Message to the College of Physicians: the safest sex is monogamous sex

When it comes to public health, we have come a long way. Having improved hygiene and medical treatments, a whole series of infectious diseases which claimed millions of our forebears have been banished.

This is often presented as just another victory for reason over ignorance, science over wrongheaded thinking. But when it comes to our sexual health policy, we seem to have moved backwards, and a peculiar modern form of superstition seems to be the cause.

Yesterday, the Royal College of Physicians of Ireland released a statement on sexual health, noteworthy mainly for what it doesn’t say.

In the past 20 years, Ireland has seen a dramatic rise in the number of people who have sexually transmitted infections (STIs), a fact briefly alluded to in the statement. This is mainly as a function of the increase in the number of people having multiple sexual partners.

In other words, the larger the number of sexual partners you have, the greater your risk of contracting an STI.

Nowhere in this document is this acknowledged. For all the talk we hear of “safe sex”, it is never suggested that in terms of sexual health, (not to speak of psychological health) the safest sex is monogamy.

Safe sex is instead effectively defined as sex with a condom plus repeated testing just to be sure.

This is without even discussing the emotional impact of having multiple sexual partners. A recent US study of single people aged 18-23 found that women who had multiple sexual partners were three times as likely to have been diagnosed with depression (30pc versus 10 percent) as those in the same age-group who have never had a sexual partner, or only one sexual partner.

As the slogan says, a condom doesn’t protect against a broken heart.

The statement refers to the World Health Organisation’s (WHO) definition of sexual health as as ‘a state of physical, mental and social well-being in relation to sexuality. It requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence.’.

It also mentions another definition which identified three aspects to sexual health and sexual wellbeing, specifically:

“A capacity to enjoy and control sexual and reproductive behaviour in accordance with a social and personal ethic.

“Freedom from fear, shame, guilt, false beliefs, and other psychological factors inhibiting sexual response and impairing sexual relationships.

“Freedom from organic disorders, diseases, and deficiencies that interfere with sexual and reproductive functions”.  

There is no hint in the above that having multiple sexual partners might be a bad idea despite the fact that it exposes you (and any of your partners) to a greatly increased risk of contracting a serious infection. That’s what I’d call a fairly unhealthy definition of “sexual health”. Again, that’s without mentioning the mental health dangers.

Finally, what does freedom from shame mean? The WHO hardly believes that someone who is unfaithful on their spouse shouldn’t feel even a little bit of shame? Or do they?