Choosing Life Without Sex

Question: How does sexuality differ across the globe?

Sara Nasserzadeh: When we're talking about global perspectives on sexuality, I have to say, again, based off my experience when I travel around the world, I can give you some really -- they are not strictly caught, you have to understand that, but on the other hand, there are some specific areas that I can generalize.

The first part is in the Middle East. The whole culture is so sexualized; the literature and the whole talking to each other women to women, men to men, they make lots of jokes and all that. But as soon as it comes to problem, problematizing the sexual life, people go silent. This is not something to be discussed. So they go to the doctor probably, at most.

In Asia and countries, South Asian countries, they are more conservative I would say. There is not a chance for you to joke around sex or use the sexual words. They are not as many sexualized words, if you like, in those cultures, even in the terminology that they have. So that is the difference between those two cultures.

But one of the similarities that you can find among Middle Eastern, South Asian, and Asian cultures is that actually sexuality is a part of the person's life; it comes naturally. So nobody tells them to supress them forever. For example, in some of the more religious Christian based countries or cultures. So they come to know their sexuality after marriage, but it is a part of the social life of a human being. So you are expected to be sexual, but it is after marriage.

But then you come to Western European countries and Northern American countries, it's mostly you can joke about sexuality. As far as you medicalize it, you problematize it, you speak about it scientifically, or on the other hand put it on the Hollywood movies, naked pleasureville and sassy, then it should be okay. But in everyday life, really, you don't sit with your girlfriends or boyfriends and joke about sex or talk about sex all the time.

So this is -- and also sex is a separate phenomenom. It could have nothing to do with your social life. You can just have sex, one night stands, and all that. It's your sexual part. And then you can have a total separate social life for yourself as well. So it's not something that is quite supported by your social network.

Question: What were some problems you saw in your London practice?

Sara Nasserzadeh: The good thing about being a clinician or practitioner in big cities like London or New York is that you don't necessarily see people from that specific city but you get to see people from all around the world. To add another plus, London, because it's close to many, many places like other European countries or Middle East or Southern Asia, I used to get some clients flying from Israel or France, different European countries as well as Middle Eastern countries or Israel. Just for short intense therapy, for specific sexual dysfunction. Most of the cases that I saw were related to vaginismus, which is the involuntary contraction of the vaginal entrance so that the penetration actually is not possible, the intercourse. So at the point that I used to see those couples, most of them would come to me based from very, very religious backgrounds and they just came to me to get pregnant.

For some of them, I would just ask them, "Is it important to you to have a sex life or are you just here to have sex to get pregnant?" If it is the second choice that you're making, no sex life but the baby, don't waste your money on me. Go and do it yourself. Like with the turkey baster or something. Or even go to a gynecologist. Just ask them to do the insemination for you. If was very interesting-- I had three couples who chose to do that, rather than going through the whole sex therapy and getting close to each other and all that. And that's perfectly okay because it really depends on the dynamic of the relationship. And when we are getting trained as therapists, the most important thing for us is the goal that the client wants to achieve because I might go there with lots of perceptions and expectations and want to impose it on my clients; that's not how it works. They come to you with specific agenda. You might give them information and based on that they might change their goals in their minds, but it doesn't happen all the time because they have their own dynamic of their relationship and the whole playing thing going on, give and take between the couple and the whole social circle around them: in-laws and the social capital that they have and all that.

Recorded on October 20, 2009

Couples counselor Sara Nasserzadeh has helped clients who don’t want, or can't have, a life in the bedroom find happiness elsewhere.

Scientists discover how to trap mysterious dark matter

A new method promises to capture an elusive dark world particle.

Surprising Science
  • Scientists working on the Large Hadron Collider (LHC) devised a method for trapping dark matter particles.
  • Dark matter is estimated to take up 26.8% of all matter in the Universe.
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Yale scientists restore brain function to 32 clinically dead pigs

Researchers hope the technology will further our understanding of the brain, but lawmakers may not be ready for the ethical challenges.

Still from John Stephenson's 1999 rendition of Animal Farm.
Surprising Science
  • Researchers at the Yale School of Medicine successfully restored some functions to pig brains that had been dead for hours.
  • They hope the technology will advance our understanding of the brain, potentially developing new treatments for debilitating diseases and disorders.
  • The research raises many ethical questions and puts to the test our current understanding of death.

The image of an undead brain coming back to live again is the stuff of science fiction. Not just any science fiction, specifically B-grade sci fi. What instantly springs to mind is the black-and-white horrors of films like Fiend Without a Face. Bad acting. Plastic monstrosities. Visible strings. And a spinal cord that, for some reason, is also a tentacle?

But like any good science fiction, it's only a matter of time before some manner of it seeps into our reality. This week's Nature published the findings of researchers who managed to restore function to pigs' brains that were clinically dead. At least, what we once thought of as dead.

What's dead may never die, it seems

The researchers did not hail from House Greyjoy — "What is dead may never die" — but came largely from the Yale School of Medicine. They connected 32 pig brains to a system called BrainEx. BrainEx is an artificial perfusion system — that is, a system that takes over the functions normally regulated by the organ. The pigs had been killed four hours earlier at a U.S. Department of Agriculture slaughterhouse; their brains completely removed from the skulls.

BrainEx pumped an experiment solution into the brain that essentially mimic blood flow. It brought oxygen and nutrients to the tissues, giving brain cells the resources to begin many normal functions. The cells began consuming and metabolizing sugars. The brains' immune systems kicked in. Neuron samples could carry an electrical signal. Some brain cells even responded to drugs.

The researchers have managed to keep some brains alive for up to 36 hours, and currently do not know if BrainEx can have sustained the brains longer. "It is conceivable we are just preventing the inevitable, and the brain won't be able to recover," said Nenad Sestan, Yale neuroscientist and the lead researcher.

As a control, other brains received either a fake solution or no solution at all. None revived brain activity and deteriorated as normal.

The researchers hope the technology can enhance our ability to study the brain and its cellular functions. One of the main avenues of such studies would be brain disorders and diseases. This could point the way to developing new of treatments for the likes of brain injuries, Alzheimer's, Huntington's, and neurodegenerative conditions.

"This is an extraordinary and very promising breakthrough for neuroscience. It immediately offers a much better model for studying the human brain, which is extraordinarily important, given the vast amount of human suffering from diseases of the mind [and] brain," Nita Farahany, the bioethicists at the Duke University School of Law who wrote the study's commentary, told National Geographic.

An ethical gray matter

Before anyone gets an Island of Dr. Moreau vibe, it's worth noting that the brains did not approach neural activity anywhere near consciousness.

The BrainEx solution contained chemicals that prevented neurons from firing. To be extra cautious, the researchers also monitored the brains for any such activity and were prepared to administer an anesthetic should they have seen signs of consciousness.

Even so, the research signals a massive debate to come regarding medical ethics and our definition of death.

Most countries define death, clinically speaking, as the irreversible loss of brain or circulatory function. This definition was already at odds with some folk- and value-centric understandings, but where do we go if it becomes possible to reverse clinical death with artificial perfusion?

"This is wild," Jonathan Moreno, a bioethicist at the University of Pennsylvania, told the New York Times. "If ever there was an issue that merited big public deliberation on the ethics of science and medicine, this is one."

One possible consequence involves organ donations. Some European countries require emergency responders to use a process that preserves organs when they cannot resuscitate a person. They continue to pump blood throughout the body, but use a "thoracic aortic occlusion balloon" to prevent that blood from reaching the brain.

The system is already controversial because it raises concerns about what caused the patient's death. But what happens when brain death becomes readily reversible? Stuart Younger, a bioethicist at Case Western Reserve University, told Nature that if BrainEx were to become widely available, it could shrink the pool of eligible donors.

"There's a potential conflict here between the interests of potential donors — who might not even be donors — and people who are waiting for organs," he said.

It will be a while before such experiments go anywhere near human subjects. A more immediate ethical question relates to how such experiments harm animal subjects.

Ethical review boards evaluate research protocols and can reject any that causes undue pain, suffering, or distress. Since dead animals feel no pain, suffer no trauma, they are typically approved as subjects. But how do such boards make a judgement regarding the suffering of a "cellularly active" brain? The distress of a partially alive brain?

The dilemma is unprecedented.

Setting new boundaries

Another science fiction story that comes to mind when discussing this story is, of course, Frankenstein. As Farahany told National Geographic: "It is definitely has [sic] a good science-fiction element to it, and it is restoring cellular function where we previously thought impossible. But to have Frankenstein, you need some degree of consciousness, some 'there' there. [The researchers] did not recover any form of consciousness in this study, and it is still unclear if we ever could. But we are one step closer to that possibility."

She's right. The researchers undertook their research for the betterment of humanity, and we may one day reap some unimaginable medical benefits from it. The ethical questions, however, remain as unsettling as the stories they remind us of.

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