Monday, October 02, 2006

The Surgeon General's Statement

In the last go-round of curriculum development, some members of the citizens advisory committee liked to complain that the school district "refused" to include information from government web sites in the sex-ed curriculum. In this post, I am going to tell you why I, as a member of the current citizens advisory committee, intend to argue against using information from a government web site this time around.

A recent Washington Blade article had this quote:
Dr. Ruth Jacobs of Citizens for a Responsible Curriculum said the curriculum should include a 2005 U.S. Surgeon General's statement that "anal intercourse is simply too dangerous to practice."

Dr. Jacobs, who is the CRC's representative on the citizens advisory committee, has also proposed to the committee that this wording should be included in the school district's discussion of condom usage.

I do not think my esteemed colleague is intentionally trying to deceive anyone, but a casual reader might have gotten the impression from that quote that the Surgeon General in 2005 said something cautioning against anal intercourse. Which is not correct.

I'm going to walk through this and then tell you why it matters. Sorry if this post is long, I'd like to get this on the record.

Dr. Jacobs was referring to an FDA web site on AIDS and condom usage, which contains this sentence:
The Surgeon General has said, "Condoms provide some protection, but anal intercouse is simply too dangerous to practice."

Site: Condoms and Sexually Transmitted Diseases . . . especially AIDS

[Note: that really is how they spelled it: "intercouse."]

That web page has a footnote after a later section on spermicides, saying:
[This section, "Should spermicides be used with condoms," was revised in 2005 to reflect new data about the potential impact of N-9 on transmission of HIV.]

This does indicate that the page was updated in 2005.

It does not indicate that the Surgeon General's comment came in 2005.

At the last meeting, another member of the citizens committee produced a document, an editorial published in 1991 in the Journal of Family Practice. The editorial was written by C. Everett Koop, who was no longer Surgeon General in 1991, but had been during the Eighties. In the article, he says:
Condoms provide some protection, but anal intercourse is simply too dangerous a practice.

That statement by the Surgeon General is fifteen years old.

But is that the original? Is that where the FDA web site got this quote, which CRC mistakenly says was made in 2005?

Well, maybe not. The statement might be even older than that.

In fact, the FDA web site linked above is a version of an FDA pamphlet that has been around for quite a while, since before the worldwide web. Though old versions are not apparently archived on the Internet, we can see an interesting article HERE; this comes from a publication called FDA Consumer, put out in 1990, which states at the bottom:
Some of the material in this article was taken from the FDA pamphlet Condoms and Sexually Transmitted Diseases . . . Especially AIDS.

which is also the title of the FDA web page. In fact, many paragraphs of that 1990 article are nearly exactly the same as the "2005" web site, word for word.

The authors of that page at least had the candor to print a disclaimer at the top that said:
This article was published in FDA Consumer magazine several years ago. It is no longer being maintained and may contain information that is out of date.

Well, if "fifteen" is "several," then ... at least they acknowledge it's obsolete.

The 1990 probably-out-of-date article contains this statement:
The Surgeon General of the Public Health Service has said, "Condoms provide some protection, but anal intercourse is simply too dangerous a practice."

Already in 1990 they are quoting this statement in the past tense.

And look -- here's an article in the L.A. Times from 1988 that says:
Fox also warned against considering any condom effective protection against AIDS when used in anal sex, which is practiced by many homosexuals. "I think the surgeon general has made the statement that anal intercourse is too dangerous to be practiced under any circumstances," he said. Condom Study Finding Wide Differences Among Brands

That's not the exact wording we're looking for, but it does appear to make reference to the same quote. In 1988.

Now look, there's even more. HERE is a ridiculous article on "the causes of male homosexuality" that is attributed to NARTH, the anti-gay therapists who the CRC agrees with. I can't tell when this article was written, but it contains a quote:
Surgeon General Everett Koop has stated that "anal intercourse, even with a condom, is simply too dangerous a practice." 39

That "39" at the end is an endnote, and it refers to a UPI news article by Celia Hooper, headlined, "Surgeon General Advises Doctors to Teach Patients about Condoms," and dated October 13, 1987.

We also find a legal article in the University of Baltimore Law Forum, where a lawyer from the Family Research Council (another group with which CRC is in accord) argues in favor of sodomy laws. This article, published in 1992, says:
Former Surgeon General C. Everett Koop has stated that "anal intercourse, even with a condom, is simply too dangerous a practice." 106

where that "106" is a footnote referencing the same 1987 UPI article as the original source of the quote.

Nineteen eighty seven. Nearly twenty years ago.

Unfortunately we have no handy way to go back and look at the newspapers from those days, but I'm sure that those who disagree with our position would agree (with one another) that the sources of the reference, NARTH and FRC, are unimpeachable. In fact, for this purpose -- chasing down a reference -- I expect those sources are just fine.

To summarize so far: the CRC has often quoted this Surgeon's General's statement, recently implying that it was said in 2005, and intends to try to have it included into the MCPS curriculum. The evidence proves that the statement was made by C. Everett Koop, at least as far back as 1990 (when it was referred to as a past statement), and probably as early as 1987.

Think back to those times. AIDS had become known in 1981, when it was noticed that a number of gay men displayed a strange suite of deadly symptoms; an antibody test was approved in 1985; the Surgeon General issued a controversial report on the topic and HIV was given a name in 1986; in 1990, Ronald Reagan issued an apology for having neglected the epidemic while he was President.

Surgeon General Koop had bravely dealt with this new disease when he was in office. He advocated fighting it through education, and promoted the use of condoms as a secondary way to prevent catching the disease, after abstinence and monogamy. The epidemic emerged on his watch (1982-1989) and he did what he had to do, as new knowledge was being discovered.

So now the question is whether a strongly worded statement from 1987-1991, issued in relation to a mysterious new epidemic seen mainly among gay men, is really the best message for high school students in 2006 and onward.

According to THIS SURVEY published by the Centers for Disease Control and Prevention, anal sex is overwhelmingly a heterosexual activity. Thirty-five percent of adult American women, and forty percent of men, report that they have had anal sex with a member of the opposite sex.

If we take the most conservative numbers (say, those given by Peter Sprigg at a CRC meeting last year), let's say that two percent of men are gay. And to satisfy the stereotypes of our friends on the other side of the debate, we'll pretend that every single one of them has had anal sex with another man. If there are approximately equal numbers of men and women in our society (there aren't, women outnumber men, but we'll ignore that), then we can surmise that about one percent of the adult population has had anal intercourse with another member of the same sex.

Averaging the percentages for men and women (again assuming equal numbers), we'll say that about thirty-seven and a half percent of the American adult population has had heterosexual anal intercourse.

That is thirty seven and a half times as many straight people having anal sex, compared to gay people (these labels don't fit as snugly as I would like, it is better to label the act than the person, but we don't have that kind of data).

If anal sex itself were as dangerous as the venerable Surgeon General's statement implies, then we would expect there to be thirty-seven-something times as many new HIV cases each year spread by heterosexual contact as by same-sex contact in this country. Do you see that? Nope.

The problem is not "anal intercourse."

This kind of intimate infection is spread through a social network of individuals, one to the next, and in the United States those social network connections have disproportionately linked members of the gay community. That's not true in some parts of the world, but it is here. Most anal sex is not gay, by a long shot, but HIV in the US is commonly spread through male-to-male anal intercourse.

The problem, to state the obvious, is having sex of any kind with a person who is infected with an STD, including HIV. In our society, a large proportion of people with HIV are gay men, and anal sex is a common form of expression for them. So that's how it spreads. You don't get it by "being gay," and anal sex isn't significantly riskier than other things.

THIS government site seems to offer good advice to teens about preventing the spread of HIV. You see the wording is gentle but clear. There is lots of information but no hyperbole: a better template for MCPS.

The truth is, for most people anal intercourse is slightly more risky than vaginal intercourse. The absorbent tissue of the rectum is more receptive than the vagina to infection (which is only an issue, however, when the partner is infected with something), and because it does not produce lubricants the tissue tends to get abrasions that admit even more infection (again, only if there are pathogens). Intestinal bacteria, spread to other areas, can be infectious. Further, though I don't see any really good data, the medical lore says that condoms are more likely to break and slip when used anally. So a word of warning certainly makes sense, if the school district decides to teach about anal sex they should include information about the risks. But that wording should be commensurate with the danger.

Also, note that we are discussing a condom curriculum at this time. The condom curriculum leads into a section on sexually transmitted infections. The issue of HIV transmission in the gay population is appropriate there, not here. But if we decide to discuss the topic here, the information we propose should be accurate and timely. In the condom curriculum, it really is sufficient to teach students to use the condom for vaginal, oral, and anal sex, and it is not necessary to go into these gory details.

Surgeon General Koop's archaic statement is inaccurate when generalized to the huge majority of pertinent situations, and is irrelevant to the topic of putting on a condom. Therefore, I oppose including it.

16 Comments:

Anonymous Anonymous said...

Again, it is vey notable that although heteros have 37 and a half times as much anal sex as gays, gays account for 5/6 of new AIDS cases originating from sexual activity in the U.S.. It's not a coincidence. When there is little social restraint on homosexuality, it tends to exhibit random and anonymous promiscuity. This fact needs to be related to kids as part of the sexual variations curriculum. We can't hide this significant fact from them and mislead them about the dangers of participating in the gay community.

October 02, 2006 3:00 PM  
Anonymous Anonymous said...

"So now the question is whether a strongly worded statement from 1987-1991, issued in relation to a mysterious new epidemic seen mainly among gay men, is really the best message for high school students in 2006 and onward."

The answer is yes, if it's true- and there's every reason to believe it is.

"The problem is not "anal intercourse.""

No, it isn't. The problem is the typical behavior of male homosexuals in societies where homosexuality is accepted by societal norms. Seeking partners for this type of activity is dangerous in these types of societies. Kids should be warned.

October 02, 2006 3:14 PM  
Anonymous Aunt Bea said...

"there is little social restraint on homosexuality"

This is precisely why people with same sex attraction should be allowed to marry and settle down. Couples who commit to monogamy through marriage reduce their own promiscuous behavior.

"The problem is the typical behavior of male homosexuals in societies where homosexuality is accepted by societal norms."

Where is this place you're talking about "where homosexuality is accepted by societal norms?" American society today considers homosexuals to be outcasts and denies them the same rights and responsibilites as everyone else.

October 02, 2006 4:25 PM  
Anonymous Peggy Sue said...

Bush, pining for the simplicity of his youth, would probably prefer a date closer to 1957 than 1987. Why? Because in 1957, "Under God" had recently been added to the pledge, segregation was the rule, the "n-word" was just another commonly used word, children were to be seen and not heard, women who didn't want to remain pregnant died at the hands of back alley abortion butchers, and father always knew best. These are the "family values" the radical right and its feckless leader hold dear.

October 02, 2006 4:33 PM  
Anonymous Anonymous said...

JimK you miss the point trying to state the obvious why should we change the Surgeon Generals statement if there is not scientific evidence to cast drought on the statement that sodmey is dangerous why do you think woman are becoming the fastest growing group that are HIV positive you think we should not warn them. Sodmey is the definition of what it means to be a gay man. You can argue against that but I have known to many of them to buy some liberal spin. The big problem in the gay community and this goes way back to the 1999 un report on aids is that too many of them know they are HIV positive and still go out and have anon sex with other men and still do not where condoms.

Peggy Sue I suppose you will be voting for the Robert KKK Byrd Party? Why does that not surprise me? Once a Klan’s man always a Klan’s man ps where do you think he hid the bodies you racist bigot.

Aunt Bea aka Gomer Pile surprise surprise surprise!

October 02, 2006 5:17 PM  
Anonymous Anonymous said...

"This is precisely why people with same sex attraction should be allowed to marry and settle down. Couples who commit to monogamy through marriage reduce their own promiscuous behavior."

State approval isn't usually a requisite for people acting as they want. If they wanted to be monogamous, they're free to be. They don't need no piece of paper from city hall, keepin' 'em tied and true.

Heterosexuals who engage in extramarital and premarital sex at least tend to have a common partner for periods of time. It's common for homosexuals to change partners frequently with numerous one-timers. It's part of the dynamic of a male-to-male coupling. It won't change based on governmental action in a free society. This should be explained to the kids in any sexual variations class.

"Where is this place you're talking about "where homosexuality is accepted by societal norms?" American society today considers homosexuals to be outcasts and denies them the same rights and responsibilites as everyone else."

Come off it. They're regularly portrayed in the popular culture and the workplace. Many places have laws protecting them from discrimination, which is not afforded to any other behavior-based identity. Virtually every American city has areas where they tend to be the major population of the neighborhood. They have their own travel agencies, their own plays, their own restaurants, et al.

They are promiscuous in America because they are free to be. One doesn't have to want to change that to think we should warn kids about the characteristics of the group if we teach about them.

TTT. Teach the truth.

October 02, 2006 5:36 PM  
Anonymous Anonymous said...

Applying a stereotype to an entire group of people is deceptive and untruthful. If you weren't so off your rocker, you may actually realise that gay people are real inidividuals who are able to think for themselves.

Anonymous said:
"Many places have laws protecting them from discrimination, which is not afforded to any other behavior-based identity."

Oh why don't you come off it. Unless you can provide your sources, don't spout illogical nonsense.

October 02, 2006 6:39 PM  
Anonymous Anonymous said...

"Anonymous said...
Applying a stereotype to an entire group of people is deceptive and untruthful. If you weren't so off your rocker, you may actually realise that gay people are real inidividuals who are able to think for themselves."

Grouping people by their preferences is inappropriate. (yeah, like, let's protect people who like broccoli from social disapproval) The discussion is about what behaviors are associated with what other behaviors. People who jog late at night tend to have trouble getting to sleep. People who engage in homosexual behavior tend to develop a tendency to anonymous promiscuity. It's a fact.

"Anonymous said:
"Many places have laws protecting them from discrimination, which is not afforded to any other behavior-based identity."

Oh why don't you come off it. Unless you can provide your sources, don't spout illogical nonsense."

Name another behavior-based identity that is protected by laws.

October 02, 2006 8:21 PM  
Anonymous Anonymous said...

Religion.

October 02, 2006 8:36 PM  
Anonymous Anonymous said...

Anonymous said:
"People who engage in homosexual behavior tend to develop a tendency to anonymous promiscuity. It's a fact."

No, that's a stereotype. Honestly where do you get your "facts" from? You've been reading too much propaganda. If you're going to apply that stereotype, be sure to exclude lesbians because you know they're stereotypically different to gay males.

Anonymous said:
"Name another behavior-based identity that is protected by laws."

Point me to a law which only grants homosexuals the protection and we can continue from there. If the law uses the term "sexual orientation", heterosexuals are also included, so er, gee, I guess that's another one eh?

October 03, 2006 4:04 AM  
Anonymous Anonymous said...

""People who engage in homosexual behavior tend to develop a tendency to anonymous promiscuity. It's a fact."

No, that's a stereotype. Honestly where do you get your "facts" from? You've been reading too much propaganda."

Jim linked a government report on AIDS recently that cited this tendency as a reason why most new cases of sexually originated AIDS result from male homosexual relations. Admittedly, they suggested efforts to encourage safe sex practices but why wouldn't discouraging homosexuality also help.

""Name another behavior-based identity that is protected by laws."

Point me to a law which only grants homosexuals the protection and we can continue from there. If the law uses the term "sexual orientation", heterosexuals are also included, so er, gee, I guess that's another one eh?"

This line of reasoning is a real laugh riot! Gee, what a relief to be protected from widesrpead discrimination against straights.

October 03, 2006 11:41 AM  
Anonymous Anonymous said...

Anonymous said:
"Admittedly, they suggested efforts to encourage safe sex practices but why wouldn't discouraging homosexuality also help."

Because homosexuality isn't the problem, unless you equate homosexuality with promiscuity. Believe it or not, there are many homosexuals who strive for monogamy and marriage with one life-long partner, but they are not the stereotypical gays who are likely to be portrayed publicly.

Anonymous said:
"This line of reasoning is a real laugh riot! Gee, what a relief to be protected from widesrpead discrimination against straights."

It's a valid and logically sound line of reasoning, and that's all that matters. Just because straight people are highly unlikely to be discriminated against because of their heterosexuality, it doesn't change the fact that protection is granted to them.

While discrimination laws are designed to protect minorities (because they are the ones being discriminated against), the laws are fair and equal in that they protect everyone, in addition to the minorities.

I could speculate that your assumption of only homosexuals being protected means that while you acknowledge that homosexuals are discriminated against, you're still against giving them any form of protection. Because you're heterosexual, you don't need the protection, so you assume you aren't affected by the law (even though you are), and laugh at the notion of being granted protection to you. That in turn leads you to believe that special rights are being granted to homosexuals, when actually you're just revealing how biased you really are.

Do you believe that race discrimination laws grant special rights to ethnic minorities? Do you believe that age discrimination laws grant special rights to the young and the old? With your illogical way of thinking, the answers to both of those questions would be yes.

If any special rights are possibly being granted, it's to followers of religion in the name of "religious freedom". Why should atheists have to abide by policies and the law when theists are able to bypass those regulations in the name of religious freedom? That's an attack at religious institutions who want to be exempt from discimination laws and claim special rights are being granted to homosexuals by those laws.

October 03, 2006 8:52 PM  
Anonymous Anonymous said...

"Because homosexuality isn't the problem, unless you equate homosexuality with promiscuity."

The fact that its possible that some gays aren't promiscous doesn't change the fact that random and anonymous promiscuity is widespread in the gay community. It's not a fairy tale out there.

October 04, 2006 11:48 AM  
Anonymous Anonymous said...

"Do you believe that race discrimination laws grant special rights to ethnic minorities?"

Yes, I do. We decided as a society that it was for the common good to correct certain social injustices. While, it could be argued that these laws haven't had the desired effect, the truth is these laws were always meant to be temporary until a social balance was attained.

There is no reason, as a society, to try and encourage the normalization or equivalization of homosexuality with heterosexuality. It's not in the common interest to grant special rights to behavior-based identities of any kind. Society is better off if heterosexuality is considered the preferable norm.

MLK said he looked forward to a day when his children would be judged on the content of the character not the color of their skin. Gay advocates don't anyone to be judged by the content of their character either.

October 04, 2006 11:58 AM  
Anonymous Anonymous said...

"If any special rights are possibly being granted, it's to followers of religion in the name of "religious freedom". Why should atheists have to abide by policies and the law when theists are able to bypass those regulations in the name of religious freedom?"

Isn't freedom of religion a type of freedom of speech? Of course, freedom is not the same as protection from discrimination. If a Muslim only wants to rent rooms in his house to other Muslims, for example, he should be free to. If a Catholic only wants to hire other Catholics to work in their ministries, they should be free to. As long as the government is not trying to establish or prohibit any religion, people should be free to associate with whom they please.

October 04, 2006 12:06 PM  
Anonymous Anonymous said...

Anonymous said:
"The fact that its possible that some gays aren't promiscous doesn't change the fact that random and anonymous promiscuity is widespread in the gay community. It's not a fairy tale out there."

You're failing to see past a stereotype. It may be more widespread amongst male homosexuals than heterosexuals yes, but that doesn't allow you to make such a generalised statement. It may not be fairy tale out there, but it's not some sex-crazed hell either.

You can teach about stereotypes, but you shouldn't teach the stereotype. Students should indeed be aware of the risks, but the risks are not due to homosexuality per se. The actual "risk" is natural male lust, which is why you fail to apply the promiscuous stereotype to lesbians. Gay sex is merely a form of expression of male sexuality, and teaching against promiscuity is what's important. "Discouraging homosexuality" is ambiguous and potentially offensive to many monogamous gay male couples, and to the gay males who dislike anonymous promiscuous sex. Why is it ambiguous and potentially offensive? Because it's not homosexuality that's the problem. A homosexual in a monogamous relationship is much safer than any promiscuous heterosexual, so the notion of "discouraging homosexuality" just falls flat.

Anonymous said:
"Yes, I do. We decided as a society that it was for the common good to correct certain social injustices. While, it could be argued that these laws haven't had the desired effect, the truth is these laws were always meant to be temporary until a social balance was attained."

You're missing the point. Although the laws were indeed implemented to correct social injustice, they do not grant special rights exclusively to ethnic minorities. Are you not able to see this? Just because ethnic minorities are directly affected by the law, it doesn't mean the law only grants protection to them.

Anonymous said:
"It's not in the common interest to grant special rights to behavior-based identities of any kind.

Well assuming you're actually telling the truth, are you also against the laws that prevent discrimination on the basis of religion? Would you accept it if a large majority of workplaces decided to only employ atheists? Would you accept it if you found it hard to find work because you were constantly rejected due to your heterosexuality?

You often opine and reach conclusions without providing sound reasoning. If you're going to let your bias affect your judgement, be consistent about it. Or even better, why not just spell it out for all of us instead of trying to twist logic and facts to fit your opinions. You really beat around the bush too much.

I'll drag you right to it: why shouldn't non-heterosexuals be protected from discrmination? In fact, let's assume special rights were in fact being granted (wich they're not), why shouldn't they be protected? If heterosexuals are never discriminationed against just because of their heterosexuality, why should society continue to let non-heterosexuals suffer discrimination just because they don't happen to be heterosexual? Is that not also social injustice?

Anonymous said:
"Isn't freedom of religion a type of freedom of speech? Of course, freedom is not the same as protection from discrimination."

Freedom of religion includes the practice of religion, which is more than merely freedom of speech. A publicly funded religious institution exempt from discrimination laws? That's not freedom of speech; that's special rights, because others are not exempt.

October 04, 2006 5:50 PM  

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