[oasis] [columns]

Michael Walker and Dr. Katherine Fordham

January 1997

Life, Love and AIDS

Welcome to the second edition of our column for Oasis. Let us say (once again) that we are so excited to be here; Oasis is providing an excellent forum for the open communication of issues affecting queer youth and the two of us are proud to be part such a noble effort.

Now on to the health issues, which, of course, is what we are here for in the first place. Since the first edition of our column was just published, and Oasis contributors are required to turn in their column material way ahead of publication time (a common and needed requirement of most periodicals); we won't be addressing any questions which you guys may have sent our way after the tenth of December in this issue. We did get a question from a reader early into the month, and that's going to be topic of the entire column this month. In the meantime, keep the questions coming!

Dear Mike and Dr. Kate:

I was reading your column and wondered about something: is anal sex safe? I don't mean about getting AIDS -that kind of safe- but I heard somewhere that you can get hurt somehow if you do it and that's why it's illegal in some places. Is that true?

Brad D.

Dear Brad:

Thanks for bringing up an important and seldom-addressed subject. Anal sex has long been a very controversial issue in the medical, religious, and social communities. Obviously, it is something which many people feel uncomfortable talking about but nonetheless, it is something which sexually-active gay men should be informed about so they can make intelligent decisions on this subject.

The anus is intended to function primarily as a means of eliminating waste from the body. It is attached to the rectum, which is the final section of the gastrointestinal tract. In the male body, the rectum and anal canal are located behind the bladder and prostate gland; the anal canal itself is only about an inch in length. The reason that anal sex is enjoyable is because the tissue of the anus is very sensitive, in much the same way that the skin of the sex organs is, and is thus stimulated in a similar manner. Also, anal sex can stimulate the prostate gland itself; thus the prostate has been often described as "the male G-spot". The opening which allows waste to pass out of the body through the anus is known as the external anal sphincter. This is also the point where something can enter the anus, in a sexual context, and much of the danger surrounding anal sex is that since the sphincter is designed to pass things outside the body, and not to act as an orifice into the body; anything that forces the sphincter to open from the outside may put strain on it. Therefore, nothing too large should be inserted into the anus. (Many of you reading this may be rolling on the floor with laughter right now; but this is an important point.) Certainly nothing that is artificial, like any sort of man-made object should ever be inserted into the anus, except in some medical procedures. Anything that is too large, or extremely hard, or sharp, can tear the soft interior tissue of the anal canal. Lubrication is essential in anal intercourse; but it is important not to use a lubrication which is oil-based as many such substances can react against latex condoms and leave small holes in them which might allow fluids to be exchanged between the two people engaging in sex: exactly what you are trying to avoid by wearing a condom in the first place!

Tearing of the tissue within the anal canal can cause bleeding and thus encourage the transmission of sexually transmitted diseases. In extreme cases, objects inserted in the anus which are very large or are inserted with severe force can lead to serious medical problems, such as damage to the external anal sphincter and other, similar, sphincters further up the rectal route. Also, the organs near the anal canal can be damaged through anal intercourse if the sexual act is unusually forceful and aggressive. Most cases of anal canal and rectal damage seen by physicians are the result of either rape, where sex is forceful and violent, or in cases of child sexual abuse where the anal canal is smaller and not fully developed, therefore more susceptible to trauma. Since this column is targeted primarily towards adolescents, we wish to stress that the younger you are, the greater the potential for injury during anal intercourse due to the smaller size of the anus and associated organs.

Another important risk factor of anal sex is that small items which are forced into the anus can get trapped in the anal canal. There have been documented cases where doctors have seen such items become lodged in the canal, including condoms which were not properly used. It is essential that a condom is worn during anal intercourse because the risk of transmission of AIDS and other STDs during anal sex is very high. But is also imperative that the condom is properly worn and that care is taken so that the condom will not come off inside the anal canal (which it should not providing that condom is being used correctly). Always pay attention to the instructions which come with condoms!

Both of us are what you can consider realists: that is, we face issues -especially sex-related issues- in a logical and realistic way. We know that some of our readers probably engage in anal intercourse and others may be considering it, and therefore feel it is our obligation to provide information on the subject. We are not going to take a moralist view on this nor condemn it outright. But please understand that while anal sex may be enjoyable, as we stated before, intercourse is not the primary function of the anus and there are dangers involved; the risk of contracting a communicable disease like AIDS and also the risk of physical damage due to the sex act itself. If you are young, the risks are greater. Also, there are psychological, emotional, and legal aspects to consider. Some people enjoy anal sex, but some others don't. Like any form of sex, you should only participate in it if you are one hundred percent sure that you feel comfortable engaging in such activity. Anal sex, or sodomy, is illegal in a fair number of states, as well. The reason it is illegal has much more to do with religious concepts than medical concerns. No matter what your personal opinion of such laws may be; keep in mind that laws are laws all the same, and there could be legal consequences for your behavior, although the sodomy laws are rarely enforced unless rape or abuse is a factor.

In closing, remember that it is your body which we are talking about and while what you do with your body is entirely your business; it is something which you should take very seriously and always consider the possible ramifications when engaging in any sexual practices. Until next month, stay safe!

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