's normative or normal or okay?
And I just want to acknowledge that any of those reactions are A, valid, but also B, representative of just how lucky you are to not have to think about it. That's exactly it. Yeah.
And you actually captured, I totally have forgotten this, did you sexual phobia, of course, is it is that technophobia and fear in general, but then it's mixed with erotocentrism, which is exactly what you just said, which is that idea that my way as an individual in being sexual and erotic is the only and most right way, right?
It's, ‘I believe this, so therefore it's right for everyone.’ And I didn't come up with that. That's Dick Skeen out of Arizona back in the early 90s.
And honestly, it's kind of the foundation for almost any of the isms when it comes to like sex, right?
It's like, if it's not what I think is right, and if it isn't what turns me on, then it's not right.
And I think that's a strong gut reaction people have to like second wave, especially digi sexual practices. It's that phobia mixed with erotocentrism.
As you guys talk through that first wave and second wave, the innovation, the fear and stigmatization, and then finally normalization, it also reminds me as it goes through wave one and wave two, it also reminds me of some of the things I've heard from Stefani about kink being at a point in time.
So we may fear this now, but that line is always moving forward.
And I think one of the things I personally have struggled with from a technologist perspective is how do we shape the trajectory of that line?
How do we lay down fundamental principles for that trajectory?
How do we give guidance for people who are building technology and deploying sex tech?
And so I wanted to ask you guys, I know you've come up with five core principles for digi health.
What are those principles and how do they help guide and shape that conversation?
That's exactly, I think what happened for Neil and I is as we were starting to explore more around digi sexuality and talk to more and more people, I mean, you know, there are people whose primary partner is a synthetic partner.
I mean, there are those people too, and we've talked with several of them. And as this technology is growing and changing, there was this moment, I think for Neil and I and Neil can share this too, where it was like, wait a minute, like people are starting to get, they were already freaked out about things like porn addiction. And I'm putting that in scare quotes because there's no evidence to support that.
And they were really freaked out about technology addiction, right?
Which again, no evidence to support that. And so I put it in scare quotes. But that doesn't get rid of this very real thing that we're talking about. People have this fear, people have what we have called digi sexual phobia, they're afraid.
And then that, especially as therapists and industry people, that actually ends up being less helpful for the people that you're working with, whether that's designing the technology and the people and helping the people who will be using it, or it's actually working with people who present with technology related problems in therapy.
And so Neil and I started talking and we started talking about, you know what, I wonder, I wonder if a definition of digital health, some way of measuring what's healthy technology wise would be helpful. And we actually looked at Doug Braun-Harvey and Michael Vigorito's framework from the out of control sexual behaviors rethinking sex addiction lens. And then I talked extensively with Doug Brown Harvey about it.
And he was really supportive of taking that platform and that idea and applying it in a technology way. And then Neil and I came up with a definition and then we shared it with colleagues at various conferences and in our classrooms, got feedback, and modified it. But the principle of Dr. Harvey's work is that we don't pre-define an activity as being problematic or out of control, right?
So you don't say, well, kink is a pathology automatically or whatever. What you say is anything can be pathological to the extent that it is interfering with you living the kind of life you lead.
But the flip side of that is that if you're able to integrate your activities into a happy life or if they're in fact part of your living a happy life, then we as therapists or philosophers or whoever aren't going to impose on you the idea that something is problematic. So that was the lens that we then applied to technology, which is let's not prejudge this here.
Let's look at how it does or does not contribute to you living the kind of life you want to lead, where the object is always just to make people have the power to be autonomous. For folks who might not be clinicians, who might not have a background in psychology, this isn't a radical framework or a radical notion.
This is really the rule of thumb that we find in the DSM, regardless of whether we're talking about alcohol or exercise or sexual behaviors.
The DSM wants us to look at is it causing the person distress?
Is it causing distress to people around them?
Is it interfering with their daily lives?
And if we can't say yes to those things, then the default assumption is, okay, well, then we're not going to assume it's problematic. Right. And so we came up with a definition and got feedback on that and revised. And then based on that, we came up with five principles around digital health. And those principles are consent, protection from exploitation and harm, honesty, privacy, and pleasure.
And then from that, we defined, and I think Neil just spoke to this really well, from that, we actually defined what it then meant if someone was going to have a problem with technology. And simply put, that really is just, it's a problem if the person's, and here comes the key part, consensual digital related thoughts, urges, and behaviors feel out of control to them. Right.
So it's about their point of view with their own relationship with the technology and those five principles. Right. So that guides the whole conversation. And you can, I mean, here's the thing. All the others sort of like when it's framed, scare quotes as technology addiction, what you'll see is it's more about, and this was Neil was speaking to, it's more about the content of what somebody is engaging with that's considered pathological.
And it's more about time. But here's the issue. All of us live on technology now, period. So time can no longer be a factor in making those choices. That's ridiculous, period. And of all, watching porn isn't more or less healthy for you than if you were online all day playing a video game versus if you were working like we are all day. Right. It isn't the technology itself.
It's what people do with it. But all the people that were framing this problem out of control, digi behaviors, they were framing it as a matter of time and a matter of what you're doing online. Right. So total judgment and morality. It really isn't tied to process or principles. Right. It's literally tied to like, these are the activities that we think are wrong.
So pay us money to get treated for a disorder that doesn't exist. Really.
I mean, truly. Yeah. Help me square a circle. I've got a little bit of cognitive distance. I need your help.
I have heard that, and again, I'm not a therapist, so I don't know if this is true, but I've heard that people come in to therapy thinking they have a porn addiction or out of control sexual behavior because society has told them that or maybe another therapist has told them that or a partner has told them that. And when talking to a qualified expert realizes, no, you're well within the bell curve.
If the person, your point about if the person feels that their behavior is a problem, I want to poke at that a little bit because if you're in the stigmatization and fears part of the cycle, aren't people going to think they're a problem when they don't have a problem?
They absolutely think they have a problem a lot of the time. And at least in terms and Stefani eloquently put this in terms of the American Psychiatric Association and the Diagnostics Statistical Manual, the fifth edition, which is what we're on, there is no diagnosis around technology. It does not exist.
Now, if you're going to follow the World Health Organization and the ICD, I think we're on 11 right now about to be 12 and I could be wrong, but they added gaming disorder and that was in 2018. So if you're somebody who operates outside of the US and Canada, you might be using that diagnosis. That's a possibility.
Having said that, the WHO has to address mental health concerns and physical concerns and relational concerns for literally the world. And when they did the gaming disorder diagnosis, it was very intentional. It was a reaction against some people who have been playing games based out of different countries in Asia.
It was only a handful, two or three people who had not been practicing health towards their own physical and mental and emotional well-being because they became very enraptured in their game play. And so they neglected their needs and the needs of another person and they died. And so the World Health Organization faced a lot of pressure to put something down around gaming.
And I can understand that in that larger global context, although I think we could argue anybody could be distracted and enraptured by all sorts of activities, right?
It's just that this time it was online gaming.
So yeah, you will get people who come in and are adamant, like they're like, oh, I have a sex addiction or a porn addiction. And I just get curious with them, like, talk to me about what that means for you. Talk to me about who has told you this. Talk to me about where you've learned this. Talk to me about how that lens is helpful for you.
And then I start breaking down with them, gosh, you know, one way to think about this is digital health. Let's look at these principles.
Let's talk about, are your practices online or with technology really something that feel out of control to you?
Or is it society?
Is it other people?
Is it stigma?
Is it whatever?
Is it internalized digisexual phobia that has told you this isn't okay?
Right. And so we break that down. If there is out of control behaviors, there's a whole framework.
Again, it's a cart horse issue. I mentioned this before we started the podcast. Kat Hurtline and I a number of years ago, over a decade ago, came up with a framework to handle technology related concerns. It's called the couple and family technology framework. And I use that. If somebody does have out of control behaviors, they really do and they want to work on it. Then that's what I moved to.
We develop a digital health plan. We talk about the hard nos, which are the reds. We talk about the yellows, which are areas of ambiguity. And we talk about the greens. These are all good for my own wellbeing technology wise. But then we have a framework that we use that addresses it.
So it actually is pretty once, once Neil and I realized that we needed a lens of digital health and principles to go with it, it sort of like made the rest of everything else make sense. And it's really helpful for people. Wolf had mentioned when he, Wolf had mentioned that when I talk about kink, I say it's specific to time and place.
And I think that is particularly true when we think about how the World Health Organization conceptualizes technology issues versus how we might in America. So we need to recognize that what is normal in one culture or at one time period is not necessarily a universal truth and that those things change. And I love the framework that you've developed in general for clinicians to use.
I love the idea of coming up with red, yellow, green activities within a relationship or within a family, because what that's doing is it's letting people really reclaim the power that comes from not owning a label, not owning stigma, not to bring it back to porn.
But you know, there were several articles, I think at least two that I can think of published recently saying that the biggest, the biggest risk factor for porn addiction, quote unquote, is the conservative nature and the religiosity of the client, not because their behavior is different at all, but because of how they perceive and internalize their behavior and how they feel about that behavior.
So when you are able to sit down with somebody over coffee with their favorite philosopher in session with their favorite therapist and say, you know, you really know what health looks like for you and you really know what your relationships look like when they're healthy.
And how can we give you a tool that you can use to define health in a way that makes sense, not only to your time and to your place, but to your people. And I think that is really amazing and powerful.
Yeah, I love these five core principles: consent, protection, honesty, privacy, and pleasure.
Of course, being in cybersecurity, consent, protection, privacy are very high on my list.
But Neil, I want to ask you in your research, in your conversations of these five, is there any particular one or two that you think needs a certain degree of focus and attention at this time and place?
I think that consent is definitely central to our conversations about sexuality right now. And I think that, you know, we want to connect it to privacy, actually.
I mean, the conversations we're having right now about non-consensual sharing of images.
I think that that's because I mean, one of the things I'm sort of interested in is how do we educate young people on these principles?
And I think that the consent piece is really important because I think that, you know, young people now are being thrown into this world of technology that is changing so fast. And it's just having, and they're being thrown into it at a time when they're already struggling with issues around consent.
So you're throwing this bomb into this very, you know, fragile, I don't know how to do it without mixing my metaphors, but you've got this very fragile, you know, edifice that you're then throwing a bomb into. And so I think that we can talk about consent too much. I think that that's always where I start when I'm teaching my classes.
When we talk about technology, this is both in terms of how your relationships are affected by the technology and are you consenting to that. I just think that to me is the cornerstone to it all. I might shock people when I say I love the fact that you say it's possible to talk about consent too much.
I am giving a lecture on kink-affirming risk assessment for the Buhler Institute on Friday, and I've been weaving in some of Laura Antenoux's thoughts on the old safe, sane, and consensual framework. And for those who don't know, Laura is like an amazing kink elder statesman in the leather community. And at one point she describes this preoccupation with safety and consent as almost a form of assimilation.
This way of saying, no, no, no, we're normal. We're just like everybody else. We're not doing anything that you need to worry about. Everything is great. And it uses those words and that framework to kind of minimize what makes somebody and their relationship so extraordinary. But they spend so much time explaining what they're not that they don't really get to fully live what they are.
And so I would love as we wrap things up to ask you, Markie, as my friend, as my colleague, as somebody who's just flipping amazing, how would you encourage the digisexuals and those who love them who might be listening to this to live authentically, to practice the digital health framework in a way that leaves them feeling proud and confident and secure in who they are?
What guidance would you give?
I think it's a really scary time to be out as someone who has digital attachments and is possibly also a digisexual person.
And I say out because that historical landscape for queer, people of queer backgrounds, identities and experiences, part of our movement has been to be out, right?
To be out, to actually do exactly what you're saying, to normalize ourselves and our relationships, to celebrate them, to show that we're healthy, happy people who also have normal problems like everybody else, right?
I would love that. There are a few people that are out. Dave Kat is an idler. That's the title he uses.
He's out about his primary relationships with dolls and robots, right?
And I think that's great. But the shame and stigma that he faces is pretty awful. And so as much as I would love to see more examples of people being out and not having pushback in negative ways, I don't know if I can really suggest that for people.
Even people who are out about having loving relationships with technology or enjoying their technology, right?
Especially young people, we shame them really quickly. And I guess my biggest issue is if it's not hurting, this is the part that always gets me.
I'm like, the whole framework is digital health.
If someone is behaving in digitally healthy ways and they have loving relationships or sexual relationships with technology, then who does that hurt?
Here we go.
I just beg people to ask themselves, why do you have an issue with something that doesn't really affect you and actually might be helping people?
That's helpful for people who are isolated, for example, or don't have access to other options.
Why would you not want them to be happy?
I don't get it.
Like, I just really, I just don't get it. So maybe that's like where I would land as a therapist.
You need to work on your own work, right?
If you're that uncomfortable with people who are having relationships with technology that don't match the kind of relationships that you think people should have with technology, okay.
Like, you need to work on that. Like any other issue around judgment you would have as a therapist. And I will say that kind of like one of the questions that really, I mean, there's tons of questions about digi-sexuality, but one of them that remains sort of out there, which Neil and I have talked about, maybe one day we can do like a follow-up study.
Is this a kink?
Is it a sexual identity?
Is it an orientation or is it a whole standalone new identity completely?
Because some people frame it like a kink, which is sort of how this sounded, but other people would say it's not that, right?
So like, and I guess I would say whatever your clients come to you or whoever you know in your life that does engage in technology related behaviors and they have an identity around that, just listen to them. However they frame it as the right way for them. I don't know why we all can't just love robots together.
I guess we're all going to be afraid forever and ever, even though Wolf started with like, they're really not that far ahead. They're not that advanced.
No, they're not, folks. It's not Terminator. Relax. Relax.
That is, that is a great final word. Relax and if other people are enjoying themselves, leave them alone.
Well, Neil, Markie, thank you so much for joining us. Thank you. It's been so much fun and thank you all for listening and tuning in to Securing Sexuality, a resource for the information you need to protect yourself and your relationships. Securing Sexuality is brought to you by the Bound Together Foundation, a 501c3 nonprofit. From the bedroom to the cloud, we're here to help you navigate safe sex in a digital age.
Be sure to check out our website, securingsexuality.com for links to more information about the topics we discussed here today, as well as our live conference in Detroit, which is where we'll see you, Markie.
Yes, for sure. And join us again here for more fascinating conversations about the intersection of sexuality and technology.