Episode 4: Charles Moser, MD, PhD: A Sexual Medical Expert on Unusual Sexual Interests

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In this program, Dr Moser talks to us about the nature and range of sadomasochism (SM). He discusses his background (a self-described horny teenager who went to the library a lot) and how he came to view sexuality from a scientific perspective. From there, he branches out and looks at how our sex-negative society has led to people internalize their feelings and desires the negative repercussions of that. He also discusses the types of medical questions that people bring to him (i.e. I want to do X, how do I do that safely?) According to him, there is nothing that hasn’t been eroticized. He looks at people’s sexual behaviors and the medical and emotional issues that arise from a scientific perspective. He approaches his patients from a non-judgemental point of view and acknowledges that good SM is whatever really gets people off and that it is different for each person. While keeping safety in mind, he says that a key way for people to learn about what they want in their sexual lives is through talking and experimenting. Sex is fun, enjoy it.

Transcript

Charles Moser, MD, PhD: A Sexual Medical Expert on Unusual Sexual Interests

Intro
This program brought to you by personallife media.com is suitable for mature audiences only and may contain explicit sexual information.

Beth C: Hello everyone and welcome to a taste of sex guest interviews.  This is Beth C your host here at OneTaste™ urban retreat center in San Francisco.  Today we are presenting on personallifemedia Dr. Charles Moser he is going to be discussing his research his background with unusual sexual interests and SM. So here at OneTaste™ we have a practice called orgasmic meditation.  So that’s our specific flavor of research, and we have about fifty people who live together in intentional community and run the retreat center and research intimacy and sensual communication and its various forms.  One part of OneTaste™ is a program that we call urban monk which is a residential sensual immersion program that’s actually hosting the lecture series that brought Dr. Moser here with us tonight so he is getting ready to present at OneTaste™ in a while here and we’re looking foreword to it.

Today on a taste of sex guest interviews join us as Dr. Charles Moser discusses his private practice in internal medicine and sexual medicine in San Francisco.  Hear what some of the usual questions are as people are exploring their sexuality and sensuality and also hear about what makes people tick around sex particularly when it comes to unusual sexual interests and SM.
Dr Moser welcome again and let’s go ahead and get started.  You have a private practice in internal medicine and sexual medicine in San Francisco.  You are the professor and chair of the dept of sexual med at the institute for the advanced study of human sexuality.  I love it! And you’ve also been widely published in such journals as the journal of psychology and human sexuality, Sexuality reproduction and menopause, and you wrote the book sexual disasters and how to survive them.

Dr. Charles Moser: I did.

Beth C: How do you fit all of this in a day? (chuckles)

Dr. Charles Moser: That’s a very good question I sometimes wonder how I do fit it in a day, but it all seems to flow and they’re fun projects.

Beth C:: What led you into sex?

Dr. Charles Moser: I was always a horny teenager

Beth C: (Chuckles)

Dr. Charles Moser: But I was also a horny teenager who went to the library a lot.  And when people had questions, I’d look them up.  And then so when people were talking in, you know, around the school I had a different sort of answer than most other people.  And so people started coming to me with questions which led me back to the library which led me to research more and more and I found it fascinating. 

Beth Crittenden: What were some of the earliest references that you respected?  Like what really got you on the path?

Dr. Charles Moser: Well, I remember very clearly I was in the fifth grade and this, the guys were sitting around and someone mentioned that one of our classmates had her first period.  And the only thing I knew about periods were they occurred at the end of sentences.  And I had no idea what was going on.  And when I didn’t know, people sort of made fun, so I had to go find out.  And then I found out about periods, and many other physiologic events.   And that led me to talk to other people about what I was doing.

Beth Crittenden: And when did you get kind of actively engaged with having partners?  Like when did your research get hands on?

Dr. Charles Moser: That’s a good question.  It depends on what you mean by hands on.

Beth Crittenden: Uh-huh.

Dr. Charles Moser: I was a normal guy who was looking to find partners.  Junior high school, maybe even, maybe even public school.  And then slowly, we began, you know,  we began looking for, you know, for first base, second base, third base, but I was always interested in exploring and finding out what other people were doing even if I didn’t want to do it myself.

Beth Crittenden: And how has it been to combine kind of traditional western medicine with the study of sexuality?

Dr. Charles Moser: It seems really natural to me.  It’s never really been an issue and I have to say I have only received support from people in medical schools and the hospitals I work everyone seems to be very accepting.

Beth Crittenden: And has your practice always been the unusual sexual aspect flavor, or did you go more, kind of mainstream for a while?

Dr. Charles Moser: Well you always have to when you’re a student, you always have to have the mainstream aspect to it.  But, no, I think I have always been much more interested in the extremes than in the center.

Beth Crittenden: And how do you define the extremes?

Dr. Charles Moser: It’s the things that get other people upset and nervous.
Beth Crittenden: (chuckles) Such as?

Dr. Charles Moser: Well, I, I do a lot of work in SM and that’s obviously one of them. But I also work with sex offenders, and people who have unusual interests, foot fetishes, hand fetishes, people who are interested in cross dressing, in changing genders.

Beth Crittenden: And when you say that you work with them, is it that you start working with people psychologically or is it a physical practice? How do you interact?

Dr. Charles Moser: Well, I started out by getting my bachelors degree in physics; minors in math chemistry and biology.  And then went to the university of Washington and got a masters degree in social work which is my license to talk to people, and then I went on and got a PhD in human sexuality and opened practice as a sex therapist.  I did that for a long time and I got antsy and decided to go to medical school, and then I went back and instead of becoming a psychiatrist and doing what I did before and write prescriptions, I learned a new trade and decided to do internal medicine.

Beth Crittenden: And you said before, when we were talking before the show that you have a reputation for people being able to tell you anything without your getting judgmental.  Is that the social work background or the personal history?  What had you be so open?

Dr. Charles Moser: I think it’s just a good mix of a lot of that.  Good practice says that you leave your judgments outside the exam room and you try and help the person with where they’re at.

Beth Crittenden: And I imagine that, well tell me if I’m wrong, but it seems like a lot of people might come to you thinking that they have some sort of a problem that may just be view point.  How often do you see that it’s just an opinion kind of getting in the way of their getting off?

Dr. Charles Moser: Often.  Often.  It’s unfortunately too common.  We all live in the society which is unfortunately sex negative and after a while, people internalize those feelings and it’s hard to get people out of it.

Beth Crittenden: And how do people find you? Have they been kind of suffering with what they consider a problem for years, or can someone really early on come and see you?  How does that work?

Dr. Charles Moser: You know I get every sort.  I get people who are referred to me from other physicians or therapists.  I have people who sort of luck out and come in the door and say ‘oh I didn’t know you existed.’  I get lots of referrals from the different sexual minority communities. I’m just around.

Beth Crittenden: How many patients do you usually see in a day?

Dr. Charles Moser: Probably about twenty patients and sometimes another ten in the hospital.

Beth Crittenden: And what’s the kind of break down of gender?

Dr. Charles Moser: Oh it’s probably fifty-fifty at this point.  And I would say it about seventy percent is something related to sex and the other thirty percent is just general internal medicine.

Beth Crittenden: So what sorts of questions could people bring to you about sex that would be relevant to medical expertise?

Dr. Charles Moser: Well people often have questions about ‘I want to do X, how do I do it safely?’  and then I have questions about ‘I want to go from here to there and I don’t know how to get there and I’m worried about it impacting my health, or impacting my relationship, or impacting my family.’  And then you, as part of the process help them figure out how to get there and present what their whatever it is they want to present, you know, in a reasonable way to their family.

Beth Crittenden: And do they, like, go home and have sex tried out and then come back to you? Do you do consultations like that?

Dr. Charles Moser: Well, when I was a therapist, that’s precisely what you do. You sort of give people what we call homework, and they go home and they do it, whatever it is, and they come back and report. And you say ‘ahh on the basis of what happened, you next assignment is this.

Beth Crittenden: And now what is it like?

Dr. Charles Moser: Well now I have a pretty much fairly internal medicine practice so I see a lot of people who have unusual sexual interests.  But they’re seeing me because their blood pressures high and their diabetes is out of control and various other medical problems.

Beth Crittenden: Do you ever kind of, get attached to people?  Do people ever kind of get inside and how do you handle emotional side of this? I know sex is incredibly emotionally charged for a lot of people.

Dr. Charles Moser: Well I obviously don’t do sex with my patients and you know, but there are, there are some patients that; I remember one woman said to me “you know if you weren’t my doctor we’d be really good friends.”  And I think that there are people who I meet who I think might be good friends, but our professional relationship doesn’t allow that.  And there are other people who really want that distance who don’t ever want to see me as a friend or a possible friend and don’t want to see me in their community. They want to just know that I am in my office waiting for them to call.

Beth Crittenden: What percentage of people in your personal life are you kind of out too about the range of your interests and practice?

Dr. Charles Moser: You know, I tend not to talk about what I do personally.  I would say if want to know what I do you’d have to seduce me.

Beth Crittenden: (Laughs) 

Dr. Charles Moser: And I think what I don’t like is being, is for people being judged on their sexual behavior.  And I see no reason to put out what I do so people can judge me on my sexual behavior.  Maybe I’m gay, maybe I’m straight, maybe I do dogs, it doesn’t matter.  You should deal with me as how I’m treating you and not about what I do in my private sex life.

Beth Crittenden: What has you have the ability to have such kind of unmagnanamous view point? What’s your source of that openness?

Dr. Charles Moser: You know I guess I really don’t know that.  What I know is that it’s always been like that for me. And that when I look at my own issues, and we all have issues, I question where they come from and I try and get back to the science and say is there a scientific basis for what I’m feeling?  And if I’m asking people, you know, people come in and they ask me what about X? and I say here’s what we know about X from science.  And maybe that’s okay for you and people say I don’t car what science says I have these feelings. Well that’s okay, but understand that they’re your feelings and maybe you shouldn’t be pushing them on other people.

Beth Crittenden: What sources of information do you most respect now around sexual practices and sexual medicine in terms of literature, websites, organizations?  Where do you think the good information is coming from?

Dr. Charles Moser: I get it from the academic journals.  Medicine, sexology, psychology, sociology, anthropology.

Beth Crittenden: And is there a lot of sexual research being done that just isn’t that out in the mainstream yet?

Dr. Charles Moser: More than I can read every month comes out.

Beth Crittenden: Oh where does the funding from it—for it come from?

Dr. Charles Moser: In most cases, people do it because they’re interested in finding the answer and they are not funded. 

Beth Crittenden: Wow.  That’s significant.

Dr. Charles Moser: That’s very significant.

Beth Crittenden: Has there been a patient who has come to you where you just absolutely drawn the line and said, “no that thing that you want I juts, I can’t have you going out of here trying that?”  has there been an absolute line in the sand?

Dr. Charles Moser: Well I mean there is first of all, there is legal issues.  I mean if someone said,” I’m gonna go out of here and hang myself.  I have a legal responsibility to report I can’t allow that to happen.  If I am told that someone is sexually abusing or physically abusing a child, I have to report that. If someone is going to do something that is obviously going to be physically damaging, then I get to tell them that your being stupid and your gonna hurt yourself.  And the issue is how I tell them, and how, and how we sort of work through that.

Beth Crittenden: Gotcha.  So, what you’re saying is grain of salt with everything.

Absolutely.

Beth Crittenden: Ya.  We’re getting ready to pause for a break to support our sponsors here.  This is Beth Crittenden hosting a taste of sex guest interviews with Dr. Charles Moser.  Please join us again after the break on personal life media as we return to talk about more unusual sexual interests and we’ll get a little deeper into SM in the second half of the show.

Beth Crittenden: Welcome back to a taste of sex guest interviews.  I’m Beth Crittenden here on personal life media from OneTaste™ urban retreat center with Dr. Charles Moser.  Welcome back.

Dr. Charles Moser: Thank you.

Beth Crittenden: So, lets get more into something we were talking about before the show which is your intense curiosity around why do people have certain unusual sexual interests? Why does one thing work for dude A and just doesn’t at all work for dude B?  What have you found around that?

Dr. Charles Moser: Well actually it’s still a question that has no answer.  And I often, there’s actually several of my papers that start off with how we developed our specific sexual or erotic interests is a basic and unanswered question in sexology.  So, we don’t know the reason and only by looking at people and their interests are we able to maybe shed some light on how people get from point A to point B.  you know it’s sort of interesting that a lot of people try to change their sexual behavior or the sexual behavior of others.  And are completely in effective in doing that.  And everybody’s sexual behavior evolves.  And it does change.  So, trying to change it doesn’t work, and there is no way we know to influence it, so it changes in a certain way.  But it does change.

Beth Crittenden: What’s your experience with he effects of not exploring our sexual interests and cravings?

Dr. Charles Moser: There is a price to be paid for both exploring and not exploring one’s sexual interests.  And sometimes it’s to someone’s advantage to explore it, and get into it, and sometimes not.  And its an individual choice, you know, people will often let’s say, go out have a fling with a whatever it is: SM, gay sex, whatever.  Have a great time eighty-three orgasms, everything’s wonderful, and then get scared.  And say I’m not gonna do that again.  And they may spend years trying not to do that again.  And sometimes they die before they do it again and sometimes they just say its a charade and they change their life and they start exploring.

Beth Crittenden: Why do you think pleasure is so confronting or threatening enough that someone would entirely shut it down in that way?

Dr. Charles Moser: Well if you think about it, people have lots of goals.  You know, if have a PhD, an MD a Masters degree.  The only way you get that is by studying.  And so there were probably a lot of times I could have been out doing something sexual, but I was back in my room studying for the next exam. And so, am I sorry I missed whatever the sexual experiences are?  Well, maybe a little, but I also like my life now and I am glad I did what I did.  And life is a trade off; you know you can eat the ice-cream and be fat, or not eat the ice-cream and be thin, and you have to decide whether you want the ice-cream or being thin is more important to you.  And people make different choices at different times.

Beth Crittenden: How do you define SM?  What’s the basic foundation of it?

Dr. Charles Moser: Its eroticizing some power exchange is how the people who do SM explain it and what I do mostly is let people self define.  And I try and get people to discuss what it is about it that turns them on.  And what you find is that even though people say, ‘oh ya what we is SM, what he and she does is SM” and you actually spend some time, it has nothing to do, they’re not similar at all, they’re very different.  When I was first doing my research, I met these two women in separate situations both of which were into SM, and both of which said they had never met another woman into SM.  This was many years ago. And so I decided to have a dinner party for the two of them so that they could meet each other.  And so they came over and I sort of introduced them and I went into the kitchen to sort of make dinner and let them chat.  And maybe five minutes later, one of them is in my kitchen chatting with me. And I said, ‘wait a minute, why are you in here chatting with me? Why aren’t you outside chatting with this woman?”  and she said something very telling, she says “well, you know, I’m really interested in all the psychological stuff, I’m not really interested in the physical stuff.  And she’s interested in all the physical stuff, and none of the psychological stuff, and we don’t have anything in common.

Beth Crittenden: (Laughs)

Dr. Charles Moser: And so they spent, we had a nice dinner talking about how people are really different.  And they had both come over thinking they were going to find someone who they could share their experiences as women and as to being in SM they were just very different.

Beth Crittenden: That’s a very interesting point.  How many people do you think keep it in the fantasy realm and how many actually physically explore it?

Dr. Charles Moser: Well, depends what you mean by exploring. You know if you’re talking about the married couple where she says “I really like it when he throws me down on the bed and has his way with me.”  Ya know there probably a lot of people who play with that on occasion.  If you talk about recognizing what they’re doing as SM and owning the identity and exploring it in some regular systemized way, probably five to ten percent of the population.

Beth Crittenden: Do you give people consultations on how to stay physically safe, mentally safe when they are undertaking these practices?

Dr. Charles Moser: Sure.  A lot of people say, this is really turning me on.  But I also want to be around for tomorrow, and the really don’t want to do things that will get them into physical trouble.  Or mental trouble for that matter.  And so there is often a little discussion of can this be done safely?  What are my chances of being hurt here, contracting an STD, contracting a physical problem?  And it’s interesting, there’s a lot of people who are very concerned about it, but very few of my patients wind up being abused by an injury related to sex.  I always tell people its much more dangerous driving to and from the party than being at the party. 

Beth Crittenden: Good Distinction.  In terms of an SM gradient, what would you say would be a range of several different practices starting from more vanilla on through to a little spicier across SM play?

Dr. Charles Moser: There are people who lets say want to be play in the submissive role and that may be very well defined.  You know, I’m going to be submissive for the next twenty-five minutes, and then we’re going to stop.  Or it could be I’m going to be submissive every time we’re in bed, but not outside the bed.  I’m going to be submissive all the time we’re together alone, but never when there is someone else present.  I’m going to be submissive all the time, but only at a very low level, or all the way up to I want to be a complete and total slave with all the time and I want you to do with me as you please. 

Beth Crittenden: What makes really good SM in your opinion?

Dr. Charles Moser: When people really get off.  And what really gets people off is different.  I mean, you know, its like saying, that person is really good at sex.  That’s a meaning less statement.  For some people it will take a he, he’s too rough; for some people he’s too gentle.  For some people he’s going too be to big, for some people he’s going too be too small, for some people too fast and some people too slow.

Beth Crittenden: So then what are the important elements that you might suggest to people around what they need to communicate what they need specifically so they can get off?

Dr. Charles Moser: Well that presumes something which is often not true which is people know what they need to get off. 

Beth Crittenden: Good point.

Dr. Charles Moser: And so what I think you have to do is get people talking.  And get people experimenting and saying alright you didn’t like it when I did A, lets try B this time.  Or we did A, B, and C last nigh; maybe A worked and B and C didn’t, so how can we expand on A and go further.  See if that will help.

Beth Crittenden: Are there any practices that leave you totally scratching your head, like you have no idea why that turns someone on?

Dr. Charles Moser: Oh, lots of things.  I mean, there is nothing that hasn’t been eroticized.  Do I really understand why people get off rubbing people’s earlobes?  No I really don’t understand that.  But I can tell you there are people that get off on it, and they really love it.  And what’s really interesting is trying to get them to talk about it and explain what it is that really turns them on.  And how, ya know, whether they like the big earlobes or little earlobes, or the brown earlobes or whatever.  And what’s special about those earlobes for them. 

Beth Crittenden: Is there qualitative or quantitative research being done where people are physiologically tested for get off?  Is there a way we can measure that?

Dr. Charles Moser: Not very well.  There are people trying to look at that.  The big researchers and trying to see if we can change people who are sex offenders.  Obviously, people who are abusing children are a menace to society, we have to protect children.  And so if people are having sex, are in hospitals or prisons, and if they have gone through a therapy program, we want to know if in fact we have changed their arousal pattern.  And there are some techniques to do that but, it’s unclear how good they are, how predictive they are. 

Beth Crittenden: Are there sex acts that have been criminalized or marginalized that you feel strongly should not be?

Dr. Charles Moser: If you’re talking globally, I mean, homosexuality is still illegal in more than half the world, and I think we have enough data now to say it harms nobody, and is a wonderful source of help for some people.  SM is a similar issue.  I do a lot of work in the, as an expert witness and I have never seen in a case where someone was involved in SM that got custody of a child in a divorce proceeding. That sounds pretty discriminatory to me.  Again I am a scientist, if you say something is sick and bad, where’s your data. Show me the data; let’s see if in fact there is truth here.  I don’t care if that is how you feel and that is your religious upbringing, that how you see the world, I care about science and data.  If you have data, well then maybe there are some things we shouldn’t be doing.  But then I want to see the data.

Beth Crittenden: So from the scientific view point, what’s the big deal about non-procreate sex?

Dr. Charles Moser: I have no problem with non-procreative sex, and I’m no sure why any real scientist does.  Most sex is non-procreative.  If you save sex for procreation, I almost want to say what a waste because you can’t procreate all the time. 

Beth Crittenden: And on the flip side of that, what do you see as the value?

Dr. Charles Moser: Of procreative sex?

Beth Crittenden: Non.

Dr. Charles Moser: Of non-procreative sex.  Its a wonderful sleeping pills, its a great way to bond with people, it sure is fun, it beats washing the dishes, I mean its hard for me to imagine why anyone doesn’t like it. 

Beth Crittenden: So what do you see people usually needing to step through to get to a kind of a healthy level of openness around sex?  What are they usually wading through?

Dr. Charles Moser: Different people wade through different things and its not really clear how many of us have open sex.  I have on occasion taken people who have said oh no, I’m really open and loose and five minutes with me and they decide oh not they’re not so open and loose.

Beth Crittenden: What do you say to them?

Dr. Charles Moser: Well you ask them.  What they like, why they like it, and why they don’t like other things.  Lets think about a simple example, if I were to blind fold you, I don’t know it your gay or straight, or bi, or what you like, but if were to blind fold you and someone would do oral sex on you, so you couldn’t see who it was, you would have a different reaction if you found out the person was male or female, and maybe if they were young or old, or maybe if they were ugly or pretty, or all these different things.  And I say what does it matter? You’re still getting the same sensation and why do you have to know?

Beth Crittenden: That’s cool.  Has there ever been a time where you felt just like, you kind of hit a wall with this that threes too much repression, too much judgment, couldn’t do it anymore, wasn’t worth it?

Dr. Charles Moser: Well is surely hit walls, but its never to the point I can’t do it.  I write my papers, and I give lectures, and I talk to people, and eventually people will remember me for being able to say he understood it.  He did good research.

Beth Crittenden: What do you understand?

Dr. Charles Moser: A little bit about the breadth and differences in sexual interests and how people express it. 

Beth Crittenden: And what’s you message to people who are struggling to fully know that part of themselves?

Dr. Charles Moser: Sex is fun enjoy it.

Beth Crittenden: Thanks so much for being here with us today, looking forward to you lecture.

Thank you.

Beth Crittenden: So, thank you for joining us tonight on a taste of sex guest interviews.  This has been Beth Crittenden your host from OneTaste™ urban retreat center on personal life media so pleased to have presented this discussion to you.  If you’d like texts and transcripts of this show, you can visit www.personallifemedia.com.  If you’d like to send us an email about whether you love us or hate us, please email us at [email protected].  To learn more about onetaste and our programs, including urban monk, you can visit www.onestastesf.com.  Thanks so much for joining us, hope you got a lot out of this and remember the message that sex is fun