Joy Juice & Oh Henrys! with Dr. Yuliya

Jems is straight-up thrilled to present Dr. Julia Rackal, who practices family medicine at St. Michael’s Hospital Family Health Team in Toronto, as one of our rockstar Community Experts. Jems spoke with the fresh-faced literal ray of sunshine straight from her shift working at a local retirement home. On her choice to go by Yuliya, she says: “It’s like fun socks… every time you look at them, they make you – or somebody else – smile. Yuliya is my true, egoless Self and every time I say it or someone says it, I am reminded of who I am as my natural essence.”

How and where did your journey start as a doctor? Is this something you have always wanted to do? 

I volunteered, then worked at Camp Can-do in Burlington, Ontario, when I was in high school. It was a unique camp at that time since it was integrated; it had children with and without  various special needs. Working there taught me so much about the essence of people and made me realize how much I loved working with people with health issues. A child could have a very profound disability yet was laughing and giggling with the other kids in the pool. I loved spending extra time helping somebody be their best and happiest self. 

That's amazing and seems like such a natural fit for you. How do you keep that inspiration alive in your current position and in your day-to-day? 

It's truly the people I see and the relationships I develop. One of my beautiful patients just died of cancer, but she lived a good quality of life. I saw her, and she saw me see her. We had such a lovely way of being. It reminded me that we are here for a short time, and then we're gone. That's what keeps me going. Your life is precariously perched; all you can do is live in this moment, do everything you can, and squeeze every little bit of joy juice out of life.

JOY JUICE! What are some causes that are close to your heart? 

A personal passion of mine is to help facilitate conversations about things that matter and that people are uncomfortable talking about. In 2017, I started an Anti-Racism Committee at St. Mike's since a potent determinant of health, which nobody wants to talk about, is racism. It's the same as when I started writing. I wanted to talk more about sexuality since there's a lot about sex and medicine that no one wants to discuss.

Have you written about sex before?

I wrote an article about why we never talk about sex in the context of sleep. Nobody was sleeping during Covid. Everyone loves to suggest [reserving] bed for light reading and never for eating, working, etc. It's rarely mentioned how sex is a great way to fall asleep and improve sleep hygiene, which made me curious about sexuality in medicine. Sexuality is such an important part of our lives. If you allow space for patients to talk about their sexuality, believe me, people want to talk about it. 

So true! Many people don't have a safe space to have these conversations. We need to find more ways to open that up since so many of us hold so much inside. 

There's still stigma and shame associated with discussions surrounding sex, but as soon as you do [start talking about it], people want it.

A lot of what we're doing at Jems is trying to open up these conversations and create a space to talk about safer sex as a whole.

The young generation is ready to talk! They're not shy. They're prepared for it, especially with so much access to information – though it's essential to question what information they're accessing because there is so much of it.

How do you define safer sex for yourself or others? 

That's such a great question. Let's put it this way: Jems is a condom. So with condoms, you're setting a physical boundary around one focal area of your anatomy and one set of fluids, which is a great place to start.

I think safer sex also starts inside of you. Number one, how are you feeling?

It's not just about the physical barrier, but are you feeling safe inside yourself? I'm not even talking about the other person yet. I'm talking about you in your body since there's often lots of shame, tension and fear of the unknown.

Am I normal? Is my body okay? Do I look okay? Do I smell? Do I have too much hair? Oh my gosh, it's never-ending. 

Do you feel like you're even able to make this decision about engaging with another person? Remember, sex can be with yourself too. Exploring oneself is still sex.

Making sex safer is working to look inside yourself with a compassionate eye.

So if the first part of safer sex is understanding yourself, what follows?

The next part is, what's your energy like with somebody? I'm not even talking about touching them yet or about being in a relationship with them. Are you in an environment with energy flow between two people, and is there a power differential? What's the dynamic between you and this potential partner? Is it loving and caring? Is there mutual respect between you two? 

It seems like you're talking about power imbalance.

Yes! Because if there is a power imbalance or a loss of mutual respect, it's unsafe.

Conversely, if mutual respect flows between two or more people, that's love.

Safer sex also comes from, are you in a safe environment? Are you living in a society that you enjoy and doesn't make you feel unsafe for who you've decided to be with and in whatever way you will engage in sex with them? Do you feel safe doing that, whether that's because of a particular kink, sexuality, or preference that you have? Do you feel you have to hide and go under the radar? That's tightening. Whether there's some threat of persecution or whether it's judgment, it's vital to feel like there's a community for you.

Those are excellent points that are often under-discussed since, again, when we think of safer sex, people immediately think of contraceptives and consent. Though, there are a lot of interpersonal, environmental and societal variables as well. Do you believe feeling safe during sex is integral to pleasure? 

One hundred percent, safety is a prerequisite to pleasure. Pleasure is fleeting. It's gonna come and go. It's a brief encounter. To experience absolute joy speaks to the deeper parts of safety. You can get fleeting pleasure from somebody and still be in an unsafe environment. But a deep sense of joy is a hard indicator of whether you're in a safe environment. That feeling is not fleeting. It's a true expression of who you are. 

It's one thing to have a sexual encounter with someone and experience an orgasm and a quick peak of pleasure. But afterwards, if you don't feel that safety, you may not feel that continuation of pleasure and mutual respect.

Right! Is there a feeling of well-being? Do you feel better about yourself? Has your confidence increased? Have you layered on another aspect of yourself? They should improve your well-being and give you peace and joy, as long as it's mutual.

Wow, thank you. We are curious to know how you maintain a positive mindset with so much going on within the sexual wellness space. How can we individually and collectively remain hopeful with constant censorship, abortion access becoming increasingly limited, and STIs on the rise?

You've got to be the change. Be the person you can be within your own space, because we radiate out in many ways. You solidify your self-capital when you stand for something. It reflects; it radiates out. I'm aware of the force of even just one person. It's powerful. Most of us are unaware. Individual forces can change the world.

Amazing! Lastly, do you have any advice or words of wisdom to share with our community?

Really good sleep, a good bike ride, and making connections with people. It's the secret sauce. I'll tell you, life is like this big Oh Henry! [chocolate] bar. You can enjoy it if you take a little bite at a time. If you try to ram the whole thing in your mouth, you're gonna choke and not be able to enjoy it. Take little bites, savour them. . . Don't overextend yourself. Do less. Set the bar so low that it never trips you. I set my expectation bar for myself so low that everyday I'm like, yay, I scored! I just walk right over it. My bar is practically subterranean. That's why I have a great day every day.