America’s Failing Sexual Health

America’s Failing Sexual Health


The increase in the rates of STDs, HIV-AIDS and pregnancy among young women indicates that America has yet to overcome the tyranny of rightwing, Christian anti-sex values. The poor and young women are the proverbial ‘canary in the coal mine’ in America’s emerging sex-health crisis, says David Rosen.


America is schizophrenic about sex. On one level, a multibillion dollar porn, advertising and popular-entertainment industry caters to every imaginable sexual taste and fantasy. On the other, the religious right endlessly rails against the evils of illicit sexual pleasure. Against this kabuki performance, an unacknowledged crisis of nation’s sexual health is taking place.

Obama inherited a nation in crisis. A mounting fiscal crisis shadowed the ’08 campaign like a growing hurricane and climaxed as voters went to the polls. They cast their votes for him in large measure because they believed he was not, like McCain, a reincarnated Bush. Shorn of his evangelical Cowboy inarticulateness, with regard to banking, health insurance and war, Obama seems but a pale shadow of Bush’s corporatist outlook.

The crisis over the nation’s sexual health stems from the Christian right’s fear of sexual pleasure. It is expressed in the right’s deep-seated opposition to women’s reproductive health (particularly the right to an abortion), its adherence to teen abstinence-only polices, its acceptance of increased reported cases of STDs and AIDS and its admonitions over the increase in pregnancies among teen girls and young women.

In place of humane policies to address these and other sexual-health issues, the Bush presidency offered only moralistic judgments. Hidden in these judgments was a fundamentalist belief that the suffering resulting from personal problems relating to sexual life, especially resulting from sex occurring outside of heterosexual marriage, was a sign of God’s vengeance: One gets what one deserves.

Many hoped that Obama and the Democrats would bring a more humane set of values to the policies of sexual health. They may yet.

Congress’ adoption of the Stupak amendment to the health-insurance “reform” bill (H.R. 3962) reveals the deepening crisis over sexuality. The amendment, engineered by Michigan Democrat Bart Stupak, further restricts a woman’s right to a safe, medically sanctioned and legal abortion. It was a brilliant maneuver by anti-choice forces that (apparently) caught the Democratic leadership with its proverbial pants down.

The issue of federal support for abortion was surely going to be a battleground in the Democrats’ effort to pass national health-insurance reform. While Roe remains the law of the land, the Christian right has mobilized for the last three-and-a-half decades to systematically restrict access to legal abortions. The Christian right embraces Republicans and Democrats, conservative and Blue Dogs; Stupak is associate the rightwing cabal, the Family, the evangelical Christian version of the Catholic Opus Dei.

Adding insult to injury, 64 Democrats voted for the amendment. They seem to have forgotten what Supreme Court Justice Ruth Bader Ginsberg acknowledged: the right to an abortion is at the “center of a woman’s autonomy to determine her life’s course, and thus to enjoy equal citizenship status.”

Other sex-related issues are part of the health-insurance legislation but garnered far less attention. These include:

Support for sex education. Under the Senate bill, two provisions are included that seem at odds with each other, the result of classic political compromise. One would allocate $75 million a year for comprehensive sex education or more secular “sex ed.” The other would allocate $50 million a year for abstinence education; the bill would reauthorize the Title V abstinence program that expired this summer. Under the Senate bill, there will be support for school based “health clinics.”

(Not surprising, Obama’s proposed budget for FY 2010 significantly shifts funding for sex education from abstinence-only programs to pregnancy prevention programs. Yet, in keeping with his “bi-partisanship,” the budget proposal includes a provision permitting those backing abstinence-only programs to receive funding.)

Support for pregnancy prevention. The House bill includes the “Healthy Teen Initiative to Prevent Teen Pregnancy” provision that creates a federal grant program to support “evidence based” programs that aim to reduce teen pregnancies; abstinence is not listed as an “evidence based” program.

Support for domestic partner tax benefits. The House bill incorporates the language of the proposed “Tax Equity for Health Plan Beneficiaries Act” which would apply marital-type tax advantages to same-sex couples. Under the bill, employees who have domestic partners would be treated the same as spouses.

Support for greater HIV-AIDS prevention. The House bill incorporates the “Early Treatment for HIV Act” that “would permit state Medicaid programs to provide HIV treatment to individuals before they develop AIDS.” It would extend the Social Security Act to give states the option of covering low-income people.

In keeping with the fear mongering over claims of “death panels,” the right has come out against these modest programs. Rep. Michele Bachmann (R-MN) warned that school health clinics would offer abortions to students. Matt Barber, director of cultural affairs with Liberty Counsel, a conservative legal group, claims that “cosmetic ‘gender reassignment’ surgeries for both US citizens and illegal immigrants who suffer from [the American Psychiatric Association] recognized ‘Gender Identity Disorder’ (GID) may also be provided – free of charge – courtesy of the US taxpayer. The current price tag for such a procedure can exceed $50,000.”

Americans for Truth about Homosexuality rails against what it sees as the encroachment of the “gay lobby.” It warns that the adoption of analytic categories like “sexual orientation” and “gender identity” will undermine the nation’s moral order: These terms “promot[e] the fiction, especially among schoolchildren, that homosexual behavior is natural and poses no health risks, admits here that the behavior involves unique health problems.”

One can only hope that the modest provisions supporting sex health and education will not suffer the same fate as abortion when the final heath-insurance bill makes its was through the reconciliation process.

The sexual health of the nation is in crisis and why should it not be so? The “Great Recession” combined with the “Great Imperialists Folly,” the military misadventure that started in Afghanistan, moved to Iraq and is now spreading to Pakistan (will Egypt be next?), is having innumerable fallouts. How, in a society marked by escalating levels of unemployment, bankruptcies, foreclosures, homelessness and domestic violence, could one not expect sexual life to reflect the crisis? The current rise in STDs, teen pregnancy and HIV-AIDS rates are indicators of this crisis.

In the decade between 1997 and 2005, the level of sexual transmitted diseases (including syphilis, chlamydia and gonorrhea) jumped by 55 percent (to 1.4 million from 0.94 million). According to the CDC [Centers for Disease Control and Prevention], there were 1.5 million reported STD cases in 2008. Most disturbing, adolescent girls aged 15–19 years accounted for 409,531 chlamydia and gonorrhea cases. Compound this situation, African-Americans, representing 12 percent of the US population, accounted for about 71 percent of reported gonorrhea cases and almost half of all chlamydia and syphilis cases.

Teen pregnancies are on the rise. The Guttmacher Institute reports that there were a total of 1 million pregnancies (i.e., births, abortions and miscarriages) by teen females 15-19 years in 1990; in 2002, teen pregnancies had fallen to 746,800. Most troubling, the Federal Interagency Forum on Child and Family Statistics finds that teen pregnancies rose between 2005 and 2006, especially among teen girls (like Sarah Palin’s daughter, Bristol, who was pregnant at 16 years) between the ages 15-17 years.

HIV-AIDS is on the rise. In 2007, there were approximately 1.2 million reported cases. However, the CDC reports that the rates of AIDS cases among males aged 15-24 years increased during 1997-2006. It states unequivocally: “The HIV/AIDS epidemic in African American communities is a continuing public health crisis for the United States. At the end of 2006 there were an estimated 1.1 million people living with HIV infection, of which almost half (46%) were black/African American.”

The increase in the rates of STDs, HIV-AIDS and pregnancy among young women indicates that America has yet to overcome the tyranny of rightwing, Christian anti-sex values that were implemented under the Bush administration “abstinence” policies. Women, the poor (especially African-Americans) and young women are the proverbial “canary in the coal mine” in America’s emerging sex-health crisis.

Since the Civil War, the Christian right only once previously had as much power as it exercised under Bush. This occurred in the ‘20s, when the temperance movement, anti-immigrationists, the KKK and eugenicists pushed through the 18th Amendment establishing Prohibition, celebrated their whiteness in lynchings and backed the casino capitalism that catapulted the nation into the Great Depression. One can only wonder if nothing less than another and still-greater depression combined with a genuine “world war” are the only forces that can truly suppress the Christian right.

The stench of the Bush administration, like a desiccating carcass, continues to suffocate today’s possibilities. The term “crisis” seems inadequate to capture the magnitude of social dislocation bequeathed by the Bush presidency: an historically unprecedented catastrophe of finance capital; escalating levels of unemployment, bankruptcies, foreclosures, homelessness and domestic violence; a mounting health-care crisis; two foundering foreign military occupations; an enraged and well-armed rightwing populous; and a growing gap between the rich and the poor. Only Herbert Hoover may have bequeathed his successor as desperate a legacy

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