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September 2011 Archives

Letter from the Chair

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Eli-Coleman-BP.jpgWe have reached a moment in history with serious global economic challenges and critical and costly sexual health problems. Around the world governments as well as regional and international health agencies are recognizing the importance of having a unified and broad sexual health approach to reduce the burden of disease related to sexual health problems.

There have been several recent, major developments which will certainly have a positive impact on the promotion of sexual health. First, there has been an effort by the Centers for Disease Control and Prevention to consolidate its initiatives in HIV prevention, STI prevention, reproductive health, school-based sexuality education, and sexual violence prevention under a broader and unified effort to promote sexual health as an overarching strategy to deal with the myriad of sexual health problems we face in this country, A Public Health Approach to Advancing Sexual Health in the United States. Second, in July 2010 the White House released a National HIV/AIDS Strategy that acknowledges the importance of addressing sexual health through prevention activities rather than simply more "testing and pills." Third, in March 2011, the Institute of Medicine released its report on The Health of Lesbian, Gay, Bisexual and Transgender People. Finally, in June 2011 the National Prevention, Health Promotion, and Pubic Health Council in the Office of the Surgeon General released a National Prevention Strategy which includes a major section on promoting sexual and reproductive health.

The synergy of these efforts has put sexual health squarely in the center of public health strategies to improve the overall health and wellbeing of all Americans. While PHS has been promoting sexual health for over 40 years, the concept of sexual health has taken root in public policy in a way that represents a revolutionary paradigm shift. It is an exciting time.

We hope that this will translate into improved funding for a strategic approach to change the sexual health climate of this country - using the powerful resources of our government. We hope that this will increase research grants, educational opportunities, and provisions for sexual health care.

During the past decade, it seemed that the leaders in sexual health were in other parts of the world. Now, the US has joined similar international efforts and may be able to assume a leadership role by advancing sexual health through public policy and public health.

PHS is involved in many of these national, regional, and international efforts. Hopefully, through this work, we will truly realize a sexually healthier climate here and around the world. It is an exciting time - a time to "strike while the iron is hot" to consolidate efforts and move the sexual health agenda forward.


First of its kind sexual health education Chair at PHS

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Joycelyn-Elders,-MD-BP.jpgThe Program in Human Sexuality exceeded its fundraising goals for the Joycelyn Elders Chair in Sexual Health Education. The Chair is the first of its kind in the nation to focus on sexuality education.

The unique grassroots fundraising efforts for the chair attracted more than 275 donors, from 24 states, the District of Columbia, and 8 countries. Together donors gave $2,008,794 to establish the Joycelyn Elders Chair in Sexual Health Education. In five years, once all of pledged donations have been received, the Program in Human Sexuality will hire one faculty member to hold the endowed faculty position and focus his/her efforts on creating comprehensive life-long sexual education curricula, increasing the number of health care providers and health educators trained in sexual health, and expanding scientific research in sexuality education. These efforts will help to change the direction of sexual health in this country and around the world.

"The Program in Human Sexuality has proven success in educating medical professionals, human sexuality research, providing clinical care, and advocating for science-based public policy. Through the Elders Chair we will build on our strengths to advance sexual health education," said Eli Coleman, PhD, director of the Program in Human Sexuality.

Joycelyn Elders, MD, has always felt a strong connection to the University of Minnesota Medical School where she completed an internship in pediatrics in 1960. "In 1959 the University of Minnesota had the best pediatric internship in the country, they could have had any student that they wanted, and they selected me. I have always been very grateful."

Sexual health has been a primary focus for Elders starting with her service as the Director of the Arkansas Health Department through her time as a US Surgeon General, and in the years that have followed. She continues to travel the country advocating for sexual health to professional organizations and college students. She said, "I have realized the detriment and destruction that can be caused from a lack of sexual health. The most common cause of poverty is children being born to children. Sexuality makes up such a great part of our life, and yet we spend so little time talking about it, teaching about it, and educating our young people about it. We must know that if we want to have a sexually healthy society, it's about education, education, education."

The Joycelyn Elders Chair in Sexual Health Education will be the second endowed Chair at the Program in Human Sexuality. In 2007 the Chair in Sexual Health was established, and the Program's director, Eli Coleman, PhD, holds the position.



CDC-report-BP.jpgEli Coleman, PhD, participated in an expert technical consultation for the Centers for Disease Control and Prevention (CDC) National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) on advancing sexual health in the United States. The project began in April 2010 when the CDC brought together 67 experts with a variety of back grounds and interests in sexual health including individuals from public interest groups, communities of faith, sexual health researchers, professional organizations, media and communications, private sector businesses, and government agencies. In May 2011 the group released a report that highlights the expert consultation proceedings titled A Public Health Approach for Advancing Sexual Health in the United States: Rationale and Options for Implementation. The report is intended to engage future partners and spur continued conversations for the initiative.

The CDC launched the initiative in recognition that sexual health is an essential component of overall individual health, that individual sexual health has a major impact on the health of communities, and that a national dialogue is critical in improving population health. The group worked to identify initiatives aimed at implementing a public health approach to promote age-appropriate sexual health. One that is consistent with the best available science, including healthy, respectful, and responsible sexual behavior, for all Americans over their lives.

Consultants were challenged to identify actions around six goals including:
1. Increase healthy, responsible, and respectful sexual behaviors and attitudes.
2. Increase the ability and awareness to make healthy and responsible choices, free of coercion.
3. Promote healthy sexuality, healthy sexual functioning, healthy relationships, and respectful sexual rights for all persons throughout the life span.
4. Optimize and educate about reproductive health choices.
5. Increase access to effective preventive, screening, treatment, and support services that promote sexual health.
6. Decrease adverse individual and public health outcomes including HIV/STDs, viral hepatitis, unintended pregnancies, and sexual violence.

In 2001 Surgeon General David Satcher, MD, PhD, released The Surgeon General's Call to Action to Promote Sexual Health and Responsible Sexual Behavior. The new CDC report states that, "Over 10 years later, many measures of adverse health outcomes of sexual behaviors have worsened, prompting a need for refocused national attention on sexual health-related issues, especially HIV prevention and adolescent sexual health outcomes (e.g., unplanned pregnancy and STDs.)" The new CDC efforts will help to revitalize the goals and guidelines from the Call to Action while incorporating new research and current perspectives.

Centers for Disease Control and Prevention. A Public Health Approach for Advancing Sexual Health in the United States: Rationale and Options for Implementation, Meeting Report of an External Consultation. Atlanta, Georgia: Centers for Disease Control and Prevention; December, 2010.



LGBT-report-BP.jpgResearchers need to proactively engage lesbian, gay, bisexual, and transgender people in health studies and collect data on these populations to identify and better understand health conditions that affect them, says a new report from the Institute of Medicine (IOM).

The scarcity of research yields an incomplete picture of LGBT health status and needs, which is further fragmented by the tendency to treat sexual and gender minorities as a single homogeneous group, said the committee that wrote the report.

The historic report, The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding, provides a thorough compilation of what is known about the health of each of these groups at different stages of life and outlines an agenda for the research and data collection necessary to form a fuller understanding.

"Based on a thorough review of the science, this report recommends a research agenda to better understand the characteristics of the LGBT population, assess their unique health needs, and to identify the factors that either compromise or promote their health and well-being," said Walter Bockting, PhD, IOM committee member and professor at the Program in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota Medical School. "The report recognizes that the LGBT population is diverse in terms of gender, age, race, and ethnicity, and calls for intervention research that addresses the needs of those with documented health inequities."

LGBT individuals make up a minority of the population, therefore researchers face challenges in recruiting sufficient numbers of these individuals in general population surveys to yield meaningful data. Stigma experienced by gender and sexual minorities can make them reluctant to disclose their orientation, worsening the problem. Moreover, it is difficult to synthesize data about these groups when studies and surveys use a variety of ways to define them.

Demographic data provides the foundation for understanding any population's status and needs, federally funded surveys should proactively collect data on sexual orientation and gender identity, just as they routinely gather information on race and ethnicity, the new report says. Information on patients' sexual orientation and gender identity also should be collected in electronic health records, provided that privacy concerns can be satisfactorily addressed, the committee said.

The National Institutes of Health should support the development of standardized measures of sexual orientation and gender identity for use in federal surveys and other means of data collection.

In addition, the National Institutes of Health should provide training opportunities in conducting research with LGBT populations. Training should engage researchers who are not specifically studying LGBT health issues as well as those who are. The agency also should use its policy on the inclusion of women and racial and ethnic minorities in clinical research as a model to encourage grant applicants to address how their proposed studies will include or exclude sexual and gender minorities.

Throughout his tenure at the University of Minnesota, Bockting has conducted research on the health disparities found among transgender people.

Bockting said, "This Report recognizes that we have much to learn about the health of this subgroup of the LGBT population, and calls for research to improve access to quality, evidence-based transgender care. The acknowledgment of this still largely invisible population and the attention the Report draws to their specific health needs is enormously validating and holds the promise of new initiatives to promote transgender health."

The study was sponsored by the National Institutes of Health. Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policymakers, health professionals, the private sector, and the public. The National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council make up the National Academies.



UN-General-Assembly-BP.jpgOn June 17, 2011, the United Nations Human Rights Council declared that all human beings should be protected by universal human rights regardless of sexual orientation and gender identity. The declaration stated, "Expressing grave concern at acts of violence and discrimination, in all regions of the world, committed against individuals because of their sexual orientation and gender identity."

The resolution went on to request a global study to document discriminatory laws and practices and acts of violence based on sexual orientation and gender identity. The Human Rights Council will then convene a panel to discuss the study findings and advance a constructive, informed, and transparent dialogue on the issue.

In a press statement, Secretary of State Hillary Clinton said, "All over the world, people face human rights abuses and violations because of their sexual orientation or gender identity, including torture, rape, criminal sanctions, and killing. Today's landmark resolution affirms that human rights are universal. People cannot be excluded from protection simply because of their sexual orientation or gender identity. The United States will continue to stand up for human rights wherever there is inequality and we will seek more commitments from countries to join this important resolution."

The declaration was presented by South African and adopted with the support of 23 countries, 19 countries opposed, 3 countries abstained, and 1 country was absent for the vote.

PHOTO: United Nations General Assembly, UN Photo/Rick Bajornas



Madrid-BP.jpgOn June 20 - 21, 2011, Eli Coleman, PhD, was one of twenty-two sexual health experts from around the globe gathered in Madrid, Spain, to help solidify an action plan to promote sexual rights and sexual health through comprehensive, science-based sexuality education.

While the European Regional Office World Health Organization recently published standards for sexuality education and a law was passed requiring sexuality education to be integrated throughout the Spanish education system curricula, there has been a backlash against these progressive efforts. In response, this global expert consultation was organized under the auspices of the Spanish Academy of Sexology and Sexual Medicine, the Spanish Association of Specialists in Sexology, the Espill Institute of Psychology, Sexology and Sexual Medicine, the Latin American Federation of Sexology and Sexual Education and the World Association for Sexual Health. The meeting was supported by the Health, Social Policy and Education Ministry of Spain, the Regional Offices for Europe and America of the World Health Organization (WHO), and the German Federal Centre for Sexual Education.

Over the two-day meeting, the group worked to prepare a consensus document regarding the principles that should underlie sexual education programs and to strategize how to build greater public support for comprehensive sexuality education.

Coleman said, "It is frustrating to have to defend over and over again the simple principle of providing basic and comprehensive sexuality education and for this education to be based upon the best available science. Hopefully, the outcome of this meeting will effectively respond to those who are thwarting the efforts to provide citizens with their basic sexual rights."


New NIMH grant to study sexual compulsivity

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Michael-Miner-BP.jpgMichael Miner, PhD, will be the principal investigator on a new $1 million grant from the National Institutes of Mental Health (NIMH) to study sexual compulsivity. Over the next three years Miner in collaboration with the Kinsey Institute and his team of co-investigators will be working to gather the empirical data needed to clarify the characteristics of sexual compulsivity and how it leads to increased levels of HIV sexual risk behavior. The findings of this study will further a nuanced approach to the development of interventions and allow for targeting the most resource- intensive prevention efforts at those individuals most likely to spread HIV.

Miner said, "This grant provides an exciting opportunity to test the assumptions that have driven our treatment interventions for decades. Further, our timing could not be better, given the recent definition of addiction put forth by the Academy of Addiction Medicine which we can empirically investigate using our methodology."

Sexual compulsivity, or high levels of sexual behavior combined with a perceived lack of control, is strongly associated with unprotected sex and other HIV sexual risk behaviors. This association has been robust across populations, but particularly strong in men who have sex with men (MSM). Miner's new project builds on previous research conducted at PHS which found that sexual compulsivity is associated with sero-discordant unprotected anal intercourse in HIV-positive MSM even after controlling for other known correlates (e.g., condom use self-efficacy, intentions to practice safer sex, etc.). However, while the association between sexual compulsivity and unsafe sex has considerable empirical support, the manner in which sexual compulsivity confers this increased risk, and therefore how to best influence such processes in order to reduce risk, is as yet, unknown.

Sexual compulsivity has been conceptualized as an addictive disorder, an impulsive disorder, and as a compulsive disorder. Others have questioned the existence of sexual compulsivity as a definable disorder and attribute the increased sexual behavior to high sex drive. Common across all conceptualizations are four factors: negative affect, sexual arousal, behavioral inhibition, and cognitive control. These factors influence HIV risk by interfering with the ability to manage one's sexual impulses, which would lead to multiple sexual encounters, and through impairments in the ability to consider multiple reinforcement contingencies and to consider the long-term consequences of pleasurable behavior which interferes with condom use. This study will provide needed empirical data to clarify the characteristics of SC and how it leads to increased levels of HIV sexual risk behavior.

A multi-method strategy will allow the research team to characterize sexual compulsivity and to provide needed empirical data to identify, and therefore help address, the underlying mechanisms that influence unsafe sexual behavior.

The research team includes co-investigators Angus MacDonald, III, PhD (U of M Department of Psychology), Rebecca Swinburne Romine, PhD, Nancy Raymond, MD, Erick Janssen, PhD (Kinsey Institute).



Robert-Garofalo-BP.jpgOn May 12, 2011, Robert Garofalo, MD, MPH, delivered the second annual John Money Lecture in Pediatric Sexology at the University of Minnesota. In his presentation, "Advancing the Health of Lesbian, Gay, Bisexual, and Transgender Youth," Garofallo discussed the process and findings of the recent Institutes of Medicine Committee Report, The Health of Lesbian, Gay, Bisexual, and Transgender People. He summarized and contextualized the state of the science as it exists for LGBT youth and as suggested by the IOM, offered a paradigm for the next generation of academic work for this vulnerable population.

Dr. Garofalo is an associate professor of pediatrics and preventive medicine at Northwestern University Feinberg School of Medicine. He is also an attending physician at Children's Memorial Hospital where he directs the Adolescent/Young Adult HIV Program. Dr. Garofalo is a national authority on LGBT health issues, adolescent sexuality, and HIV clinical care and prevention. He has been the principal investigator on five National Institute of Medicine (NIH) and two Centers for Disease Control and Prevention funded research grants and serves as a co-investigator on three additional NIH-funded projects. He is the past president of the Gay and Lesbian Medical Association. In 2010, Dr. Garofalo served as a committee member for the National Academy of Sciences/Institute of Medicine Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities.

Joycelyn Elders, MD, was present as the lecture discussant.

John Money's family established the John W. Money Endowed Fund at the Program in Human Sexuality which provides funding for the John Money Lecture in Pediatric Sexology hosted at the Program in Human Sexuality and the John Money Plenary at the Biennial World Conference of Sexual Health sponsored by the World Association for Sexual Health.

Kevin-Fenton-BP.jpgOn June 12, 2011, Kevin Fenton, MD, PhD, delivered the second John Money Plenary at the 20th World Congress for Sexual Health in Glasgow, UK. The title of his presentation was "A Public Health Approach to Advancing Sexual Health in the United States: Accomplishments, opportunities, and lessons learned."

Fenton is the director of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP). In November 2005, Fenton was named director of the National Center for HIV, STD, and TB Prevention, which was renamed NCHHSTP in March 2007 to reflect the addition of CDC's Viral Hepatitis program. He previously served as chief of CDC's National Syphilis Elimination Effort since January 2005. He has worked in research, epidemiology, and the prevention of HIV and other STDs since 1995 and was previously the Director of the HIV and STI Department at the United Kingdom's Health Protection Agency. Fenton has spearheaded the development of a number of national HIV, STD and behavioral surveillance and research programs in the UK and Western Europe including the National Chlamydia Screening Program in England, the 2nd British National Survey of Sexual Attitudes and Lifestyles and the European Surveillance of STI (ESSTI) Network. He is a Fellow of the Faculty of Public Health of the Royal Colleges of Physicians of the United Kingdom.


New human sexuality research resource

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Portal-BP-2.jpgWe are excited to share a new Human Sexuality Research Portal. The Program in Human Sexuality has built this website in collaboration with the Bio-Medical Library in order to begin to create a new information infrastructure around the sexuality materials currently held at the University of Minnesota. It is also an online research portal connecting other sexuality institutes, libraries, and researchers across the United States and the world with human sexuality and sexual health resources. The site offers helpful research instructions and connects researchers to relevant library catalogues, databases, special collections, e-books, and web-based resources.



International-Perspectives-BP.jpgMichael Miner, PhD, is one of five editors on the new book International Perspectives on the Assessment and Treatment of Sex Offenders: Theory, Practice and Research released by Wiley-Blackwell this year.

This book represents a departure from recent works on this subject. It presents a comprehensive overview of current theories and practices relating to the assessment and treatment of sex offenders throughout the world, including the United States, Europe, and Australasia. The chapters cover all the major developments in the areas of risk assessment, treatment, and management, including controversial and rarely addressed issues, such as chemical castration and the ethics of sexual offender treatment and management. Unlike most books on this topic, which tend to represent the perspectives of those in the United States, Canada, and the United Kingdom, this is a truly international and multi-disciplinary volume that integrates the Anglo-American and the European perspectives on sexual offender issues.

The project was supported by the International Association for the Treatment of Sexual Offenders (IATSO).

Boer, D.P., Eher, R., Craig, L.A., Miner, M.H., & Phafflin, F. (Eds., 2011). International Perspectives on the Assessment and Treatment of Sex Offenders: Theory, Practice and Research. West Sussex, U.K.: Wiley.



Walter Bockting, PhD, and Michelle van Ryn, PhD, MPH, have both been promoted to Professor with tenure at the Department of Family Medicine and Community Health, University of Minnesota Medical School.

Walter-Bockting6x4.jpgBockting completed his postdoctoral fellowship at the Program in Human Sexuality in 1990 and shortly thereafter joined the faculty at PHS. Bockting is a respected researcher, clinical psychologist, and coordinator of the University of Minnesota Transgender Health Services at the Program in Human Sexuality. He received his doctoral degree in psychology from the Vrije Universiteit, Amsterdam, The Netherlands (drs. in 1988 and PhD in 1998). He is also on the graduate faculty of Gender and Sexuality Studies and a co-founder of the University's Leo Fung Center for CAH and Disorders of Sex Development. His research interests include gender identity development, transgender health, sexuality and the Internet, and HIV prevention, and his work has been supported by grants from the National Institutes of Health, the American Foundation for AIDS Research, and the Minnesota Department of Health. He is currently the Principal Investigator of the NICHD funded project All Gender Health Online. Bockting is the author of many scientific articles and editor of five books: Gender Dysphoria: Interdisciplinary Approaches in Clinical Management (Haworth Press, 1992), Transgender and HIV: Risks, Prevention, and Care (Haworth Press, 2001), Masturbation as a Means of Achieving Sexual Health (Haworth Press, 2002), Transgender Health and HIV Prevention (Haworth Press, 2005), and Guidelines for Transgender Care (The Haworth Press, 2006). He is also Editor-in-Chief of the International Journal of Transgenderism, and serves on the editorial board of Archives of Sexual Behavior, Sexual and Relationship Therapy, Journal of Homosexuality, Psychology and Sexuality, and International Journal of Sexual Health. He is past-president and fellow of the Society for the Scientific Study of Sexuality and president of the World Professional Organization for Transgender Health. Bockting recently completed an appointment by the Institute of Medicine (IOM) of the National Academies to the Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities. The IOM committee assessed the state of the science on the health status of LGBT populations; identified research gaps and opportunities related to LGBT health; and outlined a research agenda that will assist the National Institutes of Health in enhancing its research efforts in this area. Additionally, the committee considered research training needs to foster the advancement of knowledge about LGBT health and identify impediments to such advancement. The committee report, The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding was released in March 2011.

Michelle-van-Ryn6x4.jpgMichelle van Ryn, PhD, MPH, is a professor in the Department of Family Medicine and Community Health. She earned a PhD in social psychology and health, and an MPH in health behavior and health education at the University of Michigan, School of Public Health and Institute for Social Research, where she also completed a 2-year fellowship on psychosocial factors and mental health and illness. During this period she won the National Mental Health Association's award for the Best Preventive Intervention, 1990. She recently completed the academic coursework needed for licensure as a marriage and family therapist and is currently seeing patients at the Center for Sexual Health. Over the last 20 years, her research (and now clinical) work has focused on the factors that create effective and empowering helping relationships across settings, circumstances, and diverse patient characteristics. She has a strong clinical interest in relationship, intimacy, and sexual health issues. In addition, she has two areas of special clinical and research interest: the impact of illness, chronic disease, and/or disability on self, relationships and sexual functioning, and methods and approaches for providing accepting and effective therapy to people involved in alternative relationships, alternative sexual lifestyles, and/or non-traditional family arrangements.


Rosemary Munns, PsyD, honored with Faculty Mentor Award

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Munns-award.jpgRosemary Munns, PsyD, was honored with the 2011 Faculty Mentor Award presented by the PHS postdoctoral fellows. Graduating fellows Eric Sprankle, PsyD, and Sheena Hoffman, PhD, presented the award.

Sprankle said of Munns, "I learned more about cognitive therapy from her in the first six months of my fellowship than in the five years of previous clinical training combined. She provided invaluable support and advice for job searching and studying for the EPPP. And most importantly, I am truly fortunate to have had her empathy and warmth when I was experiencing personal distress."

Hoffman added, "Rose has always followed through for me, and she was thorough and attentive every step of the way. Being lucky enough to have her as a supervisor my first semester/rotation here, I felt very safe. She serves as a body guard for the postdocs as needed, since she was a postdoc here herself. I have always appreciated that she is organized, on top of things, attentive, and makes sure that she has answered every question before we move forward. I have a lot of respect for her, and feel honored to have worked with her. She has served as a strong mentor to me."

Munns thanked Sprankle and Hoffman and said, "I am truly honored. Training the postdocs is a very important part of my job that I take very seriously. Thank you."

Munns herself is a graduate of the PHS postdoctoral fellowship. She has mentored postdoctoral fellows since 2001.

Munns received her MA in clinical psychology in 1995 and her PsyD in 1998 from the Minnesota School of Professional Psychology. She had 12 years of experience in the mental health field prior to graduate school. She has extensive clinical experience in assessment and treatment of substance abuse, working in correctional settings with juvenile delinquents and adults, as well as inpatient and outpatient psychiatry. Her primary interest is in providing clinical services to adults with sexuality issues. Her areas of interest are sexual dysfunctions, relationship and sex therapy, transgender issues, assessment and treatment of sex offenders, abuse recovery, compulsive sexual behavior, sexual orientation, and HIV counseling.

PHOTO: Rosemary Munns, PsyD, Eric Sprankle, PsyD, and Sheena Hoffmann, PsyD


Richard "Rick" Allen Chilgren, MD, has died

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Richard-Chilgren-BP.jpgThe first director of the Program in Human Sexuality, Richard "Rick" Allen Chilgren died on Sunday, July 17, 2011, in Lihue, Hawaii, where he has been living for about 25 years. Chilgren died of Stage 4 liver and lung cancer, following years of fighting a crippling back injury.

Chilgren was born in Eau Claire, Wisconsin, on February 4, 1937. As a straight-A student at Eau Clair High School, Chilgren was a selectee to Boy's Nation in his junior year and a State of Wisconsin first place debater as a senior. During summer vacations, Chilgren worked as the announcer at Tommy Bartlett water-ski shows in Wisconsin Dels. The development of his mind during these years, and his early experiences and successes, were foretelling of his many future accomplishments.

Chilgren attended St Olaf College in Northfield, Minnesota, majoring in pre-med. During summer vacations he travelled the country, alternating bi-weekly between New York City and Estes Park, Colorado, as a guide on bus and train tours. In his senior year he met his wife, Karin Strolberg, who was a freshman.

They were married in August 1959 and moved to Madison, Wisconsin, where Chilgren attended medical school. After graduating from the University of Wisconsin in 1963, Rick and Karin moved to Minneapolis, Minnesota, where Rick began his internship at the University of Minnesota, and continued there for his residency in Pediatrics. At this point he became Coordinator for the Medical School's Curriculum Committee, appointed to oversee a revamping of the curriculum for medical students at the U of M. Through this position, he became introduced to the Sexual Attitude Reassessment (SAR) process that was being tested by clergy from the American Lutheran Church, United Theological Seminary, and Lutheran Social Services in the Twin Cities.

In 1970, Chilgren was appointed to be the first Director of the Program in Human Sexuality, where he initiated many innovative and progressive ideas, dealt with political finesse against a barrage of opposition and difficult situations regarding the concept of the program and its aims from within and without the University. He successfully gained foundational funding and support for PHS and kept the enterprise afloat, with the help of many others, through its critical and hard-fought early years.

After Chilgren's college, med school, and residency experiences his tendency to think and act "outside the box" of the scientific or medical model became evident. His application of medical practice always reflected the exacting discipline of his scientific medical training, inclusive of his years as emergency room physician, his years as a "love boat doc" on America Hawaii Cruises, and his time coordinating the medical school curriculum and teaching at the University of Minnesota. However, Chilgren's expansive and inquiring mind always was open to the examination of philosophy, phenomena and perspective, not necessarily "western scientific" in nature, but often inclusive of other world or historic views. Chilgren saw good and potential in many things, and it was this breadth of mind that reflected his visionary nature. From his expansive mentality and strength of thought came his array of ideas, many of them before their time. Occasionally, when he became misunderstood, he would feel great frustration, since his heart was always good.

Rick and Karin divorced in 1971 and he never remarried. He purchased a large mansion on Summit Avenue in St Paul, and shared the residence with a group of friends and colleagues for a few years. During this period, PHS flourished, bringing on board many innovative folks who frequently gathered for memorable events and celebrations at both Chilgren's mansion and at the PHS building on University Avenue near the campus. Chilgren presided over these occasions with great good humor and diplomatic effectiveness.

Chilgren left PHS in 1976, and shortly thereafter moved to live permanently in Hawaii. In Hawaii he worked for several years as the resident MD on a cruise ship around the Islands. He retired from that job after injuring his back, and he spent his remaining years convalescing and writing, never giving up on his dreams of creating a world-wide network of sexual health and alternative medicine initiatives.

He is survived by his brother, Paul Chilgren, and numerous cousins and relatives. He will be remembered as an amazing man who was full of dreams and visions which laid the foundation for a vibrant Program in Human Sexuality that continues to thrive to this day.

Condolences can be addressed to:
Paul E. Chilgren, c/o Dr. Joseph J. Lang, 4126 So. LaCorta Drive, Tempe, AZ 85282

Richard "Rick" Allen Chilgren, MD memorial website


Theodore "Ted" Cole, MD, has died

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Ted-Cole-BP.jpgWe have lost one of our pioneers and founding fathers of the Program in Human Sexuality. At the age of 79, Theodore "Ted" Cole, MD, passed away on March 26, 2011.

In 1969, Cole was a young faculty member of the University of Minnesota's Department of Physical Medicine and Rehabilitation. He along with other University faculty, his wife Sandra Cole, PhD, and members of the theological community (including Jim Siefkes of the American Lutheran Church) developed the concept for a course in human sexuality for medical students. They also envisioned the formation of an interdisciplinary program which would be named the Program in Human Sexuality (PHS). While at the University of Minnesota he rose to the rank of Professor, director of the spinal cord injury program, project director of the Regional Spinal Cord Injury Center, and interim director of PHS.

In 1977 Cole and his family moved to Michigan, where Cole became Chair of the Department of Physical Medicine and Rehabilitation at the University of Michigan Medical Center until his partial retirement in 1994. At Michigan, Cole's contributions to building a strong research department continue to be recognized in the annual "Ted Cole Resident Research Day." Sandra continued their work at the University of Michigan and established a sexuality and disability training center to continue their work. Sandra also rose to the rank of Professor.

Ted and his wife Sandra were founders of the disability program at PHS. As a physician specializing in medical rehabilitation, Ted provided the medical expertise pertaining to people with physical disabilities. Sandra provided her expertise as a certified sexologist and provided educational and programmatic direction. Ted and Sandra developed the nationally acclaimed, highly innovative "Disability Sexual Attitude Reassessment" trainings to examine sexuality in the lives of the physically challenged. Faculty working in the Disability Section collaborated closely with a diverse group of people with disabilities and their partners. These individuals experienced a physical disability first hand and knew its effects on both members of the couple. These collaborators were trained to become small group facilitators in Disability SARs and continued to recommend important additional components to the Disability Section of PHS.

Several pioneering explicit films about sexual intimacy and disability were created by the PHS Disability Section. The first book to ever deal explicitly with intimacy and spinal cord injury was written by staff of the Disability Section: Tom Mooney, Ted Cole, MD, Sandra Cole, PhD, and Rick Chilgren, MD.
Through an expansive international series of training seminars, the Coles spawned a number of sexuality and disability centers, and they were viewed as the pioneers of this emerging field. The field grew and eventually there was more acceptance for the topic, and funding became available through the National Institutes of Health. Today, the topic of sexuality is commonplace in the clinical practices of the comprehensive rehabilitation teams working collaboratively throughout rehabilitation centers across the country.

There is no way to convey all of Cole's accomplishments here. Ted and Sandra were the founders of the field of sexuality and disability, and they blazed a trail that contributed to the success of PHS today. It was Cole's vision, fortitude, and perseverance that made all of this possible. We have lost a great leader and one of the key pioneers of PHS.

Memorial Gifts in honor of Ted Cole may be made to Minnesota's Disability Community Newspaper - Access Press, for the Theodore M. Cole, M.D. Memorial Fund. Donations can be sent to the Access Press 1821 University Ave. W. Suite 104S St. Paul, MN 55104. Please make checks payable to "ACCESS PRESS" and note on the memo line "Ted Cole Memorial Fund". Online contributions to Access Press can be made at

Condolences can be addressed to:
Sandra S. Cole, Ph.D, 1541 Edinborough Road, Ann Arbor, Michigan, 48104


Nancy M. Crewe, PhD, has died

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Nancy-Crewe-BP.jpgNancy M. Crewe, PhD, died Thursday, April 7, 2011, at age 71 in East Lansing, Michigan. Crewe was a counseling psychologist and associate professor in the Department of Physical Medicine and Rehabilitation at the University of Minnesota from 1962 -1987. She was involved with the Program in Human Sexuality for a number of years during her tenure at the University. She participated in the Disability Sexual Attitude Reassessments (SAR), and along with John Shatzlein, she ran sexuality groups and conducted training at some residences for persons with developmental disabilities. After she left Minnesota, she continued her work at Michigan State University.

Throughout her long and distinguished career, Crewe cared deeply about people living with disabilities and the physical and psychological aspects that affected their lives. Through her scholarship, Crewe made landmark contributions to understanding the disability experience and enhancing the quality of rehabilitation services for individuals with significant disabilities.

Her work in functional assessment helped re-orient the focus of assessment from a deficit-oriented medical model to a capacity-orientated functional model -- contributing to major shifts in public policy. Similarly, her recognition of the importance of the independent living movement resulted in co-authoring the preeminent book on the subject that captured and advanced a fundamental policy and paradigm shift, and brought her international recognition by consumers, advocates, and professionals Independent Living for Physically Disabled People. Her most recent scholarly contribution, as co-author with Carolyn Vash in the second edition of the Psychology of Disability, is an invaluable resource and text in rehabilitation education and disability studies in the United States and throughout the world.

In 1973, Crewe started the longest longitudinal spinal cord injury follow-up study ever undertaken focusing on life satisfaction and community. She passed the study responsibility on to a young student named James Krause, who has quadriplegia as a result of a spinal cord injury. Krause obtained his PhD in Psychology at the University of Minnesota under Crewe's tutelage, and he continues their work today as a professor and associate dean of research at the Medical University of South Carolina. Together they published many peer reviewed papers during their research and over a thousand individuals with spinal cord injuries have participated in the study to date. Crewe was a dynamic woman and a strong advocate for community integration and self-growth. Her daughter Laurel Crewe Cibik lives in Bloomington, Minnesota, with her husband and two daughters.

Although Crewe officially retired in 2004 after 17 years of service at Michigan State University and 16 years of service at the University of Minnesota, she continued to contribute to the rehabilitation counseling profession as a consultant, author, teacher, and mentor. Crewe was the embodiment of leadership with grace. Her balance of gentleness and strength inspired a commitment to individual excellence and a feeling of community for students and colleagues alike. She will be greatly missed.


Congratulations PHS Fellowship Graduates

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2011-graduation-group-BP.jpgOn June 8, 2011, the Program in Human Sexuality graduated three postdoctoral fellows at the Family Medicine and Community Health commencement. Sheena Hoffman, PsyD, Ashley Mercer, PsyD, and Eric Sprankle, PsyD, were recognized for completing two years of intensive clinical and research training at PHS.

Hoffman will be finishing her fellowship at the end of September and has plans to continue sexual health work either in a women's center or college counseling setting in Chicago, IL. Her clinical interests include sexual dysfunction, intimacy, sexual trauma, and sexual education with all types of genders and sexual orientations.

Mercer continues to work in sexual health as a staff psychologist at the mental health clinic at Park Nicollet- St. Louis Park.

Sprankle has started work as an assistant professor of psychology at Minnesota State University, Mankato. He will be leading a research team of graduate students and undergrads, examining sexual arousal and sexual perceptions of sexually explicit instructional videos.


Welcome new PHS staff

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PHS welcomes the newest additions to our team: Elaine Batcher, Robyn Erhart, Margaret Flaget-Greener, PsyD Bradley Goodell, PsyD, Rebecca Hall, Katie Hecksel, MD, Stephanie Hengst, Chris Hoefer, Shanda Hunt, Krista Nabar, PsyD, Bradley Nederostek, PsyD, Melinda Marsolek, and Matthew Sanocki

Elaine-Batcher-BP.jpgElaine Batcher has joined the Program in Human Sexuality as the clinic manager of the Center for Sexual Health. She joins the PHS team from Healtheast Clinics Macalester. Batcher has a background in nursing and an interest in sexual health and GLBT issues.

Preston-Blaine-BP-2.jpgWelcome back Preston Blaine. Blaine is returning to the PHS clinic, the Center for Sexual Health, after a semester of study in Vienna, Austria. He is a student assistant in the clinic's front office. Preston is a student at the University of Minnesota, and he is majoring in finance and minoring in monetary economics and financial accounting.

Robyn-Erhart-BP.jpgRobyn Erhart is a patient representative at PHS's clinic the Center for Sexual Health. She I got her BA in Sociology from St. Cloud State University with a minor in Human Relations. After college Erhart gave a year of service in AmeriCorps at Project for Pride in Living.

Margaret-Flaget-Greener-BP.jpgMargaret Flaget-Greener, PsyD, received her MA and PsyD in clinical psychology from Widener University in Chester, PA. In addition to her clinical degrees, she also received a Master of Education in Human Sexuality from Widener University. Her clinical training comprises inpatient psychiatric care, child and adolescent victims of sexual abuse, college counseling, and outpatient community mental health. Her doctoral research examined clinical psychologists' attitudes and biases towards older clients' sexuality. Her clinical interests include older adults' sexuality and sexual health, gender identity development, women's issues, and relationship therapy.

Bradley-Goodell.jpgBradley Goodell, PsyD, is a postdoctoral fellow at PHS. He received his MA and PsyD in clinical psychology from the Minnesota School of Professional Psychology at Argosy University Twin Cities. His training has included work at the Argosy University Student Counseling Service/Twin Cities; Associated Clinical Services in Herndon, VA; Yount, LLC in Washington, DC; and the Guadalupe Alternative Programs in St. Paul, MN. His doctoral research examined the subjective experience of transgender individuals while receiving mental health services. His master's thesis explored the psychological impact of abortion on women. His clinical and research interests include gender identity and sexual orientation development, adolescent mental health, issues affecting the LGBT community, and sexuality and sexual health.

Rebecca-Hall.jpgRebecca Hall is a patient representative at PHS's clinic the Center for Sexual Health. She is working on a degree in psychology at the University of Minnesota.

Katie Hecksel, MD, is a child and adolescent psychiatry fellow at the University of Minnesota., and she spends one day a week at PHS. She received her medical degree from the Mayo Clinic and attended the University of Michigan for adult psychiatry residency training. Clinical interests include women's mental health, integrated holistic health, gender and sexuality, LGBT youth, eating disorders and sports psychiatry. She currently has a Center for Neurobehavioral Development research grant to study the effect of marijuana on adolescent brain development. Previously she served as the American Medical Student Association National Women in Medicine chair and Michigan Psychiatric Society resident representative and currently is co-chief of the University of Minnesota Child Psychiatry Fellowship program.

Stephanie-Hengst-BP.jpgStephanie Hengst is the qualitative data analyst community program specialist on the All Gender Health project. She received her Bachelor's Degree in Sociology from Purdue University and Master's Degree in Public Health from the University of Minnesota. As a long-time advocate for reproductive and sexual health rights, Hengst has worked at the local, national, and international levels to advance programs and policies that support those issues. Before joining the PHS team she worked in Arusha, Tanzania, and Lusaka, Zambia, on prevention of mother-to-child-transmission of HIV public health projects.

Chris-Hoefer.jpgChris Hoefer is the project coordinator for All Gender Health Online. He received a bachelor's degree in Family Social Sciences with an Emphasis on Queer theory and a double major in Finance from the Uof M. Most of his earlier work was with at-risk youth at agencies such as The Youth and AIDS Projects, Minnesota AIDS Project and Streetworks. Chris also spent a stint as the project coordinator for the early Man to Man seminars at PHS. After becoming a registered representative for the Securities and Exchange Commission, Hoefer worked as a securities trader for a number of years before decision to study architecture led him to a career in design. In a career trajectory that may seem unique to some, Hoefer's eventual return to academia and sexual health is fueled by a desire to rejoin the ranks of those working to improve the lives of queer youth.

Shanda-Hunt-BP.jpgShanda Hunt is a research assistant on Dr. Bean Robinson's research team for the Somali Women's Initiative for Sexual Health (SWISH) project. She completed her BA at the University of Minnesota, and returned for her graduate degree in Public Health. With her coursework complete, she sought out Dr. Robinson for a master's project and has been working with her since December. Hunt's master's thesis is based on a scale used during interviews that the team is conducting with Somali women. This scale looks at perceived relationship control, and Hunt will be doing a quantitative analysis of the women's responses. Lack of control in intimate relationships is a risk factor for women in contracting HIV, and the SWISH team hopes to develop a deeper understanding of this power dynamic in the lives of Somali women.

Krista-Nabar.jpgKrista Nabar, PsyD, is a postdoctoral fellow. She received her MA and PsyD from The Chicago School of Professional Psychology in Chicago, IL. With social justice issues and equality as a primary interest for her, she received clinical training at a state-funded psychiatric hospital, a culturally-diverse family counseling center, a private practice serving primarily individuals with HIV/AIDS and the LGBTQ communities, and a community mental health center in Portsmouth, NH. Her doctoral research examined the individualistic and Western ideological underpinnings of the Diagnostic and Statistical Manual, and the ways in which it negatively impacts women, racial/ethnically diverse populations, and sexual/gender minorities. Her clinical interests include sexual health and wellness, sexual and gender identity development, sexual abuse and trauma, relationship therapy, and feminist approaches to therapy.

Brad-Nederostek.jpgBradley Nederostek, PsyD, is a postdoctoral fellow. He received his BA in psychology from Dickinson College in Carlisle, PA, his MA in clinical psychology from Towson University in Towson, MD, and his PsyD in clinical psychology from La Salle University in Philadelphia, PA, in 2010. He received clinical training in a small community mental health clinic, a large marital and family mental health clinic, and a small private practice specializing in pain disorders. In July 2010, he completed an APA-accredited internship in clinical psychology at the VA North Texas Health Care System in Dallas, TX, with a specialization in the health psychology track. Nederostek joined PHS in September 2010 to further his primary clinical interests in male and female sexual dysfunction, compulsive sexual behavior, and relationship therapy. His doctoral research furthered his primary clinical interests through focusing on the manifestations of anxiety-related processes in heterosexual males with erectile dysfunction. Nederostek employs the use of both mindfulness-based experiential therapeutic modalities and cognitive-behavioral treatment approaches in his clinical work. He is an active member in the American Association of Sex Educators, Counselors, and Therapists and the Society for the Scientific Study of Sexuality. He is passionate about helping others to examine and grow their knowledge of healthy sexuality and intimacy.

Melinda-Marsolek.jpgMelinda Marsolek is a quantitative data analyst on the project All Gender Health Online. She received her Master of Public Health degree with a concentration in epidemiology from The George Washington University.

Matthew-Sanocki.jpgMatthew Sanocki works in accounting at PHS's clinic the Center for Sexual Health. Sanocki is studying pre-pharmacy at the University of Minnesota. He will be a junior this year.






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