Over the weekend, we linked to reports on the presentation of a study in our Twitter feed and on our Facebook about the effect of sex during adolescence on academics, such as college goals, grade point average, dropout, truancy and absentee rates. On Sunday and Monday, the piece got a whole lot of media and internet airplay, even though it was clear few, if any, reporting on it had yet looked at the study itself.
This morning, we were able to sit down and read the study, Sex and School: Adolescent Sexual Intercourse and Education (Bill McCarthy, Sociology, University of California Davis and Eric Grodsky, Sociology, University of Minnesota), which Bill McCarthy graciously emailed us when we requested it, and he also graciously answered a few of my questions about it directly. We're going to have a larger conversation with them soon that we'll publish here, but as that may take a while, we wanted to clear some of the smoke before it got much thicker. It's a solid study with some important and interesting information, a whole lot of which is either being misreported or not reported on at all.
It's not news that mainstream media tends to do a poor job reporting on both science and sex, and a poorer job still job when young people are involved. Resisting salacious headlines or claims appears to be intensely challenging for many when teenagers and sex are the subject. There were a couple standouts -- and Oliver Wang's piece on this and another study over at The Atlantic deserve special mention -- but on the whole, most reports misrepresented the study and its findings in some way, and many demonstrated that right in their headline.
This study was done expressly about sexual intercourse, NOT about other sexual activities like oral sex. The study does not clearly define intercourse, so I asked William McCarthy to clarify that for me. He said, "We asked specifically about sexual intercourse and I assume that most if not all youth interpreted the question as vaginal intercourse. We did not exclude anyone from the analysis on the basis of sexual [orientation] but I think that we can't with any confidence make any claims about same gender sex." In other words, one of the authors makes clear we should probably figure these results are relevant only or primarily to those having male/female intercourse.
Many are saying that this is about "committed relationships." The term "commitment" is present in most reports, like with the brief coverage about the report at Time Magazine, which stated that, "the results found that if students have sex within a committed relationship, there is no resulting effect on grades." The San Francisco Gate said, "A provocative new study has found that teens in committed relationships do no better or worse in school than those who don't have sex. The same isn't true for teens who "hook up." Researchers found that those who have casual flings get lower grades and have more school-related problems compared with those who abstain."
However, that language is not present in the study itself. At all. It does not use the term committed, nor does it address or define what a committed relationship is or is not. It also does not define or classify intercourse in nonromantic relationships as being about, or not about, "hookups" or "casual flings." McCarthy made clear to me that they expressly avoided that language, in part because it is not at all clear what those terms mean.
What the study does address is sexual intercourse in the contexts of romantic and/or nonromantic relationships, using those terms. The data itself was not collected by the authors of the study, but gathered from other sources. Those sources, in determining which was which, asked participants to self-report what kinds of sexual relationships they were in by only those terms (romantic or not romantic), which was the primary way that status was determined. Determinations were then secondarily made based on agreement or disagreement with a series of statements about interpersonal behaviors/activities and a weighted scale was used for participants answers to those statements about their relationships.
Those statements were:
There was no mention of "commitment," no questions about length of the relationship, about if someone loves someone or not, aims to marry or make babies with someone or not, not even about sexual exclusivity. The ten criteria in that list strike us as quite sound and age-appropriate questions about adolescent romantic/nonromantic relationships that don't project older adult norms or models unto them.
By all means, for many, some or all of those behaviours often do or can signify feelings of love. However, one can't claim this study finds that love has X impact on sex or grades, since a) besides asking if a statement of love was made, love wasn't asked about and b) the authors did not use that term, but used romantic and nonromantic as terms. McCarthy made clear to me that questions about sex were distinct from those about love. There may very well have been love IN the romantic relationships teens were having and discussing, yet, there may not have been love in them. The same goes for the relationships classified and/or self-reported as non-romantic, too.
This study also can't tell us much, if anything, about the academic impact of "hookups" or "flings," since it doesn't talk about them nor were those terms used in the study, and adults reporting or classifying teen nonromantic relationships are likely projecting or making unwarranted assumptions about teens' nonromantic relationships in doing so. We cannot say what types of romantic or nonromantic relationships intercourse occurred in in the study. All one can state with authority is that the individuals in them classified them as romantic, non-romantic or both and/or did or did not mark relationships as meeting the criteria in the list above. Some of the intercourse reported as non-romantic may well have occurred in "casual sex" contexts like one-night stands. However, some may have occurred in friends-with-benefits scenarios, via open romantic relationships, in relationships pursued as romantic that didn't turn out that way, or in brand-new relationships which the participants did not yet engage in the above behaviours or don't yet classify as romantic, or other possibilities. But to classify the non-romantic sex as being about any one kind of relationship, beyond merely non-romantic, is poor reporting and is not supported by the study.
Ironically, reporting of nonromantic relationships with terminology which dismisses them or gives them a negative implication also does something the authors in the study brought up in the last paragraph of their discussion as both generally problematic and as a potential player in the why of some of the lower academic indexes/outcomes for those having intercourse in nonromantic relationships:
Sexuality is an integral part of the maturation process; pretending that it is otherwise only harms adolescents who engage in normatively sanctioned sex without helping those who do not. At worst, denying the normative dimension of adolescent sex creates unnecessary associations between sexuality and adverse outcomes that may become a self-fulfilling prophecy leading those who would otherwise engage in sex only within the confines of a romantic relationship to opt instead to explore their sexuality in a more casual way. By creating a normative environment that delegitimizes adolescent sexuality in all contexts, we forego the opportunity to confer moral legitimacy on sexual activity that takes place in the relationship context least likely to disrupt educational progress.
Some reporting and discussion of the findings suggests that big differences were found with academics for young people who had sex in non-romantic contexts and those who either have not had intercourse or who have done so in romantic contexts. But the study and the authors' comments don't appear to make that statement at all. Rather, what they seem to state is that statistically significant differences were NOT found between teens not having intercourse and those who have, but in romantic contexts, and that the same could not be said when comparing those who have had sex exclusively in nonromantic contexts to both of those groups. Those are different statements. From the study:
First, youth who have sexual intercourse in the context of a romantic relationship do not differ significantly on most of the educational experiences and outcomes we examine: only two of eighteen associations are statistically significant (one for females, ever truant, and one for males, college aspirations). Second, the negative educational consequences of sexual intercourse in other relationship contexts occur somewhat more frequently for males. For females, sexual intercourse in both relationship contexts is related to change over time in two outcomes (college aspirations and ever truant), while having sex exclusively in non-romantic relationships is significantly related to change over time in three (ever truant, days truant, and school sanctions). For males, having sex in both types of relationships is associated with five outcomes (college aspirations, school problems, ever truant, school sanctions and dropping out), as is having sex ex exclusively in non-romantic relationships (college aspirations and expectations, ever truant, school sanctions and dropping out).
Collectively, these results suggest that with two exceptions—ever truant (but not days truant) and dropping out—the negative educational consequences typically attributed to sexual intercourse are more modest when sex occurs in romantic relationships; however, these associations are pronounced when it occurs in relationships that conflict with normative views about the appropriate relationship context for sex.
The authors also talk a good deal about how all of this is not likely just about what relationship context intercourse occurs within having an impact because of those relationships, but because of many factors, including cultural views of and approaches to those different contexts. Yet more irony per some of the ways some folks are reporting on the study who clearly, even admittedly, have not actually read it.
This is a biggie: The authors do not ever, in presenting their results, use the word "cause" to connect sex & academic outcomes - they use "relationship" or "association" or "correlation."
This study does NOT show that any kind of sex causes anything per academic outcomes, only that some academic outcomes or attitudes did or did not concurrently occur when teens are also having intercourse or not having intercourse in certain contexts. Something else McCarthy explained to me was that "the GPA and other outcome data are form the subsequent year so they do have temporal order and correct for selection into sex; however,that selection is not random so we can't really talk about cause."
They also make clear that only SOME of the outcomes measured were statistically significant, and that the standard deviation for a lot of those is large, which shows a lot of variation w/in groups. That means that, beyond the problems we've already addressed in doing so, statements like "Teens who have sex outside of romantic relationships will do worse in school" absolutely cannot be made. The authors, in the actual study, appear to state that the findings with statistical significance for males and females were primarily those around truancy, and college aspiration, but that some additional findings for males had more significance. Unless we're misreading the study and the authors' commentary and summaries (something one of the authors, in reading this piece, does not feel we did), the GPA results (grades) which most reporting seems to be focused on does NOT appear to be an area the authors state as having statistical significance.
There are some really interesting things in this study, especially when we move away from trying to make broad, adultist generalizations. One big deal in them? When academic outcomes/goals with teen sexual intercourse were more negative, they were more so for male teens than females. For instance, while compared to those who did not have intercourse in any context, females who had it in nonromantic contexts had GPAs that were only 0.16 points lower than abstinent teens, while male teens who had intercourse in nonromantic contexts had GPAs that were 0.30 points lower than those who have not had sex at all. Findings like this may be one good in-road to help change pervasive cultural scripts and approaches that state or suggest that it's only or primarily young women who may have unwanted or negative impacts with intercourse or other sexual activity, which both leaves young men high and dry and continues to enable framing sex, especially sex in nonromantic contexts, as something which only or solely has the capacity to negatively impact women.
In so many areas, there tend to be greater burdens with any kind of sex for female people, such as with pregnancy and the long-term impact of STIs. In progressive sex education, we don't assume that somehow male people are unburdened emotionally, academically, or otherwise when it comes to sex, and know there are areas in which male people may or do bear higher burdens, but this isn't one we've seen before. Are the differences in those males' self-perception and chosen behaviors, are they about stresses specifically about sex or those relationships, are sexually active males in nonromantic contexts treated different in school by peers or teachers, or is it something else entirely? I have similar questions about the much-greater level of school sanctions found for those who had intercourse in nonromantic contexts.
The study also found that rates of truancy were higher for teens having intercourse in any context of relationship. This was, in fact, the one area which was stated as being clearly statistically significant by the authors, so is probably what we should be talking the most about. An assumption I'd make about that based on what we hear some young people say about their sex lives is that some sexually active teens may be ditching school because they are having sex instead of going to school, particularly if they feel a need or have a need to hide sex from parents and guardians. If that's so, that's something to do more talking about and more study on. Are the rates of truancy for sexually active teens the same for those given that privacy and time for sexual activity at home -- and permission -- when parents are or may be home, as they are for those who are not given that permission or space, and/or who are trying to hide sexual activity from parents and guardians?
In the study findings, females expressing a desire to go to college was highest for those who have had intercourse only in nonromantic contexts, and lower for those who have either had it only in a romantic context or in both contexts. However, females who had intercourse only in nonromantic contexts expected to go to college least, despite being the group who wanted to go the most. I'm not sure what to make of these results, but find them interesting.
Something else that got left out of all the reports on this we saw was address of teens who had intercourse in both romantic and nonromantic contexts. Their results were interesting, too. For example, GPAs for females reporting intercourse in BOTH kinds of relationships were lower than for either group of females reporting intercourse only in romantic relationships or only in nonromantic relationships. What's the deal there?
Lastly, finding out more, and discussing more, about the various contexts and dynamics of nonromantic relationships beyond them merely being reported as nonromantic, or not meeting the criteria for romantic relationships, is important. Are the outcomes the same, for instance, in nonromantic relationships and intercourse where both the participants prefer (rather than merely accept) a nonromantic context, or do they differ? In nonromantic relationships where peers, parents and others were more supportive and accepting of that context, or where those relationships were more included and accepted in sex education, how do the academic -- and other -- outcomes fare?
The prototypical (and very American) cultural conversation about sex in and outside of romantic relationships as good = romantic and bad = nonromantic is, and has long been, problematic for a bunch of reasons and around a whole host of issues. That shortcutting and stereotyping influences awareness and address of, and response to, abuse in romantic relationships hugely. It can support inaccurate thinking about where health and emotional risks can lie (that they only do in nonromantic contexts, but don't in romantic ones); it can make it far more difficult for people in the wide diversity of relationship contexts and models there are to best find, create and choose models that work for them and feel supported in whatever kinds of relationships they choose. It can, as the authors address, isolate those in nonromantic sexual relationships and increase a host of their risks, academically and otherwise.
Poor reporting, the inclination towards being provocative or intellectual laziness should not be taken as indications that this study is to blame or doesn't have things of value to offer, because it's a really interesting and well-done piece of work. It includes some findings young people, parents/guardians and educators should know about and furthers some really important conversation. We're very much looking forward to having more discussion about it with the authors and seeing some reporting that presents the study -- and the young people it's about -- less one-dimensionally.
Scarleteen volunteer Karyn Fulcher also contributed to this piece.
The more young people are told - usually by adults who know from their own experience it's not true -- that sex outside of marriage, outside long-term, monogamous relationships, or with any more than one partner in a lifetime, will always do them terrible, irreparable harm and make them damaged goods forevermore, the more we get questions about oxytocin, one common staple in that messaging. So, around a year ago, I started excavating. It's taken me a while to get this out here: I confess, it's mostly because I was dreadfully bored by it all. I'm not a neurochemistry geek, but a sex geek. Because so much of it wasn't all that relevant to sex, and because this just isn't my area of geekdom, every time I've picked this up what I found most amazing about oxytocin was its ability to miraculously cure my bouts of insomnia by just reading or writing about it.
Anyone who regularly reads Scarleteen knows we don't feel there's one model of relationship, or any right or wrong number of sexual partners, that will or won't lead to satisfaction, happiness or a lack of hurt or harm for everyone, and that we don't feel it's sound for us or anyone else to suggest that there is. At this point in human history and social science we've all the evidence we need to know we've pretty much tried every possible kind of relationship and social set of "rules" and strategies there are, and none have generated any identical, satisfactory or unsatisfactory results for everyone who has tried them. We also don't feel that consensual sex of any kind or in any one context is right or wrong for everyone and don't think suppositions to the contrary are sound. We stand firmly behind the understanding of people as incredibly diverse, and know that our relationships, sexuality and what we each want from those things and find is right for us is also incredibly diverse. So, while we really shouldn't have to say it, for the record, nothing I'm about to say here should be interpreted as any kind of suggestion or evidence that any one way or model of having sex or relationships, or anything a given person wants, needs, finds ideal or non-ideal when it comes to either of those things is right or wrong according to me or according to science.
There are a lot of links packed in here. If you want to dig into this topic a bit more, click away. If you'd rather have the basics, I spared you as best I could. But all the links alone should make clear that anyone who is making pat claims about oxytocin is probably either a) lazily parroting what they heard someone else say without doing any qualitative reading themselves, and/or b) dismissing the complexity actual study and the diversity of human experience has shown us about oxytocin and all of human behavior in order to further a social or personal agenda, or in order to further their hope -- as sometimes we're all wont to do -- that some of the most complex and confusing parts of our lives could be magically made simple.
The oxytocin-and-sex bus seems to have really gotten its gas with Dr. Erik Keroack, a popular lecturer for the National Right to Life Committee and the National Abstinence Clearinghouse. Ex-President Bush appointed him to head Title X, our national family planning program, for the Department of Health and Human Services. There are about a hundred reasons why that appointment made a lot of people feel stabby, but the biggest one is that Keroack was strongly against family planning. It was a lot like putting an anti-gun activist in charge of the NRA. Keroack was also particularly fond of talking about oxytocin and making claims about it (claims unsupported by science) to support his own agenda, such as that, "People who have misused their sexual faculty and become bonded to multiple persons will diminish the power of oxytocin to maintain a permanent bond with an individual."
Many claims about oxytocin regarding love, sex and bonding cite some science, but often very selectively and dubiously, so much so that some scientists whose studies have been used to make agenda-driven claims have strongly objected to the use of their studies to do so. As well, when people are talking about studies done on oxytocin and sex or pair-bonding, the vast majority of those studies have been done with and about prairie voles, not people.
A prototypical conservative claim about oxytocin, sounds a lot like this:
Oxytocin is a hormone that is released in a woman during childbirth, nursing a child, and during sexual activity. Commonly referred to as “glue,” oxytocin creates a strong bond between the woman and the other involved. In the case of childbirth and nursing this bond is important because it creates a nurturing environment for the child. In a marriage relationship where sex is safe and beneficial, oxytocin helps keep the bond between a husband and wife strong. Outside of marriage however, the oxytocin bond can increase the emotional pain when the relationship has ended. Oxytocin is impartial. Whether during sexual activity between husband and wife or in a teenage hook-up, the hormone is still released and the bond is still created. Oxytocin promises an involuntary chemical commitment.
Every parent, educator, and school administrator can undertake the mission of teaching abstinence with heightened significance as the intensity of the oxytocin bond explains why teens suffer emotionally after breakups, and often even during a relationship. Sex was created to unite two people, bringing a bond unlike any other relationship. This powerful bond is what sustains husband and wife until “death do us part” contributing to trust and security. Outside of marriage the release of oxytocin can lead to distrust, hostility, and insecurity. Sexual relationships without commitment still have a lasting bond. Oxytocin even has the power to sustain attachment within abusive relationships.
That's from The Oxytocin Factor (Kerstin Uvnas-Moberg, 2003, Aspire, Scott Phelps, 2008, The Medical Institute of Sexual Health, 2006). The Medical Institute of Sexual Health is an abstinence-only organization. Its advisory board reads like a Who's Who of purity pushers, including W. David Hager, another former Bush appointee, to the FDA's advisory board on reproductive health, who suggested prayer as a cure for PMS and whose ex-wife stated in The Nation that he had repeatedly raped her. The AMA it's not. I have not found any study done on oxytocin that shows oxytocin alone creates emotional bonds (rather than potentially playing a part in them or creating a feeling in someone they they may be bonded, even if they are not), no studies done exclusively within marriage to show it is different for married or unmarried people, and none done to determine what role, if any, oxytocin may play in the pain of a breakup. I also have not found any oxytocin studies done within or about intimate partner violence to support conclusions that the reason people stay attached to abusive partners is chemical. If only it were that simple.
These kinds of sentiments about oxytocin are often the impetus for such popular abstinence-only routines as "Miss Tape." (Which I just demonstrated for my friend's four-year-old, who now promises to never tart it up.) Here's another example of some socially conservative claims about oxy:
Oxytocin also helps females bond with men. When a woman and man touch each other in a loving way, oxytocin is released in her brain. It makes her want more of that loving touch, and she begins to feel a bond with her partner. Sexual intercourse leads to the release of even more oxytocin, a desire to repeat the contact, and even stronger bonding. But, like dopamine, oxytocin is values-neutral. It's a chemical reaction, or, as the authors write: "[I]t is an involuntary process that cannot distinguish between a one-night stand and a lifelong soul mate. Oxytocin can cause a woman to bond to a man even during what was expected to be a short-term sexual relationship." So when that short-term relationship ends, the emotional fallout can be devastating, thanks to oxytocin.
"The authors" in that quote are Joe McIlhaney and Freda McKissic Bush, who are affiliated with the abstinence-only group the Medical Institute for Sexual Health.
Not only do we know from study on oxytocin that it is not at all exclusive to women, and that oxytocin cannot, by itself, create emotional bonds, I cannot find any studies about oxytocin done on sexual activity exclusive to intercourse. That same piece also states not only that oxytocin is a girl-thing, but that vasopressin is a guy-thing, when in fact, both chemicals can and do exist in the bodies of all genders.
Let's take a look at what oxytocin is. Let me preempt what you're about to read by saying that we not only still know very little about oxytocin, we still know very little about all neurochemicals and how they affect our feelings and actions. If someone says they know something absolute and definitive about oxytocin and what it does in our bodies, that's a big pseudoscience red flag. Also, some of the claims and quotes about oxytocin report it as being about only women and men or only women or only men. Most, if not all of the time, they're talking about people who are or are thought to be XX or XY, and when interplay between men and women is discussed, they're talking about heterosexual people. If and when I use the language they used or is found in studies I'm citing, that's why, not because I'm a fan or think it's necessarily accurate (particularly when people are talking about studies done with voles and not people at all).
Oxytocin is one of many neuropeptides found and produced in mammals. It seems we've known about it for around 100 years but have only recently started studying it in any depth. Scientists currently understand it as potentially playing a part in everything from labor contractions, deep discussions, breastfeeding, autism, sexual arousal, activity and orgasm, altruism, and all kinds of general social interactions (good, bad and otherwise) for those of all sexes and genders who can or do experience all or any of those things. Apparently, oxytocin levels may elevate in people even just by being around the color blue. How much or how little oxytocin is out and about during these or other events varies widely among mammals, even mammals of any one assigned sex or who are all having the same kind of experience in which oxytocin is or may be present. It's understood to have a plasma half-life (the time it takes for half of any given substance to become inactive) of only around 3-5 minutes in the human bloodstream.
According to the APA, "Oxytocin is produced mainly in the hypothalamus, where it is either released into the blood via the pituitary gland, or to other parts of the brain and spinal cord, where it binds to oxytocin receptors to influence behavior and physiology. The excitement over the hormone began in the 1990s when researchers discovered that breastfeeding women are calmer in the face of exercise and psychosocial stress than bottle-feeding mothers. But more recent research has shown other roles for the hormone, too. Oxytocin levels are high under stressful conditions, such as social isolation and unhappy relationships."
It's been highly linked to influencing trust and social attachment between mammals (not just sex partners: parents and children, friends, even a dude and his dog). As the APA makes clear, the idea that oxytocin levels surge only in pleasant or sexual situations isn't at all accurate. Those of you using hormonal methods of birth control should prepare yourselves to hear that you apparently can't emotionally bond as well as women not using those methods, since progesterone can inhibit oxytocin release. If that and claims about oxytocin being THE thing that bonds are true, then when women are in the phase of the fertility cycle where progesterone is highest -- about half of every cycle, during the time practitioners of natural family planning who are trying to prevent pregnancy would be having sex most -- they wouldn't be able to bond as well then, either.
That same APA piece also takes a chunk out of the idea that surges of oxytocin early in life, or with more than one other critter, make us less likely to bond. In fact, they suggest that without those early-life surges, we may have problems bonding later.
Let's revisit that "many" part about neuropeptides. Rather, let's let Sue Carter, a zoologist who pioneered some oxytocin research, be clear: "The nervous system is not just oxytocin. There are many other hormones that might be just as important as oxytocin that haven't been identified yet," Carter says. "A piece of social support is oxytocin. That doesn't mean that oxytocin alone equals social support." Oxytocin so isn't just about, or just produced or possibly elevated during sex, though. Not even close.
One common place oxytocin apparently plays a big part is in breastfeeding and child-parent bonding. Suggesting a person who has multiple -- or even just more than one -- sex partners will be less able to bond to people because of potentially having oxytocin surges with more than one person would suggest that breastfeeding mothers who have more than one child would become less and less able to bond to their children. Not only am I quite certain neither is true -- particularly based on just one neurochemical -- I can hardly imagine the social conservatives who are pushing oxytocin so hard as a way to scare people about sex jumping on THAT bandwagon.
One of my favorite oxytocin fables is that it is why when men and women have casual sex, women are apparently thereafter waiting, lovelorn, by the phone, feeling they just lost the great love of their life after one hookup, while men apparently go skipping off casually, having experienced no feelings at all and having developed no attachment whatsoever to the woman they just slept with. That might well be so if that's always what happened, if oxytocin was the only thing that drove or influenced any of those feelings or experiences, and if oxytocin was something that only occurred in women. But those things are not true. It's also often suggested that it's female orgasm that's the big oxytocin power surge. However, more women than men are inorgasmic, and with casual sex specifically, it's more common for women than men not to experience orgasm, especially with brand-new partners. That given, it becomes an even stranger supposition, because the roles should then be reversed, right?
While commonly called "the love hormone," that's also not always the most accurate nickname for this particular neuropeptide, because it doesn't always create those feelings. Sometimes, it's quite the opposite.
One study in Israel found that oxytocin may also increase feelings of envy and make it more likely for a person to gloat: not so lovey-dovey, that. Those researchers and others will tend to bristle at the suggestion of oxytocin as the "love hormone" or "hug hormone," instead suggesting that what it may do is simply intensify the whole range of human emotions, not only the pleasant ones and not only feelings of love or sexual attraction. In all the actual scientific information we have so far on oxytocin, it's clear it has just as much to do with fear and stress as it does with love.
Here's my running list of when and where oxytocin has been found or suggested to surge in study done in humans and/or other mammals:
Neuropsychologist Dr. Rick Hanson suggests that, "Probably, oxytocin can also be released just by imagining – the more vividly, the better – the activities just mentioned."
Though the central oxytocin studies often used for some of these claims were with voles, not humans, if we're going to talk about them and talk about oxytocin, we also have to talk about vasopressin, another very similar neuropeptide. And if we're going to talk about orgasm or sex and hormones, we can't really pull one ingredient out from the whole soup: our bodies can't and don't, after all. That'd be like suggesting that a three-layer-cake and flour, just one ingredient of that cake, are the same thing. On a chemical level alone, there are a host of chemicals that can be or are involved with sex and sexual response: androgens, estrogens, prolactin, cortisol, neurochemical almost always inextricably linked to oxytocin -- serotonin, phenylethylamine and others, for people of all genders: not just women, not just men, and not just in interactions between women and men.
Where does a lot of this stuff come from that suggests that oxytocin, in the context of love or sex, is SO different for men and for women? As far as I can tell, a lot of it comes from sex and gender essentialism, much of which flies in the face of science. Oxytocin has also been studied far more in females than males, most likely because the most important role it has seemed to have so far is with labor, delivery, lactation and maternal behaviour.
Testosterone is known to suppress oxytocin. People might be able to get away with some generalizations about men and women because of that...but only if testosterone was exclusive to men. 'Cept it's not. Not only do we all have it, it plays some part in all sexual response. Certainly, most XY people have more testosterone, or higher levels, than most XX people, most of the time. That can be as little as two times as much to twenty times as much. When people are sexually aroused, all of our testosterone levels are elevated, whatever our sex or gender. Additionally -- estrogen may increase -- not create, increase -- the effects of oxytocin. But men have estrogen, too, even though most women have more. And as we've already talked about, sex and sexuality is not merely chemical.
Looking at that list up there of situations in which oxytocin can purportedly rear it's oxytociny head, let's apply the same kind of logic some do with statements about sex and oxytocin to some of these other situations. Let's also use the same broad brush and total certainty in making them.
If we did, we might say things like:
I'm not saying ANY of these statements are true or are things I believe to be valid. I don't, not even remotely. They sound utterly offensive and silly to me, just like the claims about oxytocin at the top of the page do. But if we're supposed to accept that things like claims about number of sexual partners and bonding ability are true, we'd have to accept some or all of these other statements are or may be equally true.
In most, if not all, of our social interactions, oxytocin may be or has the potential to be present. How much or how little probably depends on which activities we're doing, what a given one is like for us at a time, on each of our very unique cocktails of biochemistry and on the big picture of our lives, histories and feelings about and conceptions of those lives and histories. For someone of the mindset that we need to watch who we have have oxytocin surges with and in what kind of interactions that occurs, so far science seems to indicate that to do that, we'd all need to stay away from most social interactions -- pleasant and unpleasant alike -- we have with everyone, like with parents, platonic friends, romantic and/or sexual partners, co-workers, religious leaders, fellow singers in our choirs, pets, massage therapists, religious communities and yoga teachers.
Where's the bad part of oxytocin? Going back to that APA piece up top, "When it is operating during times of low stress, oxytocin physiologically rewards those who maintain good social bonds with feelings of well-being. But when it comes on board during times of high social stress or pain, it may "lead people to seek out more and better social contacts," says Taylor." But it's also worth nothing that, as Rene Hurlemann, a psychiatrist who has done oxytocin studies states, "An Israeli study has shown that when people are engaged in a contest, if one player's emotions are manipulated by the offer of a bigger prize to the other player, the first player's feelings of jealousy and ill will are actually exacerbated by a dose of oxytocin.
"Oxytocin does not make you a better person," he says. "In some cases it may simply intensify whatever you're feeling."
Love and bonding -- whether we're talking about either in a sexual or nonsexual context -- is much more complex than a single chemical. I'm not just saying that because I think so: social science has backed that up since we've had social science, and medical science tends to be in cahoots with that notion, too. We can't compartmentalize love or sexual behavior or biochemistry in the way so often done around oxytocin.
Everything I've read on oxytocin from scientists has this funny thing where they tend to use the word "may" with claims, or where they talk about how their study makes suggestions which should lead to further study. The scientists doing the studies that are then cited by so many others are not making the kinds of definitive statements about oxytocin those folks are, and some are increasingly critical of the ways studies are both being conducted and used around neurochemistry and human behavior, particularly when evolutionary psychology is involved. If those scientists aren't making conclusive statements about their own work, no one else can really justify doing so. Scientists tend to understand the difference between hypothesis, theory and fact: those referencing science, or looking to support their own theses with it, could stand to be reminded of that.
A lot of the popular claims about oxytocin, like so many made about sex or love, are exclusively or primarily about heterosexuality and binary sex or gender, both of which we know -- thanks, science! -- aren't binary at all. Some studies may actually show us differences in oxytocin with XX and XY people (if they have even been determined to be so in those studies, which they probably have not) -- or rodents -- but what about with XXY, XYY or XO people? What about male-female relationships in which both parties are trans gender?
After spending far too much time buried in oxytocin research, I'm not going to argue that the notion or suggestion oxytocin potentially plays some part in how we do or don't bond or otherwise behave with or feel about with others is invalid. It's pretty clear to me that it is valid to state it often does or may plays a part.
However, if we're going to get on board with that, we can't be essentialist or selective about it. If we're going to give credence to one of the ways oxytocin has been shown it does or may work, we have to give equal weight to all the other ways it has been shown to or may work, and we have to do so even if and when evidence about one scenario with oxytocin may make claims anyone makes about another patently false or ludicrous.
We just don't know enough about oxytocin for many of the kinds of statements that have been made, especially so firmly, to be made. And some statements made have absolutely no basis at all: the idea that any given oxytocin surge more people means a difficulty or inability to bond with fewer people ever after, for example, is something I couldn't find even one scientific reference for or study on. Oxytocin is clearly an over-convenient rationale or scapegoat for plenty of people, and not just the abstinence-only crowd.
At the beginning of this piece, we linked to scientist Dr. Rebecca Turner voicing an objection to her studies being used inaccurately. In that piece, Turner said something else that was really important:
There are always some human values involved in statements of policy, and it is fairer to the public to acknowledge what those values are," she continued. "This is something we instill in our students: in a free society, we have to be open to debate the evidence, the meaning of the evidence and its quality. At least Dr. Keroack's co-author did acknowledge that they were developing conclusions that no scientists would ever put forth.
What generalizations and conclusions can we soundly draw based on data scientists have provided, and what conclusions they have themselves drawn? That oxytocin is one of many chemicals in the bodies of mammals, one of an incredibly large pool of influences and factors, chemical and non-chemical, which very likely have an impact on some of our behavior, including but not limited to our sexual and other social interactions and responses. That how much or how little oxytocin impacts those things, how it impacts them, for whom and in what situations, clearly varies widely, even though we can say we know some situations in which it is very likely to be present and have some sort of effect. And that if we want ways to make more definitive statements than these about oxytocin, until we have a lot more study done with humans, we're going to need to stick to talking about rodents instead of people.
That's the verbatim response to the question "What if I want to have sex before I get married?" in "No Second Chance," a film that is part of Sex Respect, an abstinence-only program. Sex Respect has a host of other special and oh-so-factual messages for you in their student workbook, including such sparkly gems as:
"A young man's natural desire for sex is already strong due to testosterone...females are becoming culturally conditioned to fantasize about sex as well." (p. 11) Did you know that without cultural conditioning, women don't have any desire for sex? Of course you did. Did you know that women don't have any testosterone in our bodies, too? Note: neither of these things are true. But you knew that already.
"A guy who wants to respect girls is distracted by sexy clothes and remembers her for one thing. Is it fair that guys are turned on by their senses and women by their hearts?" (p. 94) So, when it comes to sex, men don't have emotions and women don't have any of our five senses. Fascinating. And no: that's totally not fair, but then gender stereotypes rarely are.
"These are simply natural consequences. For example, if you eat spoiled food, you will get sick. If you jump from a tall building, you will be hurt or killed. If you spend more money than you make, your enslavement to debt affects you and those whom you love. If you have sex outside of marriage, there are consequences for you, your partner and society." (p. 11) Including the not-to-be-missed consequence of having to pay over a billion in U.S. tax dollars to fund stellar education just like this.
But this particular message in the video, that sex (and only sex outside of heterosexual marriage) equals death is a common thread in many, if not most, abstinence-only curricula and programs. I figured it was high time we just unpack it, take a good look at the real deal, and be done with it.
I'm pretty familiar with common causes of death, but I thought I'd channel my inner goth and do some homework on death anyway. I even -- though most of me knew better -- prepared myself to discover that sex INDEED posed far larger risks of death than I thought, and prepared myself to share that information if I discovered it. After all, if I had any agenda or educational model that required my not being truthful about any part of sexuality or sexual health, then as far as I'm concerned, the impetus would be on me not to lie or misrepresent that information but to adjust that agenda or the way I educated. Clearly, this is a way of thinking lost on some folks.
I'm keeping this to the U.S. for a few reasons. One biggie is that if I were to pull international statistics, I'd be including nations where ultimately, very serious lack of access to healthcare or basic, healthy living conditions was often the real cause of death: where what someone died from often would have been preventable with care and a better environment. That's hardly a non-issue here in the States, but it's not the kind of issue it is here as it is in much of Africa or some areas in Asia. I'm also being kind to the ab-onlies in sticking to the U.S. If I included, for instance, HIV-related deaths from the least developed nations, I'd be showing up even more clear evidence than we have in the States that marriage doesn't prevent sexually transmitted infections. "In Rwanda and Zambia, for example, an estimated 55-93% of new infections occur within marriage or in cohabiting relationships." Same goes for deaths for pregnant women. We have to include those if we're addressing death related to sex, but while maternal death rates for the U.S. are high for a developed nation, they're peanuts in comparison to those of third world nations. Conversely, the rate of abortion-related deaths is also far, far higher in areas where abortion is illegal.
Let's go ahead and look at some current death statistics. According to the CDC, in 2006 there were 2,426,264 deaths in the United States. The top 15 leading causes of death, and how many deaths for each of those causes there were, is as follows:
It's perhaps worth noting that in 2006, there were "30,896 gun deaths in the U.S: 12,791 homicides (41% of total deaths), 16,883 suicides (55% of total deaths), 642 unintentional shootings (2% of total deaths), 360 from legal intervention (1.2% of total deaths) and 220 from undetermined intent (.8% of total deaths)." In that same vein, here is a list of U.S. military deaths in Iraq for 2006: there were 920 U.S. Military deaths (during active duty) for 2006, total. If it seems silly to mention such a relatively small number, keep reading.
You'll notice that STIs and pregnancy (including labor/delivery or abortion) aren't on that list at all: they don't even make the top 15, which might be pretty surprising when someone is making it sound like if you have sex (oh, sorry: premarital sex) you're not only going to drop dead, you're going to drag everyone else you know to the grave with you.
Of course, some of the deaths in some of those groups may have been related to sex. For instance, three leading causes of death for pregnant women are heart disease, homicide (often directly related to being pregnant) and vehicular accidents. Septicemia can also occur due to miscarriage. Similarly, those who died from HIV/AIDS may have actually died of pneumonia or influenza. And sometimes people (though not usually people your age) really do have strokes during sex. I should also mention that some of those homicides would have included hate crimes: assaults to those who were of a gender or sexual orientations others didn't like, though that's not really about how sex itself can kill you, but how people who are deeply screwed up about sex, gender and sexuality issues can.
To pick up some of those gaps, "The rate of maternal mortality in the United States declined dramatically over the last century; however, an increase in the rate has become evident in the past several decades. In 2006, the maternal mortality rate was 13.3 deaths per 100,000 live births, compared to a low of 6.6 in 1987. In 2006, there were a total of 569 maternal deaths (those resulting from complications during pregnancy, childbirth, or direct or indirect obstetric causes up to 42 days after delivery or termination of pregnancy)." That rate includes deaths due to abortions, but is mostly deaths due to sustaining a pregnancy or to labor or delivery. The rate of death for abortion overall is far lower than for that of sustained pregnancy: it's "one death for every one million abortions at or before eight weeks to one per 29,000 at 16–20 weeks—and one per 11,000 at 21 or more weeks." And only 1.4% of abortions in the U.S. occur after 21 weeks, the majority of which are performed due to serious complications of pregnancy which can include serious health risks for those pregnant women.
In 2006, the estimated number of deaths of persons due to HIV/AIDS in the United States and dependent areas was 12,113. In other words, while most deaths due to HIV/AIDS are included in the death statistics for other direct causes, this is exactly how many HIV/AIDS-related deaths we had in 2006. Sparing any deaths from cervical cancer related to HPV, and Hepatitis-related deaths (which often is acquired nonsexually), most other STIs do not result in death at all, let alone make the grade for leading causes of death.
This article (Sexually Transmitted Infections 2005;81:38-40) lists deaths directly related to sex, though for 1998, not 2006. That's important because some of these rates are different than they are now: for instance, our maternal death rate has increased and our HIV-related death rate has decreased by nearly half). Would that we had the same study for 2006, but this is the only thing like this I can find anywhere:
As part of an analysis of the burden of disease and injury in the United States, we identified and quantified the incidence of adverse health events, deaths, and disability adjusted life years (DALY) attributed to sexual behaviour. In 1998... 29,782 such deaths (1.3% of all US deaths) occurred... Viral infections and their sequelae accounted for nearly all sexual behaviour related deaths—mostly HIV/AIDS.
The table of data for that piece shows the vast majority of those deaths were HIV-related (22,455), and again, that's almost twice the rate of HIV-related deaths as we see in the states currently, primarily due to advances in HIV medical care and treatment. The next highest group was cervical cancer likely due to HPV (4,921) -- which would be included in the total rate for all cancers -- and the next rung was from Hepatitis B and C, which may or may not even have been acquired sexually. The same is likely true for some (but not the majority) of those HIV/AIDS deaths; a minority of those cases may have been due to IV-drug use, for instance. This data apparently also only included deaths related to unwanted, not wanted, pregnancy. That leaves only 414 deaths from other STIs or from unwanted pregnancy death outcomes.
Now that we've got all that sorted: by all means, having sex can result in some health issues or conditions (and some of them certainly are or can become serious) and can be related directly to a death. Comprehensive sex educators and organizations like Scarleteen want you to know that, it's something we mention (and always have) when it's relevant, and we want you to know how -- which is why we do that funny thing where we tell you how -- you can protect yourself as best you can from death and other unwanted health outcomes from sex, either by abstaining from partnered sex or by utilizing safer sex practices if and when you choose to engage in partnered sex (whether you're married or not). In other words, someone saying sex could result in death isn't lying. It can.
But. You are much less likely to die from sex than you are from a whole host of other behaviours or circumstances, some of which the same folks would not warn you about with anything close to the same urgency or intensity. I just don't see driver's ed teachers telling you that if you get in a car at all, you need to be "prepared to die," even though more people die in car accidents than those who die as a result of having any kind of sex. (I also don't imagine they say that wearing a seatbelt when you are in a car is playing "Russian roulette.") I don't see them telling that to a class about enlisting in the military. I don't see them saying that to nearly everyone eating things in the lunchroom every day which could put them at risk for the most common cause of death. "Time for lunch, everyone! Prepare to die!"
Anyone who is stating or making it sound like sex or premarital sex is something more likely to kill you than anything else is being baldly dishonest. Whether you have sex with a partner in or out of marriage, with a partner of any given gender, at any given age and even IF (though we don't advise it) you take risks with your health and don't have sex safely, it is not, by any stretch, highly likely to kill you, and you do NOT have to "be prepared to die" if you choose to be sexually active. Not any more than you need to be prepared to die because we're all going to freaking die at some point no matter what we do, anyway.
And unless the same people telling you that if you have sex YOU WILL DIE are also telling you, with the same hysteria, force and fury that YOU WILL DIE if:
...then those folks are being particularly dishonest, especially if they're telling you that they're trying to scare the crap out of you expressly out of concern for your health, rather than because they want you to conform to their own personal set of values. Because doing any or all of the things in that list are directly related to or causes of the ACTUAL leading causes of death: the real ways you are most likely to die.
Since you're here at Scarleteen, I know I don't have to tell you that if you're going to have sex with other people, we think it's a wise idea to have sex safely and responsibly (in ways which have been soundly and scientifically proven, over time, to protect your life and health, something public health agencies all agree on). I know I don't have to tell you that if you and/or any partner aren't ready to do that, we think it's a good idea to put sex on hold until you are all ready, willing and able to have sex safely and responsibly. Not just until you're married, if marriage is even an option for you or something you want to do at all. One of the reasons we think that is because some kinds of sex (most primarily vaginal or anal intercourse) sometimes can pose a risk of death, and another, the more pressing, is because far more often, some kinds of sex can pose risks to your health and the quality of your life.
But we also think that just like you choose to go ahead and drive in that car even though it's one of the most common causes of death; just like you choose to leave your home at any time even though it may expose you to things like flu viruses or people who might shoot you, that you're capable of -- and absolutely entitled to -- making choices about what possible risks in your life you want to take for the possible benefits those same actions or behaviors might offer. Because that's simply a part of living your life, the life that, by virtue of merely being alive, is going to kill you some day whether you have sex or not.