Ep 118: Men’s Sexual Health, Tops & Bottoms, and Butt Clocks with Dr. Carlton
Art by @silverillustrations
Erectile dysfunction, STIs, vaccinations, and safe anal play are important conversations for men – particularly queer men – to have with their doctor’s and partners. However sometimes the most important conversations are also the most difficult ones. In this episode, Effy and Jacqueline celebrate Pride and Men’s Health Month by speaking with the “butt stuff” doctor, Mayo Clinic trained gastroenterologist, Doctor Carlton.
How can you find the right doctor? What should you ask during your appointment? How can you pleasurably and safely explore anal play? What is unique about sexual health within the gay and queer community? And what is a butt clock?
With 3 million likes and over 200,000 followers on TikTok, Doctor Carlton shares his expertise on men’s sexual health and pleasure, tips for tops and bottoms, and sex advice for every body and orientation.
Doctor Carlton is a Mayo Clinic trained gastroenterologist in San Diego, California who you have probably seen on TikTok or Instagram talking about Butt Stuff tips and LGBTQ health. He has been featured on Mashable and in Instinct Magazine and even recently headlined Austin Kink Weekend in Texas. Who better to learn butt stuff from than a doctor who knows all the science and a gay man who has had PLENTY of real life experience with it!
To learn more about Doctor Carlton, follow him on TikTok and Instagram at @doctorcarlton.
As mentioned in the episode:
https://heymistr.com/
https://www.glma.org/
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Curious Fox @wearecuriousfoxes
Effy Blue @coacheffyblue
Jacqueline Misla @jacquelinemisla
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TRANSCRIPT:
Dr. Carlton
Simultaneous stimulation of the the penis and the prostate? The first time that ever happened to me, I thought I was on a rocket ship ride to the moon, it was the most incredible sensation ever. And it made me realize, wow, people are really missing out. It's like somebody hit my reset button.
Jacqueline
Fantastic.
Effy
Welcome to the Curious Fox podcast, for those challenging the status quo in love, sex, and relationships. My name is Effy Blue.
Jacqueline
And I'm Jacqueline Misla. And today we're celebrating pride and Men's Health Month by having a conversation about queer sexual health and best practices for anal sex. And while their conversation centers at moments on gay or queer Men's Health, we all have butts as he likes to say. And so there is important information for everyone about how to play safely and keep our bodies and relationships healthy.
Effy
I do think like Dr. Carlson said, The but is the great equalizer. We all have one. And if you like, but sex, even if you like your butt touch, maybe not on full penetration, it doesn't mean anything about your identity doesn't make you any, it doesn't make you gay, not that there's anything wrong with being gay doesn't make you have anything to do with your masculinity or femininity. It is just a part of the body that feels good for some people, a lot of people. So the invitation is just to go out there and you know, be curious and wander around and see what happens. And personally, I personally don't love being a bottom. Like, I don't like being a bottom for bad stuff. I don't mind it, I don't seek it. It's not something that I'm like, I must have it all the time. When it does happen. I actually do
Jacqueline
enjoy comes about Yeah.
Effy
I want to move like why not? The right person. So the thing that I do, I find it interesting, more than anything, anything, I find it interesting, I just think that it's a part of the body that is really sensitive. And a lot of emotion is there right? Like your but your sphincter is what a lot of like, stress is held, is connected to your mood. It's a real kind of interesting part of the body. So for me when that gets mixed up with sexual energy. For me, it's like mentally titillating as well as physically arousing, so that's kind of why I go there. And the things that I find interesting for me is that anal sex has a way to really anchor me in my body, it really goes towards my sort of like mind body connection. For me, I have to take it super, super slow. So that makes me like, take my time be super intimate, slow, patient, somewhat lazy sex that that I like. And that it, it really anchors me into my body, I really feel you know, every part of my body and I feel grounded in it. So I actually find it an interesting exercise sometimes and wait to really show up in sexual space because you can't not feel what's going on what's going on. When someone's up, you're in a nice way.
Jacqueline
What's your experience? Like as a top, then do you do you sense that the person who is bottoming is also having that full body experience?
Effy
I mostly play with men's butts. So I think the male experience is different than the female experience, actually, and we talked about we talked about this a little bit, Dr. Carlton, I don't think it feels as sort of full body experience, at least for the men that I played with. I think for them, it's much more of a topical feel, please like right and tell us how you're feeling. So if you're listening, if you're a listener, who's into that stuff, we would love to hear what it feels like for you. I think that it is a more of a concentrated experience rather than the click of a full experience that that I speak speak about. So it's hard to it's hard to know. Yeah. Yeah. I like topping To be honest, I enjoy topping hands and strap ons are really my favorite. And I think for guys, we enjoy it, obviously. So a lot of the time. You know, I'm playing with either straight or BI men currently who are interested in that kind of stimulation. And it's fun. I like it. I liked the sensation chin of penetrating masculine energy, I shall say, for some reason I don't feel so cold to women's butts. I don't know why I couldn't explain to you.
Jacqueline
We have lovely butts one day, one day, maybe you will come and explore. You can come you're invited.
Effy
I'm not, I'm not against it. I'm not like, Oh, I'm not letting go. But that's not that's not what I'm like, you know, if I was if I was playing with a woman, female identified person, anyone to be honest, like, if I was playing with somebody, and they made a special request, I'm not going to turn you down. Like if we're having fun. If I like you, were you know, this is fun and games all around. And if you're like, Hey, can you pay my butt some attention? I'm not going to turn you down. Don't Don't let me that's not what I'm saying. Personally, though, I don't feel called to from having sex with a woman. My mind isn't going to her. But I'm not like, Oh, I wonder what that's about? If I'm, if it's requested, I will totally go there and spend some time. I just don't feel called to it. Do you feel like maybe on some level, maybe some deep subconscious level? It is power dynamics, it is something that is beyond physical. It's something beyond the physical, I think, I'm guessing I honestly don't have access to it. But that's what I'm guessing.
Jacqueline
Yeah. Well, I love the suggest I love you saying ask for it. I mean, I think that is something that part of this conversation. And what we continue to talk about is certainly ask for the things you want. But normalizing talking about these things. Yes, at some point we were I was reflecting with you FB about the number of Bud related episodes, the garden fencing number of episodes. And you're like because we need to normalize talking about and we're gonna shout butts from the rooftops so that we can have conversation, both from a place of focusing on desire and pleasure, and also health which is really part of what what centered a lot of this conversation around our guide through all things, but today was Dr. Carlton.
Dr. Carlton
Hi, I'm Dr. Carlton and I am a gastroenterologist from San Diego, California, I became internet famous for my Tiktok and Instagram discussions about bad stuff and queer health.
Jacqueline
We found him as most have via his incredible and informative Tiktok channel. And we learned a lot both from his videos and from our discussion with him. We started by getting back to the basics.
Dr. Carlton
So one of the things that I think is really important for us all to know about our anatomy is the area around the anus is very rich and nerve fibers, these nerve fibers provide a major amount of sensation. And you don't even have to have penetration to enjoy anal play with this nerve sensation that supplied the light touch blowing with your with your breath, touch with a feather with your fingers ramming with your tongue, amazing sensation. So those nerve fibers provide a lot of eroticism. So I don't want people to miss out on that. It's not just about sticking it in there. Speaking of sticking it in there, your anus is made of two types of skeletal muscle. So there's an external sphincter made out of the skeletal muscle and an internal sphincter made out of smooth muscle, external skeletal muscle you can control with your mind, it's like a pinch and clench kind of thing. That's when you think about angels, key goals. You can clench down, release, clench down release, that's you controlling your external sphincter. So if you have to go to the bathroom really bad and you're running, you're running, you're running, you're running, you're you're clenching your anal sphincter, so that you don't have an accident right there. The internal sphincter, you can't really do that it's made out of smooth muscle. So you can't control that with your mind. But you can control it with lateral pressure. So one of the things that I'd like to teach that really opens up that anal sphincter on the internal side of things, is a relaxation technique called the buck clock. Now it sounds silly,
Effy
sounds great. Sounds like fun. What's
Dr. Carlton
the aim, this is a circle, gently lubricate, and slide your finger ends absolutely straight, and press over laterally at three o'clock. So that three o'clock position you hold it laterally, just lateral pressure, don't ram it over, but just gently hold it so that you feel firm pressure against the lateral edge of the sphincter. It starts relaxing that tiny little hole open to a larger opening, you move over to the nine o'clock position, do the same thing for about 30 seconds, up at 12 down at six that that sphincter really starts relaxing and loosening to allow penetration of a penis Adobo or whatever you want to put in there. I've gotten amazing feedback on that one technique that I basically learned in medical training to do prostate exams because yeah, To go a little bit deeper in there to get prostate examinations done. But I've, I've learned to take advantage of that for anal sex. So people around the world have said, Oh my God, you changed my life with this just this one little bit of knowledge about just laterally pressing up against your anus. On the inside to open it up. It's like the key to opening your asshole.
Jacqueline
Yeah. I love that, particularly because I do think that it requires that technique requires someone to be slow and patient, which I think is not necessarily what what to your point where we just like stick things in there. I think there's first of all, we're like, likely tense potentially, if we're new to you know, play and like, holding on tight. And then there's just a like lubrication and insertion. And this, I love that you're like, slow down.
Dr. Carlton
Right, right. And I think that's the most important part of anal sex is being intentional, being slow being patient using lubrication, allowing things to relax, because if you don't allow it to relax, then you can rip the lining of the annual sphincter and cause a tear called an annual fissure, which can put someone out of commission for months. Some people even go as extreme as needing surgery for an injury like that. So I think that you have to be very, very careful in those first couple of minutes. Also, for bottom, you know, it's, I'll be the first to admit it, those first couple of minutes of anal play can be a little bit harrowing. So as soon as you get over those first couple of minutes, it's amazing. But just being able to relax, make this technique part of your foreplay, so that it doesn't become mechanical. And it really allows things to open up and you can enjoy sex. And one of the funny things is I had a bottom on an Instagram sent me a direct message the other day that said, hey, just so you know, your information is getting out there. I got totally but clocked by this guy, and I didn't even ask him Yeah, so yeah, so this, this is really a way to relax and open up.
Effy
I can also see how it's also can be erotic like I can imagine even though the way that you're describing it can seem mechanical, but I can totally see how it can be slow and sensual and erotic as you're doing it. So absolutely a part of your full foreplay.
Dr. Carlton
Absolutely yes. And for for men who have a prostate gland that you know RG spot, that's where the, you know, the prostate is the g spot. So it's just a couple of inches in there, you know, two, four or five centimeters in to find that spot. If your partner is bent over in front of you in facing away from you, if you enter your with your finger in about two inches or 45 centimeters and press down at six o'clock. That's where the prostate gland is. If they're on their back and facing you, it's up at 12 o'clock. If I go come here their motion. So you know if you know if you're gonna play in there, make sure that your nails are trimmed visual cues and audio cues from your, from your partner to see if your stimulation is strong enough or too strong. You don't need to go crazy in there. But just you know, especially if you massage that area with your fingertip, especially while you're given a blow job. Simultaneous stimulation of the the penis and the prostate. The first time that ever happened to me, I thought I was on a rocket ship ride to the moon. It was the most incredible sensation ever. And it made me realize, wow, people are really missing out. It's like somebody hit my reset button.
Jacqueline
Fantastic. And I appreciate you sharing that as a bottom in the first few minutes can be tough because I think that all of us if we ever have access to seeing anything, maybe it's via porn, that's not the image, right? It looks like assertion and then rocket ship immediate, like this is the best thing that's ever happened to me. So that if you are playing in that way for the first time and it feels uncomfortable, you may be thinking something is wrong with you. Something's wrong with the positioning. So I appreciate you naming that.
Dr. Carlton
Right? Absolutely. So you really have to you have to use those first couple of minutes to relax. I always tell people you know, first of all, if you're going to play back there, make sure that the chamber is empty. You don't necessarily have to spend hours dishing out your rectum but you know, use the bathroom. I tell people to use fiber supplements to clean up the residue so it's easier to be clean back there. Rinse with a little lukewarm water until things are clear. Use that buck clock technique to open up either during foreplay or while you're in your cleanup process. If it's right before your play, lubrication, lubrication, lubrication and and reapply. You can't use too much lube when it comes to anal and I actually like silicone based lube because it's slippery here and it feels like protects a little bit better. It is a little more messy. If you get it on your sheets. and things like that. But they're that it really does a great job of keeping things protected. And it's that slippery sensation just makes things go better. And you don't have to keep reapplying. Because water based lube for angels tends to kind of gum up after a while. So I tell people also, if you're new to bottoming, or even if you're not a new bottom, start on top, so you control how fast things go in. And someone's just not ramming it in there. So start on top. So you especially if you're taking a wide COC, something really girthy you need to be able to control how things go in there so that you don't rip or tear your anal lining. So breathe as you go down, relax, you know, yoga breaths, and also another tip push out as it goes in. And that initial sensation, and it also helps open up that sphincter a little bit more as well. Interesting. I wouldn't have thought about that. Yeah, yeah. So those are the tips for bottoms that help? Sure.
Effy
How do you feel about gloves, I'm a big fan of gloves when doing a manual play as somebody who's finished reading to that, I find things like it like sharp nails, makes things more smooth, both going in and staying in that and also anything, it helps with just feeling a little bit more hygienic. And so if you play a little bit more relaxed, what do you how do you feel about that? Also a little little on the kinky side just for funsies?
Dr. Carlton
Yeah, absolutely. Yeah, the appearance of them can be really sexy. Also, I agree, you want to if there's any sharpness to your nails at all, if you have any, any nail bed underneath at all, it's going to be a lot easier for cleanup to just wear a glove for sure. It's going to be more protective. It really depends on what what floats your boat.
Jacqueline
We have a sense now of what's going on inside of our bodies. The so that's one of the barriers, often to to health and good play is just knowing what's there. The other is being able to talk about it, feeling comfortable talking even with our physicians about and asking questions. And so certainly that's what you're seeing in your practice. And I'm wondering if there are some tips around sexual health 101? What do folks need to know? And what questions should they be asking?
Dr. Carlton
Well, I think that's really important. With with queer health in particular, a lot of doctors aren't aware of the things that we need it for instance, I had a friend of mine who moved from California to Arizona and said he went to see his doctor, and was on Truvada for PrEP. PrEP is a pill that you take daily to prevent HIV eggs. So even if you're not wearing condoms, you take PrEP every day, you're not going to get HIV because this medication works off HIV infection. So he went to get his prescription renewed at his new place in Arizona, and he said he walked in the door and there was a 75 year old, gray haired old white man doctor who said, Oh, I see you're on HIV medication. How long have you had HIV? He goes, whoa, I'm not HIV positive. And he said, Well, why are you taking this medication? He goes, No, I take that to prevent HIV. And the guy looked at him and said, I don't think I can take care of you. So while that's horrifying, I appreciate the honesty of this doctor saying I don't know about your health care. So you probably should find somebody who does. And that's really I think it's our responsibility. You need to either you know, if you're if you're if you have a question about physicians, and you're in an area where there are a lot of other gay or queer people, ask them who they go to. Who do you like, you know, who do you feel comfortable with? The Gay and Lesbian Medical Association, or G lm a.org. In the United States has a directory listing of doctors that you can find by your zip code that may be more comfortable with that situation, but you need to so the things that queer men need to know are we have certain ways that we need to be checked for STI s, the traditional STI check is an HIV blood tests syphilis blood test, a urine test, or urethral swab for gonorrhea and chlamydia. And that's not sufficient for us. If we suck a dick, we need our our throat swapped, you need to get checked where you play it because if you're if your throat is infected with gonorrhea or chlamydia and same honestly, same with women, if you suck a dick and your your throat is infected, it's not going to show up on a urine test. If you get fucked in your ass without a condom, and there's gonorrhea chlamydia in there, it's not going to show up on a urine test unless you're also infected in your urethra. So you need to make sure you get checked where you play. So that's one of my big things. It's really for queer people but that's for every one. Honestly it especially in in a group of people as amazing as a curious box, who are more open minded and and play all over. Make sure you get checked where you play. Hepatitis A and B are more commonly spread and through gay sex. Hepatitis A is frequently spread through rimming Hepatitis B is just like HIV. So I recommend all people to be vaccinated against hepatitis A and B, the meningitis vaccine for an IC Area meningitis is important for all gay men every five years in my opinion as well, because there are outbreaks of meningitis there was just one in Florida meningitis. And the reason it happens in gay men, it's not a sexually transmitted disease, it's just something by intimacy, you're close to the person, a lot of it is mouth to mouth and we put our mouths everywhere, you know, so, and we tend to be clustered in saunas and steam rooms and gyms and things like that, and bars, sharing drinks, kissing, whatever, so. So when there's an outbreak, it tends to be more prominent in gay men or queer men. So the other thing is the HPV vaccine, it was thought of for little girls to 10 years ago. And then they they added, hey, well, you know, boys have sex two boys should be boys spread it to girls. So if you're heterosexual, so we should vaccinate boys too. Well, one of the things that is important for people to know is that HPV causes cervical cancer, yes, but it also causes anal cancer and throat cancer. So you need to be very careful with HPV especially if you're HIV positive, HPV plus HIV brings a 70 times increased risk of annual cancer. So if you're playing back there, you can do an animal's annual pap smear to look and see if there's any precancerous cells back there, just like for cervical pap smears. So you need to have a doctor who's willing to do that or knows how to do that as well. And then considering that HPV vaccine, it's now available for people up to 45. It used to be just teenagers. But the theory on that is that if you are you're probably exposed to HPV by that point, as you get older, but I think an ounce of prevention is worth a pound of cure when it comes to anal cancer and throat cancer and cervical cancer. So yeah, so those vaccines are important, and you should be up to date on those with your doctor.
Effy
I just want to kind of clarify something because sometimes information gets muddy. But at least what I understood from what you said is that anal sex doesn't cause anal cancer. It's the SDI is that you may catch em that might cause anal cancer, right? I just want to be super clear about that. Right? Don't misunderstand.
Dr. Carlton
Yeah, it doesn't cause colon cancer, it doesn't cause rectal cancer. The only associated increased cancer risk is from anal cancer from HPV infection. And because the HPV virus is a is a cancer inducing virus. Great, okay. And those cases are pretty, pretty rare. There's only about 9000 in the United States in a year. But if you can prevent 9000 cancer deaths,
Jacqueline
you know, for sure, I have a question for you. Because so if you are in an area to your point where you where there's some community and you can ask, ask for referrals, what if either you're in an area within the country where there aren't folks that you could be necessarily be asking, or and you shared this with us in a conversation before the podcast, that folks from other countries where maybe sodomy or gay sex is illegal or something so wondering if there any thoughts or tips of what your experience of that has been?
Dr. Carlton
Well, I'm glad you brought that up. Because in the rural United States and out you know, if you're in Alabama versus if you're in San Francisco, your likelihood of access to these this kind of care is completely radically different. There are companies who provide pre exposure prophylaxis here like Hey mister, who are able to ship out medications, ship out STI testing, that do telehealth online with, with with people to be able to make sure that they get the the preventive care that they need. While that's available in the US and Puerto Rico and other countries, it's not available, and I get people from all over the world. You know, I remember this one person from Iran messaged me saying, Hey, I'm in Iran, I have something on my anus. If I go to the doctor, I'm afraid I'll get executed. Because if you are convicted of sudden having gay sex over here of sodomy over here, you can you can actually be executed, and I'm terrified. There's something going on. I don't know what to do. And so I said, Well, I'm here I'm on Instagram DM, you can send me a vanishing picture of what's going on back there. And I can kind of let you know what I think. And they did turn out to be a hammer, right? And to be able to take off that sort of pressure off of someone, you know, oh, my God, I might lose my life. So that's been really humbling in this whole experience that people don't have access to care, people are afraid. So to be able to take that sort of absolute devastating fear of someone's back is it's been amazing. But it also points out the inequities around the world, you know, people don't have access to this sort of thing. So I try to provide as much information as I can on my Instagram for harm reduction for proper care. And I tried to give tips around situations if people can travel to get treated for things like that. Then I read Come in for them to do that they can't it's a little tricky that you know that you can't exactly help everyone.
Effy
So what are some of the ways that we can make sure that our healthcare provider or doctor can take care of us based on our needs?
Dr. Carlton
Yeah, I think the first most important thing, when you meet your doctor for the first time is to have that conversation is this is how I play sexually. This is what I do. Are you comfortable taking care of me? Do you need help? If you're you know, do you need help with what you need to know about my health care? So you make sure that you mentioned getting check where you play getting your vaccines updated? Getting if you're on PrEP, or you're interested in getting prepped, are you comfortable prescribing prep? If you're HIV positive, are you comfortable providing HIV care. So those are the things that you need to have a frank conversation with your doctor? Believe it or not, most doctors, even though a lot of doctors are very conservative, when it comes to taking care people our first oath is do no harm and to and really to take care of all people, no matter what they what creed, or race or sexual identity or nationality or whatever. So I think when it comes to when it comes to it, just have that conversation. And most people will, will do what they can or at least point you to someone that they know that kid.
Jacqueline
Yeah, that makes sense. In my experience, also the intake process has been an indicator. I had a doctor who in the intake process would ask questions about where I play, what how long with how many partners and that was just routine as if they were asking me you know, any other question that was about my meant that by health, and then certainly have been a part of practices of doctors that that wasn't the case. I'm interested in that as well around some of the more common, particularly men's health issues that are difficult to discuss, to break the ice and say, let me ask you this question. I want more information about this.
Dr. Carlton
Absolutely. Well, you know, I think that erectile dysfunction is one of the one of the most common things that all men face. And it's a difficult subject for some people to bring up. But these days, given the amount of things that are available to treat erectile dysfunction, it should be something that's very available and easy to talk about, from your medications like Viagra and Cialis, which help increase blood flow to the penis to allow erections. That's one way for people that doesn't work for and there's some people that are Viagra, and Cialis just doesn't work for there even injectable medications that you can get through urologists that are like rocket fuel to make things really work well. So yeah, there's a lot of options. So I think it's important to not be afraid to talk about the things that really bother you with your doctor. And there's that there's even premature ejaculation. And premature ejaculation is where you come before you want to some, some people can just be barely touched on their penis, and it's over. So talking about techniques and medications that can decrease that premature ejaculation that's important. Also, a lot of people can ejaculate. And it's important to be able to discuss that with your doctor. When it comes to side effects of medications. There are a lot of people on things like antidepressants and anti anxiety medications, those medications are notorious for causing people not to be able to come. So if that's causing you not to come, maybe try to figure out a different medication that may decrease your lack of orgasm.
Effy
I mean, with erectile dysfunction and premature ejaculation and not being able to come from why understanding their psychological reasons as well as medical reasons. Would you speak to your doctor about both? Would you expect your doctor to kind of also mentioned an investigation into the psychological parts as well as the medical but
Dr. Carlton
you're absolutely right. When it comes to those things, the psychology of a lot of it is often the root of most people's issues. Doctors are often programmed to think only medically. But it's important to keep that that psychological part in mind. And if your doctor is really not going to talk to you about that, then talking to a therapist about that is really important.
Jacqueline
What about tips for partners? And so I there if you are a woman who is with someone who identifies as a woman, someone who's in a Pfizer has a male body and wants to encourage some more focus on their health or anyone in your life, frankly, are there some tips that you can provide to folks around supporting the care and health of their partners?
Dr. Carlton
Yeah, I think the most important thing is for people not to take erectile dysfunction personally, it's not about it's not about the wife or the husband, that's the partner. It's about the way the person's body is physiologically aging or handling a certain situation. So I think a lot of people tend to be like, Oh, well, they can't get hard without Viagra, so they're not attracted to me anymore. No, that's not the case at all. And a lot of men start having issues with erectile dysfunction as early as their late 20s 30s 40s. And it just gets worse as time goes on as far as that that happening. So it's nothing to take personally. So I think being calm and supportive and not taking it personally is the first thing because you need to be supportive and not defensive.
Effy
Is there anything that you can do to prevent these? Is there any is there any sort of, you know, anywhere from self care all the way to medication, other things that you can do to prevent either erectile dysfunction and premature ejaculation and that group of dysfunctions?
Dr. Carlton
Absolutely the the preventive things that you can do for erectile dysfunction are not to smoke cigarettes. Smoking is the number one thing that causes erectile dysfunction. Oh, interesting. Yeah, exercise to get good blood flow, healthy diet, making sure you're monitoring and managing your cholesterol intake. Those things all have a big effect. alcohol intake also tends to cause a lot of problems with erectile function. So minimizing those things, maximizing the exercise part of things, very important for maintaining erectile function. And as far as premature ejaculation that's often something that happens as as we're younger in our teen years, and in early 20s. But it can happen throughout life and you learn to adjust your late before an event. So if you have a hot date at 10 o'clock, you might want to jerk off at eight or nine so that you're not so sensitive. The stop and hold technique is another way you can just kind of hold on to the tip of your penis as you're about to come and kind of not come and pull back a little bit and then work back up. So those are some things that can really benefit you in the long run as far as self care, as well as making sure that when you go on medications that might affect your erectile function. Talk about that with your doctor if you're having issues with your blood pressure, blood pressure medications are notorious for causing not only lower blood pressure, but also erectile dysfunction. So psych meds blood pressure medications, make sure that you choose medications that are known to have less effects on those areas.
Effy
With premature ejaculation doing things like edging, or maybe using condoms, to become a little a little less sensitive to do this, does that stuff work as well.
Dr. Carlton
That stuff is also an important part of the argument and making sure that you don't ejaculate too quickly. Condoms are great, but I've put a condom on a guy before just putting the condom on ahead of his sticky game. You know, that's how bad premature ejaculation can be. But there are some numbing solutions that you can put on, I don't really like those. But if you need to use them, you need to use them. Just don't suck someone's Dick after they've had a numbing solution on the tip of your tongue. It's gonna be
Effy
funny, I do have a question about numbing gels are lubricants. Actually, I know that some people use them for anal. And I want your thoughts on that.
Dr. Carlton
Right? Absolutely hate that. Because you don't know if you're getting injured when you're when you're not. Yes, the numbing solution helps decrease discomfort and pain. But it also can prevent you from knowing that you're having a tear happening. So it's like when I talk to a lot of people in the gay community about more stringy things like fisting or other things don't be chemically altered? Because you don't know what's happening. Sure. That's the number one way people get injured is when they can't feel what's happening.
Effy
Yeah, makes total sense. Absolutely. Yeah. You want that connection with your body and make sure that it feels good. And you're getting that feedback loop as well. So yeah, okay, that makes sense. I just wanted to put it out there because I these this stuff goes around.
Dr. Carlton
Absolutely. And a lot of people that's that's what they think they're supposed to do. No, don't do that. That hurts. There's something there's something going wrong, you know,
Jacqueline
or any other tips for tops or bottoms. I love the clock. Absolutely be using the clock moving forward. There any other tips?
Dr. Carlton
Yeah, so we talked about bottoming with making sure you clean lubrications starting on top and breathing and pushing out as it goes in for tops, making sure that your patients tease the hole a little with your tongue with your finger or with a feather even using that book like technique, generous lube application, eye contact and cue reading is the most important thing if you look like your partner, look at your partner's eyes and they don't look like they're having a good time you need to change something. So change change positions are you know, one of the other big things that we were talking about in anatomy is the rectum itself is generally a straight shot, but there are some people are built differently where there are certain things in the way the bladder sticks out a little bit this way or hitting a certain curve is painful. So just change up your position because your curves and another person's curves may fit better if you just changed positions, you know another tip, tip for Tots other than starting slow, the bottom doesn't have to come every time. And a lot of bottoms don't want to come necessarily, but if your bottom wants to come make sure they finish. The other big thing urinate after you after sex. So important to flush out the urethra so that you don't get bacteria in there. Especially if you're having anal, especially if you're in a relationship where you're not using condoms, married or on PrEP, and you just don't want to use them. There's a lot of bacteria in the rectum, you need to be able to flush that out through a simple urination after sex.
Effy
Yeah, love those. I mean, those are such, those are such good tips. Also, I think some of the things that I hear a lot is about starting small. So before you go in there with a penis, maybe go with one finger to finger, take your time, right and butt plugs just to kind of warm that area up a little bit. And then before you go to Venus,
Dr. Carlton
absolutely. I think that's great to you not only the buck clock, but a toy that gradually increases in size. So I have a dildo that has a kind of a small head. And then this the top part of the shaft is kind of small too. But as you go down that beat down the shaft, it gets wider and wider and wider and wider as you insert in it gently over time kind of helps expand things. So that when you're ready to actually take a dig, especially a thick, thick, it's a lot easier.
Effy
Sure, sure. Sure. Amazing. Such good rich information delivered with just in in normalized in such a way that I think is so valuable for not only queer men, but everybody has a butthole and why not? Just be curious and wander around, see how it feels right?
Dr. Carlton
Absolutely. And we're while we're talking a lot about queer Men's Health and but stuff, what sensations do you guys get? Because I don't have female parts. But a lot of people say the urethral spine just kind of in the same area as the prostate. Do you get any sensation when you have anal sex? Are you willing to talk about that?
Effy
I'm willing budget. I think that at least is what I think I think it's exactly I think it's hitting something that's actually on the inside the vagina, but from the, from the anus from the, from the Exactly. And I think it's the, the sensation of the fullness that just enhances the whole of the feeling. At least that's my experience. I don't think again, I don't have a prostate. So I don't know. But I'm getting the feedback that I get is that I think the prostate piece is much more of a concentrated experience feeling this is what I understand from the partners I play with. At least for me, it's not so concentrated, you're not really hitting a you know, a spot as such. But it is kind of the fullness and the the way that it's touching the vagina side in a way that it's not when you go in from, from the vagina, anything is the sensation for me. So I don't get this like one spot that is super sensitive.
Dr. Carlton
Right? One of the other things I kind of wanted to talk about as well is rimming. Like you said, Everybody's got a butthole and some people don't want to be penetrated. But rimming is provides amazing intense sensations as well. And I think that it's a starter for a lot of people, a lot of people think oh, there's no way I'm going to put my tongue in someone's ass or around there, someone's asked. But when it comes to Remy, I recommend for people to make sure that they take a shower first, just to make sure everything's clean. That makes it a lot better experience. Obviously, it takes away a lot of the nerves from this from the situation. I actually work with a company last month that has a new product with a butt scrub, that leaves a taste. So they had flavors like like glazed doughnut hole and and peach ring and things like that. So there's all kinds of there's all kinds of different companies that have those sorts of products out that if you're not a fan of the original recipe, you can you can flavor it up a little bit. Or use flavored loopback. They're a little bit yeah,
Effy
sure. Also, if you're not ready, I think barriers are okay, right dental dams or even saran wrap.
Dr. Carlton
Yeah, abs saran wrap, dental barriers. There's tons of absolute pleasure that's still come from just using a dental dam or a saran wrap.
Effy
Right, you can still get to that area, you can still get the light touch of a tongue without if you're already if you don't want to thin barrier in there and you can I think that sometimes makes people feel better about what they're doing. Right? Absolutely. Yeah. Okay, so we talked a lot about I mean, there's such amazing good information. I'm curious just about what is unique about or important know about sexual health within the queer community? What are some of the difficulties or what are some of the differences, if you will, we're used to dealing with queer queer sexual health versus your regular heteronormative lifestyle. One of
Dr. Carlton
the things that I've noticed in our community as a physician and as a member of the community is is that we tend to be a lot more sexually active than than the heterosexual community. So getting STI checks done is crucial. A lot of people in our community now don't use protection. You mentioned a lot of stuff about gloves and condoms and saran wrap and dental bands, that's not happening with us, for the most part. So prep is a way that you can prevent HIV if you're not going to use obviously, I support the use of condoms, it prevents STIs and prevents HIV really, really big to use condoms, but if you're not going to use condoms, and that's one of the things that I tell tell my audience, hey, I can preach all day to I'm blue in the face about using condoms. But if you don't use condoms, here are the things you need to do get your vaccines, like we mentioned earlier, get on PrEP to prevent HIV for non monogamous, a daily pill or even there are other ways you can take it. But to have that guarantee of not getting HIV is huge. You know, I grew up in the 80s when everybody was dying of AIDS and and it scarred me as a gay man, I was terrified to have sex until like the 2000s. Because all these people were dying around me from from HIV and AIDS. Now, if someone's HIV positive, and they're on medications to the point where they're undetectable, they can't spread the virus through sex so undetectable equals on transmittable u equals u, that's a big thing in our community now, as well as the stigma around HIV is slowly eroding. I wish it would erode a lot more quickly preventing HIV with prep. If like I said earlier, if you get in trouble, where are you? Oh, and I went out to a bar, I found a hot guy, I had no sex with them, he came in my ass, I have no idea what his name is or where he lives. Or if he's HIV positive or negative, you can get on post exposure prophylaxis to prevent HIV from taking hold. If you take it within 72 hours, it's better to do it, the closer to the event that you can as possible. And you know, your doctor or an emergency room or a local HIV clinic or there are a lot of options for getting post exposure prophylaxis. That's what it's called pet, post exposure prophylaxis. So those those things are important to know. You know, HIV care is, you know, HIV is still common in our community, I read a thing today, where one in five new HIV infections is happening in people 13 to 25 years old in the United States. So getting such sex education out to our community, to everyone, even younger people is really important to know how to prevent HIV. So those those things are important, our community also tends to drink a lot more and smoke a lot more. So making sure that we monitor our pulmonary health, our liver health, also important psychologically, a lot of gay people are depressed or anxious. Or it's important to address our psychological health as well as to reduce our risk of things like suicide, because of our lack of acceptance in certain certain communities or from our own families. So I think that all of these things kind of wrapped together to make a lot of queer health more well rounded, if you can find someone who can help you address all those
Effy
things, super helpful. And I think I feel like we've done it, we've done a little bit of holding our part to sort of at least start a conversation to get people focused on what they need to take care of. I know that a lot of our listeners queer, on the scale somewhere, you know, a lot of we have a lot of gay and queer people in our community, and even with partners, by folks are partnered with straight folks. So I think this is this is super helpful for everyone to know. Also parents, with the gay kids, we know that you know, those people in our communities as well. So in our in our curious Fox community as well. So I think this information is super relevant and important to talk about. So appreciate that and really appreciate the work that you do. I think, like you said, you're really touching people all around the world that need this information.
Dr. Carlton
Thank you. Yeah, I really appreciate all that. And then, you know, on top of that, the things that we mentioned earlier, we talked about anal anal cancer prevention, you know, with vaccines, or with anal swabs, prostate cancer checks for all men, PSD and a digital rectal examination of the prostate. The blood tests for prostate cancer called the PSA for younger men from 15 to 35, especially those monthly testicular examinations to prevent testicular cancer or to find it early. And then colon cancer screening for everyone now is age 45. And men and women 45 years old, you get your colonoscopy, you can prevent colon cancer from happening by detecting polyps, which are the things that go on changing the cancer. So all that kind of falls in that that preventive realm when it comes to sexual health, and obviously cervical cancer screening screening for people with a cervix.
Jacqueline
Thank you. I think that we've been speaking so much recently, I think as a global community in certain We as a nation around care and rest in mental health and you know, want to make sure that this is a part of that process of of taking care of ourselves so that we take care of our bodies. And then we're talking about the other things that we need. So sticking with me, you know, check where I play, certainly the annual clock, I think that there are so many things that you I can see why your tick tock famous and Instagram, you're able to digest things, your ability to put things in such easy ways to remember, before we enter time with you, you have done a beautiful job of helping us have conversations about things that are intimate. And so we want to ask you four questions to get a little more intimate view. The first of which is what is one piece of advice that you would give to your younger self, about love sex or relationships?
Dr. Carlton
I think the number one thing is to that I would change about my earlier life is to not be so jealous. When it comes to partnerships and sex. Sex is Sex and Love is love. And I wasn't able to separate sex and love as a younger person. And it really adversely affected my sex life. That way, I could have had so much more sex so much more experience so much more fun. If I hadn't been so jealous as a younger person.
Effy
Hmm. Okay, that's excellent. It's the first time we're hearing that one. Actually. That's a good advice. Yeah. Okay, what is one romantic or sexual adventure on your bucket list?
Dr. Carlton
Well, sexual adventures have pretty much been taken care of. So I would say romantic adventure. I'm going to Greece this summer. And that's on my bucket list. And I think that's going to be so romantic. I
Effy
can't wait. Yes, we're in Greece,
Dr. Carlton
Santorini, Mykonos and Athens
Effy
I'll be crosstable different use a wave at me. How wave
Jacqueline
How do you challenge the status quo? It feels self evident, but don't ask the question. How do you challenge the status quo?
Dr. Carlton
I challenge this the status quo by trying to normalize but stuff you know, everybody's got one. But you got to say there's pleasure for everyone Gay Straight by queer. Everybody's got a but and but stuff doesn't make you you know, it's not reserved for a gender or sexual orientation doesn't make you masculine or feminine. And I think I challenge that status quo daily.
Effy
Nice, beautiful. So we are a curious bunch around here and we are curious about what you're curious about lately.
Dr. Carlton
I think my curiosity personally has been around fisting. fisting is something that seems to have really gained a lot of popularity during the pandemic. It's something I've never done personally. But I'm very, very curious as to how it feels. And to this as a top or a bottom. I always thought of it as a DOM sub kind of thing. But people that I've interviewed because I teach the anatomy of it and how to do it properly. But the connection that people have with fisting, and being fisted is something that I've never expected when I talk to people who are in the fishing community. Yeah, it takes a certain amount of trust, you know?
Effy
Sure. And I imagine the reason why it got popular during COVID is that it takes time, right?
Dr. Carlton
People have lots of time.
Effy
Yeah. So I think that's probably why I would imagine that's why you got popular and boredom, right? Like boredom, of the regular like boredom, or regular sex and plenty of time. You're like, oh, let's just get into this. This thing that is a little bit on the edge. Yeah, I mean, I have to say, when I've done fishing that I've, I have fisted somebody I have I have a tiny girl hands. Right? So you know, it's kind of the right tool for this. Honestly, when I think guys fisting each other. i It does make me hold my breath a little bit. Yeah. Are they boy hands on? Like, I don't know, that's a little scary to me.
Dr. Carlton
I have friends who are who do fisting porn. And they're like, over elbow deep in I'm like, how, how in the world? How do you do that? Yeah. But but that's that's pretty wild. Yeah. So there's something that I don't necessarily want to jump into. But I'm very curious about it.
Jacqueline
That's fantastic. Yeah. Well, thank you. Thank you so much for your time. Thank you for sharing all the wisdom. This is really fantastic conversation.
Dr. Carlton
Thank you for helping me spread the message.
Effy
bootiful Porter for a little clunky on my side, but beautiful.
Jacqueline
You can learn more from Dr. Carlton on his Tiktok and Instagram channels at Dr. Carlton dtoc to our car LTO n. And while you're online, you can look us up by going to our Facebook group and joining the conversation at we are curious foxes. You can share this podcast with friends and family and share far and wide and that will also start a conversation. You can come on to our page treon where you will have access not only to our podcast episodes ahead of time, but fun extras and videos from all of our previous workshops. Also at we are curious boxes. And finally we want to hear from you. So please email us send us a voice memo share a question or story at listening at we're curious foxes.com or our new number 646-450-9079
Effy
This episode is produced and edited by Nina Pollack, who whether we're talking about Busta Rhymes or conflict resolution, make sure we sound crystal clear. Our intro music is composed by dev Saha. We are so grateful for their work, and we're grateful to you for listening. As always, stay curious friends. Curious Fox podcast is not and will never be the final word on any topic. We solely aimed to encourage curiosity and provide a space for exploration through connection and story. We encourage you to listen with an open and curious mind, and we'll look forward to your feedback. Stay curious friends. Stay curious, curious, curious, curious, stay curious.
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