Doortje Braeken has quite a breadth of accomplishments within the sexual health industry. She is the Former Senior Advisor for Adolescents and Young People at the International Planned Parenthood Federation (IPPF) and was awarded in 2015 by the World Association of Sexual Health (WAS) a Gold Medal in recognition of her lifetime contribution to sexual health. Doortje is also the co-author of UNESCO's new guidelines for sex education, including the pleasure meter, and a member of the Supervisory Board of Dance4Life, an organisation dedicated to creating a safe and healthy sexual environment for young people worldwide through information programs and online campaigns.

Needless to say, we were very excited at the opportunity to sit down and discuss sexual health among young people and what we can do to improve the current environment.

Conversation with Doortje:

What age do you think we should start teaching about sexual pleasure?

Well, I think the word makes it a bit difficult, but I think you already can with babies as well, the way you caress them and that you're not afraid to, well, not for your own pleasure, but to if you change their nappies, that it's not that something scary, but that they understand they enjoy without shame. So I think it's not always that you have to say things, but it's also how you model things and say that part of your body is not to be ashamed of. I think it can already start extremely young, to be honest, and it's not about sexual pleasure, but that your body is a part of happiness and of joy is important.

I have a big problem that right from the start in philosophy and religion there was so much of a distinction between the body and the mind and that the mind is more important than the body in most religions. And this dualism of separating the body from the mind has created a lot of difficulties in our lives. Maybe I'm too theoretical now, but I think if we could get rid of it, that the mind is always more important than the body. I think it's equally important to enjoy both and to see how you can enjoy your body as much as you can develop and enjoy your mind, but not make the one much better than the other. Your body is important. It's one thing, your mind and your body you should not separate it. So it's not only talking about how smart you are and how intelligent it's also your whole being.

How can we use the pleasuremeter to educate people and break taboos around pleasure?

Well, of course, we initially made the pleasuremeter for medical doctors and for psychologists. And not to go in-depth, it's not for in-depth psycho-sexual counselling or people with traumas. But it is if someone comes in and says I have a problem with sex that you can help to unpack what the problems are to see where you set your priorities. But I think we should use it for education as well. I was thinking maybe to also try to unpack a sexual pleasure. How can you measure it in education? That's why I also unpacked what kind of issues you have addressed in your curriculum in school. Now, these are only indicators, but I think it would be quite interesting to think about. Maybe not just talking about sex, but it's more about how are we dealing with ourselves and with the world around us? And then you can say, do I have enough respect for myself? Do I have enough empathy for others? And how do I show empathy to others? Am I able to communicate and not only say what I want but also listen to what the other person wants and find a balance between what I want and what the other person wants? Not only is sex but in a broader context. I had also written about self-forgiveness and how to deal with relationships, how to start a relationship and how to end the relationship. So I think if you can say first for sexual pleasure teachers don't like, it depends where you are, but you can say we want to address the emotional aspects of sexual relationships. Then you deal very much with the emotional parts, and then you can say, okay, how do we address these issues? It's very public health, not that there's something wrong with public health, but how now can we include much more of the emotional aspects of sexuality in our education. And I think you can use the pleasure meter for that. I'm trying to say these are topics we have to address for a happier relationship or for a happy sexual relationship. You can almost make some educational modules out of it, basically. I think that unpacking things for people, especially for the teachers and for the educators, helps a lot.

The pleasuremeter From GAB training toolkit:

I think relationships are a big one as well because it's something that is not taught at all about how you manage romantic or even friendship relationships and a lot of people instinctively just copy the relationships they see. For example, if the only romantic relationship they see growing up is with their parents, they're likely to copy that dynamic in their own relationships. You're not really taught about how you should be treated in a relationship, what to expect, and how to expect respect both ways and things like that. And then I think that further extends to sexual relationships regarding respect and also communication. I also believe that because young people don't know a lot about their bodies or their partners, especially young women, they don't know a lot about their bodies, and they themselves don't know how to communicate it because they don't know what is even going on.

I find it difficult because you have to say what you want. What the hell do I know what I want? I still don't always know what I want. And it gives so much pressure that I need to know exactly what I want. I think it was someone who said you have a battle of the sexes, but it's not a battle; it's a battle women always lose. So it's not really an equal battle. And I'm not sure whether that's totally true. And it was quite pessimistic because she said, well, actually, men and women don't use language in the same way. It is interesting that men and women use language in a different way, especially when talking about sex or relationships. So first, you have to understand what each other's language is basically. But that becomes very theoretical. But I think to understand what is a kind of common language we can use actually, I have to keep on communicating before sex, during sex and after sex. It's not a one-time before sex. Let's do this and not do that. But it's content kind of trying to understand each other because it's very difficult to understand the other, but try to understand the other and trying to in a respectful way, say to the other, well, let's not do this, but let's do something else.

Relationships have a lot to do with communication, and it's not as straightforward as I want this, and you want that. It's much more complicated than that, and to really understand each other's language, it's difficult. It's really difficult, and I don't wanna make relationships more difficult than they are. And it's also you slowly learn, and it's okay. Have you read the book of Esther Perel? I would really advise you to read that. I think you'll like what it is about, it's called Mating in Captivity, which I thought was a very interesting title. That's about committed relationships, and she tells a lot about what goes wrong. For instance, she says we have such high expectations of the other (in a romantic relationship). You also see it even if you watch television, of people who marry or whatever. "He's my best mate". "He's the best lover". And she said, actually, it's almost impossible. A best mate or best friend is something totally different from someone who you have sex with because there's also something mysterious and something exciting or something you know explored. In friendship, it's about stability, and we have so many expectations. That's where things go wrong because you want the other person (in committed relationships) to be too much and fulfil all your needs, but that person cannot be the person who pays you money and the person who is your best friend and the person who is your best lover. She said it's almost impossible, and we should not always think that this is what you can reach. I cannot say it as good as she says, but it's really, I think it's a very interesting theory what she says that we have such high expectations of a relationship.

I think it's definitely influenced by the media we consume if you think about ROM coms (romantic comedies) and things like that. I've never been a massive fan of ROM coms because I always had this sort of issue with them; they're not realistic; I mean, I think it's getting a bit better now, but in general, it tends to romanticise quite toxic relationships.

Absolutely.

Like fighting, you need to fight to have passion, and most of them are older men and younger women.

It's horrible. The myth and the prejudices.

But that's like the education that people are getting for relationships. It's either what they're seeing in their real lives, which with young people is usually their parents, or what they're watching on television, which is unrealistic or porn.

And you have to figure it out! That we still can have relationships, it's almost a miracle. But I like very much what she said that, in a way, what education does now, maybe it's really true, is promoting almost toxic relationships. I think you're right. The interesting thing is that it's, of course, not only about language. It was interesting in a lecture, one of the women said, well, maybe in a lesbian relationship, it's not a problem. And then a lesbian student said, well, I had a terrible partner, but who beat me up as well. So don't think that because you're lesbian, you better understand each other. I'm not even sure whether language only has to do with gender. That's to do who you are, actually. It could be that women talk in a different way; I'm not 100% sure, but it is an interesting thing; we have to look much more at language than we do and in the pleasuremeter we make a mistake and I'm rewriting that. We talked about the dos and don'ts, and some of them I still agree with. But actually, what we should have said is to try to understand language. If you say about pregnancy, there's a baby in you instead of a foetus, what do you want to say? What is actually the almost subliminal message you want to give? There's a baby in you. What does that mean? So you're against abortion? But it is also if you say, for instance, promiscuity, why do you use the word promiscuity? Understand why you say it. Why don't you say someone has multiple partners? And I think it's not about the do's and don'ts. For me, it's more why? Explore because language is personal. Explore why do you use those words when it's about sex?

I also find it interesting how we use genitalia in language. Like we say to someone, "grow a pair of balls", saying to be strong. But if you're a "pussy", it means you're weak. So a vagina is weak, but balls are strong.

Yes, but it's more important for me that people think about it. I want to prescribe what other words they can use because they have to speak with people who understand them.

Speaking about communication and language, regarding consent, do you think 'no means no' is enough?

I think it's much more complicated than no means no. I mean, I think if you absolutely know what you don't want, then it's fine. But again, I don't know always what I want. And it's not that no can become a yes. If I say no, it's no. But for me, the problem is that maybe not everybody knows exactly what the yes is. And people focus much more on the no than on the yes. And I think we should focus, of course we should focus on no, but we should focus much more on knowing what you say yes to.

I think many people don't, especially young people, who just don't know enough about their bodies to know what they're saying yes to.

Yeah, probably for the first time, but that's fine. You say I don't know yet, but if you absolutely don't want it, no is no; I agree with that. But I think it's much more that in your education, say try to explore what you think you want to say yes to and try to talk with a person about what it is and also say always ask for a yes. Don't assume that you know what the other wants, so I'll accept a no and always ask for a yes. That's basically the ground rule, I suppose. But the yes is much more difficult than the no because the idea that you can say yes to sex is taboo. But I would like to focus the whole discussion on consent on what do you say yes to? How do you find out what you want to say yes to?

And that's difficult, but there needs to be a lot of explanation and understanding of, like you said, about your body and but also of your mind. Because it's more about how do I look at my body? What do I experience with my body? What does that do to my emotions? All the young people we spoke to about first-time sex, the emotional issues were the most important ones, the 'do I know what I want? Do I really want this? Will I regret this?' I think we still have to find out how best to educate about the yes because we focused, rightly so, so much on the no that we forgot there is always a yes.

This links to another topic I wanted to talk about, the effect of pornography on young people.

Most young people we talked to between 18 and 28 said we know it's absolutely not the reality. I do think my problem with porn is the way, in reality, how women are exploited, basically. And also, I hardly can watch anymore because I think it's so ridiculous how they deal with women that I think poor men almost like, my God, how can you act like this, right? This double penetration and all this kind of thing.

I think also nowadays we're living in a time where people so young have access to it in a way that they didn't before, and like an 11-year-old with an iPad can access pornography. Previously, people would have usually experienced some form of sex before seeing porn, whereas the younger generation is now seeing porn years before experiencing sex.

I think it's sad because it gives you a very narrow way of looking at sex, and they all think that you have to have oral sex; otherwise, it's just not real. Or you have to have penetration, both vaginal and anal, you know, it gives a very weird idea of how men have pleasure as well. I think it's sad, and I think that's why sex education should give a lot of explanations about pleasure as an antidote to what they see in porn.

The majority of porn is very objectifying towards women. I also think not only does it affect how young boys see sex, but I think it affects how young boys see women.

But also girls. Lets not only point our finger at boys. I think they're quite vulnerable as well. I think that girls are also continuing the myths and the ideas themselves and can also not be very kind to each other in that sense as well.

It's sort of the equivalent of what used to be seeing someone in a magazine that's been airbrushed and made to look a certain way, and then you see it in porn, and you're like, this is the show I have to put on.

Yeah, it's all the reason why I think it's very sad that young people start having sex later almost every year, and people say it's fantastic. I think it's terrible because what's wrong with starting at 16 or 17? What's wrong with that?

Well, another thing I wanted to ask as well was talking about the concept of first-time sex and the stigma of premarital sex.

I tried to explain it is horrible that, especially in what we know from research and much more from Asia, that for women, the first-time sex is so terrible that they see their partner as a rapist, but only after a while do they fight because the men also don't know how to do it and the woman feels rape because they don't know what's happening. For example, the research we did among Moroccan boys who think that the hymen is a brick wall, and so you have to really push through it, so the first time is terrible. That's why I think we should give much more information about, first of all, first-time sex is not only penetration, that's I think an important thing. But the other thing is that's why we did this project. Nobody explains exactly how to do the first time and what you can expect. If it's both of your first times, that is different from if you go with an older woman or an older man, but we still have a lot of questions about the emotional aspects of how you feel. Or how am I supposed to feel? Basically, how do I act? What do I do as a girl? Do I lie still? Do I move? Do I make noise? Is he in the right hole or not? Does he actually know where to go if he only thinks there are two (holes)?

There are so many questions, and actually, if you look at textbooks, it's just about the postponement of the first time, but what the first time actually is and how it works isn't said. That's the interesting thing, and they show maybe a penis in a vagina, but the rest is not discussed. So it's very interesting that they seemed to avoid it. For us, first-time sex is not about penetration. It's about seeking pleasure and seeking pleasure together, and still, it remains difficult because is kissing first-time sex? Well, we said no, that's not, but okay if you touch each other's genitals? Or oral sex? We try to make it as broad as possible because all of them have a deep impact on how you look at sex and how it is performed.

I knew about oral sex for a girl to a boy from a very young age because boys spoke about it, but the other way around was never really spoken about.

I think if you can do those things in a nice, kind way, then that is fine. The same with masturbation. It's really one of the biggest taboos and certainly not discussed and also how to do it. You know, there was a Danish video. It was a cartoon video, and it was made 40 years ago. The best video of everything. How to have sex and how to have oral sex and how to have and it was extremely funny….they don't understand anything about each other's genitals so they explain the genitals and then they start talking about how to get excited, how to masturbate, the different ways of masturbation, and then the way different ways of how to have sex and things like that. And because it's cartoons, it's absolutely not pornographic. It's quite funny. And, of course, they also talk about condoms and also about unwanted sex as well. But it was 40 years ago, and actually, I thought, well, you, you could do a remake, but I'm not even sure if it would be allowed in schools now.

In schools, they still don't learn much about female pleasure at all, and female pleasure is often side-lined because of how reproduction-focused it is, and you don't need a woman to have an orgasm to make a baby.

I do think there is change happening. You see more and more articles. We were seen as idiots when we started, but you see more and more articles happening about pleasure, but it's still not translated into real life.

Also, with masturbation, no one is really taught about it, but I think it's much more socially spoken about among men than it is among women. There is almost shame imposed on women who masturbate, and it prevents discussions around it. I also think a big reason why people don't know what they want when it comes to sex is the lack of education around masturbation.

I agree, but I don't think we should say sexual pleasure is the same as orgasm. I think we have to be careful with that because even women who have been circumcised can still have pleasure. It's also from a very a pornographic perspective: I'm male so I have to give you an orgasm. It came out very much with our interviews with the 18 to 28-year-olds that girls don't mind not having an orgasm; they were much more focused that the man was getting one because they could do it themselves easily, and he's not needed for that. So I thought it was quite liberating to be honest. But also, we have to get rid of the myth that every sexual act should end in an orgasm otherwise, it's not pleasurable. It is also about intimacy. I think we often think that intimacy is the same as having an orgasm, and I think that probably, maybe, it has to do with age, that intimacy is almost more important; I don't need to love or whatever, but I feel like an intimate connection while we do in this together, is more important whether there will be an orgasm. But that's what pleasure means to me; everybody has their own definition. But I think that I can be who I want to be with that person, that I don't have to pretend that I think we're on the same wavelength or that we don't have to lie about things; that would be, for me, more important.

I think it links back to what we were talking about before with the pressure to perform, and when that fades, then it becomes more of an enjoyable experience.

Yeah, exactly. I think that was not absolutely right.

It's an anatomical thing as well because if you think about how when a woman gets more anxious, they're physically tightening up more (in their pelvic floor / vaginally)

Yes, of course, it has a lot to do with that. But also don't underestimate the pressure on boys. I sometimes pity boys because of the pressure to perform.

Exactly, it's both ways for sure, and one of the educational issues we have is the lack of explanation of the mind-body connection; if you're mentally under pressure, it's less enjoyable.

I think we also need to acknowledge that boys are mentally as vulnerable as girls as well, and we should not make it too dual as well and make them opposites because they are both part of something where they both are extremely vulnerable, even if they express it in a different way.

At the end of the day, they're both human beings.

Exactly.

It's important to highlight the difference between nerves and pressure. It's natural to be nervous, especially if it's your first time with somebody. Whereas the pressure of feeling like you have to do something is not okay.

I wrote a book about kindness. And I think kindness is not being sweet. It's not at all, but kindness is that you really try to think about what the other person needs and wants, without forgetting what you want and need, and that you find a balance between your needs and wants and the ones of the other person. For that, you have to be creative and you have to have empathy, and you need to listen. You really need to be able to listen.

And so, I'm writing now a book for parents as well, how to educate your child to be a kind person, and part of that is a sexual part. It's not only sex, but it's also in relationships, in your future work, with a teacher, or with your peer. For me, if we could change all the sex education into kindness education and make sex integrated into that, I think it would be much more acceptable. I think if we put it in a broader perspective of the whole human being and the relationship with the human being with someone else. They do, and then they forget about sex. But sex is a very important part of that whole spectrum in a way. And I think if we could think more about how we can become kinder to ourselves and to others. It doesn't matter if you have an orgasm, but being kind means that I care for you. I care unconditionally, not for my own needs. I mean, in a very Christian way, people are told to be kind because then they go to heaven. That's not what I mean; it's an unconditional idea. What would make you happy for instance, right? Or maybe even small things, and that you think about that. And that you don't forget yourself. Because a lot of women say I'm very kind to the other person, but then they forget themselves, and then they become like a doormat where people can walk over, right?

I tried to write an article about the importance of kindness in sex, but I'm still not finished with it. But I truly believe that if we can be kind to each other, and also in sexual circumstances, you don't have to be in love. I mean, that's not my point; it's not love, and not to say this is how it should be. And that you are asking, and you're listening, if that's what you can do. But I really believe in that. I really believe in a link with kindness.

Well, I think it's one of the reasons why we need some more sex education because I think pornography dehumanises sex a bit, and the parts of being human that are being kind and empathetic are rarely included.

There was a very interesting article in the British Journal of Psychology that shows that people who are altruistic and kind have much better sex in life.

Do you think it has to do with how they are able to connect to each other?

Yes, so there's a connection between kindness and sex; it's not totally casual, but it contributes to having good sex, asking what the other wants and listening. Don't blame the other or yourself if things go wrong; well, I'm still writing. It helps if you both feel safe in a sexual relationship and appreciate each other, you become more sexually attractive to your partner if you behave altruistically, being kind in a sexual relationship will help. However, it doesn't mean that you should feel totally responsible for the sexual pleasure of the other, you're not 100%, you're also responsible for yourself, if you don't feel like having sex for a while, search together with your partner a way to keep sex on the back burner to continue, listen to the views and experience of your partner without immediately giving your judgment.

I had a lesson from a sexologist from Hawaii, a fantastic guy, and he had some rules of thumb for kindness and having sex, be kind to each other, treat the other person as a person and not as a body, your partner as a whole, the mind and the body, give your partner pleasure and accept that the other person gives you pleasure, which is not always easy, do not assume it is a yes, but always ask first for a yes and accept when a no, know what the yes is, tell the other person what you like, and try to find a balance between lust, humour, seriousness and sensuality.

You mentioned feeling safe, so what does that necessarily mean?

Well, feeling safe is not just about using contraception; the unwanted consequence is one thing, but feeling safe is what I try to say, I can be myself with that partner. He or she will not judge me immediately if I say something or do something. The point is that I feel safe enough to say, you know what, I think we're done, that was it.

I think many people misunderstand feeling safe as not just being in physical danger.

Oh yeah, but that's a whole other aspect, this is almost being emotionally safe, that's what I'm talking about, so you have the kind of public health safety (contraception), you have the physical safety, but you also have the emotional safety, and I think that's, for me, that's the most important thing, that I have to feel emotionally safe with the other person.

I've had many conversations with people where I ask if they feel safe, and their response is, "I know he would never physically hurt me", but that's not my question.

Exactly, safe is a difficult word, but that's basically what I mean: emotional safety is as important as physical safety.

We are very grateful to Doortje, not just for chatting with us but for the work she has done, and continues to do. If you are interested in reading more about her work on the pleasuremeter click here.