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What Does a Sexually Healthy Nation Look or Sound Like?

April is STD Awareness month.  This article is one in a series  published by RH Reality Check in partnership with the National Coalition of STD Directors, focused on aspects of STD prevention, treatment and funding and the public health implications of neglecting STDs.

I recently read a conversation on Facebook between two bright college women. The conversation began with a statement about the supposed hypocrisy of Planned Parenthood. The organization is like a “drug dealer,” the first woman claimed, selling sex by telling people that they can't live without it, and then giving out “protection” with contraception. “If sex is so necessary,” she asks, “then why do we need protection?”

Her friend responded with mostly controlled outrage. She wanted her friend to understand that “people have sex. It's a fact of life. We're sexual creatures.” She went on to remind us all that people will have sex whether we want them to or not. The key, she noted, is good sex education—and condoms and contraceptives—that helps us all to avoid costly negative consequences.

While I’d like to say that this impassioned response sparked a lively debate on sex ed and sexual health, it was met with a brief acknowledgement and then—silence. And there it is, I thought, here on this Facebook exchange, a reflection of the problem our society at large is facing: silence on the subject of sex and sexual health. Silence that leads to those costly negative consequences, including sexually transmitted infections (STIs) and unintended pregnancy.

The fact that sex is part of life, and not just for procreation, is “not news to anyone,” says Jocelyn Elders former U.S. Surgeon General, and yet “it is not part of our national conversation.” In an essay published in the The Journal of Sexual Medicinealongside results of the National Survey of Sexual Health and Behavior (NSSHB) conducted by researchers Indiana University, Dr. Elders affirms that “Knowledge and open discussion are the paths to societal change that lead us away from viewing sexuality primarily in negative terms and towards viewing sexuality as a part of life that is wholesome and pleasurable.”

Learning that sexuality was “wholesome and pleasurable” was certainly not part of my experience at the Catholic schools of my youth. No sex education there, and no discussion of sexual health in my later college years either. I look back now and can only wonder what may have been different if sexual health had been an acceptable topic of conversation. I wonder if I could have been spared the heartache of infertility if anyone had suggested that my abdominal pain could be a sign of an STI, and suggested testing for chlamydia or other STIs. I wonder about the damage done by our continued silence on the subject.

Many individuals dealing with STIs suffer in silence, and we as a society suffer with silence. We need to make sex and sexuality a part of the national conversation (and not just during STD Awareness Month, although that’s a good place to start!) While my job at ASHA puts me in a position to speak about sexual health on a national stage, I’m also aware that the most important conversations happen on a much smaller scale.

My son Stephen is 16 years old. I would love to think that he will wait until he’s ready to have sex with someone he loves and I approve of, but I recognize that he is an individual and will make his own choices. My role is to make sure he makes informed choices, and to make the subject of sex and sexual health an open and safe one for conversation.  My husband and I talk to him about his personal responsibility and our expectations of him to ensure he knows how to protect himself AND his partner.

I hope we’re all having these conversations in our homes. And with our healthcare providers. And our friends—even on Facebook! Open and honest conversation on sexual health, a subject so central to our lives and wellbeing, would move us toward our goal of being a sexually healthy nation.


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