This week we learned that the HPV vaccine does not cause young women to have sex. A study looked at the medical records of 1,400 women under the age of 16 to determine sexual behavior based on pregnancy tests, contraceptive counseling, and STI screenings and diagnoses. It found no difference in behavior between those who had received the HPV vaccine and those who had not.
As Marianne Møllman points out in her piece, this fear—that their daughters would be become “sluts” —is the number-one reason that parents do not vaccinate their daughters against HPV. Apparently, this fear is even greater than the fear of cervical cancer, a potentially deadly but completely preventable disease.
You would think that this study would allay such fears. The truth is, we’ve seen this argument made repeatedly—whether it’s about making condoms available in schools, providing sex education, or allowing Emergency Contraception (EC) to be sold over the counter. The idea that access to protection will cause young women to run wild is deeply ingrained in our culture. Think of how fast Rush Limbaugh connected Sandra Fluke’s request for contraceptive coverage to her own clearly “slutty” sexual behavior. And it doesn’t seem to matter that the notion has been debunked by research time and time again.
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Though the false arguments about women’s barely controlled promiscuity likely began with the introduction of short skirts or bathing suits that showed some knee, they were prominent during the 1960s, as the birth-control pill became a medical and cultural phenomenon. In a 1966 article on birth control and morality, U.S. News and World Report asked: “Is the Pill regarded as a license for promiscuity? Can its availability to all women of childbearing age lead to sexual anarchy?” Two years later, author Pearl Buck warned iin Reader’s Digest:
“Everyone knows what The Pill is. It is a small object—yet its potential effect upon our society may be even more devastating than the nuclear bomb.”
The introduction of the pill did coincide with a change in social values and norms around sexuality, and women’s sexuality in particular. Some believe that by separating sex from procreation and giving women control of their own fertility (thereby allowing them to pursue education and employment), the pill is, in fact, responsible for the sexual revolution. Others believe it was a convenient scapegoat for a societal change that was already in the works. What we know for sure is that 45 years later, we are still debating the impact of contraception on women’s sexual behavior.
During his recent run for the Republican presidential nomination, former Senator Rick Santorum called contraception a problem:
“It’s not okay because it’s a license to do things in the sexual realm that is counter to how things are supposed to be. They’re supposed to be within marriage, they are supposed to be for purposes that are, yes, conjugal, but also [inaudible], but also procreative. “
The idea of a license to have sex came up quite often this summer when the country was debating provisions of the Affordable Care Act that required contraceptive coverage. Sandy Rios, vice president of Family PAC Federal, which describes itself as “the leading pro-family conservative political action committee in Illinois,” said on Fox News:
“Why in the world would you encourage your daughters, and your granddaughters, and whoever else comes behind you to have unrestricted, unlimited sex anytime, anywhere and that, somehow if you prevent pregnancy, that somehow you’ve helped them. I would submit to you that uncontrolled sexual behavior is what is harming our girls, not our lack of birth control—which by the way they don’t seem interested in taking anyway.”
We heard this same idea back in 1998 when the FDA was first considering approval for EC and then over and over as the agency decided whether EC should be available without a prescription. During one of these debates, the Family Research Council (FRC), a conservative not-for-profit organization, said this:
“… one might expect the medical profession to speak out against promiscuity, if only to prevent the disease and destruction it causes. Instead, public health professionals have not only made peace with sexual license (against society’s practical interests), but now virtually advocate it. The campaign for the morning after pill is just one case in point.”
We hear it practically every time a school district considers distributing condoms, and even when condoms are handed out on college campuses. Last year, for example, a state Representative chastised Wisconsin University’s Health Center for giving out condoms along with sunscreen and lip balm as part of a campaign for a safer spring break. According to a spokesperson, the lawmaker objected to the university’s role in “encouraging sexual activity.”
We’ve heard it for decades when it comes to sexuality education. Teaching kids about sex, the argument goes, will give them ideas, encourage experimentation, and undermine any message about abstinence they might have received. In a 1986 newspaper article, conservative activist Phyllis Schlafly derides a sexuality education textbook as far too liberal, saying:
“It’s no wonder that our country has a high rate of teenage promiscuity and the unhappy consequences it causes, including out-of-wedlock pregnancy, abortion and venereal diseases. Those things are the result of the sexual liberation that students are taught in required courses in ‘health’ and ‘sex education.’”
And, of course, we heard it as soon as the HPV vaccine became a scientific possibility. In 2005, Bridget Maher told the British Magazine, The New Scientist, that: “giving the HPV vaccine to young women could be potentially harmful, because they may see it as a license to engage in premarital sex.” Her warnings were echoed by Reginald Finger, a former medical advisor to Focus on the Family, who told The Hill that: “…if people begin to market the vaccine or tout the vaccine that this makes adolescent sex safer, then that would undermine the abstinence-only message.”
Though sociologists may continue to argue the precise role of the pill in the sexual revolution for at least four more decades, we now have research that directly counters the notion that recent advances in women’s sexual health have paved the way for a generation of tramps.
What the Research Says
For every argument that says a new advance—be it EC or comprehensive sexuality education—will turn women into whores, there is a stack of peer-reviewed research that proves otherwise.
- Condom Availability Programs: The first major study of condom availability programs was done in 1997 by researchers who compared New York City public high schools that provided condoms to students to similar public high schools in Chicago that did not. The study found that condom availability does not increase rates of sexual activity but does increase the rate at which sexually active young people use condoms. A similar study done a few years later in Massachusetts found that sexually active students in schools that had a condom-availability program were more likely to use contraception at last intercourse than sexually active students in schools without one.
- Sexuality Education: Numerous evaluations of sexuality-education programs have found the very same thing. These programs do not increase sexual behavior among teens, they do not cause teens to have sex at a younger age, they do not increase the number of partners young people have, and they do not increase the frequency with which young people have sex. In fact, they tend to do just the opposite. Young people who have gone through highly effective sex education and HIV-prevention programs tend to delay sex and have fewer partners. When these young people do become sexually active they are more likely to use condoms and other contraceptive methods.
- Emergency Contraception: In 2008, the Bixby Center for Global Reproductive Health at the University of California San Francisco conducted a review of 16 studies on the impact of providing EC to adult and adolescent women. The review found no evidence that access increased sexual risk taking. It found that women did not abandon their regular method of contraception when they had access to EC; did not use EC repeatedly just because it was available; did not engage in increased sexual activity; and did not have increased incidences of STIs. It also found that adolescent women are no more likely than are adults to engage in sexual risk taking when they have access to EC.
- HPV Vaccine: Research released this week examined the medical records of young women under age 16 for indications of sexual activity and found no difference between those who had been vaccinated and those who had not. This adds to an earlier study of young women ages 15 to 24, which also found no association between the HPV vaccine and risky sexual behavior. A study released in January 2012 also put to rest fears that young girls would consider themselves fully protected once they received the HPV vaccine. It found that “Few adolescents perceived less need for safer sexual behaviors after the first HPV vaccination”
Changing the Conversation
Still, years of research showing that access to information about sexual health and contraception does not increase sexual activity have not stopped right-wing pundits from warning parents that each new advance is a step toward the death of their daughters’ virtue. hy am I still surprised when science and facts lose in a showdown with judgment and fear? The question becomes, what will convince opponents to stop crying “slut” from the rooftops?
The debate over the HPV vaccine provides a piece of the answer. Earlier, I quoted a 2005 article in which Bridget Maher of FRC warned that the HPV vaccine was a dangerous license for premarital sex. Here’s what FRC says about the HPV vaccine today:
“FRC believes that Gardasil and other HPV vaccines represent a tremendous advance in preventative medicine. FRC advocates for widespread availability and distribution of the vaccine to both girls and young women. Forms of primary prevention and medical advances in this area hold potential for helping to protect the health of millions of Americans and helping to preserve the lives of thousands of American women who currently die of cervical cancer each year as a result of HPV infection.”
The truth is, many right-wing organizations that rail against school-based sex education or making condoms available to kids have only positive things to say about the HPV vaccine. As early as 2006, Linda Klepacki, an analyst for sexual health at Focus on the Family, told Time magazine:
“This is an awesome vaccine. It could prevent millions of deaths around the world. We support this vaccine. We see it as an extremely important medical breakthrough.”
While reproductive-rights experts expected these groups to opose FDA approval, and folks like Maher seemed to be gearing up to do just that, it never happened. Instead, these groups agreed that the vaccine was a leap forward in health care and reserved their opposition to attempts to make it mandatory for school children. We have not yet had that debate on the national level, though we all watched it play out in Texas under Rick Perry.
This doesn’t mean that there has been no controversy over the HPV vaccine or that we’ve seen widespread acceptance. And it doesn’t mean that no one has bought into the vaccination-will-cause-copulation argument that’s out there in the ethos.
What it does mean is that on some level these organizations—made up of people who hold extremely conservative values on sexuality—realized that they could not oppose the development and distribution of a cancer-prevention vaccine because of their own objections to premarital sex. Whether these decisions were made out of genuine concern for the public health or a superficial concern for their own public image we may never know. The take away? When the stakes are high (cancer and death) the conversation changes—at least a little.
The best way to change the conversation is to continually remind people that the stakes are always high when it comes to reproductive health.
We also have to change the conversation at a more fundamental level by attacking the “logic” that underlies the access-causes-action argument. This argument suggests that women’s sexual behavior is a problem to be controlled and that the only way to do it is to ensure negative consequences at every turn. This argument says that women can’t be trusted to make good decisions unless they’re scared to death of bad ones. I can think of no worse message to send our daughters.
I am very sure that there are no worse message than this one lurking in a package of pills or a vial of vaccine.