Condoms not always safe - Guest Blog Print

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The following post is a letter to the editor published October 25, 2012, in The Moultrie Observer. It is posted here by permission of the author, Patricia Lee June, M.D., a pediatrician practicing in Moultrie, Georgia and member of the PPL Board of Directors.

Dear Editor:

Recently, a Rant and Raver in a comment mistitled "Safe Sex" asked, "What's so bad about a student having a condom? With a condom, the student is hopefully having safer sex. Without the condom, do you really think the student is abstaining?"

Certainly the risks of a student (or other unmarried person) having sex with a condom are less than without a condom, but that does not mean that having sex with a condom is not "so bad" or by any means "safe", nor should we assume that no students are abstaining from sex.

What are the possible consequences of having sex outside of marriage, assuming that a condom is used? I will address my comments to the parents of the boy.

1. Pregnancy. Although ideal efficacies of condoms in preventing pregnancy in adults are as high as 95%, among teens under age 18, the failure rate (risk of causing a pregnancy within one year) is 20%. Nearly 39% of teens did not use a condom at last sexual encounter in 2009, and usage is actually lower among the older teens. Does your son also expect the girl(s) he has sex with to be on birth control? No hormonal birth control method is without potential side effects, including increased risk of blood clots, strokes, cancer, and osteoporosis (weak bones that could result in hip fractures many years in the future).

While there are some medical indications for birth control pills, is your son intentionally unnecessarily putting a girl at risk for these side effects? Nor is the pill that effective among teens: 20% of 12-18 year old girls using the pill become pregnant within 6 months.

What if your son does father a child? While some may think of abortion as an easy way out, it not only kills an innocent baby created in the image of God, it also causes psychological distress in men as well as in women. Additionally, he is also putting his girlfriend at risk: compared to childbirth, abortion causes higher death rates among women for up to 7 years thereafter from suicide, homicide, heart disease (possibly brought on by stress), and accidents. It increases her risk of alcohol and drug abuse. It also puts her future children at risk of premature birth, and possibly increases her risk of developing breast cancer.

Fathers are financially responsible for the support of their children until they are 18 years old. Sure, your child will be eligible for Medicaid, but even if that does not cost you anything, you are expecting other people to bear the cost of your choosing to have sex. There is also a lot more cost involved in raising a child than just medical bills. Your may have to cut your education short. Consider, too, that teen marriages preceded by pregnancy seldom last long. Children raised in a home without their father are more likely to drop out of school, commit crimes and go to jail, themselves become pregnant outside of marriage, themselves get divorced.

Single parenthood is the leading cause of poverty in the US. Almost all the children I see in my practice with major behavior problems do not live with their fathers.

2. Sexually transmitted infections (STIs). Condoms offer partial protection against some STIs, but less than is commonly assumed. Even with consistent use of condoms, 1 in 7 HIV positive people will transmit the infection to their sexual partner in a year.

Condoms are less effective in preventing transmission of other diseases: about 70% for HPV that may not bother your circumcised son, but could result in cancer of the cervix in girls he infects (and if it comes in contact with the mouth can cause cancer of the mouth and throat in men and women); about 50% for gonorrhea or Chlamydia, diseases that may case a discharge in boys and girls, or abdominal infection mimicking appendicitis in girls he may infect, or sterility in him or the girl, or if may scar down her tubes partially and result in a tubal pregnancy later, resulting in the death of her child and may endanger her life.

While condoms may prevent some Herpes, they may also occur in areas not covered by a condom. Your son can transmit an STI he does not know he has – causing the girl(s) he infect(s) disproportionate suffering.

Thirty percent of 12-18 year old girls using condoms and other contraception acquired an STI within 6 months.

3. Depression and suicide. Sexually active boys are twice as likely to be depressed as their virgin friends (3 times for girls) and 8 times as likely to have attempted suicide (3 times for girls).

4. School performance. White teen boys do worse in school for an average of 2 years after starting to have sex. This can affect college prospects and have a lifelong effect on educational achievement and earning potential.

5. Sex affects the brain and can be addictive, causing a dopamine high that rewards risky behavior. Vasopressin in the male and oxytocin in the female are released during sex, causing bonding. When bonds are repeatedly formed and broken through sexual relationships with multiple partners, they form a pattern in the brain making it more difficult to form permanent bonds in the future – leading to an increased incidence of divorce.

Future children, even those born years later during marriage, are more likely to suffer from broken homes, emotional upheaval, and poverty.

The number of teens who abstain from sex dropped dramatically from after the "Sexual Revolution" that started in California in the 1960s until about 1991, but in the last 2 decades teens are learning not to make the same mistakes that many of their parents made and are increasingly choosing to wait to have sex. In 1988, 40% of teen boys and 49% of teen girls were virgins (the double standard was still alive); by 2006-10 58% of teen boys and 57% of girls were virgins (72% of 15-17 year olds and 36% of 18-19 year olds).

It is clear that non-marital sex, even with condoms, can have numerous detrimental consequences, and we need to teach our youth that it is not enough to wait until after high school, but that there are risks to non-marital sex for "adults" also.

Most non-marital births and most abortions occur among 20-24 year olds. Cohabitation increases the risk of later divorce and of partner violence. Divorce is lowest among those who waited to have sex until marriage.

Don't shortchange our students by promoting condoms rather than abstinence until marriage.

Patricia Lee June, M.D.