The Problem With Personal ‘Confessionals’ About Sexually Transmitted Infections

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Commentary Sexual Health

The Problem With Personal ‘Confessionals’ About Sexually Transmitted Infections

Sarit Luban

In the first-person STI story, the diagnosis represents a betrayal or a fall from grace, eventually culminating in a resolution that feels almost like a moral by discovering a silver lining or positioning oneself as the righteous victim of a cheating or lying ex. These “I found out I had an STI, but now I’m OK” pieces are often composed primarily of descriptions of devastation and shame, ending as soon as things turn around.

When the internet was embroiled last year in a discussion of the pros, cons, and cultural significance of the first-person essay, I didn’t yet consider myself a writer. I was just a blogger trying to carve words out of a deafening silence in the years after a herpes diagnosis in college.

It was the silence, specifically, that fascinated me. Sexually transmitted infections (STIs) are common, so why wouldn’t anybody talk about them? That question became my motivation to get published. When I sought to better familiarize myself with the little existing writing on herpes, I observed that it usually followed a general pattern that I’ve been wary of replicating.

It is the STI “confessional”: the token STI story of mainstream media.

The STI confessional is more than a firsthand account. It’s a disclosure of the unusual, unwanted, or unexpected. The confessional is uniquely personal, yet its details are vastly secondary to its central point, which is that the author has an STI. Even though this fate awaits most sexually active people in the United States at some point in their lives, the confessional continues to be recycled, as if being STI-positive is shocking.

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And in a way, it is. There’s so much stigma around this topic that we’re surprised when someone mentions it. People with STIs exist largely in the theoretical, including to each other. The confessional, then, is an answer to the alarming absence of real voices amid statistics, dubious WebMD results, and stand-up routines that use infections as punchlines. That there is still demand for it reflects the lack of STI representation in media. But it has its limitations.

Here is the structure: The confessional has a before, a diagnosis, and an after. Frequently chronicled in great detail, the diagnosis represents a betrayal or a fall from grace, eventually culminating in a resolution that feels almost like a moral by discovering a silver lining or positioning oneself as the righteous victim of a cheating or lying ex. These “I found out I had an STI, but now I’m OK” pieces are often composed primarily of descriptions of devastation and shame, ending as soon as things turn around.

According to the confessional, an STI can be the best or worst thing to happen to you. But rarely is it neutral, because what kind of story is that? The true conflict at hand may be internal (identity crisis, dysphoria) or external (disillusionment with a relationship or lifestyle). However, the confessional can go on without being aware of that deeper conflict, because it can earn the reader’s sympathy through the perceived violation of an STI itself.

The stories told within the confessional are true stories. I tried for some time to document my diagnosis and its aftermath, but I could never get it right and I could never finish. That’s why I avoid the form: It wouldn’t feel honest.

Still, that persistent notion of STI diagnosis as “rock bottom” colors how my work is perceived. Dormant Facebook friends have come out of the woodwork to applaud me for writing about my struggles with herpes, though I can’t remember ever publicly using the word “struggle” in reference to my sexual health. Neither have I claimed to be suffering from herpes; in fact, in my first published piece, I explained why I use impartial language when talking about STIs. But that doesn’t stop people, even those who know me, from describing my experiences as such.

In a later article, responding to a science project proposal gone viral involving a pathogen-detecting condom, I critiqued the concept, considering what it would mean for STI-positive populations and how it might be received in a society where STI stigma still runs rampant. I spoke candidly about my status and the steps I take to establish healthy communication with partners, illustrating my connection to the issue to better clarify my perspective, not to recount a personal journey. Yet some people took this piece as a coming out rather than social commentary. The confessional seems to appear in my portfolio whether I’ve written it or not.

None of this is to say the confessional doesn’t serve a purpose. “It Happened to Me” tells a different story than “It Happened to Someone, Somewhere, Apparently”; hard data doesn’t know what you’re going through, and infographics won’t follow you back on Tumblr. Moreover, in the face of inadequate sex education and barriers to health care, first-person narratives not only offer camaraderie, they fill in gaps left by educators, parents, and service providers. The confessional intends to humanize.

But too often it is content to focus on, and only on, the individual. The confessional might incorporate some statistics to say, “See? It could happen to anyone!” But it doesn’t readily investigate why we have skewed impressions of STI prevalence, why some doctors hesitate to recommend HPV vaccination, or why it’s actually pretty realistic that the guy from the bar didn’t know he had chlamydia before passing it on.

The confessional prefers to ask “Why me?”—a question with no simultaneously satisfying and accurate answer. Upon realizing this, the confessional becomes a tale of self-acceptance. (The confessional is less about how to live with an STI than it is about how to live with yourself with an STI.)

The problem isn’t that these stories exist. It’s that they’re some of the only ones that exist. I think of the editor who responded to my multiple story ideas with the suggestion that I just write a personal piece about what it’s like to have herpes, and the countless others who reach out to STI-positive writers to commission articles following the confessional’s outline nearly to a T. Conveniently, what makes an essay particularly infuriating, scandalous, or unfair also tends to drive traffic to it.

Or maybe the confessional is simply palatable. Because, stripped of the institutional and systemic context in which STI stigma is experienced, the confessional demands that its author grow, not that its audience change how they think about STIs. It’s taboo without necessarily challenging anything.

For all its imperfections, the confessional matters because STI content matters. We’re still very bad at talking about STIs. We sweep them under the rug, pretending they don’t affect us, until they emerge in a body—mine, yours, a lover’s—like weeds. Our reluctance to give STIs the attention they deserve feeds the fears that discourage people from testing, disclosing, and treating infections, even from bringing up their possibility. But talking about sexual health shouldn’t require a confession. We need space for many stories and our many, vast experiences. We need words for it all.