Figleaf's Real Adult Sex

Cory Silverberg of Sexuality.About.Com has a genuinely wonderful, thoughtful, and informative post up this week. The nominal topic is about sex of course, anal sex generally, and lubrication used during anal intercourse in particular. While I’m not going to call any of that part superficial (it’s informative, relevant, thoughtful, and positive in both the attitude- and the sex- senses) what really draws my attention, and makes me like Silverberg very much, is his wonderful sense of journalistic, scientific, public-health, and (most important, considering the topic) sexual/erotic ethics.

But more about that in a moment. The subject at hand is a pair of studies measuring the role popular sex lubricants play in tissue damage and STI transmission during penile/anal intercourse. If you were to just skim the headline/teaser versions of the story you’d conclude that it’s risky to use lube when having anal intercourse.

Perhaps because he’s comfortable enough talking about sex that he doesn’t have the distraction of squeezing his knees together and giggling, and perhaps because he’s just a darn good science reporter, Silverberg explains what it means, what it doesn’t, some good takeaways, and (my favorite) some nice analysis of the pitfalls of over-interpreting individual study results.

Anyway, here’s Silverberg

Taken together, these two papers seem to be suggesting that using lubricants, or at least some kinds of lubricants, might actually be a bad idea when you’re on the receiving end of anal intercourse. And if you listen to the press conference that followed the presentation of the data, it sounds like at least some of the researchers are comfortable interpreting this very early data with some significance.

But don’t put away that lube bottle just yet (and probably you won’t be putting it away ever). Remember that collecting data, interpreting it, and reporting on it are three very different activities. While some blog posts have suggested this is radical news, consider the fact that all of the reporting from the researchers themselves and from IRMA makes it clear that this is very preliminary research, and should be interpreted as such.

He said it here.

So far so good. Here’s a great caveat for assessing not just sex-related research but almost any-related research.

Risk is never absolute and it never exists in a vacuum. The clinical study seems to suggest that using lubricant increases risk of getting an anal STD. But it doesn’t consider the risk of infection without lubricant. Sex educators have said for years that lubricant makes anal sex safer because it reduces friction and tearing, and therefore reduces the risk of STD transmission. This new data doesn’t contradict that because it doesn’t address it.

So that’s the first cool part: Even if there are some risks to using lube for anal intercourse those same risks are even greater if you don’t!

A scandalous oversight? Not really. The researchers are pretty clear they’re offering preliminary research, not final recommendations.

Another non-scandal that’s… probably more closely related to problems with technical and “folk” use of words like “findings,” “risk,” and even “safety.”

Similarly, the lab study of lubricants, which does seem to draw conclusions that some lubricants may be “safer” than others, needs to be contextualized, lest we forget how slippery the term “safe” is. When a researcher says that a silicone lubricant was found to be safe, what they mean was that it didn’t do the one or two bad things they were looking at. It doesn’t mean that if you use silicone lubricant you will be safe, or even safer, if you don’t also consider other factors.

Cool, eh? They’ve drawn some conclusions related to very specific questions they were trying to answer: if you’re worried about, say, lube-induced dessication of surface cells in the rectum then yeah, they’re your guys. Those aren’t the only concerns, though, so as Silverberg (and most likely the researchers) you’d want to assess all the risks before making decisions.

And best of all? The paragraph I’m about to quote makes not one but two really cool, really related points: first that to be really helpful such studies need to take sexual enjoyment into account, and second of all he explains why enjoyability is relevant. (Emphasis mine.)

As usual, sexual pleasure isn’t being talked about at all, and this too needs to be addressed in both the conducting and reporting of future research. The end goal of all this research is awareness of risk and behavior change. We aren’t talking about dental hygiene here. We are talking about activities people engage in for a reason, and sexual pleasure is often part of that reason. To talk about anal intercourse and lubricant, particularly to talk about lube as a risk factor, outside of the context of pleasure makes sense only in the lab, only in theory. It doesn’t matter how good the research is, if you want to affect change in people’s lives, you have to speak to us in a way that we can connect with. If the only argument you make for behavior change is numeric, it might scare us for about three minutes, but it’s not likely to help us at all.

Yup. If something feels good enough to want to do in the first place, even good enough to want to do over and over and over, you need to take that into consideration.

All in all a nice, thoughtful post.

You know how there’s that sort of informal recommendation that you replace your smoke-alarm batteries twice a year when daylight-savings time changes? Vanessa of Feministing says there’s a similar movement afoot around backing up your birth control after New Years Eve.

[E]mergency contraception sales more than double the days after New Year’s Eve. It’s good to see someone addressing that; this comes from a new project of the Back Up Your Birth Control Campaign.

Read the quote in context, and find a link to a can’t-help-but-giggle video, here.

To be honest you probably don’t need to replace modern smoke-alarm batteries every six months, though you should check at least twice a year to make sure they work correctly. And to be honest the day after New Years Eve might not be the best time to backup your birth control, as for at least some people the message instead might be to restock. But for those with a serious prospect of partnerships that could result in an unplanned, unwanted pregnancy it’s just as important to keep your emergency (and regular!) contraception up to date as it to make sure your smoke alarms are in working order.

_In case I forget, remind me to add

Via Em & Lo, Emily Nussbaum, writing in New York Magazine says

Earlier this month, the journal PLoS Medicine analyzed data from a study of over 50,000 pregnant women and came to a simple but stunning conclusion: Older fathers have dumber kids. The more geriatric the dad, the dimmer the progeny, on measures including “thinking and reasoning, concentration, memory, understanding, speaking, and reading.” (Luckily, geezer offspring had no problems with motor skills, making them ideal for wheeling around their elderly dads.)

It was another unsettling addition to the growing pile of evidence that men have their own biological clocks, with older fathers also producing higher rates of schizophrenia and autism. But what really caught my eye was the secondary finding, which was that older mothers were associated with smarter children. I quickly did the calculations and was pleased with my findings. The most intelligent children, I deduced, must be the outcome of 45-year-old career women inseminated by their 21-year-old personal trainers.

Read the quote in context here.

Oddly usual amen chorus of ev-psych/sociobiology apologists are silent on this confirmation of the exact opposite of traditional gender ideology and sexual stereotype.

Mind you the actual authors of the study (who I’ve heard interviewed) are clear that the decline in intelligence with paternal age is very real, it’s also very, very slight — on the order of one IQ point drop for every ten years or so after the father turns 35.

Not that that’s ever stopped pop-evobios before…

Hmm, must be some other reason. Can’t imagine what that might be.

—-

Seriously, a one or two point IQ drop isn’t a terribly serious liability for offspring of older parents. Certainly not compared to the many other, potentially much more serious liabilities.

—-

And speaking of other liabilities, the most recent but still substantially scientifically unverified being a sixfold correlation between older fathers and children with autism. And considering how, um, cautious people have been about extremely difficult to confirm links between autism and vaccination a strong, 6x correlation with paternal age ought to be a category-five, slam-dunk, outta-tha-ballpark red flag.

—-

It might not be the most important reason for older gentlemen to become “extinguished members” of the vasectomy party. But it’s not a bad one. (By contrast an excellent reason being that sex is just more enjoyable when the possibility of unplanned, unwanted pregnancy is remote.)

[Note: “Continue reading…” image is… almost modest but still better viewed in private. —fl]

Years ago the generally very health-conscious, and healthy, women of Marin County, California, had a very nasty scare. Compared to most parts of the country there was a higher rate of breast cancers, especially among younger women. Worse, even though people in the county took steps to increase awareness and mitigate possible causes the rate of new cases actually increased.

After quite a bit of study epidemiologists worked out that it wasn’t that Marin County posed higher-than-average risk factors for breast cancer, it’s that the relatively affluent health-conscious citizenry was more diligent about screening with the result that more cancers were detected, and detected earlier. And of course as word spread more women came in for screening with the result that more cancers were found. But while there’s still concern resonating in that community what’s important was that a lot of cancers that might have been missed, or missed till it was too late, were instead detected when there might be something to do about it.

Incidentally I don’t bring that up in a “oh those whacky Californians” kind of way. If 15 years ago even one link in a chain of coincidences (one being that I heard about all those early detections in Marin County) had broken I wouldn’t have gotten a “well, you’re too young but let’s take a look anyway” colonoscopy, and consequently today, 15 years later, what were then still-benign polyps would by now have almost certainly morphed into colon cancer!

I mention this because Dr. Kate of Gynotalk mentions a similar possibility about STIs

The CDC just released its annual report discussing trends in sexually transmitted diseases in the US (summary here). The upshot: chlamydia and syphilis are on the rise. And gonorrhea is stable (yay?) but at still-high rates. The CDC doesn’t track HPV or herpes in the same way, so we don’t know if these too are increasing.

Why in the world might this be a good thing? The increased rates of STDs may mean higher rates of infection…but it may represent better screening of these diseases. The scariest part of the STD crisis is just how many people have an infection, and don’t know about it. I’ve had patients of all ages tell me they’re too frightened to get tested, because they “really don’t want to know.” But the consequences of an undiagnosed STD can be devastating. Not only might you unsuspectingly pass chlamydia to a partner, for example, but the infection can cause irreversible damage to your fallopian tubes – leading to tubal pregnancy, chronic pelvic pain or infertility.

Knowing you have an STD may suck, but not knowing is worse.

She said it here.

What Kate said: Knowing may suck. Not knowing? Definitely worse.

(Actually I appreciate most of Kate’s posts. if I don’t get around to a separate post about it her answer about partners with lower libidos is just dead on.)