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Thinking about the risky stuff…

Hmmm, so, having my morning coffee glancing through my news feeds, and I came across an article on Think Big called The Sky is Falling.  Should We Worry?  It’s about asteroid strikes (yes, I’m a science geek (sigh)).  If you’re interested, here’s the link (http://bigthink.com/ideas/41151?page=1).

It didn’t catch my attention so much for the discussion on the psychology of risk assessment and asteroid strikes (clearly I need to read things more uplifting with my morning coffee btw), but rather how easily we can remove all the space-science terminology in the article and replace it with terms about STIs and sex-related health issues, and how we think about risk in relation to those terms.

We talk a lot about sexual risk in health research into sexual behaviour.  Risk risk risk risk risk.  Casual sex is called risky sex, hooking up is framed as risky, and so on and so forth.  Should we worry about risk?  I’m not saying that we shouldn’t but as Think Big points out, we worry about risk the more we hear about it.  And as we hear about sex and risk so often together, we really have to ask if we are creating a culture of fear around sex, and how that is going to impact on how we conduct our sex lives.  The sky is falling apparently, because we are having casual sex.

The first thing we need to be aware of, I think, is that when we talk about risk we are not necessarily talking about danger.  These terms are not as synonymous as we are had to think.  Just becuase something is risky it does not mean that it is dangerous.  As Slovic notes, danger is real but risk is a concept we as a culture/society create, and it is complex.  “Risk assessment is inherently subjective and represents a blending of science and judgment with important psychological, social, cultural, and political factors.” (1)   And how we define risk determines what we do about it.  Defining risk therefore becomes quite a political endeavour – a quick look at how the western world handles the definition of risk in relation to terrorism is a transparent example of the politics of risk and its definition, how it creates cultural and behavioural change, and informs a culture of fear-based behaviour and thinking.  If risk-talk can do this about terror and  ethnicities (for example, the discourse suggests that all Muslims are potential terrorists – clearly a fatuous idea), then what does risk-talk about sex do for those of us having it?

If Slovic is right about the politics of risk, and frankly it seems commonsensical, then we ought to be careful about how we read research (well, anything really) that talks about sex and risk, because the way it is often defined suggests that the way to avoid risk is to not have sex outside of relationships.  Casual sex is risky – how to avoid risk, don’t have casual sex.  The problem is, risk is not that narrow.  Relationship sex can be just as risky as casual sex when it comes to contracting disease and infection, to emotional, physical and psychological harms, and issues of autonomy and consent.  There is however less research in this area, and even less looking at the bigger picture with respect to sex and danger.

I am not saying that sexual health researchers have an agenda in researching from a risk perspective other than trying to find ways to improve population health and reduce exposure to health dangers.  What I am suggesting is that if we are to approach sex research (and sex itself) from a risk framework, then we really need to think about what it is we mean by risk, how it relates to actual dangers, and what politics we are engaging with when we talk in risk-related ways.

If we are to talk about risk, what needs to be understood is where the actual dangers are with respect to bad outcomes from sexual interactions, rather than the kinds of sexual contexts those outcomes are encountered in.  From my research, I see that the greatest dangers come not from casual sexual engagements, but from ones where individuals feel they do not have the power to communicate their desires, to assert themselves as agents (ie, they determine the what/how/when/with whom aspects and are active in whatever they are doing, instead of being done to), to trust sexual partners to act ethically and responsibly, and to act ethically and responsibly themselves.  These aspects of behaviour can be present or absent from any kind of sexual context, whether it be casual or committed.  And they are in my mind the forerunner of sexually responsible and mindful behaviour.

For example, two strangers decide to have casual sex: both are self-responsible in having regular STI checks, and in respecting themselves with respect to their sexual health, both actively use and carry contraception, both communicate clearly about what they want from the sexual encounter, and treat each other with respect before/during/after the act, do not stigmatise the other or malign, and so on.  Risk/danger in this kind of interaction is low.  Then consider a couple in a relationship: one has not had a STI check prior to entering into the relationship, and as they are in a relationship considers using condoms to be unnecessary (one of the hallmarks of committedness in the modern sexual context), one partner is sexually dominant in determining the how/when and where of sex, and the other does not feel confident enough to voice their wants and desires and lack thereof; little communication occurs, and one partner can sometimes feel disrespected, whether through not being heard, or being judged or stigmatised by a partner.  This scenario, one I saw often in the comments of the young women I researched, presents a greater potential with respect to risk and real dangers than the casual sex encounter outlined above.

The point of the above example is not to throw into the risk-circle yet another kind of sex to be wary of but rather to highlight why risk needs to be thought about critically, and approached from a wider perspective than perhaps is focused on in the predominance of sexual health research.   In doing so the kinds of changes that would be encouraged in the sexually active community would more likely have better results with respect to negative sexual health outcomes.  For example, research shows that young women who feel they have a right to speak up and out about what sex they want to have, and how, are more liable to use condoms and insist on condom use, thus reducing the risk of exposure when partners are potentially unsafe.

The other aspect of thinking critically about the gap between risk and danger has to do with the kinds of risks that we are wary of, and the likelihood of that actual danger occurring.  A good example of the gap between risk and danger can be seen in the current climate of parental fear around child abductions.  Stranger danger is the predominant message around child abductions, yet most children are abducted by someone they know.  Very few are taken by strangers.  Yet our proscribed behaviour to mitigate the risk is to drive our children to school/the mall/the park/playdates etc, and to have them accompanied by someone at all times.   Hardly the kind of behaviour that offsets the actual danger of child abduction, but one that suggests that the actual gap between risk and danger is quite large and that the politics of risk management in childcare is not quite on target.

It is worthwhile considering this gap too when it comes to what research describes as risky sex.   Now,  I don’t have access to statistics on the likelihood of contracting an STI from a casual sex encounter.  The best I came up with was a link discussing the likelihood of catching gonorrhoea from an infected parter (http://dermatology.netfirms.com/mdderma/STDcenter/STDFaqs/STD_FAQ_transmission.html) – 20%.  Note that the partner has to be infected already – likelihood gets far more difficult to predict when we try and calculate that a partner has an STI in the first place.  A likelihood that would drop the actual danger (brain rattles whilst pulling out school stats probability stuff).

This isn’t to say that we should be cavalier about STIs, rather it’s to put things into perspective.  It’s one thing to look at a sexual partner as a potential source of sexual risk, and another to act as though they actually are.  The former suggests precautionary measures, the latter, avoidance.  If we approach risk as danger, then our behaviour changes to something that is perhaps not favourable – already we are criticising parents who over-coddle their children in response to a plethora of risk-messages about the unsafeness of everyday environments.  Overt attention to risk can result in negative outcomes unrelated to the actual danger they are warding against.

Couple statistical likelihood with sexual health outcomes, and the life-destroying tone of risk messaging swings even more into questionable territory.  Modern medicine puts many STIs within the curable category, and many more in the treatable and manageable category.  And as long as we are responsible before, during and after, then danger is reduced (even if risk is not).  But we do not treat STIs the same as we treat other communicable diseases – as regrettable, treatable, and curable.  Instead we stigmatise.  If we were as scared of catching the flu as we are of an STI we’d never leave our homes.

Again I am not dismissing the impacts of STIs, rather I am suggesting that the gap between perceived risk and actual danger might not be as narrow as the litany of educational and medical messages around non-relationship sexual activities might suggest.  But I am definitely suggesting that we ought to take the fear out of risk-discourse around STIs – because it’s being scared that can stop people acting pro-actively to manage their sexual health.  Is it a big deal you got Chlamydia?  Sure.  Will it destroy your life? No (as long as you manage your health).  But does the world treat your differently when it finds out you’ve had it?  Yes – it may not destroy your life, but it certainly can alter it.   And that’s the kind of risk we shouldn’t have to negotiate.  When we catch STIs from unfaithful partners, yet have safe casual sex … well, you can see the disjunct in how we treat people.   And why risk-discourse can be off-target.

Risk is a complicated issue – about that, Slovic is right.  When we talk about risk the politics involved can be hidden, and certainly not straight forward.  However, this doesn’t mean we shouldn’t be critical in our approach to sex as risk, and the messages we receive about it.   It ought to prompt some internal reflection, about how we conduct our sex lives, not as risk-averse, but danger-averse.    If we have a more targeted approach to our sex lives we can then start to change our sexual community to a safer one – because we have our eyes on the right targets.

 

 

 

 

 

 

 

(1) Slovic, P (1999). Trust, Emotion, Sex, Politics, and Science: Surveying the Risk-Assessment Battlefield in Risk Analysis, 19(4).

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