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U.S. Journalist James Foley Beheaded By Islamic State

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Realizing You're a Pedophile Can Make You Want to Kill Yourself

Sexually abusing kids is about the worst thing you can be accused of in our society. The hatred reserved for those who do it is so intense that moral values we otherwise hold sacrosanct can be thrown out of the window in an instant in the rush to condemn. In the summer of 2013, for example, residents on a housing estate in the English city of Brighton burned a 44-year-old disabled man to death who they accused (wrongly, it turned out) of being a pedophile.

But pedophilia can be especially hard to live with for those who haven't committed a crime, and are forced to come to terms with an identity that most people regard as monstrous. For many pedophiles, that reality is the source of major depression.

"When I hear other pedophiles tell me that they are even relatively happy in life, I sometimes am tempted to ask them what fucking planet they live on," said Brett (not his real name), a 40-year-old landscaper who lives with his parents in the suburbs of a major US city and has suffered with depression since his early teens, when he first realized he was attracted to children. "How in the world can anyone go through every day living with this curse and not want to fling themselves off the nearest bridge on a daily basis?"

Sure enough, happy pedophiles seem to be the minority. A 1999 study of pedophilic sex offenders by the University of Minnesota's Department of Family Medicine and Community Health found that 76 percent had suffered from major depression in their life and another 9 percent met the criteria for mild depression.

"When you have a sexual preference that is as stigmatizing as pedophilia, then there's nowhere to go with it, there's no one to really talk to about it," said Professor Michael Miner, one of the study's co-authors. "So you stew in your isolation, which certainly makes one depressed."

Todd Nickerson is a 42-year-old pedophile from Tennessee. Struggling to come to terms with his sexual identity caused him many years of crippling depression. "I look back on it now and find it amazing that I never got to the point where I picked up a gun and ended it," he told me. "There were days when I got up and it was all I could think about. I'd tell myself, 'I just want to die. I just want to die.' All day, for days on end."

Nickerson's depression was made worse when, in his early 20s, he made the mistake of confiding in a cousin his attraction to young girls.

"Maybe it was an act of conscious self-sabotage because I knew my cousin and I knew he would spread it around," he said. "I live in a small southern town so I thought the whole town knew. I couldn't go out in public. I was constantly anxious and didn't want to leave my room."

Nickerson is a self-identified pedophile, but he insists he has never acted on his attractions and believes strongly that any sexual contact between adults and children constitutes abuse. Since most pedophiles are secretive about their sexuality, it's impossible to know how many share Nickerson's stance, but there are at least enough to have spawned an online forum, Virtuous Pedophiles, for those who acknowledge their taboo sexual interest without acting on it.

One of the co-founders of Virtuous Pedophiles, who goes by the pseudonym Ethan Edwards, said depression is so common among members that they have an ongoing poll on suicidal thoughts. While he acknowledged the results aren't scientific, they are nonetheless startling: Nearly 90 percent of responders said they have thought about killing themselves; 20 percent said they have tried.

Edwards, 60, who claims only to have realized he was a pedophile when he was well into middle age, said there are common reasons members give for feeling depressed. "Some just hate the awareness of the attraction itself. Some hate keeping a secret. Some hate having to be single. And a few worry about offending against a kid. I think a lot worry about not downloading child porn, which is a very compelling desire."

It's hard to feel sympathetic for someone who is depressed because they're resisting a temptation to watch child pornography. But even those who work with victims of child abuse stress the importance of separating pedophilic desire from behavior.

"Pedophilia refers to a strong sexual attraction to prepubescent children," said Dr. Ryan T. Shields, assistant scientist for the Moore Center for the Prevention of Child Sexual Abuse at John Hopkins University in Baltimore. "Many people who commit sex crimes against children are not pedophiles—they are situational offenders who are actually more attracted to peers. Likewise, many pedophiles never act on their attraction because they don't want to hurt children."

Of course, these nuances are largely overlooked in mainstream media, which tends to use the terms "pedophile" and "child sex offender" interchangeably. The truth is that not all pedophiles are child molesters, and not all child molesters are truly pedophiles, according to Dr. Shields.

"When we assume that only 'monsters' or total strangers are capable of hurting our children, we fail to see, much less act on, evidence that something might be wrong in our own social circles, because none of us believes our friends, relatives, or partners are 'monsters' and therefore they couldn't possibly be trying to engage a child in sex," said Dr. Shields.

Yet in reality, he said, "most of the time child sexual abuse is perpetrated by someone the child knows. In fact, half is committed by other children."

The "pedophile as monster" trope has also helped encourage the kind of vigilantism which, even when it doesn't lead to the horrific violence in Bristol, England, can still have terrible repercussions.

In 2013, someone accused 48-year-old Steven Rudderham of being a pedophile in a Facebook post. It's not clear what prompted the post (Rudderham had no record of sex offenses, and no one had complained to the police about him) but the post, which called him a "dirty perv," was circulated hundreds of times and Rudderham began receiving death threats. Three days later, Rudderham hanged himself.

The zenith or, depending on how you look at it, nadir of the vigilante justice movement came with Dateline NBC's show To Catch a Predator, which ran for three years until 2007 and featured stings operations where men seeking sex with children would be outed on TV. (The series was rebooted last year, and is now called Hansen vs. Predator.)

Men were lured via online chat rooms to safe houses where they would find themselves confronted by the show's host, Chris Hansen. In 2006, the show's crew joined police at the property of Louis Conradt, an assistant district attorney accused of grooming young boys online. After SWAT team members burst down the front door of his home in Murphy, Texas, Conradt shot himself in the head.

Much of the investigative work behind To Catch a Predator was carried out by volunteers from Perverted Justice, an online vigilante group that has made it their mission to expose pedophiles. Nickerson was targeted by the group after he outed himself as a pedophile in an online pedophilia forum.

"They called my job—I was working at Lowe's at the time—and got me fired," he told me. "Then someone in town found out and printed out my biography from the website and started leaving it around town. My dad's boss found out and fired him. My dad was mad at me and threw me out of the house."

Nickerson left town and went to live with a friend in Michigan. His depression grew worse and he started seeing a therapist. Before then, he had always steered clear of therapy, fearful that if he told a therapist about his sexual preference they would be bound by professional ethics to report him to authorities. This therapist didn't report him, but told him upfront there was little she could do for him since this was his sexuality and it wasn't likely to change.

While some people are unbothered by the idea of persecuting someone not because he committed a crime but because of a sexuality they didn't choose and don't want, there are good reasons to be against this kind of mob justice. While studying adolescents who sexually abused other children, Miner, the professor from the University of Minnesota, found these individuals had often grown up socially isolated and that this isolation "more likely predicts committing sex crimes against children as against committing other sorts of crimes."

"The less they have to lose, they less likely they are to adhere to social convention. It seems like it's to society's advantage to have those individuals with a propensity for acting out in some sort of deviant way to have better contact with social institutions, social norms, social involvement. That's a protective factor," Miner told me.

So pushing pedophiles further into the shadows by persecuting them at every turn may well increase the possibility that they will offend. Distancing pedophiles from society has also made some adopt extreme stances, like Tom O'Carroll, a British pedophile activist, who during the 1980s chaired a notorious pressure group called the Paedophile Information Exchange, which advocated abolishing consent laws completely. O'Carroll, who has been jailed for child pornography charges, admits on his blog that his views remain at odds with mainstream thinking with regards to "children's sexual self-determination."

Brett, while self-identifying as a pedophile, has "nothing but disdain and contempt" for people like O'Carroll, who are known within the pedophile community as "pro-contacters."

"It's partly because of that crowd so many people are unwilling to listen to me and pedophiles like me," he told me.

At the height of his depression, Todd Nickerson found himself being pushed towards the "pro-contact" agenda while using a pedophile forum, which he describes as being "like a cult" dominated by a few influential moderators.

"That's both the advantage and disadvantage of the internet," said Miner. "It allows these isolated people to reach out and find a likeminded community. The problem is that in reaching out they might make contact with those who encourage them in negative ways."

Nickerson said he eventually abandoned the forum and as he emerged from his depression was able "to see things for how they are, and not for how I want them to be."

It was around this time he also discovered Virtuous Pedophiles, which he credits with helping saving his life. Like Brett, he now works as a moderator on the site and is committed to helping other non-offending pedophiles find a way to learn to live with themselves in a world that still regards their existence as anathema.

"There are a lot of people out there who want to paint pedophiles as ticking time bombs and when you think that way it can become a self-fulfilling prophecy," said Nickerson. "But I'm here to say it doesn't have to be. I've been out for ten years and I've never abused a kid."

And while most of us are understandably horrified by Tom O'Carroll's belief system, it's worth considering how he believes he got to it. He told me that when he was younger he "accepted the general view that pedophilia must be harmful."

"Seeing only a bleak future with nothing to offer to a family or society or myself, I tried to take my own life," said O'Carroll. "If I had received some sympathetic help before it reached that point, my life might have taken a course for the better as many would see it: not so confrontational, working with society, not against it."

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Kreutz Ideology and Kreutz Religion advocate the patriarchy, which is the rule by mature men. This is, of course, gender politics. Gender politics is natural. Feminism also is gender politics. But feminism is whimsical.

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Can female preferences shape male behavior? In scientific terms, probably.

Can female preferences shape the behavior and appearance of males? This is a scientific question with a long, controversial history.

Shortly after the 1871 publication of Charles Darwin’s “The Descent of Man,” a biologist named St. George Mivart wrote a review criticizing its proposed theory of sexual selection: Mivart refused to believe that the preferences and choices of females could constitute a selective pressure that shaped the behavior and physiology of male animals. Relying more on Victorian male prejudice than scientific reasoning, Mivart concluded that “the instability of vicious feminine caprice” could never shape the evolution of males.

Darwin, however, believed that female preferences could in fact shape the evolution of ornamental traits in males (deer antlers, peacock feathers and the like). He even described sexual selection occurring through the mechanism of female agency: “The male Argus Pheasant acquired his beauty gradually through the preference of the females during many generations for the more highly ornamented males,” he wrote in “Descent.”

Darwin’s was a minority opinion, and it remains one to this day. Alfred Russel Wallace, the co-discoverer of evolution by natural selection, first articulated what has become a dominant view — that female animals simply prefer traits that are proxies for health and fitness. Beauty, in short, is just a sign of good genes, and females select mates on this basis alone.

A new book by Yale University ornithologist Richard O. Prum revives and expands Darwin’s provocative notion that beauty and genetic fitness are not always entwined. In “The Evolution of Beauty: How Darwin’s Forgotten Theory of Mate Choice Shapes the Animal World — and Us,” Prum develops a theory of aesthetic evolution that shows how the females of many species select male traits not for their fitness value but simply because they are pleasing.

This might sound like an esoteric distinction within evolutionary biology, but its consequences are far-reaching. If animals prefer mates based on criteria that are not simply proxies for genetic fitness, then evolution is a far more expansive process than generally imagined. It can even accommodate some maladaptive features and behaviors, so long as they have sufficient aesthetic appeal.

Darwin and Prum present evolution as more than an engine that selects organisms with adaptive advantages. They claim that sexual selection operates in part through individual aesthetic preferences for songs, dances, displays, ornaments and even behaviors. Animals are not only shaped by the natural world, they also shape their own evolution through their preferences.

It makes sense that an ornithologist would be a champion of the aesthetic dimensions of evolution. Prum has observed more than a third of the roughly 10,000 species of birds in the world. The vast variety of distinctive avian colorations and song patterns is difficult to explain solely in terms of adaptive fitness. The club-winged manakin, for instance, is a species from the Ecuadorian Andes that “sings” by rubbing its wings together at high frequencies. These wing songs require evolutionary changes that are actually maladaptive. While other species of birds have hollow bones, the club-winged manakins have solid ulnas that help enhance the sound production of their wing songs. This decreases their flight capacity and efficiency, but these disadvantages seem to be offset by the mating opportunities that the songs create.

This is just one of many examples. Spotted bowerbirds from Australia have precise preferences for the types and colors of materials they use to build bowers, the ornamental structures they use to attract mates. One species favors a particular shade of royal blue, while another uses an optical illusion known as forced perspective that makes objects appear to be a different size than they actually are. The birds are not simply advertising their physical strength by collecting bower construction materials that are more difficult to find. They use very common materials — the skill is in the arrangement. “There is no compelling evidence that bower decorations are costly, honest signals of male quality,” Prum writes. “Rather, they appear to vary like any other aesthetic styles among species.” Males with better-constructed and more elaborately decorated bowers are rewarded with more mating opportunities.

The particulars of avian architecture, courtship dances and songs are thus somewhat contingent and arbitrary. Rather than functioning as signals of health or genetic quality, these complex behaviors develop over generations through the selective pressure of countless individual choices by avian females. Prum argues convincingly that the subjective experience of animals — the pleasure they take in aesthetic display — is a major evolutionary force. What is less clear and never really considered is whether animals are conscious of this pleasure and what it means when we say they experience beauty.

Prum opens his argument with avian examples, but he closes it by considering how the same principles might have shaped human evolution. He speculates that a broad range of features and behaviors — such as deweaponized canine teeth, eyebrows and pubic hair — may have originated through aesthetic evolution. Perhaps human females preferred some of these traits in males on purely aesthetic grounds: It’s hard to account for eyebrows as a highly functional indicator of genetic quality.

Prum is particularly eager to emphasize the role that female mating preferences may have played in human evolution, as if feminist arguments were simply waiting for the imprimatur of a biologist. While some of these conjectures are more plausible than others, the book is a major intellectual achievement that should hasten the adoption of a more expansive style of evolutionary explanation that Darwin himself would have appreciated.

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Arson is the terrorism of the future. Maximum damage. No need to sacrifice their lives.

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95 percent of the victims of violence are men. Because women feel flattered when men fight each other and kill each other to prove that they are real men.

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The pleasure doctor fighting to restore clitorises after female genital mutilation

Marci Bowers’ clinic in California is famous for those seeking gender-reassignment surgery. Her work as a gynaecological surgeon over the past 25 years has made her one of the leaders in this field – and also in restoring sexual function in clitorises. She is one of only a handful of surgeons who performs this surgery on women who have suffered female genital mutilation (FGM) or cutting.

Reconstructive surgery to repair the physical damage of FGM has been around a long time. But the technique to restore clitoral function began developing only a decade ago, pioneered by French urologist and surgeon Pierre Foldès. His idea was to not only reconstruct the clitoris, but also nerve networks to restore sexual sensation. After training with Foldès, Bowers performed the first clitoral repair surgery in the US in 2009. Since then, she’s operated on around 100 women.

For many women and girls who undergo FGM, it’s a traumatic experience. FGM is the partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons. Up to 140m women and girls live with the consequences of this practice and it is widespread in 29 African countries, but it also occurs in Asia, the Middle East, Latin America and among migrants from these areas.

The clitoris is an important part of a woman’s sexuality and along with the severe medical and psychological consequences that cutting can have, it can also come with psycho-sexual problems.

The clitoris

The clitoris is a complex organ, and when a woman undergoes cutting, only the visible part of the clitoris is cut off. But it is much larger than most people ever assume. It has a root that is about 10cm long that lies beneath the surface, arching around the vagina. It is this that reconstructive surgeons use to rebuild a working organ.

“It’s only like losing the visible tip of the iceberg,” Bowers says. The surgery, also known as clitoroplasty, involves removing scar tissue, pulling the remaining clitoris up to the surface, and then stitching it into its natural place.

According to Bowers, the restoration of sexual pleasure is possible because the whole clitoris is sensory, not just the tip. Along with better cosmetic appearance, sensation, and reduction in pain and infection, Bowers says that patients have reported having orgasms for the first time.

But it’s not just about the restoration of sexual sensation. “The number one reason is restoration of identity,” she said. Women who have been cut feel their sense of womanhood has been stolen from them and they want that back. “They want their body back and to feel more normal. It’s about not being different any more.”

The fall out

As good as all this might sound, the procedure is controversial. In 2012, Foldès and colleagues published an article in The Lancet assessing the immediate and long-term outcomes of reconstructive surgery. Over an 11-year period they operated on nearly 3,000 patients, and of the 29% who attended a one-year follow-up consultation, more than half said they were having orgasms and nearly all reported feeling clitoral pleasure.

But a group of British doctors responded in a critical letter to The Lancet. In addition to the lack of a control group, they said the Foldès’ claims were anatomically impossible in cases of type 2 FGM – the partial or total removal of the clitoris and the labia minora. “Where the body of the clitoris has been removed, the neurovascular bundle cannot be preserved … There is therefore no reality to the claim that surgery can excavate and expose buried tissue,” they wrote.

They also said that the campaign against FGM “could be undermined by a false proposition that the ill effects can be reversed”.

Bowers doesn’t agree – both in terms of the surgery and of undermining efforts to fight FGM. “You see the clitoris every single time, 100% of the time. You can’t deny it’s there,” she says. According to Bowers, their response reflects antiquated but persistent notions of female sexuality. The work of NGOs is important, she argues, but if something can be medically fixed, it should be fixed.

And she’s not short of patients. Twice a year she leaves her reported 14-month waiting list for US$21,000 gender reassignment surgery to operate for free on women who come to her for clitoroplasty, although patients still pay a $1,700 admin fee to the clinic.

She’s adamant that she only helps those who want it and who, she says, often come to her unhappy, angry and sad with husbands and partners. “We were only there to help women who found that they were suffering as a result of FGM,” she says. It’s probably fair to say, then, that Bowers is an evangelist for reconstructive surgery.

The pleasure hospital

Bowers became involved in the FGM reconstruction surgeries because of Clitoraid, a private, non-profit organisation that helped fund her training in Paris. The organisation is backed by volunteers of the Raëlian movement – one of the world’s largest UFO religious sects – whose members believe that humans were created by extra-terrestrials. Clitoraid promote free sexuality, sexual freedom and pleasure for all women.

Bowers’ own motivation doesn’t come from a Raëlian perspective, she says, but from her own philosophy that human beings have a sixth sexual sense. “When the sexual sense is taken away, it’s no different than if someone had taken away your sense of smell or your sense of taste.”

It’s clear, though, that her belief runs in parallel with the aims of Clitoraid, which has concentrated its work in the small West African nation of Burkina Faso, recently building a hospital nicknamed the “pleasure hospital” to offer reconstructive operations free of charge. The hospital was supposed to have opened its doors in March 2013 with local medical staff and trained surgeons, but the government stopped the project because of licensing issues. Clitoraid has said its authorisation was revoked following pressure from the Catholic Church and accusations that the group would attempt to convert women to the Raelian movement. The group still intend to open next year.

Ultimately, Bowers claims the enjoyment of sexual activity is a human right. “Sexuality is part of what makes us human beings and what makes life pleasurable,” she says. Before transitioning to life as a woman, she herself was born male. And this, she says, gives her empathy with victims of FGM. “For me, womanhood didn’t come without my own sacrifices and struggle. I empathise with women who have to have surgery to achieve and regain their womanhood. They are struggling to regain their identity, just like I had to do once upon a time myself.”

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Mahatma Gandhi was just another Indian creep. When he couldn't get it up anymore, he vowed celibacy. For him, this meant: no penetration, ejaculation. That's easy for an impotent guy. But even impotent men are sexual. For Gandhi, the pervert trickery were his "experiments". Spend the night in nakedness with undressed women, young girls, even female children. Do harmony, but no penetration. Gandhi's creepy chastity.

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The "Vagina Whisperer" Will See You Now

As far as publicity stunts go, the “first ever designer vagina showcase” was pretty damn effective. Timed to coincide with the spectacular runway parades that mark New York Fashion Week, the event was Dr. Amir Marashi’s chance to show the world what he can do: With a little slicing and suturing, he can give you the vagina of your dreams.

Inside the sprawling midtown conference room where the “show” would take place, sparkling rosé and cupcakes were served. Guests were greeted by a perfectly taut, hair-free, millennial pink silicone vagina model, which Dr. Marashi then used to explain the slate of procedures on offer during his powerpoint presentation of before-and-after vulva shots. There were the uneven labia minora that he’s trimmed (click), aging labia majora that he’s plumped (click), lax vaginal openings that he’s tightened (click), and those were just the surgical options. If you don’t like the idea of anesthesia, he can plump your lips with fillers, inject your G-spot with your own blood plasma to improve orgasms, or stick a laser wand inside you to painlessly tighten things up. If you didn’t walk into the showcase thinking your vagina was defective, you likely walked out of there worried over just how many ways it could be flawed.

For his part, Dr. Marashi, the self-described “vagina whisperer,” walked out with a lot of press. Yes, the concept was vulgar, but it got the job done: Over the next few days, there were articles in the New York Post, Jezebel and The Sun. He’s since been interviewed by Z100 and The Daily Mail, and outlets are becoming increasingly happy to add “vagina whisperer” to his other title, board-certified Ob/Gyn, as if it’s an actual qualification. All of this is why, two months after the showcase, I find myself in scrubs in a nondescript surgical center in Downtown Brooklyn waiting for Dr. Marashi to lead me through an up-close look at what this is all about. Yep, I’m about to observe a designer vagina surgery IRL, and it’s almost curtain time.

In the operating room, he’s telling me about how important it is to find a doctor who does these surgeries regularly. “This is why I do revisions a lot,” he says, in his slight Persian accent. “People think somebody is on Park Avenue so they’re good, but they might not do these over and over again.” He says he does these procedures three days a week, and has probably done more than 700 by now.

Dr. Marashi’s patient for today is lying on the operating table, knocked out, intubated, and covered by a sheet. She’s a 48-year-old mother of four who says she can feel nothing during sex. A nurse and surgical technician have just positioned the patient’s legs in stirrups, wrapping each one up in a sheet, so only her vulva remains exposed. Dr. Marashi is explaining that these cosmetic surgeries only make up half of his practice; he spends the rest of the time doing laparoscopic surgeries for pelvic pain related to endometriosis and fibroids. For those surgeries, “we listen to Enrique,” he says, and I assume he means Iglesias, but I don’t ask because he’s moving so quickly. “For vaginoplasties and labiaplasties, I want to get the right side of my brain to work, the more creative side. So I listen to Frank Sinatra.”

“Can we turn up the music?” Dr. Marashi asks with a wink, and “My Way” comes over the speaker. It’s a fitting song for a man who would later tell me he started doing cosmetic surgery because he likes to be “outside the box.”

Dr. Marashi sits down on his stool in between the patient’s legs and snaps a “before” pic on his iPhone. He slips on a pair of gloves and enters full doctor mode as he signals me to come take a look. Her vagina looks just as expected. But then Dr. Marashi spreads her lips, revealing a startling laxity and — "What’s that?" I ask, about the round, meaty tissue bulging down from the top of her vagina. “That’s the bladder,” he says. More importantly, though, is that her perineal body, the muscle tissue that separates the vagina from the rectum, is completely flaccid. He sticks a finger in her anus and pushes up to show me how weak and sponge-y it is, and how this creates a drooping of the vaginal opening into the woman’s butt. This is what creates the lack of sensation, he explains. The vaginal opening should hug two fingers, and it should be much higher.

“This is a patient who has had four vaginal deliveries,” he says. Her kids are aged 19 to 27, and she hasn’t enjoyed sex for a long time. Her first husband left her, and she blames her inability to grip his penis during sex as one of the reasons. But she’s in a new relationship now and she doesn’t want to put up with it anymore. (At least, that is what Dr. Marashi tells me. The patient declined to speak to me directly.) “She didn’t take care of it sooner because of the taboo that’s with it, or maybe she didn’t have the money, you know all these things that get in people’s way.”

The “taboo” that Dr. Marashi refers to is very real. Between 2010 and 2016, the United States saw a more than 100% increase in labiaplasties, a surgery to trim the inner or outer labia. No one is tracking the number of cosmetic vaginoplasty procedures, also referred to as “vaginal rejuvenation,” because the practice is too new, but experts estimate a similar increase in demand thanks to new non-surgical options and greater public awareness. (Kourtney and Kim Kardashian have both reportedly been “rejuvenated” via the new non-surgical laser options.) A lot of this rise has coincided with a surge in social media, reality TV, and endless amounts of free porn, which has, in turn, been blamed for creating an impossible standard of beauty for female genitalia — as if women needed yet another standard to measure themselves against, another reason to hate their bodies.

"Is this really what women want? Or is this really a form of new-age ‘circumcision’ based on an obsession with Barbie doll looks?," asked a scathing 2012 editorial in Obstetrics & Gynecology. A Jezebel article on Dr. Marashi’s vagina showcase described people who choose labiaplasty as women with minds “warped” by the porn industry. That’s what critics have said, and that’s exactly what I was thinking, walking in. But now that I’m witnessing the surgery, it’s not clear that assessment is fair.

Dr. Marashi uses a blue marker to map out where he will cut. Once he’s done that, Charles, the surgical tech, clamps her vagina open, and Dr. Marashi begins to cut away a diamond-shaped chunk of muscle and skin from the bottom of her vaginal opening. Then comes the most important cut: a deep crevasse into the perineal body.

“It’s really important to take your time and dissect this very meticulously, because behind here is the rectum,” and any crossover could lead to a dangerous infection, he says. Dr. Marashi then sews multiple rows of sutures into the perineal body, starting from further inside of her vagina until he gets to the outside, where he finishes with a row of stitches up from her anus to the new, lifted bottom of her vaginal opening.

“Remember in the beginning how close the vagina and the anus were together? You're gonna see in the end how far apart it’s gonna be,” he says.

In the end, I do see how much higher the vagina is. The hour-long process reminds me of a slower version of that magical strapless, backless bra Amber Rose has been advertising on Instagram: It’s as if he just threaded it all, and pulled the strings tight so that the whole vagina is miraculously lifted an inch higher. The final stitches are the tying of the bow that holds it all in place.

If I had to choose a vagina for myself, I’d pick this one over the one she had before. This makes me feel really bad, until I remember that there are also the anatomical realities here: Sewing it all back together with multiple layers of sutures is not just for aesthetics; this is a repair job for that muscle. This repair will also create a lift in the bladder that may even help alleviate stress incontinence, not to mention making penetrative sex feel good again for her partner, yes, but also for her.

It’s hard to square all that with the way Dr. Marashi has marketed himself, and indeed the way the entire, fast-growing crop of “cosmetic gynecologists” have marketed this burgeoning industry, as though this is just about having pretty, youthful genitalia. In the operating room, it’s clear that selling this the way women were sold facelifts, Botox, or even breast lifts is not quite right. Having sagging breasts and wrinkles may not make you feel so great about yourself (especially in our youth-obsessed culture), but those things don’t make sex physically impossible to enjoy. And they have nothing to do with a problem as distressing as incontinence.

To hear Dr. Marashi describe it while he’s actually doing the procedure, women choose this surgery mostly for functional reasons: to make sex better, the way it was before they had a baby or three, and to stop peeing their pants (even just a little bit) when they sneeze or lift weights. So, why on earth is the best way Dr. Marashi can think to market himself a grotesque showcase that frames everything in terms of how the vagina looks? More importantly: Why is this woman paying out-of-pocket for a one-time tune-up for her perineal body, when her partner could easily get insurance to cover his lifetime supply of Viagra?

To even begin to answer these questions, you have to understand where “cosmetic gynecology” came from in the first place. Plastic surgery — cosmetic gynecology’s closest cousin — has always been controversial, but it has also always been a mixture of reconstructive surgeries (like implants after breast cancer) and elective surgeries (like breast lifts or implants simply because you want them).

Cosmetic gynecology seems to be a similar mixture — but thanks to a toxic combination of entrenched sexism and continued dismissal of women’s sexual concerns, even the reconstructive procedures are still deemed frivolous, unscientific, and ironically, misogynistic.

The truth is that gynecologists have always done vaginoplasties and labiaplasties, but historically they would only do them for women with “true” medical problems, such as uterine prolapse (when the pelvic muscles collapse completely and the uterus descends into the vagina) or labial hypertrophy, which is when the labia minora or majora are extremely long or uneven. Outside of that, most doctors deemed them unnecessary, says Marco Pelosi, III, MD, a pioneer in the field. “There has always been a chasm between what doctors consider a problem and what women consider a problem when it comes to their sex lives,” he says.

Variations in labia length are totally normal, as any gynecologist or even anyone who watches porn regularly, can tell you. And while, say, painful sex or prolapse are “real” medical issues, constant irritation caused by your long labia or even a change in sensation after childbirth are not, according to traditional medicine, Dr. Pelosi explains. So for years, the procedures remained unpopular thanks to low awareness and low interest among women, as well as low adoption among qualified physicians.

Then, Sex And The City happened. Brazilian waxes became very popular — and baldness meant better opportunities for women to actually look at (and, yes, scrutinize) the physical characteristics of their vulvas.

In a post-Samantha Jones world, the gates opened: Women were much less shy about openly complaining to their doctors about their sexual dissatisfaction. And when their doctors didn’t listen, they found another doctor. All of a sudden, women had gotten the message that they deserve pleasurable sex. This created a huge opening for the few doctors who did offer these vagina alteration services to grow their businesses.

On the East Coast, Dr. Pelosi (along with his father Marco Pelosi, II, MD) — who had been offering elective vagina procedures since the ‘90s — began training surgeons in Bayonne, New Jersey. Eventually, due to demand, the father-son duo founded the International Society of Cosmetogynecology in 2004; they were the first to coin the phrase “cosmetic gynecology.”

Meanwhile, in Beverly Hills, Dr. David Matlock had trademarked the term “laser vaginal rejuvenation” and started a franchise business where he performed surgeries and, for a hefty fee, trained other doctors in his procedure. This allowed doctors to use the term to market the procedure, which is essentially a slightly modified version of vaginoplasty, the same way he did. This being L.A., Dr. Matlock also managed to swing an appearance on an episode of the E! network’s Dr. 90210 in 2006, giving "laser vaginal rejuvenation" its first national spotlight.

Soon, as a workaround to Dr. Matlock’s hefty fee, other doctors just dropped the “laser” and started calling it simply “vaginal rejuvenation.” This prompted the American College of Gynecologists (ACOG) to issue a scathing committee opinion in 2007 deeming the marketing practices and franchising surrounding the term “troubling” and the procedures “not medically necessary.”

But warnings from ACOG didn't do much to stem the rising tide of demand. As the rise of social media and Dr. Google continued, labiaplasty alone started to explode in popularity, experiencing a 44% increase between 2012 and 2013 (the first period for which data was tracked). Dr. Matlock only grew more famous — and not necessarily in a good way. He went on The Doctors with his wife Veronica, who got a vaginoplasty, labiaplasty, and “pubic liposculpting” from her husband. And who can forget when Brandi Glanville, the Real Housewife, infamously charged her vaginoplasty to her cheating ex, Eddie Cibrian’s, credit card? Dr. Matlock was her doctor.

Soon, there were myriad non-surgical options for “enhancements,” each one more bizarre than the next. There were liposculpting and fillers for your vulva, followed by g-spot injections (which would supposedly improve orgasms), and targeted skin lightening treatments that would change the shade of a vulva to Carnation Pink. In hindsight, the vajazzling phenomenon — the iconic ‘00s trend of adorning your waxed pubic area with rhinestones — seems inevitable. And while it’s easy to roundly mock all the upgrades and accoutrements, the thing is, the vulva was having a moment, one that no one seemed to notice except to mock.

Most recently came the big innovation (and the big money-maker): lasers and radiofrequency devices that use thermal energy to tighten the vagina. FemiLift, the machine Dr. Marashi uses, came first in 2013. Then MonaLisa arrived in 2014. Both machines are FDA-approved for “vaginal laser ablation” to induce the growth of collagen in the vaginal walls. This is said to not only tighten and lift the vagina, but also to improve the health of the mucosal lining, making lubrication easier. Another side effect: The lifting may help some with stress incontinence, and in some cases may even shorten labia. Other machines that use thermal energy technology to the same effect: ThermiVa, Diva, IntimaLas, and more.

No doubt the ease in getting non-surgical vaginal rejuvenation has coincided with the huge increase in demand. According to data from the American Society for Aesthetic Plastic Surgery (ASAPS), more than 10,000 labiaplasties were performed by plastic surgeons in 2016, a 23% increase just from 2015. Now more than 35% of plastic surgeons offer the procedure, compared to 0% in 1997 when the society started their surveys. But the full breadth of designer vagina procedures remains a mystery, since nobody is tracking the variety of procedures that fall under the term vaginal rejuvenation, nor the number of doctors performing them, according to a spokesperson at ASAPS.

Because a laser treatment or an injection requires no anesthesia or downtime — all it takes is a series of in-office visits that amounts to having a laser wand inserted into your vagina — “it became a gateway,” Dr. Pelosi says. “Once you have a nonsurgical way to address some of the needs, it becomes way easier to do. It’s like Botox. Now everyone does Botox.”

Sandra*, a 31-year-old mother of one, has spent the past five years since the birth of her daughter yearning for her pre-baby vagina. Before she gave birth, sex was great. Now it’s lackluster. It wasn’t until she started Googling her symptoms and found her way to Dr. Marashi’s website that she realized there was a single thing she could do about it.

“After you have a baby, everything changes,” she says. “I realized during sex I wouldn’t stay as wet, and it just felt different. Also there were the urination issues, too.”

“This is definitely going to help a little bit with that,” Dr. Marashi says, handing her a pair of protective glasses. She’s laying on her back with her feet in stirrups and a paper gown over her lower body, ready for her second of three treatments with Dr. Marashi’s FemiLift machine. This time, he has outfitted me in a white coat to serve as his assistant while observing Sandra’s procedure.

It’s hard to say exactly how common Sandra’s situation is, but any mom (or any doctor) can tell you that it’s pretty prevalent. We all know that childbirth changes things. Another thing we can say for sure: A full third of women who have given birth vaginally have some damage to the muscles responsible for vaginal tightness. Vaginal delivery is the strongest predictor of developing a pelvic floor disorder, such as uterine prolapse, rectocele (when the rectum bulges into the vagina), or cystocele (when the bladder bulges into the vagina). The feeling of “looseness” that so many women come to plastic surgeons and cosmetic gynecologists to fix may actually be one of the earliest precursors to true prolapse, per a 2014 study in Surgical Technology International.

The treatment takes 10 minutes, tops. We all put on our protective glasses. Dr. Marashi replaces the glass cover on the probe, which looks like a clear dildo with a mirror on the tip to direct the searing light, with the one Sandra had to purchase. Each patient must bring her own personal probe cover ($150, not covered by insurance) with her to appointments.

Next, he inserts the probe, attached to a long bending metal arm that is connected to a machine. He steps on a pedal while simultaneously pushing the probe in and out and twisting the probe around inside of her. Every time Dr. Marashi presses the floor pedal, the laser is turned on and the mirror directs it to burn 81 tiny holes into the lining of the vagina. With the twisting and maneuvering, what you end up with is thousands of tiny holes, which draws a lot of healing blood flow to the area and promotes the growth of collagen, making the skin more taut. Industry-sponsored studies have also shown that it makes the vaginal lining thicker, which is why lubrication is easier. This is repeated three times at increasing levels of intensity. As his assistant, I press the button when he tells me to, to ramp up the intensity.

Afterward, Sandra says that it didn’t hurt at all — just a bit of tingling and burning toward the end. But it was hard not to notice the grimace on her face when the laser was all the way turned up.

Even just after the first treatment, she already feels some difference: “Sex is amazing,” she says. “It’s much better.” And now after this go-round with the laser, she should feel 70% of the potential effects; she can have sex after just two days of healing. In another 4 to 6 weeks, she’ll come in for a third appointment, and that’s when she will really see how amazing this treatment is, Dr. Marashi promises.

But it’s unclear how “amazing” the treatment really is in general. The machines are FDA-approved, which means they are safe to use. Many of the studies on the non-surgical options show positive results as far as improving lubrication and stress incontinence, but the studies are small, with only short-term follow-up. There is also not a lot of high-quality data on how well the machines work for improving vaginal laxity or sexual satisfaction. In practice, the experts I interviewed said although women can expect some result, it can vary widely depending on the particular patient and how experienced the person doing the procedure is — which is risky considering the cost ranges from $1,200 to $4,000 depending on the device.

The same can be said of the actual surgeries, in part due to the same reason there aren’t statistics on vaginal rejuvenation surgery: It’s still an ever-evolving term, and it can mean different things to different doctors. One 2012 paper from The American Journal of Cosmetic Surgery says it’s difficult to study whether vaginal rejuvenation surgery “necessarily, usually, or reliably” improves sex because surgeons don’t want to share their surgical techniques (this is why ACOG hates the trademark model; when surgical techniques are “owned” by a doctor, they become hard to evaluate independently), and the outcome measurements are fickle (it’s difficult to reliably measure sexual satisfaction).

Otherwise, a few smaller studies have been conducted on specific techniques: One 2016 Turkish study of 68 women who chose surgery after complaining of vaginal laxity found that 88% said they were satisfied with the results after 6 months. There were no serious complications, except that 10% of patients reported pain during sex at follow-up. Another 2014 study conducted in Iran followed 76 women for 18 months following an elective vaginal surgery to address sexual complaints. At six months, researchers found that sexual satisfaction increased on average a few points on a validated sexual function questionnaire, but that painful sex and dryness had also increased. By 18 months, though, sexual function scores increased significantly, while the pain and dryness issues disappeared. These results are promising, but again the studies are too small to be certain, and results can vary based on minute changes to the surgical technique.

Still, many women swear there are completely valid reasons for these procedures — that their lives are changed for the better because of them, even for the procedures that seem totally about looks, like labiaplasty. “Absolutely love this doctor. He is very respectful and listens to what you have to say and doesn't give you the run-around,” reads one of the many breathless Zocdoc reviews for Dr. Marashi. “He performed a labiaplasty due to an accident I had a few years back and omg it looks sooo good like as if the accident never happened.” Katina Morrell, 41, another of Dr. Marashi’s patients, tells me she got a labiaplasty because her long labia made working out uncomfortable.

Jennifer Walden, MD, a plastic surgeon based in Austin, TX, who does “a high volume of labiaplasties and vaginoplasties,” was among the first wave of doctors to see the potential value of the laser machines. She also happens to be a woman, the mother of twins, and to have tried two of the procedures herself: ThermiVa and Diva. As a practitioner, she describes vaginal rejuvenation procedures as “absolutely, the opposite of misogynistic.” As a patient she describes the results as simply “awesome.”

Before the laser machines hit the market, there was nothing to offer women with sexual complaints other than surgery, which, unless they had a severe injury, could cost up to $12,000. There was no treatment for mild or moderate stress incontinence, outside of the “disastrous” vaginal mesh surgeries that were only worth doing for the worst of cases and medications that hardly work, she says. There was also nothing outside of estrogen creams (which are too dangerous for some women with a history of breast cancer or heart disease) to solve dryness or other lubrication issues. The laser procedures can still be pricey, and they don’t work as well as surgery. Also: the effects may only last for about a year, but still, it’s something, Dr. Walden says.

“Within the past 5 years, we’ve seen a sort of a-ha moment happening for women. It’s become okay for women to talk about their labia and their vagina with their doctors. It’s become okay for women to finally talk about sex and the real issues they’re having,” she says. “And, at the same time, we’ve finally had something to offer them.”

Yet the conundrum persists: Why then, on God’s green earth, is “vaginal rejuvenation” marketed as a frivolous lifestyle choice, instead of a possible treatment for a legitimate problem?

Well, partly it’s that the majority of pioneers in this field are men, and so the desire and need for these treatments is framed from their perspective — ah, the male gaze at work. Add to that the general cultural tendency to code all things female as frivolous and vain and to reduce women to their looks, alongside our inability to talk openly about female sexual pleasure, and it makes more sense.

It is the marketing of the treatment — not the treatment itself — that risks preying on women’s insecurities, and it would be a mistake to ignore the ugly fact that though vaginal rejuvenation is a positive for some (maybe even many) it does create a perception that there is a perfect-looking, or even a perfect-working, vagina out there, and no, you don’t have it.

In my time with Dr. Marashi, there was a 43-year-old mom of two who learned about Dr. Marashi’s Femilift procedure from Groupon, who had no sexual or urinary complaints. She seemed most attracted to the idea of being 18 again.

Then there was the second vaginoplasty I observed on surgery day. It was identical to the first, technically, except that the next patient was much younger, a mother of one, who was in a new relationship with a man who is “small,” Dr. Marashi explained. Her perineal body wasn’t nearly as damaged, and she had no visible signs of bladder prolapse. The idea that she did it for her partner made me sad, and before I could ask Dr. Marashi his thoughts he said: “Honestly she could have gotten away with this. I told her she could wait. But she said no, she doesn’t want to have any more children, and she’s with this new guy. So that’s her reasoning.”

In that moment, all over again, I was reminded of the critics who say this whole thing is just a gold rush of money-hungry, often male doctors willing to pathologize normal biology in service of making the vagina the final frontier in plastic surgery. That all this boils down to is a sanctioned form of Female Genital Mutilation (FGM), just another way to reduce women’s bodies to mere objects for male pleasure.

Dr. Marashi doesn’t go that far. But he does admit that, a lot of the time, these procedures are a simple matter of want, not need. “So many times I get a patient and I’m like, 'Look, you don’t need anything to be done.' Now it’s a different story if they say, 'I want to do this.' I figure out why, and if they are good candidate, I say 'Okay, I’ll do it for you,'” he says. “At the end of the day, if I don’t do that procedure, someone else will do it, and I know I will do a better job.”

He doesn’t see the harm in doing what they want as long as he screens patients appropriately: He always looks for signs of body dysmorphia or partner pressure, of course. But in his view, the procedures are no more risky than other elective surgeries, and he’s personally seen the benefits in his patients for himself.

Still, wouldn’t it be better to explain to these women that, for example, it’s totally normal for their labia to be a bit longer? When Dr. Marashi is pressed on this, he launches into a diatribe about how a woman, not a doctor, should be making the decisions about what she does or does not deem a problem or a symptom for her body and her life. “I tell my patients: 'All vaginas, all labias, they’re all beautiful in their own way,'” he says. “I always tell people, ‘Do not ever do this for anybody else. You own your vagina.’”

As right as he is about that, it’s impossible to completely untangle the desire for these procedures from the pressures women face simply being alive in a youth- and beauty-obsessed culture. What’s also impossible to ignore, though, is that women’s sexual function has never gotten the same amount of research — or respect — as men's.

So perhaps in the end, Dr. Marashi is neither villain nor hero — he is but an emissary. Make what you will of his misguided self-promotion methods. But he has also devoted his life’s work to studying and addressing a facet of women’s lives that — until now — most of medicine has refused to acknowledge even exists. If that makes him a “vagina whisperer,” then so be it.

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It's not that all cultures are of the same quality. Some cultures are better than others. They have more value. Other cultures are pretty miserable, and some cultures are outright shitty, and should be eradicated. European culture, for example, is deplorable. The Arab and Chinese cultures are much better.

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"Are there any last words?" Harrowing VR simulator reveals what final moments are like at assisted suicide clinic Dignitas

The Last Moments offers viewers an interactive experience of being helped to die at Dignitas - where hundreds of Brits have chosen to end their lives

Mirror

"Are you sure you wish to drink this in which you will sleep and die?".

These are the harrowing words in which people are helped to die at Dignitas in a new virtual reality film.

Wearing a headset, viewers are transported to the Swiss assisted suicide clinic where hundreds of Brits have chosen to end their lives.

The eerie experience was created by London-based writer-director Avril Furness whose film The Last Moments allows people to choose when to die.

The film's trailer states: "What would your last moments look like?"

It then cuts to two women in a hospital room.

A blonde woman, seemingly a loved one or relative, tries to feign a smile as tears run down her cheek as she sits at a table.

While a brown-haired woman, who is a nurse apparently, is silently stood at the window apparently overlooking the Swiss countryside.

The film then switches so the viewer is in a bed having their hand held by the loved one while the nurse walks in with a bottle of pharmaceuticals and a cup of water.

She asks the viewer: "Are there any last words?"

They are then offered the drink in which they are warned they will sleep and then die.

Writing on her website, Ms Furness said the interactive docudrama allows people to "experience an assisted suicide and either end their life or carry on living".

She added: "The choice the viewer makes directly impacts the outcome of the film and also allows for choices to be polled to help spark debate on this sensitive issue."

Ms Furness came across the idea for the film when she saw a full-scale replica of the Dignitas clinic at Bristol University while writing a dystopian script inspired by Charlie Brooker's Black Mirror.

According to the film, one Briton travels to Dignitas every two weeks to end their lives since the clinic opened in 1998.

In May last year the film was shown to medical specialists, PhD researchers and right-to-die campaigners at a euthanasia conference in Amsterdam.

It has since been submitted to various international film festivals with plans to take it on a tour of UK venues.

But Ms Furness said she is wary of making the film more accessible online without the "necessary framework".

She told Wired magazine: "It’s important to introduce context upfront, allow the viewer to experience the film, and then provide an “after-care” environment for people to decompress and potentially hold debates around what they’ve just witnessed."

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Tongkat ali standardization is a scam, copied many times over on the Internet. Good for you if it's just a lie (which most probably it is) . Bad for you if indeed they enrich their alleged tongkat ali with eurycomanone. Because it would be reagent grade eurycomanone, not pharmaceutical grade. Better be careful with your health.

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You probably have to look at imagery of death and dying regularly to stay focused on what really counts in life: great sex before you are gone anyway.

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Botox Claimed To Be A Treatment For Erectile Dysfunction

Truelibido

Erectile dysfunction is a condition that affects hundreds of millions of men. Many of these men could potentially permanently overcome their sexual dysfunction by changing their lifestyle and simply live a healthier life.

However, many men treat erectile dysfunction by using drugs like Viagra, Cialis, and Levitra. Now, there is also a new candidate for treating erectile dysfunction: Botox.

Please note that Truelibido does not support using pharmaceutical drugs or Botox to deal with erectile dysfunction. These remedies only treat symptoms but do nothing to permanently solve these problems.

Two Canadian urologists believe that the Botox injections can increase blood flow to the penis by paralyzing the nerves in the penis that instruct the smooth muscles to contract. The injection would last for about 6 months and patients would then need to get new injections every six months. The treatment is claimed to be safe and has not had any side effects.

We are highly skeptical. Keep in mind that Botox is a neurotoxin. It paralyzes the nerve system and is in some studies reported to not remain in the local area of injection, but can spread throughout the body.

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Many men who are good in making money are total failures when it comes to spending it. If you have money, buy love, and the best sex ever. Because having the best sex ever not only is satisfaction, but also generates your immortal soul. See Kreutz Religion.

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Punishment in Saudi Arabia

Saudi Womans blog

We’ve all heard or read about the strict laws and forms of punishment in Saudi Arabia. The most notorious of which is cutting off the hands of thieves. But many people don’t dig deep enough to know that a thief has to steal a substantial amount to get that punishment. No one gets their hand cut for petty theft, but when you have a gang who goes around robbing houses, then that punishment comes onto the table. In all my years here, I’ve only heard about it happening once. A friend of mine had their apartment robbed. Jewelry, TVs, computers and everything of value was taken. Eventually the robber was caught and my friend’s father was asked if he would forgive the robber or not. His refusal to forgive him contributed to the judge’s decision to have the thief’s hand cut off. I don’t know the details such as whether or not the thief had a previous history of stealing. I do know that this type of punishment does not happen often. Another instance is one time my husband and I met a real estate agent to show us a house we were interested in. This guy was a young apparently healthy Saudi guy and one of his hands was cut right at the wrist. Both my husband and I did not say anything so I don’t know if it was cut off as punishment or due to an accident or illness but I bet lots of people wonder when they meet him.

The punishments that are most newsworthy when it comes to Saudi Arabia, are the ones given to people guilty of khilwa (unrelated man and woman alone together) and extramarital sex. A punishment for khilwa is common and we’ve all come across muttawas trolling coffee shops and restaurants searching for pairs who seem too happy to be related. But what happens after they are caught? I don’t know about expatriates but with Saudis, the man and woman are separated at the spot and questioned to see if their stories correspond. Questions like name, relatives’ names and even color of furniture, address, employment and all other things married couples naturally know. If they fail the test or refuse to cooperate, they are taken to the local muttawa center. The girl’s father is summoned and the guy is locked up usually after being given a few slaps and punches. The girl is handed over to her father (if he’ll take her) and the guy is later released after they put his information into the system. He is then required to show up in front of a judge, usually two weeks later to take his sentence. How he appears at the sentencing decides his fate more than anything else. The way he dresses and addresses the judge has more influence than the number of times he has been caught, how and where he was caught…etc. His best bet is to dress like a muttawa, start to grow a beard, hold his head down and look remorseful. He should also tell the judge that since the incident, he has become a born again Muslim. If he could get an established muttawa from a mosque to vouch for him, then he might be lucky enough to be let go with a warning. Otherwise he will most likely be sentenced a number of lashes across the back.

Extramarital sex on the other hand is extremely serious and at the same time very hard to get convicted for. In the Holy Quran, it states that four witnesses to the act have to be found for it to be punishable. Here, unless a person has confessed or made a tape it’s unlikely to be considered as extramarital sex. Even if an unrelated couple checks into a hotel together, they will only be convicted of khilwa. In cases where a confession is made, then other things come into play, such as was it consensual or rape and whether either of them was married at the time. Infidelity is an automatic death sentence. Singles are imprisoned and whipped.

Young Saudis have their ways to get around these laws. One that I heard of is that they go in groups. Another is that the guy takes his sister along and voila it is no longer a khilwa.

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Feminism is about the domestication of men. Feminism wants to force men into being docile, so women have all sexual rights, at no risk. That will be all the less feasible the more violence there is in a society.

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