When I hear the word "cunnilingus," I think about the popular Tootsie Pop owl that came to fame in the 1970s. You know, the one from the original commercials for the popular candy, who is asked, "Mr. Owl, how many licks does it take to get to the Tootsie Roll center of a Tootsie Pop?" The owl always responds, "A good question. Let's find out." He starts licking the Tootsie Pop. "A-one, a-two-hoo, a-three--" Crunch. "A-three!" The commercial ends with the narrator telling us that the world may never know the answer to that question. This commercial is arguably what made this candy so famous, especially given that there were many versions of it, each for a different flavor of Tootsie Pop. The candy was a childhood favorite of mine, unlike cunnilingus.
Last week another thing made me think of cunnilingus, something that doesn't have a Tootsie Roll center. Michael Douglas, who has famously battled throat cancer over the past few years and is the star of the recent film Beyond the Candelabra, had quite the interview last week with The Guardian, in which he suggested that when he licked a certain lollipop, he got the human papillomavirus (HPV).
After this news broke, numerous outlets picked up the story, and seemingly overnight, Michael Douglas became a poster child of HPV. But just as quickly as he took on this new role, he relinquished it, coming out a day later to say that he actually doesn't know what caused his throat cancer, and that he was just using that interview as a platform to highlight the fact that getting to third base with a partner can sometimes result in cancer. Speaking at an American Cancer Society fundraiser on Monday evening in New York City, Douglas told the audience:
I never expected to become a poster boy for head and neck cancer, but, if after what started out as trying to answer a couple of questions about the suspected sources of this disease results in opening up discussion and furthering public awareness, then I'll stand by that.
Vice's David Schilling wrote an interesting piece about all the press surrounding Michael Douglas. In his article he suggests that Douglas was trying to brag about all the "young trim Hollywood has to offer." This is an interesting theory, especially as the spotlight is currently on Douglas for playing one of the most colorful musicians of the past 60 years, Liberace, who was gay. I guess it's not too hard to believe that a heterosexual man would want to regain some "straight points" after playing a flamboyant gay man onscreen. But was this really what Douglas was doing, or was he actually giving us an opportunity to learn a much-needed lesson about men and HPV? And are men really that at risk for HPV, which has most commonly been associated with cervical cancer in women?
According to the Centers for Disease Control and Prevention, each year in the United States, 400 men will get HPV-related cancer of the penis, 1,500 will get HPV-related cancer of the anus, and 5,600 will get HPV-related cancers of the throat. (However, many of the cancers of the throat are caused by tobacco and drinking, not by HPV.) As of 2011, HPV-related anal cancer affected 2 out of 100,000 people in the U.S., but gay and bisexual men are as much as 17 times more likely to be diagnosed than straight men. Also, 1 percent of sexually active men in the U.S. will have genital warts caused by HPV at any one time. Think of it this way: You're in a gay bar on any given Friday night, and at its peak there are about 300 men in there. Three men in the bar will have warts at that moment.
Earlier this year, the British Medical Association wrote to Anna Soubry, Britain's Minister of Health, urging her to offer HPV vaccinations to young gay men in sexual health clinics because of an "alarming increase in anal cancer in gay men." These vaccines would be the same ones that are suggested for young women to protect against cervical cancer. The letter also highlights the fact that vaccines are not currently economically viable in the UK. Since this letter, nothing has changed.
Here in the U.S. we see a similar push for getting young boys vaccinated, but it's not being paid nearly enough attention. The CDC's Advisory Committee on Immunization Practices made headlines in 2011 by recommending that young men and boys as young as 11 be vaccinated to protect from throat and anal cancers caused by HPV. However, we haven't seen this effort gain much traction, and in 2013 we are still seeing HPV rise and men getting vaccinated at low rates.
This aversion to allowing HPV vaccines to be more widely accessible has many activists, physicians, and politicians in general shock. Dr. William Schaffner, chairman of the Department of Preventive Medicine at Vanderbilt University School of Medicine and a nonvoting member of the CDC's Advisory Committee on Immunization Practices, said, "This is cancer, for Pete's sake. A vaccine against cancer was the dream of our youth."
Many have pointed to the conservative right's efforts to block any national movement to allow HPV vaccines for both young boys and girls because they don't want to talk about the fact that some boys and girls may be having sex at the age of 11. Most famously, in 2011, former Sen. Rick Santorum (R-Pa.) implied that by mandating the HPV vaccine for young girls, the state of Texas was promoting sexual activity between 11- and 12-year-olds. His argument doesn't take into account the fact that the vaccine would protect young girls, and even boys, for a lifetime.
It should come as no surprise that the pushback against HPV vaccines even in the face of rising HPV rates is largely about sex, which is quite sad, because, as Dr. Schaffner pointed out, we now have a way to vaccinate against cancer. But it still seems that many people, especially Rick Santorum, would rather put youth at risk for cancer than face the fact that they may sometimes forego their Tootsie Pops for something a little less sugary. Only time will tell whether we as a country will move toward making HPV vaccines more accessible to young people, including boys.