Ass Backwards
The media's silence about rampant anal sex. Sept 20, 2005

William Saletan

wrote about politics, science, technology, and other stuff for Slate Magazine. He’s the author of Bearing Right.

"Oral Sex Prevalent Among Teens," announced Friday's Washington Post. "A federal survey finds more than half of 15- to 19-year-olds have had oral sex," said the subhead in the Los Angeles Times. "Sex Survey Shocker; Concern as most American teens have had oral sex," cried the Boston Herald.

Across the United States—and beyond it—any newspaper that didn't focus on lesbianism in the sex survey (released last week by the National Center for Health Statistics) declared a crisis of oral sex among teens. Experts and journalists, unwilling to express plain old moral dismay at the idea of their kids doing the deed, cited its health risks. "Oral sex has been associated in clinical studies with several infections, including gonorrhea, syphilis, herpes and the human papilloma-virus," observed the Post. Teens "have not been given a strong enough message about the health risks of oral sex," an expert warned the Times. "We need to provide them with information about the public-health consequences," another expert told Time.

If only it were that simple. Talking to your kids about oral sex is the easy part. If you're going to be frank about the most dangerous widespread activity revealed in the survey, you're looking at the wrong end of the digestive tract.

There's no delicate way to put this, so I'll just quote the survey report: "For males, the proportion who have had anal sex with a female increases from 4.6 percent at age 15 to 34 percent at ages 22–24; for females, the proportion who have had anal sex with a male increases from 2.4 percent at age 15 to 32 percent at age 22–24." One in three women admits to having had anal sex by age 24. By ages 25 to 44, the percentages rise to 40 for men and 35 for women. And that's not counting the 3.7 percent of men aged 15 to 44 who've had anal sex with other men.

The last time major national surveys asked about this practice, in the early 1990s, only 20 percent of men aged 20 to 39 said they'd had anal sex with a woman in the preceding 10 years. Only 26 percent of men aged 18 to 59 said they'd ever done so. In the first survey, the 10-year limit excluded half the sexual career of half the sample, but that isn't enough to explain a doubling in the percentage saying yes. In the second survey, according to the current report, the inclusion of men aged 46 to 59 might have diluted the sample with "cohorts that were less likely to have had anal sex." But that's the point: Newer cohorts are more likely to have tried it.

Why does this matter? Because anal sex is far more dangerous than oral sex. According to data released earlier this year by the Centers for Disease Control, the probability of HIV acquisition by the receptive partner in unprotected oral sex with an HIV carrier is one per 10,000 acts. In vaginal sex, it's 10 per 10,000 acts. In anal sex, it's 50 per 10,000 acts. Do the math. Oral sex is 10 times safer than vaginal sex.

Anal sex is five times more dangerous than vaginal sex and 50 times more dangerous than oral sex.

Presumably, oral sex is far more frequent than anal sex. But are you confident it's 50 times more frequent?

A CDC fact sheet explains the risks of anal sex. First, "the lining of the rectum is thin and may allow the [HIV] virus to enter the body." Second, "condoms are more likely to break during anal sex than during vaginal sex." These risks don't just apply to HIV. According to the new survey report, the risk of transmission of other sexually transmitted diseases is likewise "higher for anal than for oral sex," and the risk "from oral sex is also believed to be lower than for vaginal intercourse."

If you live in Bergen County, N.J., congratulations. You get the only newspaper in the world that mentioned heterosexual anal sex, albeit briefly, in its write-up of the survey. Two other papers buried it in lines of statistics below their articles; the rest completely ignored it. Evidently anal sex is too icky to mention in print. But not too icky to have been tried by 35 percent of young women and 40 to 44 percent of young men—or to have killed some of them.

But if your moral standard for judging sex acts is the risk of disease, anal is worse than oral. The spin that activists, scholars, and journalists have put on the survey—that abstinence-only sex education is driving teenagers to an epidemic of oral sex—doesn't hold up. As the survey report notes, data "suggest that there was little or no change (accounting for sampling error) in the proportion of males 15-19 who had ever had heterosexual oral or anal sex between 1995 and 2002." The more interesting numbers are in the next age bracket up—and the next orifice down.

I understand why we fixate on the oral sex numbers. Even liberals can digest sexual revolutions only one taboo at a time. We think oral sex is the new frontier. We think talking about it in print and sex education classes makes us hip and candid. It doesn't.

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