Can't We All Just Get It On?

January 1999: In the midst of the Presidential impeachment trial, Journal of the American Medicine Association (JAMA) editor Dr. George Lundberg chooses to publish a 1991 Kinsey Report article finding that 59 percent of college students don't consider oral sex the same as "having sex." He is immediately fired from his 17-year post at one of the most respected medical journals in the nation. The same month, Atlanta Falcon Eugene Robinson is arrested for soliciting oral sex from an undercover police officer. The next afternoon he gets to play in the Super Bowl.Apparently, in this country opening a public discourse about oral sex is a worse crime than actually getting some. Of course, Dr. Lundberg's transgression is drawing the medical community into America's tawdry debate over the definition of sex. The study, which ran in the January 20 issue of JAMA, was conducted at a Midwestern university in 1991, before oral sex was a regular topic at American dinner tables. Certainly the authors of the study, Stephanie A. Sanders, Ph.D., and June Machover Reinisch, Ph.D., had no idea the oral sex component would be a political debate eight years later. Students were asked a series of questions starting with "Would you say you 'had sex' with someone if the most intimate behavior you engaged in was...," and then there was a list of different types of physical contact. 59 percent responded "no" to oral-genital contact. Given the timing of its publication, we're supposed to draw a conclusion here. If a bunch of 18-25 year olds don't define oral sex as "sex," then President Clinton wasn't exactly lying when he gave us that whole bag of sassafras about not having "sexual relations" with Monica Lewinsky. At least that's what Dr. Lundberg's bosses thought he was implying. Most Americans receive the majority of their health news from media reports based on the research published in JAMA and its rival, The New England Journal of Medicine. While considered "hard science" journals, both have caught flak from the medical community in past years for sensationalism. Lundberg in particular has fanned the flames by giving space to research articles concerning the effects of complementary healing therapies like massage and homeopathy. His attempt to draw connections between America's political and scientific events gave his conservative bosses reason to can him for "inappropriately and inexcusably interjecting JAMA into the middle of a debate that had nothing to do with science or medicine." Since when do attitudes about sex not have anything to do with science and medicine? We used to think it didn't have anything to do with politics, remember? The medical community tends towards a lofty separation between medicine and people, defending that messy human conflict has no place in the sterile walls of pure research. Those familiar with hard science know that it's necessary to keep it that way to ensure untainted results. But what's the use of research results that aren't applied to contemporary issues? Dr. Lundberg was a sacrificial lamb. There have been others. Many scientists have tried to connect their findings about sex with education and have been rebuffed by their peers. Masters and Johnson conducted studies about sexual behavior in the 50's that debunked previously held theories and were ostracized by much of the scientific community. Dr. Jocelyn Elders resigned from her position as Surgeon General for blasting myths about masturbation when she contended that it's actually healthy. By applying some 1991 research to America's debate over the meaning of oral sex, Dr. Lundberg dragged JAMA into the ugly situation on the Senate floor, dissolving the boundaries between medicine and politics, research and practical health care, science and the rest of us. His firing represents the medical community's refusal to get down and dirty in the pigpen of real life.It's unlikely that the study had any effect on the Senate jury, but the research dregs up attitudes worthy of reflection. Just what were those college students, 59 percent of which were women, thinking? Do they subscribe to the Bill Clinton attitude: "It's being done to me, and I'm not involved -- if it's not intercourse, then it's not real"? If 59 percent of college students don't think oral-genital contact is sex, then what are the chances they're protecting themselves against AIDS and other sexually-transmitted diseases when they're engaging in it? Deadly viruses don't discuss the how's of infection. From an epidimiological standpoint, the only difference between oral sex and intercourse is gossip around the water cooler. It's fine for people to disagree about the definition of oral sex. It may even be acceptable that our President's attitude about the act doesn't jive with our idea of what a moral leader, or even a regular guy, should believe. But is it wise for a medical journal to fire the messenger who added science to the conversation, especially at a time when information about our sexual attitudes has dangerous implications for health care and disease prevention?Dr. George Lundberg had the audacity to bring out more material about America's sex life when most of the country would rather put it to rest. But it's evident that we need to keep talking about it at the dinner table even after the Senate decides the President's fate or the next sports hero is caught with his pants down. It's more than gossip at this point, folks.

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