(++++) SEX MATTERS

Mayo Clinic Guide to Fertility and Conception. By Jani R. Jensen, M.D., and Elizabeth A. Stewart, M.D. Da Capo. $23.99.

Sex: An Uncensored Introduction. By Nikol Hasler. Illustrations by Michael Capozzola. Zest Books. $14.99.

     How to get pregnant – and how to enjoy sex if you do not want to get pregnant – are the subjects of, respectively, Mayo Clinic Guide to Fertility and Conception and Sex: An Uncensored Introduction. The Mayo Clinic book is exactly what anyone familiar with this outstanding medical establishment would expect: thorough, engaging, fact-packed and plainspoken. It is also full of surprises – for example, Jani Jensen and Elizabeth Stewart suggest that both partners, not just the woman, should have good body-mass index (BMI) numbers to maximize the chance of a pregnancy. The book is also upbeat in some rather surprising ways, explaining, for example, to “forget about positions and routines” when trying to get pregnant, because “there’s no scientific basis for the idea that certain positions during sex will enhance conception. By all means, though, feel free to get creative if you like!” The highly positive tone of this book makes some of the more-complex elements of it much easier to accept; the personal stories sprinkled throughout are helpful, too. But it is a fair bet that most people who buy Mayo Clinic Guide to Fertility and Conception will do so because they want to know how to start or expand a family – the writing style and other people’s stories will be subsidiary. The book proves to be just as helpful (and, not surprisingly, scientifically accurate) as anyone could wish. The authors have impeccable credentials, Jensen as co-director of the In Vitro Fertilization Program at the Mayo Clinic and Stewart as chair of the Division of Reproductive Endocrinology and Infertility. The 20 chapters here focus clearly on just about all aspects of getting pregnant, and each chapter breaks down its topic into accessible, easy-to-follow, clearly written sections. “Ovulation and Fertility Signs,” for example, includes “Your menstrual cycle,” “Your fertility window,” “Products that can help,” and a personal story – and each of the first three of these parts is itself broken down into smaller subsections. This makes the very complex topic of fertility and conception much easier to understand, and has the added advantage of letting readers skip sections in which they are not interested and get right to the ones on which they want to focus. There is, for example, a chapter called “Miscarriage and Ectopic Pregnancy” that includes “Miscarriage,” “Recurrent pregnancy loss,” “Ectopic pregnancy,” “Trying again,” and the usual personal case history. Turn to “Trying again,” for instance, and there is the expected statement that “Pregnancy loss can be an extremely difficult experience. …Keep in mind that you and your partner may deal with a pregnancy loss in different ways. It may not always be easy to recognize that the other person is hurting.” But you will also find the unexpected here: a short description, with photo, of the Japanese custom of making offerings to Jizo, an enlightened being thought to watch over miscarried and aborted fetuses. Of course, Jensen and Stewart do not suggest purchasing a Jizo statue and dressing it in a cap and bib, as is done in Japan; here as elsewhere, they explain more than they recommend. But by including this unfamiliar-to-Westerners custom, they subtly show that the pain of the ending of a desired pregnancy takes many forms and generates many different coping mechanisms. It is this sort of inclusiveness, this openness to multiple approaches to becoming pregnant and carrying a baby to term, that makes Mayo Clinic Guide to Fertility and Conception so valuable. The book really does go through pretty much every possible child-related alternative, including surgery, reproductive assistance, third-party reproduction, single parenthood, adoption – and child-free living. The expertise of Jensen and Stewart is matched by their empathy, and anyone seeking to start a family or expand one, and who is looking for some sound, scientifically grounded advice and cheerleading, will find them served up here.

     Mayo Clinic Guide to Fertility and Conception of course includes a “How Babies Are Made” chapter with illustrations of male and female sexual organs and diagrams of fertilization, implantation, and even the different ways twins develop in the womb. Sex: An Uncensored Introduction includes reproductive-organ illustrations, too, but this is a book primarily targeting teenagers, and its style is therefore very different – starting with the bird and bee shown on the front cover. Nikol Hasler aims for a mixture of accuracy, humor and nonjudgmental, uncensored advice here, and manages a pretty good mix some if not all of the time. Hasler, a mother of teens, hosts a Web series about sex and works in public TV, and she is scarcely a medical expert, but Sex: An Uncensored Introduction is scarcely a medical book. In trying to speak to a teenage audience, Hasler includes elements such as occasional boxes called “There are no stupid questions – except for this one.” An example: “Can I get my mom pregnant if I masturbate in a sock and then my mom washes the dirty sock, gets dried semen on her hand, and later wipes herself?” Also here, in addition to what Hasler calls “the basics” about sex, are entries such as “What’s in a name?” – where she says “there are lots of great (and not so great) names for your body parts! Here are some of our faves.” Those include, for breasts, “airbags…tittybojangles, tracks of land, chesticles…dairy pillows,” and for penis, “one-eyed trouser snake, schlong, purple-headed yogurt slinger…tallywhacker…pork sword.” Clearly this is not a book as straightforward as the Mayo Clinic’s. But there is an underlying seriousness of purpose to Sex: An Uncensored Introduction, as shown in answers to a variety of questions that raise concerns ranging from “My penis is kind of small” to “I’m an openly gay kid, and I am really sensitive to guys thinking I want them”; from “I was raped as a young girl, and because of this I feel like I have lost the magic” to “Will my new boyfriend still want to have sex with me when he finds out that I am all loose and stretched out?” Hasler takes all these questions seriously and answers them carefully and nonjudgmentally – indeed, the nonjudgmental aspect of the book is one of its strongest points. A weaker element is the way Hasler bends over backwards to stay with-it and trendy, probably because she wants teens to pay attention. Thus, her first entry under “Gender Identifications” is: “Cisgender: People who are comfortable in the gender they were assigned at birth.” Assigned at birth? By whom? What exactly does that mean? But the basic advice in the book is sound and is delivered forthrightly: “Sex or foreplay should be consensual every time you have it, no matter what kind of sex it is and who [sic] you are having it with.” If anything, Hasler errs on the side of caution, as when discussing sexually transmitted infections: “If you are sexually active, you should be getting tested every six months, even if you are using condoms (which you’d better be).” There is nothing pandering or smarmy in Sex: An Uncensored Introduction, despite the fact that it lives up fairly well to Hasler’s promise to discuss “everything that has to do with sex.” The book is not an advocacy tract: “This book is not here to tell you to have or not to have sex – it’s to tell you what you need to know if you are having sex, or ever will.” Yes, some of the attempts at humor fall flat, such as the chapter title, “Oral, Vaginal, and Anal Sex: You’re Going to Put That Where?” And whether some items are humorous is a matter of opinion, such as this “no stupid questions” entry: “If I want to make it to third base on the first date, does it help to bring a baseball bat?” However, the biggest issue with Sex: An Uncensored Introduction is that the humor and seriousness sometimes coexist uneasily and imperfectly, with the funny elements tending to override the far more important serious and health-related ones. For the intended teen audience, though, that may be no issue at all, although it is sometimes difficult to remember that Hasler is addressing teens – as when, for example, she feels obliged to write a definition implying far more naïveté than teenagers are likely to possess: “Some people like to look at pictures or movies of people having sex. This is called pornography, or porn.” Still, the bottom-line message here, and it is one that Hasler delivers effectively, is, “We’re all wired differently, and we all like different things for different reasons.” That is a comment that teens – and parents of teens, such as Hasler herself – can hopefully take to heart…not just to their sex organs.