Melinda Gates drew some nervous laughter at a recent TED-x presentation by bringing up the subject of sex in a discussion on contraception. She deserves our applause for doing so because, as clearly related as these subjects obviously are, we family planning specialists rarely put them together.
The purpose of contraception is to make it possible for couples to enjoy the pleasures of sex without the consequence of pregnancy. A lot of people -- and at least one Church -- disagree with this, and many of those folks oppose contraception. But the great majority of couples around the world today practice birth control, believe it is virtuous and healthy, and tell us that it improves their lives. Fully 61 percent of all couples in the world today are having sex and using one or another contraceptive method to avoid pregnancy.
The international family planning profession, of which I have been a member for more than 40 years, has always been nervous about sex. When I took my Masters' degree in family planning in 1969, we had courses in demography, epidemiology, reproductive physiology, and health administration. Sex was never mentioned. Even reproductive physiology was more about the corpus luteum than the clitoris. To this day you seldom read anything about sex in the family planning literature. The reason, I think, is that sex bothers people, especially good sex. We hear a lot about problems with sex (and there are many), but very little about good sex, very little about the quantum of pleasure in the world enjoyed by the two billion women and men (and same-sex couples) who regularly enjoy consensual sex. Is not such sex a good thing? Should not we family planners celebrate the fact that the contraceptives we provide make it possible for people to have more sex? Isn't more sex good?
This idea makes people antsy. Sex has a long, negative reputation in human history. The early Christians despised sex. Historian Reah Tannahill reminds us that "it was Augustine who epitomized a general feeling among the church fathers that the act of intercourse was fundamentally disgusting." A trend in this negative history has been men's fear of women's sexuality. Women were thought to steal men's vitality, to undermine their very sensibility. Remarking on Cleopatra's power over Mark Antony, Plutarch noted: "The unreined horse of concupiscence did put out of Antony's head all honest and commendable thoughts." Delilah's sexuality stole Samson's power. "His strength is useless against love," Delilah sings in the Saint-Saens opera. "He is my slave." "Down from the waist they are Centaurs," intones Shakespeare's King Lear, referring to women's genitalia. "Though women all above. But to the girdle do the gods inherit, beneath is all the fiends'." Eve Ensler's liberating play, The Vagina Monologues, makes note of this tradition. One character says, with maximum irony, "it's a cellar down there... You don't want to go down there. Trust me." And, of course, it's men's fear of women's (dangerous) sexual attraction that forces women to cover their bodies and faces in many Middle Eastern countries today.
Sex, thus, is controversial, and so is birth control. That being so, the family planners who oversee the hundreds of millions of dollars devoted to family planning around the world prefer to focus on women's health, an indisputable benefit of family planning. But we'd do a better job I think if we addressed the subject of sexual pleasure head-on. After all, sex without pregnancy is a powerful expression of love for many couples. It is an important bonding experience, linking two people physically as well as emotionally, bringing them as close to each other as it is possible for two people to be. For most of us, it is an important and fulfilling part of life.
There are some positive signs on the horizon. A brave band of concerned family planning and HIV/AIDs professionals has formed The Pleasure Project, which works tirelessly to remind conference goers and others that sexual pleasure is an important part of the equation. At one international conference, the Pleasure Project put up posters in the corridors, asking "Did you have sex with yourself last night?" And condom advertising especially has begun to enjoy a solid dose of sex in its marketing mix. Here are some examples. My own organization, DKT International, helped spearhead this. We linked up with the Pleasure Project and Condomania at the recent HIV/AIDS conference in Washington DC to "put the sexy back" in safer sex and condom use. How? One way is variety. DKT's project in Brazil, for example, includes condoms with colors and aromas (strawberry, chocolate, mint, tuti-fruti, banana, cola, and watermelon), condoms lubricated with mild anesthetic to delay ejaculation, extra large, anatomically shaped condoms, condoms lubricated to create a cool sensation and condoms lubricated to create an extra warm sensation, among others.
So let us celebrate. Sex is unquestionably necessary; why shouldn't we be pleased that it is also good?
Philip D. Harvey is president of DKT International, an international family planning organization.
Notes: Tannahill: Sex in History, pp 138-48
Shakspeare's Plutarch (1875), p. 184.