A flaw in my sex education: adventures with imaginary STIs (taste warning - may contain TMI)

Last Saturday, I paid a visit to my GP. The reason for the visit was an unusual lump that I had detected on my anus, and I wanted confirmation of what said lump was. Chances were, it was piles. But, specks of blood on the loo paper are a thing one should generally get checked out, and weird lumps likewise.

The thing is, having detected the lump, my natural reaction (which may not be natural for most people, but it is for me) was to try to get a look at it. Not having the flexibility of a politician (who seem to be able usually to get their heads up their arses, no problem), this was going to require the application of Technology. Namely, my digital camera. (No, I am not going to share the resulting picture!)

So, now I had something visual, that I could use to compare with things online. I types a description of what I could see into google images, and looked for something that matched. It came up with a few options, the most common of which was piles, naturally. But one page said that something that looks like piles might be genital warts. And the picture it showed looked sort of like the picture on my camera.

And then, on Wednesday, I noticed three little lumps on my penis!!!

And on Friday, I noticed some odd white flecks around my lips, of two different kinds, which I vaguely pondered might be oral thrush or something.

So, I went to the GP with these symptoms, having half-convinced myself that somehow, despite not having sexual contact with another person for just about 10 months, I had managed to contract and develop symptoms of, a wide range of STIs.

Of course, my fears were unfounded (as this post's title may have already given away). I did have piles, specifically a singular pile, with a long name that started with the word "external". A digital rectal examination produced the result "nothing abnormal detected" (the doc stuck his finger up my arse and couldn't find anything wrong with me). The lumps on my knob were definitely NOT warts (the GP was very clear on that) but instead were "penile flaccid cysts", and could safely be ignored. The first kind of odd flecks were, apparently, nothing, and careful examination inside my gob produced the verdict that there was nothing wrong with me there either.

As it happens, I am pretty sure I do have a cold sore (that was the second type of odd fleck). Google is my friend (although not always very helpful for a hypochondriac!), and revealed that anxiety and stress can prompt an attack if one is already infected (as explained in that link), and given the imaginary illnesses I had conjured for myself during the week, it's fair to say I had worked myself into quite a stressed and anxious state. (So there's at least one STI that may not be imaginary here.) I also discovered that it is believed around 80% of US adults carry the herpes simplex virus that causes cold sores, and depending on which source, 60% or 70% of British adults do (the above link says 70%). As it happens, I believe I know how I first got infected, and it was a non-consensual kiss by a woman I barely knew, a few years ago - I got symptoms for the first time a few days after that, I believe, and wondered at the time whether I had caught a cold sore, but it didn't match anything I had seen in sex ed classes.

And that, finally, brings me to the point of this post!

You see, all the things I worried about last week, I did not have any clear idea of what to look for. And the reason for this is, I think, something to do with sex education and its aims. I think it is something that can be done by both safer-sex approaches and abstinence-only approaches.

You see, when either of these approaches teaches about STIs, there does seem to be a tendency to want to use fear to prompt action. Whether it's the abstinence-only "Don't have sex!", or the safer-sex, "Don't have sex without a condom!" the method is quite similar. The subtext is, "Because if you do, you could end up like THIS!!!" (drama button) I recall it from when I was at school (about 15 years ago now), and it was also prevalent in the Sex Education Show's episode talking about STIs.

And of course, it's tempting to believe that that's more effective if you show the most advanced, hideous, out-of-control examples of an illness that you can (my other doubts about that approach are explained in my "Sex Education Show" post linked above). AIDS is pretty bad as it is, so they don't need to take quite the same approach with that ("It's gonna KILL YOU!" seems to do the job with that quite well, although I am not sure how effective current treatments are at delaying that outcome or preventing it).

The problem with that is that, if something does go wrong, you don't really know what to look for to know whether you should be worried or not, until it gets bad enough to look like those photos.

That's how it's taken me so long to figure out that I had probably contracted the herpes simplex virus - the pictures of cold sores that were shown were like nightmares, and nothing at all like what I had. Most of the time if I had an attack, I just got the start-up tingling and nothing else, even, and didn't know that it might be a cold sore. I stumbled across the information (see the link earlier) last weekend when I was clicking links related to my other worries. So then I went looking for images of cold sores, and finally found something that looked like what I had experienced a few times before during periods of high stress, and not like a hideous pox that invaded your entire face (I exaggerate the worse pictures, of the type they showed in sex ed classes - but not by that much!). Of course, some of them looked a lot like ordinary zits (and to be honest, my worst attacks I assumed I had just got a zit on the edge of my lip!) It's only the other symptoms that make me think I probably have it (and the fact that 60 or 70 percent of people do, so on balance of probabilities I would be more likely than not to have it).

And the same goes for the things I imagined I had but didn't have, like genital warts. I really didn't know what to look for to know one way or the other whether the things I had spotted on my body were benign, or non-infectious, or absolutely hideous diseases in the early stages, because the only images I had seen of such things were the nightmarish scenarios that I assume were the worst possible outcomes of being infected. So I was left with wondering if maybe the flaccid cysts were the "early stages" of something far worse? That the GP was able to be so definite about them makes me feel like there's probably features of genital warts that are very different from the features of my tiny little cysts.

So, I think that the objective of teaching people, "Make sure you use barriers/contraception", while certainly that's a very important lesson to impart, kind of leaves the second row of defence - early detection and treatment - very ill-prepared. Some STIs, of course, don't have effective treatments available, but a lot of them do. And early detection is still important to help prevent the infection being passed on to others, even when there isn't a way to treat it.

So, in conclusion, sex education would help young people (and people who will grow up not to be young!) better, I think, if the early warning signs were made the focus, instead of the "shock, horror!" approach of "This could happen to you!" Sure, you want people to know why STIs are very bad things to catch, but more importantly, you want them to know as soon as possible that they have.