Health check: When is having sex having sex, and when is it politics?

WHAT IS sex? I'm sorry, I'll try that again. What counts as "having sex"? This is not a Valentine's quiz, though you may think the answer is obvious or trivial. Yet this seemingly simple question has triggered the sacking of the editor of one of the world's leading medical journals, and has convulsed the international medical establishment.

The reason is that the question turns out to be not quite as simple as it seems. When US college students were given a list of activities, ranging from kissing to sexual intercourse, and asked to say which of them counted as "having sex", more than half answered that oral sex did not.

The study was fast-tracked to publication in the Journal of the American Medical Association by its distinguished editor, George Lundberg, and appeared last month as members of the US senate began considering whether the sexual high jinks of the President, and his subsequent denials, should result in his impeachment.

Impeccable timing, you might have thought. The majority American view of whether oral sex counts as having sex is surely relevant to the events now unfolding on Capitol Hill. That, however, is not how the luminaries of the American Medical Association saw it. To them, Dr Lundberg's decision to time publication as he did was an unacceptable intrusion into the political process. Dr E Ratcliffe Anderson, executive vice-president of the AMA, said that he did not object to the contents of the paper, but to its accelerated publication. "I happen to believe that Dr Lundberg was focused on sensationalism here, not science," he said.

The sacking has provoked an extraordinary reaction which cannot have been anticipated by the AMA. The story dominated the broadcast media for most of the day on which it was announced, and at least 53 metropolitan newspapers carried it on their front pages. Since then, acres of newsprint have been devoted to the sacking, almost all of it critical of the AMA, which has been depicted as hidebound and out of touch. As the New York Post put it: "I haven't heard recently of any editor being fired for being relevant about what's going on in the world."

On this side of the Atlantic, the British Medical Journal had within 10 days received 67 responses on its website to its comment on the sacking, 55 of which (82 per cent) were outraged by Lundberg's dismissal. Half of these were editors themselves. One, Magne Nylenna, editor of the Journal of the Norwegian Medical Association, suggested establishing a George Lundberg Award for editorial integrity.

There are several bizarre aspects of these events. The first is that the AMA is itself deeply embroiled in national politics. In the last decade, as the St Louis Post-Dispatch observed, the AMA's Political Action Committee has given more than $14m (pounds 8.8m) to political candidates, with about two- thirds going to Republicans. It has also criticised every health reform bill as "socialised medicine". The charge of hypocrisy is difficult to resist.

The second is the suggestion that doctors should keep out of politics. Yet, as most doctors acknowledge, political change over the last half- century has brought greater improvements in health than medical advance - tackling poverty, improving housing and employment.

In terms of public health, timing is critical. A warning about sex or smoking may fall on deaf ears on one occasion and capture the limelight on another, often for reasons that are hard to predict in advance. It depends on linking with other events, riding on a tide of opinion, catching the zeitgeist. In this instance, the Clinton link, as well as being interesting in itself, gave a reasonable chance that the message of the study would be widely disseminated.

Nor is the finding unimportant. It carries a message that goes beyond the parlour games of the chattering classes. (Does sharing a bedroom with a member of the opposite sex count as adultery? Does sharing a bed?) For doctors and other health professionals with an interest in adolescent and sexual health, the issue of what young people understand as "having sex" matters a good deal. It demonstrates that closer and more specific questioning may be necessary to elicit details of activities that could, in the context of Aids and other sexually transmissible diseases, be dangerous.

As one correspondent to the BMJ - Simon Chapman, editor of Tobacco Control - discovered when he questioned his teenage children, fellatio may be commoner than we think.

Arts and Entertainment
Joel Edgerton, John Turturro and Christian Bale in Exodus: Gods and Kings
film Ridley Scott reveals truth behind casting decisions of Exodus
Arts and Entertainment
An unseen image of Kurt Cobain at home featured in the film 'Kurt Cobain: Montage of Heck'
filmThe singers widow and former bandmates have approved project
Arts and Entertainment
Jake Quickenden and Edwina Currie are joining the I'm A Celebrity...Get Me Out Of Here! camp
tv
Arts and Entertainment
George Mpanga has been shortlisted for the Critics’ Choice prize
music
Arts and Entertainment
Roisin, James and Sanjay in the boardroom
tvReview: This week's failing project manager had to go
PROMOTED VIDEO
Arts and Entertainment
Carrie Hope Fletcher
booksFirst video bloggers conquered YouTube. Now they want us to buy their books
Arts and Entertainment
Damien Hirst
artCoalition's anti-culture policy and cuts in local authority spending to blame, says academic
Have you tried new the Independent Digital Edition apps?
Arts and Entertainment

ebooksNow available in paperback
Arts and Entertainment

ebooks
Arts and Entertainment
A comedy show alumni who has gone on to be a big star, Jon Stewart
tvRival television sketch shows vie for influential alumni
Arts and Entertainment
Jason goes on a special mission for the queen
tvReview: Everyone loves a CGI Cyclops and the BBC's Saturday night charmer is getting epic
Arts and Entertainment
Image has been released by the BBC
tv
Arts and Entertainment
Will there ever be a Friends reunion?
TV
News
Harry Hill plays the Professor in the show and hopes it will help boost interest in science among young people
arts + ents
Arts and Entertainment
A Van Gogh sold at Sotheby’s earlier this month
art
Arts and Entertainment

MusicThe band accidentally called Londoners the C-word

Arts and Entertainment
It would 'mean a great deal' to Angelina Jolie if she won the best director Oscar for Unbroken

Film 'I've never been comfortable on-screen', she says

Arts and Entertainment
Winnie the Pooh has been branded 'inappropriate' in Poland
books
Arts and Entertainment
Lee Evans is quitting comedy to spend more time with his wife and daughter

comedy
Arts and Entertainment
American singer, acclaimed actor of stage and screen, political activist and civil rights campaigner Paul Robeson (1898 - 1976), rehearses in relaxed mood at the piano.
filmSinger, actor, activist, athlete: Paul Robeson was a cultural giant. But prejudice and intolerance drove him to a miserable death. Now his story is to be told in film...
Arts and Entertainment
Taylor Swift is dominating album and singles charts worldwide

music
Arts and Entertainment
Kieron Richardson plays gay character Ste Hay in Channel 4 soap Hollyoaks

tv
Arts and Entertainment
Midge Ure and Sir Bob Geldof outside the Notting Hill recording studios for Band Aid 30

music
Arts and Entertainment
Look out: Broad shoulders take Idris Elba’s DCI John Luther a long way
tvIdris Elba will appear in two special episodes for the BBC next year
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    Cameron, Miliband and Clegg join forces for Homeless Veterans campaign

    Cameron, Miliband and Clegg join forces for Homeless Veterans campaign

    It's in all our interests to look after servicemen and women who fall on hard times, say party leaders
    Millionaire Sol Campbell wades into wealthy backlash against Labour's mansion tax

    Sol Campbell cries foul at Labour's mansion tax

    The former England defender joins Myleene Klass, Griff Rhys Jones and Melvyn Bragg in criticising proposals
    Nicolas Sarkozy returns: The ex-President is preparing to fight for the leadership of France's main opposition party – but will he win big enough?

    Sarkozy returns

    The ex-President is preparing to fight for the leadership of France's main opposition party – but will he win big enough?
    Is the criticism of Ed Miliband a coded form of anti-Semitism?

    Is the criticism of Miliband anti-Semitic?

    Attacks on the Labour leader have coalesced around a sense that he is different, weird, a man apart. But is the criticism more sinister?
    Ouija boards are the must-have gift this Christmas, fuelled by a schlock horror film

    Ouija boards are the must-have festive gift

    Simon Usborne explores the appeal - and mysteries - of a century-old parlour game
    There's a Good Girl exhibition: How female creatives are changing the way women are portrayed in advertising

    In pictures: There's a Good Girl exhibition

    The new exhibition reveals how female creatives are changing the way women are portrayed in advertising
    UK firm Biscuiteers is giving cookies a makeover - from advent calendars to doll's houses

    UK firm Biscuiteers is giving cookies a makeover

    It worked with cupcakes, doughnuts and macarons so no wonder someone decided to revamp the humble biscuit
    Can SkySaga capture the Minecraft magic?

    Can SkySaga capture the Minecraft magic?

    It's no surprise that the building game born in Sweden in 2009 and now played by millions, has imitators keen to construct their own mega money-spinner
    The King's School is way ahead of the pack when it comes to using the latest classroom technology

    Staying connected: The King's School

    The school in Cambridgeshire is ahead of the pack when it comes to using the latest classroom technology. Richard Garner discovers how teachers and pupils stay connected
    Christmas 2014: 23 best women's perfumes

    Festively fragrant: the best women's perfumes

    Give a loved one a luxe fragrance this year or treat yourself to a sensual pick-me-up
    Arsenal vs Borussia Dortmund: Alex Oxlade-Chamberlain celebrates century with trademark display of speed and intuition

    Arsenal vs Borussia Dortmund

    The Ox celebrates century with trademark display of speed and intuition
    Billy Joe Saunders vs Chris Eubank Jnr: When two worlds collide

    When two worlds collide

    Traveller Billy Joe Saunders did not have a pampered public-school upbringing - unlike Saturday’s opponent Chris Eubank Jnr
    Homeless Veterans Christmas Appeal: Drifting and forgotten - turning lives around for ex-soldiers

    Homeless Veterans Christmas Appeal: Turning lives around for ex-soldiers

    Our partner charities help veterans on the brink – and get them back on their feet
    Putin’s far-right ambition: Think-tank reveals how Russian President is wooing – and funding – populist parties across Europe to gain influence in the EU

    Putin’s far-right ambition

    Think-tank reveals how Russian President is wooing – and funding – populist parties across Europe to gain influence in the EU
    Tove Jansson's Moominland: What was the inspiration for Finland's most famous family?

    Escape to Moominland

    What was the inspiration for Finland's most famous family?