John Diggs Disputes Surgeon General’s Report

 By John R. Diggs, Jr., M.D.
August 2001

Somehow, the safe sex educators badgered the current Surgeon General Dr. David Satcher into endorsing sex education as the answer to the problems that sex education has produced. The report, "A Call to Action," fully supports the dual message: abstinence is best but if you can't be abstinent, use condoms and pills.

Although the ‘retreats' to draft such a report were convened during the Clinton presidency, the artificially generated demand that such a report be released became evident only 10 weeks ago when a series of articles began to appear in the New York Times and elsewhere. President Bush's recorded support for ‘abstinence-until-marriage' education rather than sex education has frightened sex educators into soliciting an attack on abstinence-until-marriage from the Office of the Surgeon General.

That those in favor of teaching youth how to ‘safely' be promiscuous had the clout to generate the release of such a document is remarkable. That this report is described as “balanced” is disheartening. The Satcher group claims to have sought a “conservative opinion” but none who unequivocally support abstinence until marriage are listed among Contributors or the Steering Committee. Instead it is stacked with radical, sexual laissez-faire champions like John Bancroft of the discredited Kinsey Institute.

The wide-ranging report covers a variety of topics but starts with a common ploy of establishing “common ground.” Typically, this means that principles should be abandoned before negotiating policy. In this instance, Satcher's “common ground” demands acceptance of the bizarre notion that children are sexual from birth. Repeatedly Satcher calls for education "throughout the lifespan." What he doesn't understand is that the contributors to the document actually mean starting in infancy. The Kinsey Institute representatives are well aware that Alfred Kinsey, in Sexual Behavior in the Human Male claims to record infants as young as four months stimulated to orgasms. SIECUS documents over the years have called for abolishing the taboo against adult-child sexual relationships. Unwittingly, “Call to Action” endorses pedophilia.

Obvious Inaccuracies

Obvious inaccuracies make it clear that the document was rushed out. Satcher mentions "5.5 million new cervical cancer cases occurring per year." This is wrong. Although one statistician claims 5.5 million HPV infections per year, there could easily be 50% fewer or 50% more. All the same, the best statistic actually indicates about 15,000 cervical cancer cases each year, not 5.5 million. The Surgeon General is only off by a factor of 367!

One of the most egregious assertions made by the Surgeon General is that "Sexual orientation is usually determined by adolescence, if not earlier, and there is no valid scientific evidence that sexual orientation can be changed." First, real people know this not to be the case. Thousands of people who used to practice homosexuality have told their personal stories to offer hope to those trapped in a self-destructive activity. Second, the periodic brouhaha over the discovery of a “gay gene” is always followed by much quieter retractions. No scientist confirms the presence of a “gay gene.” Third, people are not homosexual; they perform homosexual acts. We humans are male or female; “gays” do not have different “equipment.” Satcher blames those opposed to homosexuality for the high rates of mental disease found among those practicing homosexuality. To come to this conclusion, he must ignore similar high rates of mental disease, including suicide, documented among practitioners in societies which have come to embrace homosexuality. Lastly, he ignores the fact that most “anti-gay violence” is perpetrated by “gays” in domestic violence settings. The Surgeon General's statement erroneously leads people to believe they are trapped.

Dr. Satcher confuses unintended pregnancy with unwanted pregnancy; while 50% of pregnancies may be unintended, that does not mean 50% are unwanted. Furthermore, there is no established link between “wantedness” and child abuse. On the other hand, the legal and social acceptance of abortion has indeed paralleled the upward charge of child abuse statistics.

Satcher bemoans the high number of abortions in the country but encourages ‘reproductive health services' which usually include abortion. He reports wide consensus that abortion should be rare. If it is not killing, why should it be rare? If it is killing, why does he seek more access?

On another point, Dr. Satcher, by repeating the erroneous assertion that 22% of women are raped, blurs the distinction between a variety of unwanted sexual interactions and rape. Yes, statistics do show that 22% of women have experienced unwanted sexual touching but to equate all of these episodes with rape is to trivialize rape and artificially inflate a statistic that needs no exaggeration to be regrettable.

In one area (perhaps only one), Call to Action deserves applause. David Satcher recognizes parents as the first educators for their children and says they "should help guide other sexuality education efforts so that they are consistent with their values and beliefs." Of course, to follow through, I expect Dr. Satcher to call for the removal of sex education from schools because, there, all students are subjected to the same instruction regardless of individual parental preferences.

Missed Two Major Opportunities

The Surgeon General missed two major opportunities for really useful work in his comments on Public Health approaches. First, he could have reinforced the importance of primary prevention. Especially in the case of the incurable viral STDs, this is the only effective method of prevention. So far, the emphasis has been on expensive treatment which still ultimately results in failure -- ongoing infection in the case of herpes, death in the case of HIV.

Doctors still do not have the right to inform uninfected spouses of the deadly contagion that their HIV positive spouse brings to the marital bed. Someone needs to bring standard public health interventions to bear on stopping HIV. Who better than the Surgeon General to call for public health rather than political expediency? Second, he could have disseminated information on his second point - "identifying protective and risk factors." This document would have been a great opportunity to bring forth what is known about the deficient protection of condoms for all STDs. Instead, comprehensive sex educators continue to give youth and adults a false sense of security, claiming that condoms are 99.7% protective.

The real public health threats caused by out-of-wedlock sex are not emphasized.

• Lack of effectiveness of condoms in curtailing many STDs.
• Lack of contact tracing and HIV notification by name.
• Childhood exposure to pornography. The report mentions unsolicited pornography, but what about the high volume of pornography that youth actually seek?
• Sexual exploitation due to lack of enforcement of statutory rape laws.
• The role that the ‘safe sex' teaching has played in the habituation of promiscuous activity and in spreading STD.
• The ultra-high disease and health risk of anal intercourse (heterosexual and homosexual).
• The de-emphasis of marriage – the only time-tested stable institution that benefits women and children and encourages fidelity.
• The rash of reports of oral genital contact among shockingly young students.
• Post-abortion trauma and the documented relationship of increased breast cancer to elective abortion, especially for the young.

The dual message is just ‘safe sex' in an abstinence wrapper. If a standard is not taught, why should youth elect abstinence until marriage? To lower risk of pregnancy and STD? Simultaneously, they are told those risks are vacated by pills and condoms. If marriage is not unblushingly taught as the standard context for sexual activity, the health risks are not reduced, children are not protected, women will be exploited, and future marriages will fail.

All told, The Surgeon General's “Call to Action” calls into question the primacy of promoting the health of the public in the Office. True public health stresses primary prevention, especially for those maladies for which there is no cure or for which the cure is dangerous or expensive. True public health informs the public. We are not informed of condom effectiveness rates. On a number of points we are, instead, misinformed by the document. Fear not, the document can still be useful... as confetti.  

Dr. Diggs is a resident of South Hadley. He has appeared on national television programs and is co-chair of the Massachusetts Physicians Resource Council and an Executive Committee member of the nationwide Physicians Consortium. As a physician, Diggs has 16 years of clinical experience in caring for ethnically and socio-economically diverse patients in communities from New England to California.

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