The general consensus of those-in-the know is that the healthiest thing for us sexually is for us to have one, lifetime, monogamous sexual partner. If that's not possible, the fewer the partners the better, and always use condoms. Right?
Wrong. Or, at least, Not That Simple.
The fact is that there may also be advantages to having intercourse without condoms with more than one partner. Health advantages for women include reduced risk of breast cancer and reduced rates of depression and suicide. Makes ya stop and think, doesn't it? It did me.
I wrote back in September about a Planned Parenthood report on the Health Benefits of Sexual Expression. From that paper:
Pregnancy and, possibly, exposure to sperm are believed to provide a protective effect against breast cancer. A fetal antigen hypothesis proposes that a fetus inherits breast cancer genes from the male partner. These genes indirectly provide a protective effect to the mother via immune response (Janerich, 1994). A study that evaluated this hypothesis found that a woman’s lifetime risk decreased as the number of male sex partners increased, leading to further speculation that this immune response may be a result of sperm antigens, as well as fetal antigens (Rossing et al., 1996).
A study of nearly 300 sexually active college women found that exposure to semen — having sexual intercourse without a condom — was associated with lower levels of depression and fewer suicide attempts as compared to women who occasionally used condoms, women who always used condoms, and women who abstained from intercourse (Gallup et al., 2002).
When I first read these reports I will admit I was a bit taken aback. My reactions of surprise were indicative of the fact that even though I think of myself as a sex-positive, knowledgeable, up-to-date sexuality educator, I still think of “unprotected” sex with multiple partners as physically risky and ONLY risky. And when I shared the research with friends, I realized I wasn't the only one. The primary response I heard? “But that's dangerous! It can't be good for you!”
But, of course, I already knew that semen contains all kinds of good things that can affect our moods positively: testosterone, estrogen, follicle-stimulating hormone, luteinising hormone, prolactin and several different prostaglandins. So I guess I shouldn't have been surprised.
The thing is, the reality is just not that simple. Reality is never simple.
Having multiple sex partners without using barriers such as condoms may have benefits, pleasures, and advantages, including but not limited to those mentioned above. Having multiple sex partners without using barrier also carries potential risks, discomfort and disadvantages, including but not limited to sexually transmitted infections, some of which cause few long-term health problems and some of which can cause serious health problems, even death. And the ways in which people assess those risks and benefits will vary from person to person.
Now, I hope it is clear that I am NOT telling my readers to go out and have intercourse without condoms with a whole bunch-a sexual partners, just as I am not going to tell you to choose one person and have sex with only that person for the rest of your life. The thing is, it's not possible for me (or anyone) to make an accurate, generalized statement about the “ideal” number of partners or the “best” choices to make about condoms or other barriers, no matter what my personal opinions, beliefs, proclivities or political stances. I am not going to tell you which risks are the most risky or which benefits are most important. I can't make those choices for anyone but me.
What I am suggesting is that the results of these studies are further evidence that there is no “right” or “best” or “healthiest” way to be a sexual being, as long as one's behavior does not violate the rights or freedoms of anyone else.
There are risks and benefits of any sexual choices, just as there are risks and benefits of almost any other choices we make, from driving a car to eating out at a restaurant. There are, for example, many valid reasons to choose celibacy, monogamy, serial monogamy or open relationships (swinging, polyamory, and other forms of ethical non-monogamy). There are good reasons to use barriers for sexual contact, good reasons not to, and good reasons to use certain kinds of barriers in certain situations. And, of course, there are many more choices to make sexually than just those! Ultimately, what it comes down to is assessing the risks and benefits for yourself, examining ways to reduce your risks while keeping the benefits that are important to you, making a choice that works for you, and communicating that choice clearly and honestly with everyone with whom you may become sexually active with, so that they can assess their own risks and benefits with complete information. There may be no “best” way for everyone, but there probably are some choices that will work better for you and your partner(s) than others.
Some of the factors folks sometimes consider (either consciously or unconsciously):
Wrong. Or, at least, Not That Simple.
The fact is that there may also be advantages to having intercourse without condoms with more than one partner. Health advantages for women include reduced risk of breast cancer and reduced rates of depression and suicide. Makes ya stop and think, doesn't it? It did me.
I wrote back in September about a Planned Parenthood report on the Health Benefits of Sexual Expression. From that paper:
Pregnancy and, possibly, exposure to sperm are believed to provide a protective effect against breast cancer. A fetal antigen hypothesis proposes that a fetus inherits breast cancer genes from the male partner. These genes indirectly provide a protective effect to the mother via immune response (Janerich, 1994). A study that evaluated this hypothesis found that a woman’s lifetime risk decreased as the number of male sex partners increased, leading to further speculation that this immune response may be a result of sperm antigens, as well as fetal antigens (Rossing et al., 1996).
A study of nearly 300 sexually active college women found that exposure to semen — having sexual intercourse without a condom — was associated with lower levels of depression and fewer suicide attempts as compared to women who occasionally used condoms, women who always used condoms, and women who abstained from intercourse (Gallup et al., 2002).
When I first read these reports I will admit I was a bit taken aback. My reactions of surprise were indicative of the fact that even though I think of myself as a sex-positive, knowledgeable, up-to-date sexuality educator, I still think of “unprotected” sex with multiple partners as physically risky and ONLY risky. And when I shared the research with friends, I realized I wasn't the only one. The primary response I heard? “But that's dangerous! It can't be good for you!”
But, of course, I already knew that semen contains all kinds of good things that can affect our moods positively: testosterone, estrogen, follicle-stimulating hormone, luteinising hormone, prolactin and several different prostaglandins. So I guess I shouldn't have been surprised.
The thing is, the reality is just not that simple. Reality is never simple.
Having multiple sex partners without using barriers such as condoms may have benefits, pleasures, and advantages, including but not limited to those mentioned above. Having multiple sex partners without using barrier also carries potential risks, discomfort and disadvantages, including but not limited to sexually transmitted infections, some of which cause few long-term health problems and some of which can cause serious health problems, even death. And the ways in which people assess those risks and benefits will vary from person to person.
Now, I hope it is clear that I am NOT telling my readers to go out and have intercourse without condoms with a whole bunch-a sexual partners, just as I am not going to tell you to choose one person and have sex with only that person for the rest of your life. The thing is, it's not possible for me (or anyone) to make an accurate, generalized statement about the “ideal” number of partners or the “best” choices to make about condoms or other barriers, no matter what my personal opinions, beliefs, proclivities or political stances. I am not going to tell you which risks are the most risky or which benefits are most important. I can't make those choices for anyone but me.
What I am suggesting is that the results of these studies are further evidence that there is no “right” or “best” or “healthiest” way to be a sexual being, as long as one's behavior does not violate the rights or freedoms of anyone else.
There are risks and benefits of any sexual choices, just as there are risks and benefits of almost any other choices we make, from driving a car to eating out at a restaurant. There are, for example, many valid reasons to choose celibacy, monogamy, serial monogamy or open relationships (swinging, polyamory, and other forms of ethical non-monogamy). There are good reasons to use barriers for sexual contact, good reasons not to, and good reasons to use certain kinds of barriers in certain situations. And, of course, there are many more choices to make sexually than just those! Ultimately, what it comes down to is assessing the risks and benefits for yourself, examining ways to reduce your risks while keeping the benefits that are important to you, making a choice that works for you, and communicating that choice clearly and honestly with everyone with whom you may become sexually active with, so that they can assess their own risks and benefits with complete information. There may be no “best” way for everyone, but there probably are some choices that will work better for you and your partner(s) than others.
Some of the factors folks sometimes consider (either consciously or unconsciously):
- Personal desires, preferences, “gut instincts” and proclivities
- Desires, preferences, and proclivities of current partner(s)
- Religious, spiritual, moral and ethical concerns, beliefs, and standards
- Cultural standards of families of origin, friends, and communities
- Health benefits of specific sexual activities
- Health risks of specific sexual activities
- Emotional perceptions of potential risks and benefits (i.e. For some, the stigma or emotional impact of a “sexually transmitted infection” may be greater than the physical symptoms of that infection. For others, emotional impact is related to relative impact on physical health rather than mode of infection—sexual or otherwise.)
- Potential risks and benefits not yet “discovered” or scientifically validated
- Regularity with which one is tested for sexually transmitted infections
- The risk factors for the actual activities in which one is participating (i.e. There are different risks for unbarriered kissing on the mouth than there are for unbarriered anal intercourse.)
- Testing status of partner(s)
- Sexual history of partner(s)
- Number of sexual partners
- The "label" one uses to describe the particular relationship(s), and the meaning attached to that label.
- Emotional impact of various possible outcomes (on oneself, one's family, community, partner(s), children, and loved ones)
- Level of trust among partner(s)
- Level of commitment among partner(s)
- One's knowledge-base and experiences
- Information, thoughts and feelings about barriers, such as condoms, dental dams, etc.
- Information, thoughts and feelings about sexual lubricants and other sexual toys and aids
- And I am sure we could come up with more! (As always, I solicit your suggestions.)
Few of us probably sit down to make a list of pros and cons before we have sexual contact with someone. (Though I'd suggest it might be a great idea to do so!) And certainly sexual decision-making need not be a formalized process unless that is one's particular style. But I must admit that I wonder how actively engaged most people are in their own sexual decision-making. I don't even begin to have an answer to that, but it is a subject that intrigues me and which I will explore further over the coming weeks or months as I write about sexual decision-making, sexual integrity, sexually transmitted infections, and personal risk-benefit analysis.
(Disclaimer: If, by chance, I have distorted any findings, know that that was not my intent, but that I will accept responsibility for having done so and gladly change it here. I did not do any analysis of the methodology of the research itself.)
(Disclaimer: If, by chance, I have distorted any findings, know that that was not my intent, but that I will accept responsibility for having done so and gladly change it here. I did not do any analysis of the methodology of the research itself.)
3 comments:
Wow, great post with lots of food for thought, here. Thank you for providing a balanced perspective!
My distrust for studies & statistics rears it's ugly head.
The Gallup poll (or, at least the piece you've quoted) leaves me wondering what the representative sample was drawn from. Correct me if I'm wrong, but among that age bracket isn't there a higher rate of depression among self-identified bi/lesbian women?
Also, depending on the location--wouldn't there be a difference in condom-use stats & partner-count stats between a conservative Christian school (Liberty, Oral Roberts, etc.) than, say, a traditionally more sexually-expressive-tolerant school?
Not that I'm disagreeing with the base concept, I just wonder if the base info is slanted.
Are there psychological/physiological benefits for men, too? :)
Thanks, Kiki! It has certainly been interesting for me to ponder!
And Grond, your questions are all valid. I made a disclaimer in the original post (12/9/08) about the Planned Parenthood article that I had not actually do any analysis of the methodology, a disclaimer which I should have re-posted here.
In this particular case, I have made the choice to trust the authors, as they have better stats analysis skills than I do. Beverly Whipple, in particular, has done some of the most important and scientifically rigorous sexual research of our time, and I have known her to come down fast and hard against research that has slanted base information. Could I be wrong to impart this trust? Sure thing. I would absolutely support someone with such skills in analysis finding the study itself and reporting back to me! (*nudge!*)
As far as the rates of depression among women of different sexual orientations, I do have some vague memory of having seen statistics like but my memory is not strong enough of them to feel informed. I am not sure how much sexual orientation played into that particular Gallup report. In this case, they did seem to be comparing women who identified as heterosexual or bi since, except in the case of those who abstained, all of the categories seemed to have involved intercourse. (And I am making the assumption that they would not have included strap-on intercourse in their statistics.)
And I would be curious as to condom use at conservative Christian schools vs. more sexually tolerant places, for sure. My *personal* experience with friends has been that the largest variation in condom use seems to be among those who are "average"--neither extremely conservative nor extremely sex-positive, well-informed, sexually liberal activist-types.
And oh, yea, there are many benefits for men. I chose these two particular studies to look at because they so blatantly seemed to fly into the face of common knowledge. Read through the Planed Parenthood article for a sampling of some of the others. Seems like every orgasm makes you healthier! (Whereas, interestingly, some of the benefits for women seem to be related to how much women *enjoy* sex even more than how much sex they actually have.)
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