Saturday, April 28, 2007

Marriage Is Not The "Magic Bullet"

There has been a lot of discussion lately over the statistics released this month that point to the overall ineffectiveness of abstinence-until marriage sex education. I hate to be the one to pour more cold water over the abstinence crowd (OK, maybe I don't hate it THAT much), but the poor job it does keeping young, unmarried people out of harm's way is really only the tip of the iceberg.

Marriage is no panacea regarding STD's (or anything else, for that matter). The fact that someone "waits" until marriage is no guarantee they will never be infected. This seems like common sense, but even the mainstream medical community does a poor job of communicating this. Consider the following statistics: 22 percent of men and 14 percent of women admitted to having sexual relations outside their marriage sometime in their past, according to a study done in the 1990's. The same study found that 70 percent of married women and 54 percent of married men did not know of their spouses' extramarital activity. On top of that, consider the fact that annual well-woman exams rarely include STD testing for women who self-identify as married or in a monogamous relationship, and most men do not go to their doctors at all for regular checkups. The following quotes from the University of Tennessee Medical Center give insight into the prevailing attitude of the medical community regarding STD's:

Your care provider may want to perform other lab tests to make sure you
are healthy. Sexually transmitted diseases (STDs) are a big problem in
who have multiple sexual partners and don’t use condoms.

They go on to say:

Many times women are not aware that they are infected because they
have no symptoms. For this reason, women at any age with a history of
behavior or evidence of problems, may need special tests.

Now, it would seem the fact that women often fail to notice symptoms would be reason enough to test all women for STD's, but the "risky behavior" clause is again thrown in. Considering the statistics above about infidelity, how many people who feel "safe" in a marriage are really unwittingly in the "risky behavior" category?

So, we have folks going around, telling teens and young people that the best way for them to avoid STD's is to avoid sex before marriage, and they do so by framing it in mystical, loaded language that relies on religious "sanctification" of the act. Here's an example I found on a site about the "Top 10 Reasons Why Sex Should Wait Until Marriage".

Premarital sex breaks the 10 Commandments given by God. The 10
Commandments are given to man by God to make man happy. They are
not outdated and they are not restrictive. If we follow these laws, we
create happy and prosperous lives. If we don't follow them, we will pay
heavy price in divorce, disease, abortions, illegitimate children and loneliness.

We see marriage portrayed as a sort of "Get out of Jail Free" card. If you just wait until marriage, you don't have to worry about things like divorce, disease, abortions, illegitimate children, or loneliness. And don't just take MY word for it-- this is God's law, after all (?!) Now, I expect as much from the radical right, but it just appalls me that the medical community has fallen in lockstep with such absurd notions. So we have married people who think they are protected when they are not, and who the medical community just ignores as potential infection risks. Except, of course, when a woman is pregnant. Because anyone who has ever been pregnant knows that, as a matter of course, all women (married or otherwise) are given a full battery of STD tests during the course of their prenatal care.

Because, you know, we've gotta keep those embryos and fetuses safe, even if that means admitting married people sometimes get STD's.

My recommendation is simple. All annual checkups (for women or men) should have STD tests as a part of the regular battery of tests to perform, regardless of their relationship status. People should opt out, rather than opting in to these crucial tests. And, of course, we should dump the abstinence until marriage education, and paint a more realistic picture about what marriage and the transmission of disease really look like. That assumes, of course, that we're really worried about lowering STD infection rates, and not just indoctrinating people with "family values" falderall about the sanctity of marriage.

My first marriage was one of the 17 percent of marriages that end in divorce due to infidelity. I never saw it coming, and to this day, I don't know what kind of sexual activity my ex-husband may have participated in with "the other woman" while we were married. Never once, until I expressly asked for it (after finding out about the infidelity) did any of my doctors offer me a STD test while I was married except for when I was pregnant. Marriages provide little enough protection from the vagaries of human emotion, let alone the transmission of disease. Society needs to be honest to people about both.