Volume 1: The Pain and the Suffering
Last night was a typical Thursday evening that consisted of curling up on the couch with a mug of peppermint tea, staring at the wall, and thinking about sexually transmitted infections. With songs from Antichrist Superstar playing in the background, I became nostalgic for the 90s and began reflecting about my early sex education in junior high.
If you had a similar experience as my own, sex education was a one-day lecture within the general health class. I did not learn about masturbation, sexual identity, sexual decision making, or the importance of assertive communication within intimate relationships. Instead, I learned how sex was going to kill me.
This death was not going to be quick from cardiac arrest following the bliss of an orgasm. No, this death would take its time, slowly filling my body with pus-filled sores until I resembled a biblical leper. And as I lie writhing in pain, shunned by my family and friends, with blood oozing from every orifice, I would take my last breath cursing the day I decided to fornicate.
If this vivid message wasn’t enough, the health teacher dimmed the lights and turned on the slide projector for the visual aids segment. With the shuffle of the carousel slide, the first photo was projected and was met with gasps from my peers. Featured was a close-up of a penis (circa 1972) with genital warts. There wasn’t just one pinhead-sized wart at the base of the penis. Instead, the warts sprouted like cauliflower, enveloping the entirety of the man’s penis head.
The second shuffling of the carousel projected a herpes outbreak. It was a close-up of a woman’s vulva (circa 1966) that looked as though it was hit with buckshot. The tiny red blisters peppered the vulva from pubic bone to anus and glistened from the flash of the camera. I began struggling keeping down the red slushie and Fudge Rounds I consumed 30 minutes prior to this visual onslaught of horror.
The carousel rotated once more. Secondary stage syphilitic rash.
Kaposi’s sarcoma lesions.
Infant herpetic conjunctivitis.
I sat wide-eyed and disgusted. My genitals retreated to an internal cavity. I could no longer hear what the teacher was saying. My eyes were the only remaining sense that continued to absorb the slideshow of grotesque infections.
Finally, there was a blank slide. The lights were flipped back on and I gazed around the room to regain my bearings. I was no longer looking at my attractive classmates and trying to conjure up the nerve to ask them out. I looked at them like they were walking death genitals.
I felt my skin crawling with pubic lice. I convinced myself my acne was syphilis. I left the room no longer feeling like a sexual being. I was repulsed and ashamed. Sex was going to kill me. It didn’t matter who I was, what behaviors I would be engaging in, or what part of the world I resided, sexually transmitted infections were going to hunt me down and slaughter me.
The scare tactic was unbearable. I did my best to suppress the mental remains of the images for the rest of the day. The cognitive dissonance escalated. Sex was supposed to be something fun, right? But sex is going to kill me?
Later that evening, after watching a couple of syndicated episodes of Married…with Children, the former belief overtook the new information I consumed that day in health class. Kelly and Bud Bundy helped rejuvenate my interest in sex. The cognitive dissonance disappeared.
However, for the remainder of the year in health class, the carousel of death sat in the corner of the room poised to stigmatize the sinful.
There's a penis under there.
Volume 2: The Truth and the Restructuring
I am sure many of you had similar scare tactics thrown at you in the hopes of stopping the spread of STIs. But what did those lectures actually accomplish? Do you know the probability of transmission, mode of transmission, course, and prognosis for each infection? Probably not. What you likely took away from the lecture is that having sex leads to looking like Sloth from The Goonies.
Clearly this isn’t the most effective way to understand the risk of STIs. But instead of listing off CDC-Fact-Sheet-style information about each infection, a better approach is to first put STIs into the appropriate context in order to reduce the stigma associated with them.
Sex is a behavior no different than any other behavior, including eating, driving, and playing sports. And with any behavior, there are positive and negative consequences associated with engaging in these activities. However, sex is treated much differently than most common behaviors humans participate in.
Take, for example, a true story of a trip to Honduras:
In the summer of 2007, I was on vacation throughout the western Caribbean islands. I was heeding all of the health warnings by only using bottled water and being cautious what food I consumed. During a stop at Roatan Island, I over-indulged. I was able to relax on a private beach, explore untouched parts of the island, and best of all, interact with capuchin and spider monkeys. I became so caught up in the fun experience that I ended up eating a tortilla-wrapped, meat and cheese thingy from a street vendor. I didn’t think twice about the quality of the food storage or preparation as I devoured the tasty snack. It was fantastic. However, 24 hours later, my digestive system was being ripped to shreds by an intestinal, bacterial infection. The next three days were spent being married to porcelain and downing a Z-Pak.
Now let’s look at a fictionalized story of the same vacation:
In the summer of 2007, I was on vacation throughout the western Caribbean islands. I was heeding all of the health warnings by using condoms during sexual encounters. During a stop at Roatan Island, I over-indulged. I was able to relax on a private beach, explore untouched parts of the island, and best of all, interact with capuchin and spider monkeys. I became so caught up in the fun experience that I ended up having sex with a fellow tourist without protection. I didn’t think twice about the potential risk as I delighted in the exciting encounter. It was fantastic. However, 48 hours later, my urine felt as though it contained fire ants caused by a urethral, bacterial infection. The next three days were spent wincing during urination and downing a Z-Pak.
Both stories involve behaviors that had positive consequences, but also a certain degree of risk of negative consequences. Both behaviors resulted in a bacterial infection that was subsequently cured with oral antibiotics.
While telling the first story to friends, the reaction was one of slight amusement and empathy. Responses included, “Oh that sucks!” and “Yeah, we’ve all been there!”
However, a likely reaction to the second story would include looks of horror and slow, back-stepping. Responses would include, “What are you, fucking crazy?” or “Well, you got what you deserved.”
Imagine someone saying “You got what you deserved” as you are huddled in the bathroom and eating Imodium like they are Skittles because of a food-borne illness.
Do we shame athletes when they break bones or experience concussions? No, because we understand that all behaviors include risks and even when precaution is used (condoms, helmets, seat belts), accidents still happen.
Sex education that relies on images of severe, untreated cases of STIs does nothing to prevent their prevalence. They only increase anxiety, shame, and guilt that actually have the likelihood of decreasing testing and treatment.
All behaviors we engage in carry risks. The probability of risks increases depending on the specific behavior, precautions used, and timing and location of the behavior. Sex is no different than anything else. Let’s focus on empathy and compassionate care. And in parts of the world where diarrhea is a bigger killer than AIDS-related illnesses, maybe we should focus more on what is coming out of our asses than what we are putting in them.
You deserve that broken leg for jumping so competitively.