Question: In a previous column you spoke against premarital sex. This recommendation might be good for teenagers, but once someone is an adult is there really any harm? You seem way out of step on this.
Answer: You are not alone in your opinion. Surveys indicate that the majority of people, somewhere around 80 percent, believe that premarital sex is acceptable when feelings of love exist between two adults. Indeed, many believe that sex before marriage is helpful in determining a couple's compatibility before committing to a lifelong relationship. They reason that if the sexual relationship is good there will be fewer problems after they're married.
At the risk of seeming prudish and unenlightened, I maintain a contrary position on this. To my knowledge, there's no data that supports the idea that good premarital sex helps avoid divorce. In fact, there is some limited information that suggests a higher divorce rate among those who have been sexually active before marriage.
Regardless, there are many reasons why premarital sex is unwise, unhealthy and sometimes even dangerous, for adults as well as teenagers. Of the several reasons that could be discussed, I'll mention four:
1. The most obvious consequence of premarital sex is unwanted pregnancy. This is currently a huge problem in our society, with effects I have witnessed hundreds of times. Sadly, about one-third of the babies born in the United States are born to single women.
The arrival of a newborn baby in the life of a single woman changes the direction of her life forever, mostly for the worse. Single mothers struggle with far greater financial and social stressors than those experienced by married women and can commonly lead to child neglect and abuse, a dependence upon state and federal welfare and a downward spiral of poverty and deprivation, from which many women never recover.
2. Another physical consequence of premarital sex is sexually transmitted diseases (STDs). Each year more than 10 million people are diagnosed with an STD. Even more go undiagnosed. Some of these infections have dramatic repercussions, including infertility and death.
Of course, many health experts state we wouldn't have a problem if people just used "safe sex." However, safe sex is a myth. There is no completely safe sex except for mutual lifelong monogamy. Why? Because safe sex is dependent on two factors: knowing your partner (which ostensibly helps you avoid contact with an infected person) and using condoms (which is intended to prevent transmission if one partner has an infection).
But knowing your partner and using condoms successfully is not possible in the real world. Knowing your partner depends on asking a detailed sexual history of all prospective sexual partners, something that is difficult to do.
And even if you do ask, you have no way of knowing whether you're getting the straight scoop. Prospective sexual partners often lie about their sexual histories in order to avoid rejection. In other cases, prospective partners believe they're free of disease but really are not. This is especially true for such viral STDs as papilloma virus and HIV.
The other arm of safe sex is condom use, but condoms are not foolproof. Ten percent of couples who use condoms get pregnant because the condoms break or are not used properly. It seems incongruous to expect condoms to prevent STD transmission when they fail so often as a contraceptive modality!
3. Premarital sex also has emotional consequences, which are less tangible but no less damaging. These include self-loathing, guilt and depression following the breakup of a sexual relationship or when one feels manipulated just for sex. It can also provoke a tendency to jump into other sexual relationships in an attempt to make right what was wrong, thus creating a destructive cycle that is repeated over and over.
4. Those who are involved sexually often have difficulty evaluating their relationship on an objective basis. High emotions cloud rational thinking and make it hard to walk away from a bad relationship. Some men and women even marry because of "good sex," not because they think it's the best or right thing to do. That's certainly not the basis for a lasting lifelong relationship.
Adults are not immune to any of these consequences. I've had patients in their 40s with unwanted pregnancies and in their 70s with STDs. Anyone who makes poor choices has to endure the consequences — and the consequences are no respecters of age.
Stephen Lamb practices OB/GYN at the Millcreek Women's Center in Salt Lake City. He is also the co-author of "Between Husband and Wife." E-MAIL: slamb@desnews.com