#78 Unlocking Intimate Communication with the STARS Method

What if you could transform awkward and difficult conversations about sexual health into empowering discussions? That's exactly what you'll uncover with Dr. Eveline Molina-Dacker, a trailblazer in the realm of sexual health and a family physician who has crafted a revolutionary method to facilitate these talks. Her STARS framework—standing for Safety, Turn-ons, Avoids, Relationship intentions, and Sexual health disclosure—serves as a roadmap for exploring desires and boundaries with both clarity and compassion. We delve into Dr. Dacker's personal journey and the inspirations behind this framework, revealing how it offers a structured approach for fostering trauma-attuned and consensual communication in sexual relationships.

Chapters

• 0:00 Framework for Conversations About Sex
• 5:46 Creating a Framework for Sexual Conversations
• 21:22 Navigating Sexual Relationships and STI Stigma
• 29:45 Exploring a Sexy, Fun Framework

Transcript

Speaker 1: 0:00

Welcome to the Straight from the Source's Mouth podcast. Frank talk about sex and dating.

Speaker 2: 0:05

Hello, Tamara here, Welcome to the show. Today's guest is family physician Dr Eveline Molina-Dacker, who specializes in sexuality and sexual health, and we'll be talking about how to have conversations about sex. Thanks for joining me, Dr Dacker.

Speaker 1: 0:21

Hi. Yes, I'm excited to be here with you today. Thank you, hi. Yes, I'm excited to be here with you today.

Speaker 2: 0:24

Thank you. Well, everyone is having sex generally not everyone, of course, but talking about it is the harder part of it. So having a lens on somatic and trauma attuned.

Speaker 1: 0:40

Yeah, yeah, you know it is. It's really hard to talk about sex and I know that there's other. You've had other podcasts about people talking about sex and I know that there's other. You've had other podcasts about people talking about sex and we always say like we have to have this conversation and it's a really important conversation to have. But what I found was a missing piece in it is having a way to remember what to talk about and having some kind of framework for us to understand our own sexual desires and needs.

Speaker 1: 1:09

I know for myself, being a Gen Xer, that in my sex education we never really talked about what was important. So I had to learn all of these things as an adult. And then I came up with like wow, everybody talks about talking about sex, but nobody has a way of doing it. Then I came up with like wow, everybody talks about talking about sex but like nobody has a way of doing it. So I came up with a framework. I came up with a framework for myself. I came up with a framework for my patients, because I am a family physician, and a framework for my young adult children as they were entering college, and I call that framework the STARS talk.

Speaker 1: 1:45

Some people call it the STARS method. It's really just a way of remembering the five what I think is like essential things that we need to be able to have these conversations. The STARS talk and it's an acronym. It stands for safety and kind of our safety needs. It stands for our turn-ons, or the things we like, our avoids, which are our boundaries or things we don't like our relationship, what our values are, what our expectations, what our intentions are in those relationships. And then at the very end, we talk about our sexual healthT-I disclosure and status. So that's the basic framework of it and it's been developed over the last. How many years like eight years I've been working on this and it shifted and changed a little bit, and now I like to call it as a way of having a trauma-attuned consensual conversation with a person Back at episode 14, where she talked about the method, and now I'm talking to the person that actually created the method.

Speaker 2: 2:49

So I think that's pretty cool. So, yeah, say and yeah, I mean you just you pretty much said why or how it came about. So then, how easy is it for people to do, or what have you? What have people come across? Or yeah yeah, how does it help?

Speaker 1: 3:06

Yeah. So you know it's interesting. I'll tell you a little bit about the origin story because sometimes people are like well, where did that come from? So you know, when I was in my mid forties going through like my menopausal you know, perimenopausal phase or entering it, I started and being a family physician watching women go through this transition, I thought, oh my gosh, like I'm going to lose my sexuality and I don't want to lose my sexuality, so what do I do to not lose it? So I started taking a lot of courses on sexuality, on sexual health, and that's kind of when I pivoted my work from just being a functional and integrative holistic family physician to doing more specific sexual medicine. I also do a lot of menopause medicine. I work with a lot of people going through life transitions.

Speaker 1: 3:54

So during my going to doing all these classes, I heard about people having these elevator talks. And the elevator talks is like when you're about to go for a hookup or some kind of sex and you kind of give them your download, like this is what I like, this is what I don't like and this is it. And I thought, oh my gosh, this is so fascinating. Like why doesn't everybody do some version of this. And then, like I also went to like I learned about kink and I realized, oh, look, people who do kink like actually have these negotiation talks before they do a scene.

Speaker 1: 4:29

And not only do they have these negotiation talks before they do a scene, they also talk about what they want afterward and they make a point of aftercare, like after the scene is done. They do stuff Like they hug or they give each other, like maybe you get some ice cream, I don't know, you get something. So I was like wow, how fascinating is that the people do this. And then, as I learned a little bit more about Tantra and sacred sexuality, I kind of learned about how people make bubbles and they create these bubbles where they could actually again talk about their desires and what they don't want and their boundaries. And I was like this is amazing, like why doesn't everybody do this? And I came to this idea that, like if everybody in the world knew that there was a way of actually communicating and had some kind of framework to put their thoughts and their desires in, and everybody could just be like, hey, let's do our stars talk before you actually like engage in any intimate behavior, I was like that could really change everything.

Speaker 2: 5:30

Yeah, yeah, definitely, and I like that you add the kink in the tantra. Yes, tantra. Yeah, because I haven't had many episodes about it, but I know of tantra, so I'm glad that you encompass or brought in all that stuff and it's a great background to have about.

Speaker 1: 5:46

Yeah, yeah, you know, with my medical part and talking to people from all phases, you know, as a family physician too, like I work with people from babies until they die, so I have this beautiful window into life and life spectrum and because I've worked in the same community for almost 30 years, I have some patients that I've seen through so much. You know I really like to address and sex is not something that's often discussed in a medical like. Usually my patients feel like they have to bring it up because doctors have such a hard time wanting to talk about sex unless there's a problem. So I really was making this. As I said, I was making this framework for myself to learn how do I could have conversations with my patients, also to be able to teach my patients, because I had so many coming in, you know, recently divorced, who ended up coming in with chlamydia or gonorrhea, and I'm like, did you talk about, like STIs and and and safer sex? They're like, oh, we don't have to because we been married so long, or I'm not going to get pregnant, so I don't use condoms, and I'm like, well, you could still get chlamydia, like your test shows me, or you still could get an STI. So talking about things is something I realized was such a gap in most people's understanding of how to do. I'll be the first one to raise my hand.

Speaker 1: 7:06

I'm not a sex therapist. I didn't go and become a certified sex educator. All of my education came from kind of real life and going and actually getting to know different subcultures, and so tantra, or I call it like it's neo-tantra, it's kind of sacred sexuality. It's about really getting in your body and understanding. It taught me a lot about somatics. What is somatics? Somatics is a way of getting into our bodies and listening deeper and being able to use our body's wisdom to help guide us in the way we navigate the world. And so much of my newer thinking about the stars talk comes from a somatic lens as well, because, again, when I went to medical school, we learned how to treat a body. We learned how a body functions, we learned how to fix things that go wrong, but we weren't taught how to be in our body. People don't know how to do that. I almost feel like we're walking just talking heads and we're not connected to this. So this goes into my very first S. So the very first S in the stars talk is safety needs. Before. When you think about sex and safety needs you think about like condoms and reproduction and how to prevent an undesired pregnancy or an undesired outcome.

Speaker 1: 8:36

I kind of switched that that really safety is about. What does it feel like being safe? Like, how do you know you're safe? How do you know that certain touch is safe? How do you know that there's things you don't want and could we take a breath and go into our body's wisdom and figure that out? How do we trust you know, when you're in a situation that you just inherently feel a little ick about, but then we tend to if you're a people pleaser or if you're someone who's taught to override that like then you don't learn how to trust that ick feeling. So you know a lot of what I teach with the Star Talk is like trust that feeling. Like, where does that feeling come from? Trust it Then. How do you communicate what you need to stay in the place where you feel good and this helps.

Speaker 1: 9:24

This is part of that whole trauma-attuned consent lens, that trauma-attuned.

Speaker 1: 9:29

So if we don't recognize that, we live in a world where everybody has some level of trauma. I don't care if it's little T or big T trauma, but you all have some. And then understand that when we have a trauma response, really it's our body trying to keep ourselves safe and what do we need and what triggers those, and can we let someone know? Oh, you know, by the way, if you end up I'm going to just use something. If you call me a slut, you know, for some people that could be a turn on right In this right context, but in other contexts it could feel really icky and it could feel like, oh my God, now I'm not safe and this is the way my body responds. In this trauma response I end up fighting, I end up having a fight reflex. So if you see me starting to fight, I could clue you in to let you know that, oh, you might've triggered something and let's have a conversation over what that could navigate. Now I understand this is pretty high end.

Speaker 2: 10:31

It's not like I'm going to meet somebody at a bar and be like, oh, this is my trauma, this is, you know um, yeah, like as you're in it or close to it, yeah, yeah, and a lot of women have a hard time talking about this stuff.

Speaker 1: 10:43

So, having a method where you it's like tuning into yourself and thinking what do I need to feel safe in an intimate environment, vulnerable context.

Speaker 1: 11:13

So then you know, once you kind of work in that, then what do I need to communicate to another person so that I'm safe in that engagement? So, for example, alcohol, that's one of my safety needs. Like, if somebody is drinking a lot, I don't feel safe. If somebody tends to be a heavy drinker, that creates situations for me where I'm not going to trust their yeses and they can't really trust my yes. So one of my safety needs that I very much communicate with people is that if you drink more than two drinks of alcohol, then any intimacy is off the table, unless we're in a deeper relationship and we know each other and we have navigated that In the beginning. Yes, that is one of my safety needs. Another one of my safety needs is I don't give my phone number out on dating apps. I don't want to give my phone number out until I meet a person face-to-face and I know they're real, because I know there's bots out there that take your number or I know that they're a safe person to have an ability to contact me at any time. Another thing that's safe is like I don't send explicit photos, but that you know other people do, but for me I don't. I don't take, I don't do any explicit photos with a person unless we're in a long you know, unless we're in a relationship, and that safety has already been built. So locations like where we're going to meet I want to meet somebody in a public place. I recently had somebody ask me on a date and then asked me to pick him up and drive him and I was like I'm not going to go have you in my car, who I have never even met, and then he invited me to his house. I'm like no, no, no, like let's just meet and have coffee and make sure that, like we're good. But this is something like I had to learn, I think, like when I was 20 or 30, I would have been like sure, Okay, because I want to please people. So that's kind of like the, and I feel like safety has to come first, like that is just the foundation of anything, of everything, of every relationship. Right, we have to feel safe with one another. So talking about that, then the next T is things that I like. And it was so interesting because when I first started this work, like I didn't even know what I liked Like.

Speaker 1: 13:34

People said, like, what do you like, what do you like to do? When I ask my patients, sometimes they come in and they're like, oh, my libido's gone. I'm like, well, are you having sex the way you want to? Like that you like? They're always like, oh, especially if they're in a female body and they consider themselves a cisgendered woman. Oftentimes they're like, well, yeah, my husband takes care of me, he makes sure I orgasm, and I'm like, yes, but are you still? Are you having the sex you want to have?

Speaker 1: 14:02

Because so much of what we think about what sex is, and especially in a heterosexual, cisgendered context, is penetrative sex, that is, and like penetrative sex, where the person with a penis ends up, you know, having an orgasm.

Speaker 1: 14:18

Then you feel, okay, we were successful here, right, and then hopefully, like the person with a vulva and vagina gets to orgasm too.

Speaker 1: 14:26

But there's such an orgasm gap is unaddressed because we don't know, we don't realize like there's so many other ways of getting turned on, realize like there's so many other ways of getting turned on and and speaking about that and like knowing what it is could be so empowering and like taking that again, slowing down getting into your body. Do I really like being touched in this manner, or do I want to be touched softer? Or do I want to be touched slower? Or do I really need, like, a conversation with a person before I get turned on? Do I need to just like feel comfortable and feel safe and to get turned on so you know, really understanding, like a lot of the stars talk. What's so great about it, too, is it really is for us to understand ourselves. It really is a way for us to inquire into like wow, this is I, like you know, having my hair tugged a little bit, I never knew that and allowing us to explore different sensations and different ways that are not just about penetration and orgasm.

Speaker 2: 15:50

Yeah, for sure, I talk about that a lot too, so I am right there with you.

Speaker 1: 15:55

So learning about that, so empowering and and it's amazing to me how, how it's such a newer concept, especially to people, you know, who are a little older. And then, you know, with younger adults who are just exploring, we, a lot of them, them like, what does supposed to turn us on? And so much sex education, especially for youth and young adults, is coming from pornography. And then there's this thing like, oh my gosh, I'm supposed to like that. I had somebody once come up to me and and talk about dating and and she was like, do I have to be choked? Is that like something I just have to do now, because that's what all the men are doing? And I'm like, oh my God, like, well, only if it's one of your turn ons.

Speaker 1: 16:37

But, leading me to the avoids, you know, section, it's like it's okay to not like something that everybody is doing. You know I don't necessarily like to be spanked, like, hey, you know, like it's, just because you think that everybody's liking it doesn't mean that I like it. So, you know, talking about the things that we don't want and the things that may, and, if we like, taking a step even deeper, like the things that we know may cause us trauma and that's so big. I mean that's so big so big.

Speaker 2: 17:13

I mean, that's so big and yeah, and even if, if, if it is a trauma response and a guy doesn't know what's going on, he could you know, or the other person could take it like have no idea what's going on Suddenly they get, like you said, in the fight mode and then you're like whoa, and then if you don't talk about it, you have no idea and then you're wondering forever.

Speaker 1: 17:33

Yeah, you know, one of the trauma responses. I think that, uh, and I'm talking definitely, I'm going to just name it then I'm talking from a cisgendered woman's perspective who is a gen xer. Okay, so I was brought up to a very specific time where, you know, we went through first wave feminism, second wave feminism and you know things were a little different then. So I'm coming from a perspective of, like people pleasing and um fawningawning, and these are these trauma responses, some dissociation trauma responses that I have, that when they're in the context of a sexual encounter, could look like I'm having fun. You know that I'm enjoying it, even though it might be a trauma response. One personal example for me is that one time I was having, I was playing with a very long term partner, so a partner that really knew me well and we're we're kind of roughhousing more than we normally did, and all of a sudden he slapped me and immediately I just went into kind of this dissociative state where I was just like out of it, because it was so shocking for me and it was something that I obviously had, like I didn't know that that was going to be a trauma response, but we never talked about it, we never did this and so you know we're together for almost two decades. So you know it was a long relationship together for almost two decades. So you know it was a long relationship and and I could see how with some people, like if they're in the middle of an encounter with somebody they don't know, that kind of like dissociation could look like they're really into sex or the man or the person who's with them, their partner might think that they're just maybe so into their own body that they're not, they're not attuning to each other, like With the turn-ons and avoids. So much of that conversation is really about learning how to attune to one another. If we recognize that we all have trauma and we recognize that our bodies give us wisdom, then we can actually become attuned to one another through this trauma awareness.

Speaker 1: 19:32

I like that called trauma-attuned consent. So with our voids, of course we need our boundaries. Our boundaries are I want to just name I just read this wonderful kind of post about this by Betty Martin, who does the Wheel of Consent and her work is really pivotal and really important work around consent and she called boundaries our limitations. You know, like those limits that we have with each other and then you know, when we are able to negotiate those limits so that they could be a little bit more flexible and fluid with one another. And the way we do that is through attuning to our bodies, attuning to our partners, and learning that attunement is going to require us having conversations. So then, so our turn-ons and avoids could change, and then, you know, they could be both and it could depend on the situation. But really having an idea of like, oh, these are my turn-ons, listen, these are my like hard no's and this is my boundaries that I need people to navigate and these might be some of my trauma responses. So like, oh, these are my turn-ons, listen, these are my like hard no's and this is my boundaries that I need people to navigate and these might be some of my trauma responses. So like having an understanding of ourselves in that and I really encourage people to write this down you know that we all keep a little stars document for, not that we necessarily share with other people, but that we have for ourselves. And then we could track as we change and grow, because we do and then the R the R is oftentimes the place we actually naturally start in a stars conversation because it's what we want. It's what sex means to us, it's what our intentions are when we date, when we're in a relationship like what do we want? What do we get? And then the ways and then the expectations of to be treated. Like how do I, what is my aftercare needs? Like bringing that back in to the conversation.

Speaker 1: 21:22

I know I had a person once tell me like, oh, you know, after sex I need space, like I need to just get back into my body. I don't want to touch, I don't want to cuddle, I just want to like be alone. So oftentimes I have to get out of the bed, jump out of bed and go to the bathroom so I could just like be alone. Because if I lie in bed and my partner wants to cuddle, like then I I hurt their feelings because that's not what I need. And I'm like did you ever tell anybody that? Like, have you told your partners that what you need is just a little bit of self, getting back into your body, into yourself? They're like no, wow. And I'm like yeah, see, that's an aftercare need, that's an aftercare need and we are allowed to claim it, we're allowed a lot of attention. And you're with somebody who's like oh no, I need space. Wow, that's a terrible time to find that out after you've had sex or after you've been intimate.

Speaker 2: 22:18

Yeah, for sure, I was just thinking that the other person, if there's basically what you said, yeah, yeah.

Speaker 1: 22:25

So claiming what it and again, some of us don't even know that's what we need, which is kind of this unconscious thing. I often think, like you know, back when we used to see movies and everybody would have the cigarette after sex. See, that was an aftercare need, an aftercare need to kind of like relax and get back into ourselves. It wasn't really that they needed the cigarette, it was just more like they needed that little break in space of self-care. Like they needed that little break in space of self-care. So, you know, it's a big question of like, what is? What does sex mean to me? Right, what does sex mean to me? Why am I going to, why do I want to have this intimate time with this person?

Speaker 1: 23:07

And it can mean many things, like sometimes it means just a physical release, Sometimes it means an intimacy need that could be met. Sometimes it means oh no, it means that we're in a committed relationship now. Sometimes it means we're going to have a baby. I love when we start thinking about sex outside of penetrative sex I put this in big quotes like queer sex right, because it's sometimes like the alternative communities and queer communities that could teach us that. And like Tantra and BDSM, like all of these communities, really kind of help broaden the spectrum of what is available, what is accessible. Broadened the spectrum of what is available, what is accessible, normalizing all the different things that we need to have relationships and relationships are really an important part of why we get together and being clear with ourselves of our intentions kind of helps us navigate that.

Speaker 2: 24:10

Yeah, and I was going to say too, now with the alternative lifestyles of polyamory and different stuff like that and that's a lot more of that going on and consensual non-monogamy, I don't know that. I would imagine that it falls in your R as well.

Speaker 1: 24:25

Oh, definitely, definitely in the R. I mean, because we need to talk about things like that. And if you're coming from an ethical, non-monogamy perspective, then you are talking about things like that. And you were talking about agreements that you may have with your partners, and this is definitely where it comes in. Like I often say, like we start the R with understanding how we identify and how we orient. So do you identify like whatever that means to you, like I'm oriented at this moment as this I personally have identified as many different things.

Speaker 1: 24:56

I've identified as a monogamous, heterosexual married person. I've identified as a bisexual woman. I've identified as a pansexual, you know, and they change. I've identified as monogamous, as polyamorous, and it's not like you're always one thing. I mean, some people are always one thing, but other people, like me kind of, are able to you kind of navigate life for where it shows up for me. And so, starting like and what you need, like I write personally, like right now I'm, I am single and I'm holding, I'm not really dating, I'm like dealing with a lot of life things, but if I was to date, I'm looking for more of a monogamous or monogamous situation. So like I have to put that up front. I don't want to date somebody and not tell them the truth about where I'm at, um, and then, you know, at times when I've had multiple partners going through like this is where my agreements are with this person, and because I believe that if we are in a bigger sexual network, it's important that we take care of each other, and communicating each other's needs is really important.

Speaker 2: 26:08

So that's the R and then the big one and then the scary one at the very end.

Speaker 1: 26:16

The big one, the scary one it's really shouldn't be that scary is our sexual health needs and disclosing sti status. You know, it's interesting that you call it scary and because because it's so scary, we don't do it. Because it's so scary, people just kind't do it. Because it's so scary, people just kind of like bypass it, especially if you're someone who carries a chronic STI like herpes or HPV or HIV or even hepatitis B or C. You know, some of these viruses are with us for our whole life. So it is important that we disclose.

Speaker 1: 26:50

But that feeling of rejection could be so scary and rejection isn't just a thought. I mean, when people feel rejected it's in our bodies, right, going back into that somatic stage. It's in our bodies and it hurts. And if you're being rejected about something you have no control over, such as herpes, then that's really something you may not always want to tell, especially if you're like, oh, it doesn't matter, I'm never going to see that person again. I have a very good friend. In fact I'm wearing a shirt. I just want to show you this shirt. It's a stigma with STI. That's a race stigma, and the way that we erase stigma and the way that we navigate these difficult conversations is by normalizing that, and the more we are saying to each other I have herpes on my mouth or my genitals, or I have had a positive HPV or whatever it is that one has, the more we realize how many people actually have it and the more we can actually again get rid of the stigma associated with the things that happen when we have sex.

Speaker 2: 27:59

Yeah, especially herpes, like I have several people have mentioned. Oh, I started getting like on my mouth when I was eight or nine and like, and then to have to have a myth. You know that is so bad and like terrible and yeah, the whole thing have a myth.

Speaker 1: 28:13

You know that is so bad and like terrible and yeah, the whole thing Absolutely. And you know, I feel pretty impassioned about this because I feel STIs are really like our metaphor for our sex negativity and that's what makes it so hard, because we all carry this like like sex is a bad thing. It's something that we shouldn't be doing, only should be doing in this context, and if we do it in that context, we should never have an STI. I mean, I have plenty of patients who've had one partner and they have herpes, or one partner and they have HPV. It's not about it just happens. I often I'd like to tell, just remind people that over a million people have died from COVID since 2020. Nobody has died from genital herpes. And yet which one are we stigmatizing? Which one are we so scared of? It's not about the virus, it's not about the infection. It's about how we get the infection and how scary it is to have an infection that could impact our sexuality. So that's kind of that's the stars. You know, that's the stars talk.

Speaker 2: 29:17

Yeah, awesome, yeah. And then, like I said, we covered in episode 14, but this is much more in depth and you were the creator of it, so definitely cool to hear. And then the stuff that you've added since. So, yeah, as you've refined it. So, are there any closing comments you want to leave the listeners with?

Speaker 1: 29:34

Yeah, you know, I do have a free workbook on Make Time for the Talk, which is the website, because I want to remind people to make time for the talk and again, it could be a conversation. It doesn't have to be formularic and it actually could be quite fun and even a little sexy and it actually could be quite fun and even a little sexy.

Speaker 2: 29:53

And if you want to I forgot to mention if you want to have people be able to reach out to you, or just more of the website is enough.

Speaker 1: 29:59

Yeah, yeah, you could find me on the website and you could find me on social media On Instagram, I'm at sexmeddoc, and Facebook, I'm on Eveline Dacker and you could find me at all those different places. And, yeah, I'm on Eveline Decker and you can find me at all those different places. And, yeah, I'd love to talk about this and thank you so much for having me on your show.

Speaker 2: 30:20

Yes, thank you very much for being on. It's super cool to have you All right. Thanks everyone. If you love this episode, be sure to tell your friends about it and rate it as well. And thank you again, dr Decker. Thank you.