Lisa Appignanesi: Sex may be fun, but it can also be frightening

Sexual health clinics are overcrowded and underfunded. Not even the experts know why this rise in STIs has happened


"Sex is about fun," my 17-year-old says, with that look on her face which intimates that I certainly don't know the meaning of either of these three-letter words. We're having one of those arguments engendered by nothing much more than the fact of my maternal existence.

"Sex is about fun," my 17-year-old says, with that look on her face which intimates that I certainly don't know the meaning of either of these three-letter words. We're having one of those arguments engendered by nothing much more than the fact of my maternal existence.

I'd been about to tell her that there is much more to sex than fun. But she anticipates me, declaring that I must be worried about sexually transmitted infections (STIs). In fact, I wanted to tell her about sex being about the other person, as well as yourself. About what you want from others, and about what you want to be. Next week, next year, as well as now. I begin, but she does not wait.

"Oh Mum!" she groans, and rushes off. Her telephone has beeped, will carry on beeping and beeping, between the speedy clicks of her return texting. I'm left thinking that children do on the whole expect their parents, like teachers and government ministers, when they talk about sex to talk in terms of prevention or punishment. Prevention being condoms; punishment being (too early) pregnancy and a rash of STIs.

The statistics are worrying. Since 1996, the instances of syphilis - that disease which so hideously coloured Western history and sexuality - have risen by 486 per cent. Chlamydia, a secret stalker that gives little sign of its early existence only to manifest itself in pelvic or testicular pain and possible infertility down the line, has gone up by 108 per cent. One in 10 young people have it. Meanwhile that old perennial, gonorrhea, has gone up by 87 per cent. And last year, 6,500 people in the UK were told they had HIV.

Sex, it seems, is as scary as it ever was. People do it and it makes people sick. The clinics can't cope. Something must be done.

According to a new report by the influential Commons Health Committee, we've entered crisis times. Sexual health clinics are overcrowded, under-resourced and underfunded. Patients can wait for as long as six weeks before seeing a specialist. Diagnostic equipment is out of date. More and better sexual health clinics are needed, together with a national sexual health strategy, a chlamydia screening programme, and sweeping changes in the way sex is taught in schools.

All of which is, of course, a tall, if necessary, order.

The problem is that no one, not even the experts, is sure why this astronomical rise in STIs has taken place. It may be partly that diseases themselves, infections and our relation or susceptibility to them, change over time. Just like sexual behaviour (although changes in sexual behaviour alone are not sufficient, according to the experts, to explain the increase). In other words, what rise there might be in sexual activity doesn't explain the far greater rise in sexually transmitted infections.

There are, however, some changes in sexual behaviour which have probably contributed. One is the decline in the use of condoms among the young. In the 80s and early 90s, the anti-Aids campaigns terrified people into using condoms, which are still the only form of contraception to counter STIs. But it's not only the young engaged in casual sex who are at fault, here. Couples in stable relations have grown complacent, too; apparently, they don't wash their sex aids. Lesbian couples don't make enough use of dental dams. Then, too, among heterosexual couples, contraception tends to fall to the woman in the relationship. And in one of the aspects of sexuality which hasn't changed all that much, women are still better at swallowing their pills than at asking their partners to don a condom. (So get those masks or "dominos" out, boys, like those old Venetian revellers and ravers, and go out prepared to disguise; after all, con dom, with domino, is the origin of our word condom.)

Whatever the experts may say, this lay anthropologist - with a tribe of young at her doorstep - does think certain aspects of sexual behaviour have changed enough to make a difference, not only or principally to the rise of STIs but to the way we might consider "teaching" sex in schools. It seems to me - though this may just be the eternally recurring illusion of the middle-aged - that more people are doing it more, and younger, and with more partners than they were in my youth. It's not because today's young are more lascivious or more debauched. It's just the way things seem to be, both chemically and technologically.

Take the latter first. The mobile phone means that in a matter of minutes, through a spiralling network of contacts, you can get some hundred people together. "Going to meet some friends" at the cinema or café or park, or wherever, can turn into a pack in no time at all. Parties are overrun. Let alone clubs, where queues coil round streets and blocks, in a brand new version of that very British institution.

So my children and their friends know far more people than I ever knew - and will certainly ever text. Knowing them here does not necessarily mean in the biblical sense, but it is certainly one step closer than not knowing them at all.

Then there are the chemicals. Ever since it was invented (arguably by the Romantics), youth has been about "fun" and "now" and the life of the senses. The thing about the drugs, which go along with the sex and the rock and roll perhaps more than they used to, is that they're so emphatically about now - instant gratification - that they can annihilate any sense of then (of time and its passage).

What parents and teachers and ministers (probably not only the governmental kind) tend to offer is a then of prohibition and punishment. This is what is too often instituted as sex education. Use contraceptives or else you'll end up with HIV or STIs or some other form of damnation.

My modest proposal for sex education in schools is that we treat it as well, sex. Sex really isn't just those few minutes or half hour set apart from the rest of the curricular flow. Sex, in fact and fantasy, is part of life. And yes, it's fun. Even with condoms. It can also be sad or heart-rending or painful. About your parents or about your children. About quite a lot, really.

So, in schools, teachers might consider integrating education about sex into the larger curriculum, rather than giving it its own little period set apart in brackets of embarrassment and sniggers. Chemistry, biology, poetry, literature, the media, philosophy, psychology, name it -- all of them contain large chunks to do with sex. Any of us writerly lot would happily come up with 10 scenes from Tolstoy to Sex in the City, from Freud to Friends, to help teachers along. On top of that, given the excitements of sex in science (from animal behaviour to the chemistry of pain and pleasure, to STIs themselves), schools may even end up producing a few more chemists and biologists.

The writer's most recent novel is 'Sanctuary', published by Bantam

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