Sexual Intelligence
An Electronic Newsletter

Written and published by Marty Klein, Ph.D.

Issue #38 -- April 2003


1. Shame R Us
2. Abortion & Breast Cancer--No Link, Finally
3. Viagra: How Much Is Enough?
4. Like A Virgin--Really
5. And Me



1. Shame R Us

For some 4 or 5 years, various American cities have been using shame as public policy. The format is known as "John TV"--public access programs that publicize the names and pictures of men arrested for soliciting prostitutes, and, sometimes, information about the prostitutes themselves. It's been tried in Kansas City, Orlando, Charlotte, Denver, and elsewhere.

Now "John TV" has folded in Oklahoma City--for lack of interest. The show's poor ratings stand in contrast to those of prostitution, which is still flourishing there.

"John TV" raises crucial questions about how we govern ourselves. As usual, some people think that sex-related offenses demand exceptions to the democratic process and judicial system. Others find prostitution so horrible that any attack on it is justified. As Kansas City Councilmember Teresa Loar said, "I don't care who I embarrass or who I humiliate...I just want it out of my district."

These programs are troubling because they use government tools to punish before establishing guilt. They're also problematic because they assume that prostitution is worse than, say, identity theft or embezzlement. Denver, for example, which publicizes johns' identities on its city website as well as on TV, is also the headquarters of Qwest Communications, the phone company that cooked its books (and investors) for over $1 billion. Clearly, Denver is humiliating the wrong people.

"John TV" follows an established media formula: using disapproval to justify running sexy stories it otherwise couldn't. That's how Ricki Lake and Jenny Jones rationalize showing teen strippers: "look at this awful stuff! Look at those nubile young bodies in hot pants, gyrating to the trashy music we supply. Isn't it terrible?"

Contrary to their chaste protests, such media executives and civic activists are clearly obsessed with sex. One recalls Jerry Falwell, who is so obsessed with homosexuality that he even accused a tele-tubby of being gay. The latest example of obsession masquerading as civic concern is Oklahoma's Brian Bates. Calling himself the "video vigilante," he runs a website he vows will expose "all [local] individuals charged and/or prosecuted for prostitution-related offenses." Bates supports himself through appearances on smut-fests like Maury Povich ("Oh, the horror of it--don't miss our exclusive film!") and by selling videotapes. Bates claims he has videotaped dozens of lewd acts around the city. In addition to sending tapes to police, he also mails them to johns' wives, and alerts their employers.

Commercial sex between two consenting adults morally reprehensible? Where does that put Bates, who interferes in others' lives; Povich, who makes a living exploiting Bates' outrage; or communities that stigmatize prostitution more than murder or embezzlement? Compared with these characters, prostitutes and their customers look perfectly wholesome.

2. Abortion & Breast Cancer--No Link, Finally

The war on contraception and abortion rights has a virtually unlimited number of fronts. Hydra-headed, no sooner is one destroyed than another appears.

For several years, anti-choice activists have claimed that abortion increases the risk of breast cancer. This allows them to say that abortion is a health hazard, even though the mortality rate from childbirth per 100,000 women is 600% higher than for a comparable group having abortions. And so when adds breast cancer deaths to the few actual abortion-related fatalities, its voodoo mathematics can show that abortion leads to death 52 times as often as childbirth.

So it was good news when the government recently announced that there was no link between abortion and breast cancer. The New York Times even ran an editorial praising the study's "definitive scientific judgment."

"The best minds that could be assembled by the National Cancer Institute," said the Times, "have determined unequivocally that no such link exists...with a conclusion supported by the highest [government] category of proof." Issued by a government that is no friend of abortion, this report is definitive indeed.

Obviously, abortion violates some people's moral principles. If they like, let them proselytize in the marketplace of ideas, converting as many new believers as they can. But it is morally corrupt--and therefore quite ironic--to see anti-choice activists resort to dishonest arguments and faux feminism in their attempt to changes others' behavior.

Thus, these activists' concerns about women's health are blatant hypocrisy. They endanger women's health by spreading lies about condoms not working and preventing the distribution of STD information to poor women. They also lie about premarital sex leading to divorce and mental problems, they oppose lesbians adopting or gaining child custody, and they criminalize pornography even if it's made by women, meant to be enjoyed by women.

To paraphrase Samuel Johnson, concern for women's health is the last refuge of those who are anti-woman.

3. Viagra: How much is enough?

Britain's state-funded National Health Service has been recommending one Viagra pill per week for men with erection problems, but new national survey data indicate that this doesn't meet the needs of younger patients, who are, on average, having sex more often than that.

Britain limited its free distribution of Viagra in 1999, a year after it was launched, fearing government costs would soar if the drug was available on demand. So free prescriptions were limited to men suffering from serious conditions like prostate cancer, multiple sclerosis, spinal cord injury, and kidney failure.

American HMOs have faced similar policy issues around Viagra. Although Blue Cross initially wanted to consider medical necessity in its coverage guidelines, it eventually decided to pay for six pills per month to any patient with a prescription. The ease with which most American HMOs covered the drug when first available drew the wrath of activists who had been trying to get coverage of contraceptive pills and devices. Ironically, the contrast between insurance coverage of Viagra and non-coverage of contraceptives ultimately led to increased coverage of birth control--although there are still far too many exceptions.

The British and American policy concerns raise important philosophical questions about health care and sexuality. Should the allowance for Viagra be based on how much sex a man currently has? On how much he would have with unlimited Viagra? On how much sex the average man his age (or education or religion or marital status) has? On how much his mate wants? On how much sex society says is normal? What about men who are gay, or HIV-positive, or recently divorced?

Western culture has always been ambivalent about sexuality: privilege, duty, necessity, luxury? Health issue, moral issue, recreational issue? In last month's British Medical Journal, a group of respected physicians and researchers noted that the government policy on Viagra--that it's free only to certain kinds of patients, and limited to one pill per week--discriminates in two ways. "It identifies certain groups who are eligible for treatment, and that is quite an arbitrary grouping," the authors said. "And there is also the frequency type of rationing, which is not evidence-based."

Any policy discussion about Viagra or contraceptives is a surrogate for fundamental political questions: who has the right to have sex? For what purpose? Are Viagra and contraceptives medicine for medical conditions, or are they lifestyle items like breast implants and hair transplants? These questions make many policy-makers squirm. They'd rather that sex be kept quiet, not discussed in polite company or for attribution. Once we conceptualize sexual activity as a fundamental right, crucial to a sane society, logic demands that we make it as safe and enjoyable as possible for as many people as possible. For a country in which same-gender, non-marital, and non-procreative sex are still suspect and often illegal, these larger considerations are scary, not sexy.

In WWII, American field ration kits contained 8 condoms per month. This wasn't nearly the hot political subject a half-century ago that it is today. Oh, for the progressive days of the 1940s.

4. Like a Virgin--Really

VirginMe is a product now sold online for $199. According to distributors, just add some fake blood, cry out in pain, and you, too, can reclaim your virginity without surgery. The FDA has never heard of VirginMe, and doctors agree that it's a scam. But it does have its market: women from cultures that view virginity as a symbol of female purity and innocence.

We can laugh or sigh about the suckers laying out two hundred bucks for this, but consider: every year, American doctors perform hymen repair surgery on hundreds, even thousands of young women who fear stigma or even murder if their sexual experience is discovered.

These patients tend to be Middle Eastern, Asian or Latina. Sent here for college, they have sex like other American young adults. On returning home to marry--or in arranged marriages here--they face divorce or even death if they aren't virgins. Since this disgraces their entire family, the family itself is often the instrument of stigma, ostracism, or murder.

And so, like illicit, life-saving abortions forty years ago, women who can afford it resort to surgery, which reconstructs the hymenal ring inside the vagina. It costs about $3,000--ironically, a year's wages in some of the countries involved.

It's easy to refer to these cultures as "patriarchal," damning the men who demand that women be pure and non-threatening. But let's remember that every one of those men is raised by a mother, a mother who treats him differently--feeds him better, educates him more--than she treats his sisters. And it's typically mothers and aunts who perform the clitoridectomies we find so horrifying.

For decades, in contrast, American mothers have been sending their daughters to college, encouraging them to postpone marriage and childbearing. Most American dads now support their daughters in growing up--not as virgins, but as adults.

It makes you wonder about those 70 virgins each Islamic suicide bomber supposedly gets in heaven. Are they using VirginMe or some other method to renew their status, or does heaven get a fresh batch of virgins delivered each morning?

5. and me

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