Monday, March 12, 2007

Two Factors, Not One

Poor me, I never even heard of this book, Unhooked, I am so out of it. But Google News this morning has 130 stories linked, people arguing about whether what this lady says is true or not, and of course, if it is true, is this the end of the world?

Here's a typical article, an AP story carried in this morning's Baltimore Sun:
During a class discussion on adolescence, a high school teacher recently asked her students whether they go on dates. We don't "date," the 12th-graders reported. We "hook up."

If you're in your 40s, "hooking up" might mean catching a friend downtown for lunch. But to people in their teens or 20s, the phrase often means a casual sexual encounter - anything from kissing onward - with no strings attached.

Now a new book on this not-so-new subject is drawing fire in some quarters for its conclusion: That hookups can be damaging to young women, denying their emotional needs, putting them at risk of depression and even sexually transmitted disease, and making them ill-equipped for real relationships later on.

For that, Laura Sessions Stepp, author of Unhooked and a writer for The Washington Post, has been criticized as a throwback to an earlier, restrictive moral climate, an anti-feminist and a tut-tutting mother telling girls not to give the milk away when nobody's bought the cow.

The author "imagines the female body as a thing that can be tarnished by too much use," wrote reviewer Kathy Dobie in Stepp's own paper, and suggested that Stepp was, in one part, trying to "instill sexual shame." For Meghan O'Rourke, literary editor at Slate.com, Stepp is "buying into alarmism about women," and making sex "a bigger, scarier, and more dangerous thing than it already is." The fight over casual sex

I'm going to sidestep the argument about the empowerment of women and whether it's old-fashioned to make boys wait. It's interesting, but I want to tie this to a discussion we're having in Montgomery County.

I usually think of the Sexual Revolution as something that started in the 1960s, with Kinsey and birth control pills, and ended in the 1980s with first herpes, then AIDS -- diseases with no cure. Playboy glamorized the so-called revolution, but nobody I knew actually ever went to a party like what you saw there, with women running around naked and people having sex endlessly and indiscriminately, all of them groovy and far out.

It seemed to me the Sexual Revolution was something that may have happened to other people, and maybe it didn't actually happen at all, at least the way it was in the movies and magazines.

But there was something, a shift of a greater magnitude, that those magazines and movies may have symbolized. If you're my age, you remember that moms didn't work when we were kids. Now they do. You will also remember that people used to get married before they moved in together. Cohabitation, once a crime, is now a norm.

Things have definitely changed, the balance of power has shifted, at least, and norms have definitely changed in our lifetime. I'm afraid "dating" as a formal convention started going out of style in my generation, and if these books (there's this one, and some others) are correct, it is now mostly a thing of the past. That whole knock-don't-honk, go-in-and-meet-the-parents, the-boy-pays-for-everything business seems to have passed under the bridge.

This book seems to be talking more about people in their twenties, and it is not clear what happens in high school. Seems to me there's a lot of "chilling," which is not "hooking up" but more like "hanging out." But then I'm a geezer, it's not like I'd actually know what teenagers do these days.

OK, here's why I wanted to write about this.

The Citizens for a Responsible Curriculum keep wanting to talk about the dangers of being gay, the health risks. We can see web sites like this one that says:
...unprotected (without a condom) anal sex (intercourse) is considered to be very risky behavior.

This is in response to a question about HIV.

I want to point out one thing here, an assumption in this statement, and in lots of other statements like it.

The assumption is that the reader does not know if the person they are having sex with is infected or not.

Because, listen, if you have anal sex with someone who does not have HIV/AIDS, you're not going to get it. Zero transmission rate there. It doesn't matter if you're straight or gay, if your partner doesn't have an infection there is no risk of transmission.

So the assumption here is that the person asking the question is talking about having sex, essentially, with strangers.

And that's a stupid thing to do. A risky thing.

Apparently, according to this book and some other research, college-age people these days are having sex, what they call hooking up, on a casual basis. That is a situation that presents risk. If you don't really know the person you are having sex with, or if they are also having casual sex with other people, then there is risk, condom or not.

That category of behavior needs to be spelled out.

People like the CRC's Ruth Jacobs who constantly tell us that anal sex is risky are assuming that people -- and especially gay people -- are constantly having anal sex with strangers.

The fact is: promiscuity is a risk factor. Hooking up is a bad idea.

The other fact is: anal intercourse appears to be somewhat more risky than vaginal sex, because of certain differences in the tissues of those orifices. Nobody really knows, there's no good research (because it would be unethical to ask someone to repeatedly have anal sex with an infected person for a research experiment), but it seems very likely that it is easier to catch an infection from your partner that way.

Those who argue that anal sex is horribly dangerous are confusing two things: the slightly higher vulnerability of the rectum to infection, and the stereotype of gay promiscuity. A faithful, monogamous couple, where both people know they are HIV-negative, is at zero risk of infection if they practice anal intercourse, whether they are the same or opposite sex.

I am going to try to portray this the way I think about it, in a two-by-two table. We have two factors: whether the partner is infected, and, let's say, vaginal versus anal intercourse. I will agree that risk is higher for anal intercourse.
                   Risk of Transmission of Infection

Vaginal Anal
Intercourse Intercourse

Infected partner High Risk Higher risk

Non-infected No risk No risk

Does it seem reasonable to single out anal intercourse as the risk factor here?

Let's not confuse these two things: promiscuity and ... point of entry.

The problem is having sex with a person who carries an infection.

The CRC has their own reasons for talking about anal sex all the time, which have nothing to do with actual risk.

5 Comments:

Blogger Dana Beyer, M.D. said...

We had our first discussion about the Conservative Movement's recent ruling on ordaining gay rabbinical students and the performance of same-sex commitment ceremonies at my synagogue. It was a very heated, passionate, but well-informed discussion on the most part. What was striking was how our rabbi made the same incorrect deductive leap being pushed by the CRC. Gay men are men; men are inherently more promiscuous than women; bisexual men should be encouraged to be more hetero since it would reduce the risk of promiscuity. The underlying assumption is that gay men are naturally more diseased than straight men.
When you come down to it, as Jim points out, the best way to reduce STDs is to encourage monogamy, single or serial. Promiscuity raises the risks. Creating an institution in which gay men can strengthen their monogamous bonds would, therefore, be a good idea.

March 12, 2007 3:46 PM  
Blogger andrear said...

I am sorry that I missed the discussion. We will have to talk about it off-line. I know that the CRC thinks we promote wild sex with anyone and anything. However, I am pretty sure most of us believe in love, commitment, self-respect- for ourselves and our children. I do occasionally think about Hugh Jackman- but I find it unlikely that he thinks about me- so monogamy is likely to be my continued status. "hooking up" -sex as an activity - much less with a virtual stranger- seems pretty gross as well as dangerous- not just for STDs. True, I am really old but still... Now Hugh Jackman is a different story.

March 12, 2007 8:45 PM  
Blogger grantdale said...

You know Jim, you're all too sensible to have to spend your days with CRC people. Imagine that -- you cannot get infected by an uninfected person!

Anyhoo, apart from "promiscuity and point of entry" we might want to also add another few cells to that matrix...

Person doing the pokin'.

Did you know... the insertive partner in either unprotected vaginal or unprotected anal sex is at the same risk for infection?

(And, of course, as you've pointed out, that includes a zero risk of infection if the other person is not infected.)

We know this, cause Dr Jacobs told us. She's still referencing Bartlett and Weber, so I assume she still agrees with the figures.

Then again, I'm sure Dr Jacobs would also love to find some way of scaring the bejeebus outta people with the idea of gay (male) couples simply cuddling on the couch with all their clothes on.

(And that cuddling on the couch is a real high risk activity too: before you know it you've both snoozed off and will wake up with a cricked neck. Oh, the agony.)

Still trying to imagine what "trauma" either of us could cause to each other. A bad meal? Carelessly burn a hole in his favourite shirt?? Letting him leave the house with his fly undone or toothpaste on his face???

March 13, 2007 4:43 AM  
Blogger Orin Ryssman said...

I am reading the book, Unhooked, by Laura Session Stepp, and while I am only into the first chapter, I can say one thing I've noticed so far: her book bears little resembleance to the reviews either by her colleaugue at The Post, or the ever licentious website Salon.com.

March 13, 2007 6:02 AM  
Blogger andrear said...

Books often have no resemblance to reviews- same with movies.

March 13, 2007 10:00 AM  

Post a Comment

<< Home