Sex is arousing. It was arousing when you hadn’t experienced it first hand and will likely remain so no matter how many intimate interactions you’ll accrue over time. Porn lets us gander at people’s wildest fantasies and stretch our imagination as to what our own fantasies could be. Selfies, and social media at large, encourage us to showcase a sensual and desirable self we would have traditionally been more private about. But who do we turn to when we have health related questions about sex? Or worse, when our health related questions become health related problems that might have originated from sex?
Rita Anderson’s job involves answering those questions. Rita is a nurse practitioner and works for a reproductive health organization, where her day-to-day occupation is all about making sexual health information and medication more accessible to anyone. Our chat was refreshing. For her, sex is a foundational part of our lives and everyone deserves to have a happy sex life, no matter your gender and sexual orientation. That is what she helps people strive for, one visit at a time. But when she listens to the dozens of people that come in every day, sex is coupled with things like uncomfortable sexually transmitted infections (STIs) that affect patients’ physical and mental health. Hearing that you have an STI is not easy, and how you hear about it can make it a lot better or …a lot worse. When I got diagnosed with genital herpes, my gynecologist gave me a dose of accusatory looks and a condemnatory tone along with my acyclovir prescription. But not all providers are created equal, so I was curious to shift perspectives and hear what Rita was confronted with as a medical provider in reproductive health. I was eager to know what she had learned about how people view and relate to sexual health (all opinions are hers).
Irrespective of how precocious/late your first time was, we can all agree that we generally start having sex before we learn a lot about it. As if we were going for the driving practice test before having passed the written one, we generally begin riding lacking the fundamentals of how to do so in a pleasurable AND safe way. On the pleasurable side of things, Rita says she hears a discrepancy in how men and women’s sexuality is regarded. “The idea that women aren’t supposed to be sexual or are sluts if they are remains pervasive in our society. Or that heterosexual men have more freedom and less judgement around their sexuality than women or people in LGBTQ communities. I wish no one was made to feel bad about their desire and sexuality, as long as it’s consensual.” Now, whichever way you’d try to describe sex, it would always come across as a form of communication where instead of words people exchange pleasure. Isn’t the exchange the reason we prefer sex over self pleasure? But how earnest can the exchange be when one party feels or is made to feel ashamed? Rita adds: “It is sad and I’m not entirely sure why, but people are pretty uncomfortable talking about sex.” A finger could be pointed at religions for long chastising our yearning for carnal pleasure and portraying sex as a perverted act. Another one could be pointed at Sex-Ed, which the inaccuracy of information reportedly allowed in 37 states leaves it up to us to inform ourselves about how sex works.
Ultimately, our sex IQ could greatly benefit from empowering each other, all genders alike to voice our specific needs and concerns.
Another victim of ignorance is safety. “I have some patients who haven’t heard of gonorrhea or chlamydia. When I taught Sex-Ed in high schools, some of the students had never heard of HIV. If we don’t know about things because we aren’t given good information, we can’t care about them or protect ourselves the way we should.” Indeed, the fact that more than 50% of Americans will have an STI at some point in their lifetime clearly indicates that when it comes to sex, we underestimate how easy it is to go from satisfaction to infection. The usual reaction to learning you have an STI is fear and panic. And when there’s no cure available like for genital herpes, a particularly emotional reaction adds onto doctors’ list of symptoms to treat. “I often wonder why herpes has gotten this huge rap, when other infections like chlamydia can lead to worse consequences and yet don’t have that stigma. Sadly because of popular stigma, people get really scared when they hear their diagnosis of genital herpes. They become worried that they are not going to have happy sex lives anymore and that something really bad is going to happen.”
RITA POINTS TO A POIGNANT TRUTH: WHAT’S EVEN MORE INCONVENIENT THAN HAVING GENITAL HERPES IS KNOWING YOU HAVE GENITAL HERPES
Why? Because if genital herpes is uncomfortable only during outbreaks, knowing you have it (and that is, for life) makes you feel insecure and unattractive every single day. Knowing you have genital herpes puts a responsibility on your shoulders to disclose to potential partners the risk they need to assess before pushing through. And knowing you have genital herpes is what will make you an asshole in their eyes should you take that risk for them. But no one likes to be the bad guy, going around and telling people they have to take responsibilities! Not even the Centers for Disease Control and Prevention (CDC). I asked Rita what she thought about the CDC’s stance on not recommending to include genital herpes in the general STI test. “This comes up at work every day with patients. In medicine we try to do tests that have a purpose, that will inform our treatment and our care for someone. With genital herpes, we don’t really consider a diagnosis of herpes with a positive blood test alone. It just means that at some point, the person was exposed through kissing, oral sex or sex. So to do a test where most of the time it’s going to come back positive and it doesn’t really affect a person’s care… it’s kind of not seen as a necessary test. We can do something with a lesion, but we can’t do much with a positive blood test. Herpes is not fully understood, and how often or if ever a person will experience outbreaks depends on their immune system and other factors. And for people getting these results, they are not sure what to do with that information.” I cringed as Rita finished her sentence. To me, that information lets people know that where medicine can’t do anything for them, they can do something for others. If communication can’t cure anyone from genital herpes, it can at least control the spread. Because despite how shitty it can make carriers feel about themselves, knowing they have it empowers them to voice out when to hold off on sexual activities and ultimately protect their partners. And that feels great!
But more at large, to reckon a virus like herpes in a dormant stage – which even when dormant can remain contagious – as something that does not affect people’s health made me take a step back and ponder how we view healthiness. Why do we keep thinking being healthy means being disease-free when the CDC considers we’re perfectly healthy when carrying the herpes virus, as long as it doesn’t manifest itself? Could being healthy coexist with carrying viruses that don’t disturb the regular functioning of our body?
IF SO, THERE SEEMS TO BE A GAP TO FIX SOMEWHERE: EITHER IN OUR DEFINITION, BECOMING A STATE OF NOT BEING PHYSICALLY AFFECTED BY A DISEASE, OR IN HOW WE RELATE TO IT – MORE AS AN IDEAL TO STRIVE FOR RATHER THAN A NORM TO MAINTAIN.
And lastly, I was curious to hear if the diagnosis of herpes affected people differently according to their gender. Do they have the same concerns? What do they instinctively think it means for them? For their partner? As Rita hasn’t diagnosed enough men to give an accurate answer, she promised to get back to me should she gain more knowledge on that. However, she had an interesting insight to share around how unlike men, women disproportionately worry about the smell of their genitals. “Women talk about smell all the time and use feminine wash with scents like rose or tropical rainstorm to change the smell of their vaginas. But in the health center we try to normalize the fact that vaginas are self cleaning organs and these feminine wash, contrary to their heavy marketing, actually cause a lot of yeast infections or bacterial vaginosis, which are some of the things we see most commonly at work. I don’t ever hear guys talking about the smell of their penis, and I don’t even know if there are washes targeted at changing the smell of their genitals!” It is hard to know whether women were preoccupied by the smell of their genitals prior to the arrival of feminine hygiene products on shelves, but one thing is for sure, those products did nothing but increase the paranoia that vaginas’ smell is something women should worry about!
People say there’s never one side to the story. But in Rita’s case, there are actually many stories to her side. She hears the stories of carriers and partners, patients and providers, people of different genders and sexual orientation, etc. And as a human being before being a provider, she empowers those individuals to navigate the collective mindset and become more confident about having genital herpes. Funny enough, I on the other hand, am trying to empower the collective to navigate individuals’ experiences and become more discerning when thinking about genital herpes. Even when having different stories, you can definitely be on the same side.