Category Archives: Medical Stuff

Polyamory and Pregnancy: Contraception and Fertility

I removed gendered language from this post, cleaned up my phrasing and fixed a few typos. On a personal note, I gave up on abstinance eventually, and my fourth child is now a year old. I have plans to get an IUD this month, fingers crossed it works as advertised. After some debate I decided not to add detailed info on different contraceptive methods. This post is meant as a general overview of issues that can crop up in polyam relationships, and I think it does that well. Revised Feb 8, 2017.

Oops–one last thing. Please excuse all the ‘yelling’. I was apparently feeling very strongly about these issues when I wrote this post.

I touched on this one briefly in my discussion of unexpected pregnancies, but it probably deserves some special attention.

To start, I am not an expert on contraceptive methods, because once it was established that the most common methods don’t work for me, I pretty much stopped bothering, aside from using condoms. So I’m not going to be throwing around statistic this and study that. (If you are interested in what is more or less effective, WebMD has a comparison chart. In comparison, you are considered to have fertility problems if are trying to get pregnant for a year and can’t.)

Instead of going into those details, I’m going to be looking at some fundamentals of how contraceptives work, and how this can impact your polyamorous relationships. (Oh, and why is this under pregnancy? Because if you aren’t careful with your contraceptives, you are probably going to end up needing the rest of the pregnancy stuff sooner of later.)

Contraceptives

So . . . first off, the open secret of contraceptives that no one talks about: the person with internal genitalia is in control. Yup. It sucks, but it is true. Except for the most failure prone contraceptives (withdrawal and condoms), all contraceptive medication and devices are designed for people with internal genitalia. Which I’m sure many of us don’t see a problem with – it’s our bodies if we get pregnant. Kind of a foolish and one-sided view, but hey people are people. However, if you espouse that view, and you are polyam, stop and think for a minute how you feel about the fact that your partner with external genitalia has no access to effective contraceptives when with their other partners. Yup, it sucks.

Now, I am not saying that people with external genitalia are excused from responsibility for doing everything they can to protect against unplanned pregnancies. They damn well should be using condoms and doing everything possible to reduce the likelihood of pregnancy. But, reality is .  . .

However, if you have external genitalia you can still be involved in contraception. Ask the people you are involved with what kind of contraceptives they are using, be aware of their schedule, stay informed, if you know a person you are with is forgetful, bad with schedules, whatever, then offer to help them remember the next pill/shot/ring/whatever. Hell, if they are using the ring, make putting it in and taking it out a part of your sex play! Whatever it takes STAY THE FRICK INVOLVED.

And for those of us with internal genitalia, our externally-equipped partners have every fricking reason to want to be involved and aware of what we’re using and how effective it is. For the love of chocolate, do not tell them it is none of their business – if we get pregnant, it’s their kid too! Keep them aware, keep them informed, keep the communication going!

Fertility

Next up: fertility. Personally, I think if it’s affordable (which it isn’t for me or most people) everyone who can, should get their fertility levels checked at least once. Why? Because knowing how fertile you are has a big impact on what contraceptives you should consider and how much you need to worry. Me? I am walking fertility drug. I kid you not, my partner was told his sperm count was so low he was infertile, and I got pregnant. Same thing happened to two of my aunts. And my mother has had 11 pregnancies (6 full term) half of them on various kinds of birth control. I’m told that I am too fertile to get my frigging tubes tied! (I’d end up with ectopic pregnancies – not good.)

A friend of mine had to jump through hoops like a circus dog to get pregnant. If she’d known that years ago, she could have fretted a lot less about the possibility of becoming pregnant before she was ready.

Since fertility testing is so expensive, at the very least, do what you can to check the family history. That can give you some clue as to what you might be able to expect out of your little swimmers or floaters.

Tubal

Number 3: Getting your tubes tied is not a guarantee!!!! A female friend of my had her tubes cut and tied, and a uterine ablation (her UTERUS cauterized) and still got pregnant. A male friend of my mother’s? Had his tubes tied, got his wife pregnant – it turned out that he had THREE tubes, and they missed one. Again, if it’s possible, get your fertility checked after your tubes are tied if you want to be sure.

Plan B

Fourth and ten – three words MORNING AFTER PILL!!!!! If you have any reason to believe that your birth control may be off, may have failed or may just be fricking useless, stock up on this little gem. If you have it you can always choose not to use it. The reverse is entirely not true.

 

Now, folks with internal genitalia jumped on the pill with cries of ‘hallelujah!’ for a reason – overall, the thing works. Since its introduction, there have been thousands, if not millions of people who have happily made like rabbits for years without getting pregnant. My point here is not to be crying sexual Armageddon, and if you are one of those lucky stiffs who can take the pill regularly, have your fun for as long as you want, and then get pregnant as soon as you decide you are ready? My hat’s off to you (and as a side note, I hate you). But please be aware of the facts, options, and what not to make educated decisions about what you and your partners do.

As for me? I am fricking paranoid for a reason (see above), and I am abstaining until further notice. (Michael, the blessed saint, is willing to put up with it too!)

Educating Polyamory Friendly Professionals

Minor edits and updates. In the years since I first wrote this my family spent some time living in Tennessee. Still not problems from doctors and such about being polyamorous. Though it helped that we could pass as monogamous as the time. Polyamory is well known these days, so you are more likely to find random professionals who are familiar with it. Revised Dec 20, 2016

It comes up with near predictable regularity in polyam forums:

How do I find a polyamory friendly professional?

The polyamory friendly professionals list is always referenced, but there is an assumption we need to find professionals who are already polyam friendly. Which kind of bothers me. If we keep going to the same polyam friendly professionals, where will new polyam friendly professionals come from?

To be fair, CARAS does good work and is providing more education to professionals all the time, but they aren’t miracle workers. So rather than searching the friendly professionals list in vain for someone local, how about we start educating our own polyam friendly professionals?

Over the past seven years, I’ve discussed and explained my lifestyle to obs, midwives, lawyers, shrinks, social workers and god-help-me Children and Youth Services representatives. I have never once dealt someone from the polyam friendly professionals list, and only once did I ever have a problem.

Now, living within an hour’s drive of NYC my whole life means that I’ve probably had a lot better luck than I would have if I was living in the Bible-belt. But I’ve chatted with polyam-folk in forums who lived in the Bible belt and who never had problems.

Educating a professional about polyamory is surprisingly easy. I’ve found the upfront and open approach is best. Request a consultation, and say something like ‘So-and-so recommended that I come to you, that you are the best in the area. I am in a polyamorous relationship, where I am in relationships with ___ other people. I need to know if you can be accepting and supportive of this.’

In general, I’ve found 4 common responses to this introduction:

“I’ve never heard of it before, but I’m willing to learn.” – great, answer questions, refer them to the PolyResearchers group on Yahoo!, or whatever else you can do to help them understand.

“I’m afraid I can’t be supportive of a lifestyle that is clearly (fill in reason they disapprove)” – thank them for their time and leave.

Initially say they accept, then get passive-aggressive about it – only ran into this once. I’m not sure if she honestly didn’t realize how much her bias’ were affecting her behavior, or was just an a—hole. Either way, these are the most annoying IMO b/c of the way they waste your time.

“Oh – like that show Sister Wives/Big Love. Sure, I have no problem with that.” – I just started running into this in the past year or two. In general, you can work really well with a professional who has this reaction. They are likely to be open-minded and accepting. However, you may need to deal with some misinformation on their part. Also, sometimes they want to hear how your relationship is different from the one they see on TV. Of course, sometimes it doesn’t matter either.

Resources for educating your local own polyamory friendly professionals:

Resources for educating your local own polyamory friendly professionals:

CARAS – CARAS is dedicated to the support and promotion of excellence in the study of alternative sexualities, and the dissemination of research results to the alternative sexuality communities, the public, and the research community.

What Therapists Should Know About Polyamory – article introducing what polyamory is, how it is practiced and some of the psych studies on polyamory over the past several decades. Written for therapists, but can be useful for family doctors/primary care physicians

Yahoo! PolyResearcher’s Group – this is a great place that your professional can go and ask questions. The group includes over three hundred members in varying fields of study. A great resource for anyone wanting to learn about current research in polyamory.

NCFS – the national coalition for sexual freedom should be a great resource and is the group that sponsored the article What Therapists Should Know About Polyamory, but in general while they support polyamory in theory, they are more focused on support for the BDSM community. Hard to blame them when kinksters are in danger of going to jail for their sexuality. The one area where I have found NCFS to be helpful in polyam situations is legal stuff. They may provide a lawyer with references, precedents, and research relevant to a legal case where your lifestyle is an issue. I understand that some of NCFS’ board members are moving to have more of a focus on polyamory and non-monogamy in the future.

Polyamory and Pregnancy: Prenatal Care

Another post with minor grammar edits. Nothing much has changed in prenatal care in the last five years, as my pregnancy last year demonstrated. Updated: Dec 13, 2016

Dealing with medical stuff and polyamory can be a pain in the neck when you aren’t dealing with the stress of a new pregnancy. When you are? Well, stupid rules and regulations + hormone swings can make doctors look like very good targets.

With luck, you already have an ob/gyn who is familiar with your lifestyle and is willing to include all your partners in your prenatal care. If you aren’t already seeing a poly-friendly professional, you may need to do a little searching and a little educating.

My best experience was a home birth with a nurse practitioner midwife. She accepted our relationship without a qualm, included both my partners in all our consultations. when the baby was born, one caught and the other cut the umbilical cord.

Midwife-assisted home birth gives you control. In a hospital, you need to deal with their rules and regulations. Since midwife-assisted home birth is just as safe for low-risk pregnancies than hospital birth, it is something you may want to consider. (Actually, some studies have shown midwife assisted high-risk births in the hospital have better outcomes than obstetrician assisted, but you’re in the hospital either way.)

The biggest problem of a hospital birth from a polyam-perspective is many hospitals limit the number of people who can attend the birth. If you have a number of partners or a large poly family, this can leave you needing to choose who will be there with you, and who won’t.

That said, please, please please, put your and your baby’s safety first.

Ultrasounds and any other medical test often have the same problem—hospital or clinic limits on people who can be with you. Hard to blame them in a way—I’ve known people who would have crowded their entire extended family in to see the ultrasound! And there just isn’t that much space in the ultrasound rooms. But it can leave a polyam mom in a tough position.

The best advice I have on this one is to talk with your partners and your doctor. If your doctor understands your relationship and is willing to work with you then you shouldn’t have too many problems. And there is a good chance that if you have a big polycule, not everyone will be as interested in going to ultrasounds and what-not. Some people just don’t see the fascination in smudgy black and white pictures on a screen. Don’t feel bad if some of your partners feel that way. Include them in what they want to be a part of, and be glad that you don’t need to leave someone out who wants to be there with you.

All in all, mixing non-standard relationships and medical protocol can always be a hassle, but with prenatal care, it may be then you may fear. Which means you can focus on taking care of mommy and baby.

Originally posted July 14, 2011.

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Mental Illness and Polyamory Recap

This blog series is already one of the longest I’ve written, and I’m about to add a bunch more information. So before we dive back in I decided it would be good to do a quick recap of the key points of the series so far.

Educate Yourself

If one of your poly partners suffers from mental illness, take the time to learn about their illness and how it affects them. This includes both reading up on the general information about the illness and learning about how your partner experiences their illness.

There is No Quick Cure

Mental illness is not something people can just “get over” and there is no fast treatment or cure. Medication can help manage mental illness but is NOT a cure or fix. And just finding the right treatment approach can take months, if not years.

Mental Illness Can Mimic Relationship Problems

Mental illness can mimic jealousy, abuse, loss of interest, and a number of other relationship problems and red flags. Treating mental illness like relationship problems just compounds the problem. Treat mental illness like mental illness and relationship problems like relationship problems.

The Big Book of Poly Doesn’t Always Apply

There’s a lot of great advice for folks in poly relationships. However, some of that advice doesn’t work when combined with mental illness. Following the standard polyamory advice may not work or may even make things worse. If this happens it doesn’t mean you/your partner are bad at poly. It just means advice formulated by and for mentally healthy people doesn’t always apply when dealing with mental illness.

Sometimes Mental Illness Isn’t

Michon Neal shared a horrific experience of being misdiagnosed and having physical illness dismissed as “all in zir head” and mental illness. In Michon’s case the problem was compounded by the way doctors tend to overlook or dismiss all black women’s problems as mental illness.

For Michon this meant, ze was not only NOT getting the treatment ze needed, but was put on unnecessary medications with severe adverse effects. Nearly as harmful is when the wrong mental illness is diagnosed. Depression and bipolar may seem similar from the outside, but the respond very differently to treatment. Bipolar and schizophrenia are often mistaken for each other.

Irrational Feelings Are Still Feelings

Mental illness makes people feel things that have no basis in reality. Telling someone feeling abandoned because of depression “You are wrong to feel that way!” or “how dare you say I don’t do enough!” or anything like this doesn’t help anyone. That doesn’t mean you should try to fix problems that don’t exist. But understanding and empathy go a long way. “I’m sorry you feel that way. I hope you know that I love you and would never abandon you. Would cuddling for a bit help?”

This post is part of the Polyamory and Mental Illness blog series.

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Safe Sex and STIs Wrap Up

Okay folks, that’s about it for the very lengthy Safe Sex and STIs blog series. If you have any questions I haven’t answered, contact me or leave a comment.

We may have a guest post next week. If not, I’ll be picking up Polyamory and Mental Illness.

Defining Safe Sex

Last week I said safe sex means different things to different people. On a personal level, that means each of us needs to define safe sex for ourselves. Today we’re going to walk through defining safe sex. What is means to you, and how you can take steps to keep yourself safe while enjoying the sex life that suits you.

How Safe Do You Want to Be?

An Indie driver and a commuter both try to be safe when they drive–but what an Indie drive considers “safe” most commuters would consider suicidal. Race car drivers wear fire-proof undies for a reason.

Do you want to be completely protected from any risk of STIs? Are you comfortable with maybe getting herpes but want to be sure you are safe from HIV? Maybe you know your statistics and just want to get tested once in a while so you can get treated for anything early.

In addition to STIs, there is also pregnancy. Unlike STIs, how protected you want to be when it comes to pregnancy may vary from partner to partner.

As far as pregnancy goes you can opt entirely by never putting penis and vulva together. Or (slightly less extreme) never have PIV and except the infinitesimal risk that sometimes comes with getting semen on the outside of the vulva.

You can use various forms of birth control, which has more risk that not having PIV sex at all, but way less risk than going without birth control.

Or you can say fuck it, I don’t care about starting a pregnancy (or fuck it I WANT to start a pregnancy) and go for all the PIV sex with no birth control.

STIs are complicated–maybe there are some STIs you are willing to risk (Personally, I don’t give a fuck about herpes) but others you want to be protected from. What protects against some STIs won’t offer protection against others.

In general terms, you can choose not to have genital contact at all, and that will reduce your chance of getting STIs to almost nothing. (Sexually transmitted infections can be transmitted other ways–they aren’t exclusive to sex. For most STIs however, non-sexual transmission is rare.)

You can only have genital contact with people who get tested regularly and weren’t infected at the time they got tested. This offers significant protection, but not perfect protection. The more frequently you and your sex partners connect with new sex partners, the less protection it gives.

You can use barrier methods such as condoms and dental dams. This provides some protection against some STIs. It provides significant protection against HIV and Hep B, two of the STIs that are the most worrisome in terms of treatment and long-term impact.

You can combine STI tests and barrier method for more protection than either alone.

You and your partners can do visual checks of each other for outward signs of infection, which provides some protection against a few STIs.

You can not worry about protection for most STIs ahead of time. Truvada will protect you against HIV.

You can just get tested yourself regularly so you can catch and treat any infections early.

Which of these options sounds like “safe sex” to you?

Once you have a general idea of how you would define safe sex, it’s time to do some research. Learn about the different STIs and how they are transmitted. Learn about different birth control options. As you learn, you are further defining safe sex for yourself.

Maybe you started with wanting the protection that comes from only having sex with partners who test regularly and test STI negative. But as you learn more you decide that you really aren’t concerned about herpes and genital warts, so you’re comfortable being with a sexual partner who has either one of those STIs. Maybe you aren’t worried about barrier methods as protection from STIs, but as you learn about birth control options you decide that you definitely want to use condoms in addition to any hormonal birth control. That extra protection is reassuring.

Make sure you take the time to talk with your partner(s) about how they define safe sex. You don’t need to agree, you do need to respect each other’s definitions. Always remember that people need to be able to consent to risks. Don’t put your partner at risk in ways they don’t consent to, and if a partner puts you at risk without your consent, it’s time to get out of that relationship.

This post is part of the Safe SEx and Polyamory blog series.

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Everyone’s Safe Sex Definition is Different

A few weeks ago, I said that safe sex is like safe driving. You do your best to keep yourself safe and take reasonable precautions, but there are no guaranteeing. Sex is like driving in another way. Some people are comfortable driving in Le Mans and the Indie 500, some won’t go over 55 mph on the freeway, and some won’t drive at all. Safe driving for someone running the Indie is going to be a bit different from safe driving for someone on the freeway. And if no driving is safe enough for you, that’s why there are bicycles and trains.

The definition of “safe driving” depends on who you are talking with. Defining “safe sex” is the same.

Reid Mikhalo openly identifies as a slut. You might call him a race car driver in the world of safe sex. He’s comfortable with a much lower level of safety than many people, but it’s safe enough for him. Me? I’m comfortable on the freeway. I’m not overly worried about STIs, but I want to take reasonable precautions. You might catch me pushing 70 mph sometimes, but I try to keep it around 65*. My partner Michael has an extremely low comfort with risk. When it comes to sex, he’ll drive around town, but no way in hell is he getting on the highway.

Each of us has learned about safe sex, the risks involved in sex, and decide for ourselves how to define “safe sex.” All of us accept some risk in order to have the joy of sharing our bodies with our partners. All of us have different levels of risk we are comfortable with.

Of course, like safe driving, defining safe sex effects other people. A race car driver may go over 200 mph on the Indie, surrounded by other race car drivers. When they’re on the freeway, they usually keep the posted speed limit. They know that folks driving on the freeway aren’t prepared for racing style driving–among other things they don’t usually have Nomex underwear. In the same way, we need to think about not just the amount of safety we need to feel comfortable, but the amount of safety our partners need.

Michael’s low-risk level impacts my sex life. His boundaries are pretty clear, and if I pop on the sexual highway he will not be comfortable continuing our sexual relationship. That chafes at me.

Don’t get me wrong, there is some beautiful scenery on those back roads, and I love sharing it with him and other folks who are comfortable keeping it slow. But that highway is damn tempting. Sometimes I want to take Michael and shake him. “It’s just a highway!” I want to say, “People drive on it safely every day!”

But it is his choice and his right to set the safety level he is comfortable with. I can choose to keep to his speed, or I choose to strike out on my own. What I can’t do is bully, badger or shame him for his choice.

Which is why, should the opportunity arise, I will not be revving it up to 90 and jumping into bed with the very sexy Reid Mikhalo.

Obviously, it is easier to be in a relationship with people who have similar comfort levels to your own.

Sadly, it is also very easy to fall into the trap of shaming people for having different comfort levels. Attacking people as “promiscuous” or “prude” is a part of monogamous culture (at least in the US), that we really need to leave behind. People have reasons for the way they define “safe sex.” You don’t need to agree with their reasons. You don’t need to like their reasons. You don’t even need to know their reasons.

You only need to do three things:

  • Decide what your safe sex definition
  • Set your own boundaries based on that definition.
  • Respect the boundaries of other people.

Setting your safe sex definition is the first step. If you haven’t done it yet, now’s a pretty good time to start.

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This post is part of the Safe Sex and STIs blog series.

*The normal speed limit for freeways on the East Coast of the US.

Zika Virus: A New STI?

Over the past several months, new reports in the US have focused on a “new” threat: the zika virus. Until recently, zika was believed to be transmitted only by mosquitoes, but there is now new evidence for sexual transmission.

Some History

The zika virus has been around at least since the 1950s. It was originally found in rhesus monkeys in the equatorial regions of Africa and Asia. Very rarely it was spread to humans in the region. Sometime in the early 2000s it made the jump to humans as a preferred host and began spreading. Between 2007 and 2014 the virus spread through Micronesia and Oceania before appearing in the South America in 2014. From South America it spread north, and the first cases appeared in the US in 2015.

Symptoms

Zika fever, caused by the virus is usually very mild. Headache, rash and fever are common symptoms. It is estimated that 1 in 5 people infected with the zika virus develop zika fever.

Long Term Complications

Since the zika virus appeared in Brazil there has been spike in cases of microcephaly. Microcephaly is defined as a skull that is within less than 2 standard deviations of normal for size and age. In other words, a skull that is too small for the brain to develop properly. Children with microcephaly frequently suffer from neurological disorders and shorter lifespan.

We do not know if zika causes microcephaly. At this time, scientists have proven that it is possible for zika to be transmitted from mother to fetus. This means that zika may be the cause of these birth defects. Other possible causes have been proposed. It is notable that increases in microcephaly are not being reported in other areas with the zika virus. For the time being, governments in South American countries with zika infections are advising their people to avoid pregnancies until the epidemic is under control.

Zika fever also appears to be connected to the development of Guillain–Barré syndrome in adults.

TransmissionUpdate May 12, 2016

Scientists have recently determined how the zika virus causes birth defects. We can now say with certainty that zika causes birth defects, and is most damaging during the early stages of pregnancy.

HIV PrEP: Truvada

Of all the sexually transmitted infections out there, HIV is the biggest concern for most people. That’s why in the US the FDA’s approval of a drug to help prevent HIV infection was greeted with such relief. Several other countries have also approved Truvada to help prevent the spread of HIV.

Truvada is the first medication approved as a pre-exposure prophalyxis (PrEP) for HIV. That means taking Truvada before being exposed to HIV protects you against infection.

Truvada is actually a combination of medications. Tenofovir and emtricitabine are both anti-retroviral drugs which have been used to treat HIV/AIDS for years. They are most often used in combination with protase inhibitors, which use a different biochemical process to attack HIV.

For people who are not infected with HIV, but might be exposed, Truvada is believed to offer significant risk reduction. However it has some rare adverse effects that are extremely damaging. For this reason, the FDA recommends it only for people who are at high risk of infections:

  • Gay or bisexual men who have either have had anal sex without a condom or been diagnosed with an STD in the past 6 months
  • Heterosexual men or women who do not regularly use condoms during sex with partners of unknown HIV status who are substantial risk
  • Injection of illicit drugs in the last month with sharing of equipment
  • Discordant heterosexual and homosexual partners where one partner is HIV-positive and the other HIV-negative

Taking Truvada consistently can reduce your risks by up to 92%. However PrEP is like the birth control pill. Not taking it consistently leaves you unprotected. Benefits of taking Truvada take affect after 72 hours on the medication. It is necessary to continue taking Truvada for 30 days after a high risk exposure to be sure HIV transmission levels stay reduced.

Your doctor will not prescribe Truvada unless you have tested HIV negative in the past month. While on Truvada you will need to be tested regularly, and if you do become infected with HIV will need to stop taking Truvada immediately.

This is very important. Anyone taking Truvada during stage 1 of an HIV infection is putting themselves at risk of developing a drug resistant strain of HIV. This means during later stages, when you actually need the medications, they won’t work.

As I mentioned before, Truvada has some risks associated with it. If you look up side effects of Truvada you will get a long and scary list of potential side effects. It is important to realize that this list is a combination. It includes side effects of taking Truvada in combination with other drugs for treatment of HIV/AIDs and side effects of taking Truvada as PrEP. The most common reported side effects for taking Truvada as PrEP are headache, abdominal pain, and decreased weight. Truvada can in rare circumstances cause loss of renal function. People taking PrEP are advised to get their renal function tested every 3-6 months while on Truvada.

Whether or not Truvada is of benefit to someone in a polyamorous relationship will largely depend on your approach to safe sex. If you take a low risk approach–only having sex with people who are tested regularly for STIs, using condoms, etc, Truvada is probably not right for you. If you are comfortable with a high risk approach to safe sex–going bareback with multiple partners, getting tested infrequently or having sex with new partners often enough that testing is not effective for protection, than Truvada may be a good idea. As always, talk with your doctor, I am not an expert.

Standard Disclaimer

This post is part of the Safe Sex and STIs blog series.

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Safe Sex Vs Safer Sex

I don’t know about the rest of the world, but in the US over the past ten years or so, it has become common to speak of “safer sex” instead of “safe sex.” The idea, apparently, is that sex is never 100% safe, no matter how careful you are there is always the risk of getting an STI or someone getting pregnant, and, therefore, it is misleading to speak of “safe sex,” we should always and only speak of “safer sex.”

I’m calling bullshit.

When I was learning to drive I didn’t take a “safer driving” course, I took a safe driving course. The mandatory certificate for food handlers is called ServeSafe, not “ServeSafer.” Neither driving nor food handling can ever be made 100% safe. In the case of driving, because no matter how careful you are, some other idiot on the road can ram into you. In the case of food, because if the spinach came into your kitchen with e coli already on it, no matter how carefully you wash the leaves, someone might get sick from your salad.

In every similar context, American English is happy to use “safe” to mean “making the best effort to be safe.” But suddenly, when it comes to sex, “safe” can only be used to mean “100% without risk.”

Folks, show me anything 100% without risk and I will show you where you are wrong. Life doesn’t work that way. But in the rest of life, we are comfortable saying, “Yes, there is risk, I accept that and do my best to reduce the risk.” The push to use “safer sex” is coming from the same sex shaming viewpoint as the pamphlets at the local anti-abortion place that tell people you should never have sex outside of monogamous marriage or you might get an STI.

Like I said at the beginning, this may be just a US thing. God knows we have sex stigma to spare here. But it needs to stop. Which is why throughout this blog series I talk about safe sex. Not safer sex.

This post is part of the Safe Sex and STIs blog series.