Is it possible to restore the norm of no premarital sex?

News today about gaps in sex education has a fantastically clear quote about the goals of conservative policy towards sex education:

"I don't think we'll be able to overcome this problem unless we restore the social norm of not having sex and not getting pregnant before marriage," said Peter Sprigg, senior fellow for policy studies at the Family Research Council.

Social conservatives do not generally support research about social norms about sexuality, so we do not know as much about sexual norms as we would otherwise. According to the earliest representative studies by sociologist Ira Reiss, the attitudes to allow what Ira Reiss called "permissiveness with affection" started shifting in the 1940s, and the shift was well underway by 1950 and definitely by 1960 when Ira Reiss wrote Premarital Sex in America (the link goes to the actual book). It seems unlikely that such a long-standing attitude shift could be easily reversed. By now, it is the standard that even many Evangelicals follow. If they marry right after college, it's possible they may abstain, but if they marry later, it's very unlikely, and many do marry later.

I would argue that permissiveness with affection is not a policy issue. No public health problems result from premarital sex within long-term committed monogamous relationships. Disease spread is self-limiting. Still, if changing that social norm is a worthy public policy goal, they have to look to more recent trends first.

One norm that has changed more recently are attitudes towards what Reiss calls "permissiveness without affection:" just as AIDS was emerging in the early 1980s, academics were declaring this to be the new norm. From the poll data in the link (which I would guess is an incomplete picture of the available data), it looks like endorsement of the norm may have declined with AIDS/HIV, and has begun to reemerge to some extent and even become part of public discourse, with everyone having heard of the idea of "Friends with Benefits". Unlike permissiveness with affection, there is some degree of a public health justification due to the herpes and HPV risks.

But that means you have to acknowledge that that nearly all Americans have premarital sex, and teach real sex education to protect them.

And then you have to think of a policy that can change social norms. Incidentally, changing social norms would seem to be totally inconsistent with a limited government of the sort that Conservatives say they want.

Open letter to Senator Lieberman

Dear Senator Lieberman,

As a Harvard Health Policy PhD and Jew, I am sad to hear that you are weakening health care reform.

As a Health Policy PhD, I refer you to my professors in the Harvard Health Policy program, who say the original Senate health care bill is the best available solution.

As a Jew, I remind you that the Rabbinic Sages teach us not to be like the men of Sodom who would say שלי שלי ושלך שלך "What is mine is mine and what is yours is yours." The Sages taught that justifying inequality is not just negligence, but actually evil.

The present US system could be a model for Sodom: discounted prices to the rich/insured/healthy and inflated prices to the poor/sick/uninsured. Any solution that perpetuates inequalities between privileged/healthy and poor/sick perpetuates the health care system of Sodom.

Strong health care reform is a policy and Jewish imperative.

Janet Rosenbaum, Ph.D. Health Policy, Harvard 2008
Johns Hopkins Bloomberg School of Public Health

Quantifying and qualifying casual sex

A recent paper compares measure of "psychological wellbeing" between people whose most recent relationship was casual versus serious, and finds no difference. The paper motivates itself by the speculation in public discourse and the teachings of abstinence-only sex education that casual sex is harmful.

The qualitative research on the subject of casual sex seems pretty clear that, to the extent that they exist, the harms of casual sex would be unlikely to be found on a psychometric measure. Kathleen Bogle's qualitative study found that college-aged women feel frustrated and sometimes their feelings are hurt by differing expectations, which is also consistent with what Laura Sessions-Stepp reports in her journalistic book. I haven't ever seen anyone suggest higher rates of mental illness among people who have casual sex. It seems highly unlikely that casual sex poses a public mental health problem. (Casual sex does likely increase the total lifetime number of sex partners, so increases STD risk, but that's not the main issue here.)

The lack of a quantitative measure for romantic frustration doesn't make it unimportant. Just as quantitative research finds that married men seem to be in better physical and mental health than unmarried, but no difference for women, doesn't diminish the importance of the desire of many unmarried women to be in committed relationships. Likewise, quantitative research finds that people with children are more unhappy than people without, and yet there is an entire medical subfield dedicated to making people unhappy by helping them have children. (Likewise, my understanding is that US medical doctors stopped performing sex reassignment surgery after quantitative studies found no improvement after surgery, and yet qualitatively transgendered people who choose surgery report an improvement.)

Intangibles are important. Keep those qualitative studies coming.

Abstinence-only music videos.

Washington City Paper features Top Five Abstinence Only music videos as well as a music video about the Christian Side Hug.

The potentially most negative video for STD prevention, "Ain't NO safe way" shows a couple in a drive-through. The man says no on the grounds that sex is dangerous. The woman holds up a condom saying vacantly as if hypnotized, "If they give these out in school, it must be safe." Her eyes widen further, unblinking, crazed, as she intones, "Don't worry. It's SAFE." "Safe" echoes in the background. Heavy metal music starts with "Wages of Sin = DEATH" on TV screens blinking in the background. (The boy says no, and gets out of the car, and the girl drives away disappointed.)

All five of these fall into the shaming language of "lose" and "take" virginity, and one girl even telling her friend "you should be ashamed" for having sex, as well as the ethnic stereotypes: many feature black women saying no to black men, and none feature Asians (who are disproportionately represented among virginity pledgers, but the stereotype is that they have no problem saying no.) Nor do they include black men turning down women.

Twilight books romanticize domestic violence?

The Twilight book series has been thought of as promoting abstinence, so I've followed it somewhat because of my work. I found it interesting to read this post, which goes through the checklist from the National Domestic Violence hotline for Bella and Edward's relationship, and finds 15 signs that their relationship is abusive. Fifteen! I have only read articles about the books and movies, not read the books or seen the movies myself, so I am frankly surprised to hear that Edward throws Bella through a glass table. But even the other signs, like repeated statements of jealousy, abandoning her in a dangerous place, threatening suicide. . . This is supposed to be romantic? Religious groups can't possibly approve of these books, abstinence message or no.

Also: the view from a school librarian (and member of my Cambridge synagogue).

Hormonal contraception makes women less attractive and choose worse partners, says review paper

A few months ago, I said that hormonal contraception (the pill, Depo, etc.) messes up women's choice of mates because of results we knew that women choose differently and asked whether that's responsible for higher divorces in those couples. We still don't know that information, whether divorce is more likely among women who chose their partners using hormonal contraception.

But a review paper has come out solidifying that finding that women choose partners differently on hormonal contraception than off and adding that women are less attractive while they're taking it because it suppresses ovulation (during which women are more attractive to men).

That's another reason to add to the book that just came out saying that women ought to consider other methods besides the pill.

Hormonal contraception is a standard, and evidence probably won't change that, but there are other equally reliable methods of pregnancy prevention such as intrauterine contraception (IUC) that currently have miniscule proportions of women using them. I wonder whether we'll see even a slight shift.

(Conflict of interest disclosure: I have a very nice pen given to me by the company that makes an IUC device that I happen to have used this morning, but really that's not why I wrote that. This is just the first time I've ever had one of those legendary conflicts of interest.)

Political compromises on sex ed

I'm an ardent moderate, but I find the administration's compromises counterproductive. Obviously the stimulus compromise didn't work: the bill was watered down, and virtually no Republicans voted for it anyhow.

If the health bill passes, the sex education situation will go to $50 million for abstinence-only education, $50 million for evidence-based comprehensive sex education, and $25 million for experimental comprehensive sex education. That's not compromise. That's going also against popular opinion: 52% of even politically "very conservative" parents favor teaching birth control in schools, and 89% of the general population of parents. Just as most of the public and most physicians favor the public option, but that doesn't make it into policy either.

More importantly, it's going agsinst the findings of the Congressionally-mandated study finding that abstinence-only sex education doesn't work.

They're not listening to either the public or the researchers they hired.