Commentary Sexual Health

How to Help Youth Develop Healthy Attitudes Toward Sex

Donna Harwood

When discussing STDs, it's important to take a proactive approach, because early conversations help shape healthy attitudes and knowledge about STDs and sexual health. That’s especially true for youth.

See all of our coverage of STD Awareness Month 2013 here.

April is STD Awareness Month. All too often, conversations around health only happen when someone’s health is threatened by a disease or disorder. When discussing sexually transmitted diseases (STDs), it is important to take a more proactive approach. Why? Early conversations help shape healthy attitudes and knowledge about STDs and sexual health. That’s especially true for youth.

When it comes to helping youth develop healthy attitudes about sex, we as adults must first overcome our own fears and anxieties around the subject. All of us who interact with youth have a role to play in STD prevention. I run an LGBTQ organization called Lions Pride, which provides diversity resources, including sexual health education. I remember having a conversation with a youth member of Lion’s Pride about teen pregnancy at the young person’s school. Because of the sexual health information she received as a member of Lion’s Pride, she knew more about sexual health than all her straight friends and they were always coming to her for advice and help.  While I think it is great that youth are helping each other out, my thought was: How unfortunate that these teens do not feel they can come to adults in their lives with questions about sex, pregnancy, and prevention. The question we must ask is: What can we do to make youth feel safe coming to adults with their sexual health questions?

As youth leaders, educators, adult family members, religious leaders, health workers, and role models we must be sure to educate ourselves enough on the sexual health issues that our youth face today, and be willing to have those difficult discussions with our youth. These conversations can be especially difficult for parents, since parents may not want to embrace the thought that their kids may be having sex. The difficult truth is that many are, and we need to make sure our youth have the knowledge to keep themselves STD-free.

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Talking to youth about sexual health always requires medically accurate information. Sometimes the parents of Lion’s Pride LGBTQ youth ask for advice on talking to their child about sexual health. They are especially concerned because many of these parent are straight, and that can add another layer of difficulty as they talk to their gay teen. The advice I like to give to these parents is simple: If you don’t know how to have “the talk” with you LGBTQ teen, then sit down and discuss what you do know about sex and relationships in general and then make a commitment with your teen to take an educational journey together so the tough issues can be worked out with one another. I think that’s pretty good advice regardless of the sexual orientation of the parent or youth. If parents do not take an active role in their kid’s sexual education, the youth will seek it out on their own, and who knows if the information they find is accurate, healthy, and safe.

For those parents who don’t know where to go for information, your local or state health department is a great place to start. The health department can often provide information and other local resources that can help you get started in pointing your youth in a healthy direction. Moreover, the STD programs at local and state health departments are staffed by experts in sexual health who can answer any question your youth ask!

I know that talking about sexual health with your youth, regardless of the information that you have at your disposal, is tough. Believe me, I know. The youth in Lion’s Pride ask some pretty challenging questions. But we need to be willing to create safe places for youth to ask their questions before they step out and explore their sexuality. If we don’t talk to our kids about sex, then we’re not doing our part to make certain they have the tools and the information to develop into healthy, happy adults.

Roundups Sexual Health

This Week in Sex: The Sexually Transmitted Infections Edition

Martha Kempner

A new Zika case suggests the virus can be transmitted from an infected woman to a male partner. And, in other news, HPV-related cancers are on the rise, and an experimental chlamydia vaccine shows signs of promise.

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

Zika May Have Been Sexually Transmitted From a Woman to Her Male Partner

A new case suggests that males may be infected with the Zika virus through unprotected sex with female partners. Researchers have known for a while that men can infect their partners through penetrative sexual intercourse, but this is the first suspected case of sexual transmission from a woman.

The case involves a New York City woman who is in her early 20s and traveled to a country with high rates of the mosquito-borne virus (her name and the specific country where she traveled have not been released). The woman, who experienced stomach cramps and a headache while waiting for her flight back to New York, reported one act of sexual intercourse without a condom the day she returned from her trip. The following day, her symptoms became worse and included fever, fatigue, a rash, and tingling in her hands and feet. Two days later, she visited her primary-care provider and tests confirmed she had the Zika virus.

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A few days after that (seven days after intercourse), her male partner, also in his 20s, began feeling similar symptoms. He had a rash, a fever, and also conjunctivitis (pink eye). He, too, was diagnosed with Zika. After meeting with him, public health officials in the New York City confirmed that he had not traveled out of the country nor had he been recently bit by a mosquito. This leaves sexual transmission from his partner as the most likely cause of his infection, though further tests are being done.

The Centers for Disease Control and Prevention (CDC)’s recommendations for preventing Zika have been based on the assumption that virus was spread from a male to a receptive partner. Therefore the recommendations had been that pregnant women whose male partners had traveled or lived in a place where Zika virus is spreading use condoms or abstain from sex during the pregnancy. For those couples for whom pregnancy is not an issue, the CDC recommended that men who had traveled to countries with Zika outbreaks and had symptoms of the virus, use condoms or abstain from sex for six months after their trip. It also suggested that men who traveled but don’t have symptoms use condoms for at least eight weeks.

Based on this case—the first to suggest female-to-male transmission—the CDC may extend these recommendations to couples in which a female traveled to a country with an outbreak.

More Signs of Gonorrhea’s Growing Antibiotic Resistance

Last week, the CDC released new data on gonorrhea and warned once again that the bacteria that causes this common sexually transmitted infection (STI) is becoming resistant to the antibiotics used to treat it.

There are about 350,000 cases of gonorrhea reported each year, but it is estimated that 800,000 cases really occur with many going undiagnosed and untreated. Once easily treatable with antibiotics, the bacteria Neisseria gonorrhoeae has steadily gained resistance to whole classes of antibiotics over the decades. By the 1980s, penicillin no longer worked to treat it, and in 2007 the CDC stopped recommending the use of fluoroquinolones. Now, cephalosporins are the only class of drugs that work. The recommended treatment involves a combination of ceftriaxone (an injectable cephalosporin) and azithromycin (an oral antibiotic).

Unfortunately, the data released last week—which comes from analysis of more than 5,000 samples of gonorrhea (called isolates) collected from STI clinics across the country—shows that the bacteria is developing resistance to these drugs as well. In fact, the percentage of gonorrhea isolates with decreased susceptibility to azithromycin increased more than 300 percent between 2013 and 2014 (from 0.6 percent to 2.5 percent).

Though no cases of treatment failure has been reported in the United States, this is a troubling sign of what may be coming. Dr. Gail Bolan, director of CDC’s Division of STD Prevention, said in a press release: “It is unclear how long the combination therapy of azithromycin and ceftriaxone will be effective if the increases in resistance persists. We need to push forward on multiple fronts to ensure we can continue offering successful treatment to those who need it.”

HPV-Related Cancers Up Despite Vaccine 

The CDC also released new data this month showing an increase in HPV-associated cancers between 2008 and 2012 compared with the previous five-year period. HPV or human papillomavirus is an extremely common sexually transmitted infection. In fact, HPV is so common that the CDC believes most sexually active adults will get it at some point in their lives. Many cases of HPV clear spontaneously with no medical intervention, but certain types of the virus cause cancer of the cervix, vulva, penis, anus, mouth, and neck.

The CDC’s new data suggests that an average of 38,793 HPV-associated cancers were diagnosed each year between 2008 and 2012. This is a 17 percent increase from about 33,000 each year between 2004 and 2008. This is a particularly unfortunate trend given that the newest available vaccine—Gardasil 9—can prevent the types of HPV most often linked to cancer. In fact, researchers estimated that the majority of cancers found in the recent data (about 28,000 each year) were caused by types of the virus that could be prevented by the vaccine.

Unfortunately, as Rewire has reported, the vaccine is often mired in controversy and far fewer young people have received it than get most other recommended vaccines. In 2014, only 40 percent of girls and 22 percent of boys ages 13 to 17 had received all three recommended doses of the vaccine. In comparison, nearly 80 percent of young people in this age group had received the vaccine that protects against meningitis.

In response to the newest data, Dr. Electra Paskett, co-director of the Cancer Control Research Program at the Ohio State University Comprehensive Cancer Center, told HealthDay:

In order to increase HPV vaccination rates, we must change the perception of the HPV vaccine from something that prevents a sexually transmitted disease to a vaccine that prevents cancer. Every parent should ask the question: If there was a vaccine I could give my child that would prevent them from developing six different cancers, would I give it to them? The answer would be a resounding yes—and we would have a dramatic decrease in HPV-related cancers across the globe.

Making Inroads Toward a Chlamydia Vaccine

An article published in the journal Vaccine shows that researchers have made progress with a new vaccine to prevent chlamydia. According to lead researcher David Bulir of the M. G. DeGroote Institute for Infectious Disease Research at Canada’s McMaster University, efforts to create a vaccine have been underway for decades, but this is the first formulation to show success.

In 2014, there were 1.4 million reported cases of chlamydia in the United States. While this bacterial infection can be easily treated with antibiotics, it often goes undiagnosed because many people show no symptoms. Untreated chlamydia can lead to pelvic inflammatory disease, which can leave scar tissue in the fallopian tubes or uterus and ultimately result in infertility.

The experimental vaccine was created by Canadian researchers who used pieces of the bacteria that causes chlamydia to form an antigen they called BD584. The hope was that the antigen could prompt the body’s immune system to fight the chlamydia bacteria if exposed to it.

Researchers gave BD584 to mice using a nasal spray, and then exposed them to chlamydia. The results were very promising. The mice who received the spray cleared the infection faster than the mice who did not. Moreover, the mice given the nasal spray were less likely to show symptoms of infection, such as bacterial shedding from the vagina or fluid blockages of the fallopian tubes.

There are many steps to go before this vaccine could become available. The researchers need to test it on other strains of the bacteria and in other animals before testing it in humans. And, of course, experience with the HPV vaccine shows that there’s work to be done to make sure people get vaccines that prevent STIs even after they’re invented. Nonetheless, a vaccine to prevent chlamydia would be a great victory in our ongoing fight against STIs and their health consequences, and we here at This Week in Sex are happy to end on a bit of a positive note.

Culture & Conversation Human Rights

‘I’m Not Saying Anything That’s Radical’: A Q&A With Matt McGorry

Regina Mahone

Matt McGorry spoke with Rewire about his experience working at the intersections of Hollywood and activism, how personal fitness is nothing like social justice awareness work, and why more men should care about targeted regulations of abortion providers.

You may have seen Matt McGorry’s face splashed across the internet today along with his co-stars promoting season four of Netflix’s hit show Orange Is the New Black. But this interview isn’t about that series’ latest premiere or McGorry’s role in one of my favorite ShondaLand productions, How To Get Away With Murder.

In the past year, McGorry has become an outspoken advocate for gender equality, Black Lives Matter, the importance of sexual consent via the White House’s It’s On Us campaign, and reproductive rights. And I have to admit: I’ve been a bit skeptical of all the headlines about him. For womenespecially Black women, who are constantly being talked over—seeing white men praised in the media for talking about what we’ve been talking about for decades with often zero recognition can feel about the same as when partners are praised for “babysitting” their own kids or for making dinner. As even McGorry will admit, “it can be triggering,” and the actor said that he was planning to pause interviews about his social justice work so he could actually “reflect and figure out a way to have deeper impact.”

But after speaking with him before the annual Gloria Awards in late April and then again in May via phone about everything from the film Captain America: Civil War to targeted regulation of abortion providers (TRAP) laws, I can report that McGorry’s not mansplaining or looking for applause. It’s the media that must focus less on how much of a bae he is and more on how other aspiring allies and accomplices can learn from him. So that’s what this interview is about.

McGorry and I spoke at length about his experience working at the intersections of Hollywood and activism, how personal fitness is nothing like social justice awareness work, and why reproductive rights is a men’s issue.

Here is an edited transcript of our conversation.

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Rewire: You talk a lot about being an advocate for gender equality. What does that mean, and what does that look like in practice?

Matt McGorry: There are obviously many different ways to do it. I think as a man, a big part of it is learning to understand and parse apart my privilege and my understanding of that, essentially how it influences my life and the choices that I’ve made in the past and the choices I continue to make even in doing the work. And continually learning and reading books and reading articles. It’s really about listening, and part of that listening is self-education. And part of that is talking to and being open to conversations with people in my life who are women or people of color when it comes to racial issues, but still being aware of the fact that it’s not women’s responsibility or people of color’s responsibility to educate me about these things.

I have to be careful that I’m not requiring that of people that I’m talking to who are marginalized. Sometimes I won’t be wanted or invited to conversations, and that’s OK too. And sometimes they won’t even tell me that they don’t necessarily want me in the conversation, and I have to be aware of that and take that into consideration as well.

I have been fortunate enough to have a platform due to acting that, since I have a certain number of followers [on social media], as I’m educating myself on these issues, I can retweet or repost articles or videos. I think that’s valuable for people to do even if they don’t have a following of my size.

One of the friends who got me very interested in Black Lives Matter was posting about these issues—and, unfortunately, it took my friend who’s a white man … to get me to pay attention. But sometimes that is the unfortunate nature of privilege.

It’s not that I need to be telling Black people about Black Lives Matter and I don’t need to be telling women about gender issues, but I need to be telling the people who are in my position. Some people have said that it’s useful to be able to point to me when talking to their white male friends about these things … I think there is some value for other men to see a man who says, “I am a feminist.” But it’s now asking myself the question: How do I make a deeper impact?

Rewire: You’ve written and spoken about how it’s only been a year in your journey as a feminist. Tell us what that experience has been like up to this point.

MM: I’m starting to examine my own views on the world … I don’t care how well your parents raised you or how inclusive your parents are—and my parents were very inclusive. You still grow up in a society where your media, your peers, and all these outside forces are pushing you toward sexism, racism, and all these things in a very insidious way. So … I then said I want to hold myself to a higher standard, but you don’t even know what that looks like at that time.

As you start learning about injustices, you start to realize aspects of your own self that are problematic. And that can be painful because, in these moments of realization, someone calls you out and you already feel like this is a risk. Obviously, the risk that I take in speaking about these things is relative to the risk that people who are not white or men or cis or straight take in this.

Rewire: I do wonder if there is a bit of a tension between the celebrity aspect of your identity, which may be about promoting the self, and the activist aspect, which is about lifting up other people who are not as privileged. How do you navigate that?

MM: I’m always thinking about it and always trying to figure out what might be the best way … as I have had opportunities like this or getting on the Nightly Show to say these things, it was important for me to have enough education on these topics, and conversations [with people] in real life to know how to not fuck up something like that, and to hopefully be more of service to any of these movements than to make it about myself, therefore excluding people and not being able to have as much of an impact. 

There’s not any [clear-cut path with these things] … I can ask women in my life about issues of feminism, and they are going to disagree with other women. And there are people online who don’t think that men should call themselves feminists. It was a conflicting moment for me actually when I was nominated [through an online poll, by supporters] as a potential “Feminist Celebrity of the Year.”

It’s a tricky conversation and has to be had with the right people because … essentially feminism is about gender equality. I think even in the community the word does tend to be gendered … and there were people, even friends of mine, who were like this [nomination] feels wrong.

I said, what if it was “Gender Equality Advocate of the Year,” would that feel different? And a lot of the time they would say, yeah maybe, which is very telling about our own perception with how we gender the word that we know is not really supposed to be gendered.

Bridging the gap between celebrity culture and [advocacy] is tricky … [but] if we’re not making ourselves uncomfortable, then we’re not really growing and we’re not forcing other people to grow too.

Rewire: It’s like when you decide to go on a diet, right? In order to go on this diet, you need to change your lifestyle. You want to exercise more, you want to start eating healthier, but often the people around you will say, “What is wrong with you? You’re acting strange.” Has that been your experience?

MM: I’ve never inherently been someone who likes confrontation. I was a personal trainer for ten years and even then I never really liked to force anyone to do anything. I would have clients come in and say, “Well, how much should I weigh,” or “What body type should I be”? I would answer, “Well, it’s whatever you want it to be. If you’re happy the way you’re now, then that’s great. Let’s work out, have fun, and keep you healthy. But if you have an issue with the way you look or with your health, let’s examine that.”

But social justice work is different from the world of personal training. In the world of fitness and personal training, it’s all very much personal preference. I do believe there is a right way of treating other people in this world, and I think that’s why activists and social justice work can quickly get so radical. It’s because, as soon as you see that you’ve been doing things wrong for a long time and then essentially, if there is a right way to do the things, it’s hard to pace oneself in terms of how much you try to turn other people to that as well and—I’m only a year in doing this. I’m engaged to see how the journey evolves over time, but I’m in a optimistic stage right now.

I feel like it’s quite possible that two years from now or a year from now, I won’t be arguing with someone like Piers Morgan because I’ll realize that he might not ever get it.

I think there was a value to having that conversation about what he thinks of as “reverse racism.” Having that conversation publicly in a way that other people can see it as well, even if he doesn’t get it. But it’s a very strange process. Because, it felt like the moment that I understood how bad things were, was the moment I felt compelled to act. There’s a bit of a disconnect for me [when I see] people that do understand it or that have some understanding of it or are starting to understand it, but that don’t act.

And what I’ve found is anyone who doesn’t take action on these things doesn’t really fully understand them yet. We can understand there is a problem with how our criminal justice system is run in our country, but I think understanding it in a really full and deep way and understanding how … someone like me gets to benefit from the criminal justice system that essentially keeps us safe but doesn’t keep everyone else safe in quite the same way.

Rewire: So, you have aligned yourself as an ally with various social justice movements. Are there any issues in particular within these movements that you’re most concerned with?

MM: In terms of racial justice issues, I would say that The New Jim Crow has had a profound effect on me and my view of the criminal justice system, and according to [its author] Michelle Alexander, that’s the biggest issue of our time, or what she calls the New Jim Crow. And so that’s been the thing that has stood out the most for me—how the “war on drugs” disproportionately has had negative effects on communities of color.

People are still serving lifetime sentences for first-time nonviolent drug crimes. And getting to meet in Washington, D.C., a number of these people who have received clemency from different administrations and are now free and are now really incredible members of their communities who are advocating for at-risk youth and other incarcerated individuals—I mean it’s incredible.

We have these internal biases—a lot of us do—that if someone ended up in prison, [we think] they must have done something that was terrible and violent. It’s not to say that drugs are good, but people make bad choices and people are more likely to make bad choices when they don’t have a lot of choices available to them.

Understanding what other people don’t have the luxury of has made me appreciate and understand more what I have had the luxury of growing up. Things that I didn’t even particularly like—I didn’t really enjoy much of classes in college or being tutored in high school or taking SAT prep classes—but those things are actually all privileges. And it does put me in a more advantageous position to succeed if I do have those opportunities available.

The criminal justice stuff for me stands out in a very big way because it’s just something that I’ve been totally blind to my whole life. I think what the book is very successful in accomplishing is forcing us to look at how we discriminated against criminals or people who have been incarcerated and how we justify the tactic, and we think that that’s okay.

Rewire: Earlier this year you launched a fundraiser to benefit NARAL Pro-Choice America. Why was it important for you to advocate for reproductive rights?

MM: A lot of men don’t understand it, or that this group is under attack, because of the TRAP laws and all this new legislation that people are trying to push. And again, as it always is with any of these issues, it’s really important to have people with privilege give a shit and say something and stand up against [bad policies].

These are not just women’s issues: They are human issues and human rights issues. In my mind, staying silent on this stuff when you have an opportunity to say something is essentially just telling women, “It’s your problem to deal with pro-choice issues.” That’s not fair and it’s not right.

We [as a society] need more men who care, and who care enough to say something. I’ve come to believe that if you say that you care about a thing but you don’t actually do something about it, you can’t really say that you care that much.

You might feel like you care. You might, if you had the choice to make abortion legal everywhere, you might wave the magic wand and say yes. But if you’re not willing to take a risk on for yourself, then you’re really not doing the work that needs to be done.

And I actually lost an opportunity because of the shirt. But it’s important for people in my position to be willing to make those sacrifices. The more men we have speaking out about these things, the less anyone else has to take the brunt of all these attacks.

If enough men gave a shit about women’s reproductive rights, these clinics would be staying open, and these TRAP laws wouldn’t be going into effect. The problem is, ultimately, not as many men care about these issues as women do.

Rewire: You spoke in a recent interview about how important it was to your gaining a deeper level of consciousness that you are working on shows like Orange Is the New Black and How to Get Away With Murder that allow you to wave your intersectional feminist flag with pride. What about the folks who aren’t in those environments? Just thinking about what it might be like if your next gig isn’t as “woke.” How do you see people navigating those spaces?

MM: I’m not in a place in my life where I have enough money to live even an extended period of time without working .… There is almost a guarantee that at some point in my future where I will work with someone on a project who is problematic, and I unfortunately won’t necessarily be able to call it out in a way that I would want to.

I have thought about that and I dread that day.

I just saw Captain America: Civil War, and there’s a great quote in that movie that resonated for me in terms of the social justice work. The theme behind it is that the United Nations wants to govern the Avengers and some of them do think it’s okay to be governed and some of them don’t want to be governed.

The quote is, “Compromise where you can. But where you can’t, don’t.” That’s not an easy thing to figure out, where you can and can’t. But it is an important part [of the work] and it’s one that’s a continual process.

I also think that part of the thing that scared me initially [about taking a stand] was I’m not always going to know what opportunities don’t come to me because of this stuff. The director is not going to call me up. They are going to go another way and you are not going to know.

I think for people who think they can’t speak out in some way, there is always other work to be done. There is always volunteering, community organizing, and having conversations with people [in small groups and] educating them.

I hope that I’ll be able to stay as much in line with my beliefs as possible as time goes on. It’s a constant process of figuring out and navigating, and I think it always will be. Any time you’re trying to go against the status quo, that’s not going to be a simple task.

Rewire: In the past year, you’ve gone from posting on Facebook about the gender pay gap and writing for Cosmo about your feminism to calling out Piers Morgan on Twitter about his response to Beyoncé’s Lemonade. In the spirit of trope-ing, why are you such an angry white man speaking about these injustices?

MM: There is a component of it that I’m never [taking] the direct brunt of this, of speaking out about these issues the way, for example, that Black women are. And I’m not getting that same backlash and hate and threats of violence against me.

So when I do speak to other people about this, I try to remind myself that the less angry I can be or the less angry at least I can appear to be, the more effective I think I am at having these conversations. That has to be the paramount thing, because I am angry but I am not angry from a first-person perspective having to experience these things directly.

There are too many people who don’t listen to Black women for example, and claim that it is because they are too angry. As you know, if someone is telling you the right thing, even if they are not telling you it in the way that you want to hear, it is important to listen to them as much as you can.

Ultimately white people, white men, need to be more outraged with the injustices of racism and discrimination than we are when someone is telling us that they don’t like something that we are doing, for example.

I think if I’m talking to people whose points of view I simply couldn’t help but be infuriated by, I probably don’t need to be talking to them, because they are not welcoming any sort of actual dialogue.

It’s unfortunate that some of the deeply, deeply bigoted people are harder to [communicate with] and are not going to change through social media posts. But most of my work is really focused on how do I activate and change the minds of those people who really are interested in justice and maybe don’t understand these things fully, and don’t understand how to be an ally or that they even can be an ally as a white person. For me, if we can get enough people in these positions to care and to take action, there would be a point of critical mass that would pull the rest of everyone else even further toward the side of progress, whether they wanted to or not.

It’s what Martin Luther King said in his “Letter from Birmingham Jail”—he said that the KKK is not the greatest stumbling block for the African American; it’s the white moderate who prefers order rather than justice. And who says, essentially what in today’s terms would be, “Whoa, you are being too loud” or “You should not go to these political rallies and yell Black Lives Matter.” It’s the people who prefer the order, who think, “not now, this is not the time or the place.”

I read in an article a while back how the movement [for racial justice] doesn’t need allies; it needs accomplices. That was an interesting way to think about [the work white people like me can do] too. We need to be there getting our hands dirty and taking on some of the risks, even in Hollywood, where we pretend we’re expressing those [messages], but we’re really not.

Again, I’m not saying anything that’s radical or that women and people of color haven’t been saying for years.

This interview, which was conducted in-person and later finished on the phone, has been edited for clarity and length.