Are sex researchers afraid to get our hands dirty? Sex-positivity and the policy and media discourses.

The left, [George Lakoff] argues, is losing the political argument – every year, it cedes more ground to the right, under the mistaken impression that this will bring everything closer to the centre. In fact, there is no centre: the more progressives capitulate, the more boldly the conservatives express their vision, and the further to the right the mainstream moves. The reason is that conservatives speak from an authentic moral position, and appeal to voters’ values. Liberals try to argue against them using evidence; they are embarrassed by emotionality. (Zoe Williams, The Guardian, 1 Feb 2014)

WILL MCAVOY: If liberals are so smart, why do you lose so goddamn always?  (The Newsroom.)

When I began for the Victorian AIDS Council ten years ago, I got a really thorough apprenticeship in community-based HIV work from my colleagues, Guy Hussey, Tex McKenzie and Asvin Phorugngam.  It was grounded in three main principles:

  • Sex-positivity
  • Adult learning principles
  • Close personal understanding of the gay community

There have been big shifts in how HIV prevention is understood within the sector and the public health system.  Australia’s first national HIV strategy talked extensively about education, but by the third release of the strategy, it was talking about health promotion reflecting the slow diffusion of the impact of the Ottawa Charter for Health Promotion (WHO, 1986).  In 2004, I was a project worker in a position called Health Educator in a team called Health Promotion.

There have been further changes, such as a further shift in the self-concept of prevention work from health promotion to public health. At the recent AFAO Gay Men’s HIV Education conference in Sydney, I met gay men who’d done Masters in Public Health degrees before coming to work in gay men’s health, and many of them were excited about some pretty mundane ‘technological innovations’.  (Popup ads on Grindr — high tech shit.) My concern is that, along the way, many of the good things about adult education have been lost from our collective understanding of how HIV prevention works.

In the same time period, Australian society has become markedly less progressive, particularly around sex.  No, not sexuality, if you understand that as a reference to sexual orientation rather than ways-of-being-sexual.  As gay identity has become more and more acceptable, there has been an increasing level of comfort talking about what kind of sex gay men shouldn’t be having, and dis-comfort around what kinds of sex gay men are actually having.  For example, there has been extensive mainstream news coverage ‘othering’ barebacking — unprotected anal sex — as something the ‘bad gays’ do and the ‘good gays’ (the ones who get married) apparently don’t.

Similarly, there have been media panics around the increasing uptake of heterosexual anal sex and decreasing age of first sex and increased access to porn via the Internet and apps and increased use of online and mobile dating services and sex work and surrogacy as human trafficking.  *deep breath*

One bright spot has been the emergence of feminism as a viable alternative body of thought for social criticism to fill the void left by Marxism.  I’m not wild about the literalism of ‘feminism=for women’ that informs splitting Daily Life from the Fairfax online properties, particularly since those properties have become increasingly un-feminist in their coverage.  But it has had an undeniable influence on public debate around the deaths of Jill Meagher and Traci Connelly and the need for wide-scale feminist law reform.

There have also been feminist positions taken against sex work, against pornography, against casual hookups, against stripping, against pole-dancing, against, well, sex itself.  They have gone hand in hand with social conservative and Christian positions dating back to the Howard government that went more or less unchallenged under Rudd and Gillard.

All of this makes sex-positivity an increasingly challenging position to take.

During the week, the Burnet Institute did a press release that got a heap of coverage.  It was for two conference presentations.  It summarised multiple years of surveys at the Big Day Out.  Across the different time points, the average age of first sex got younger.  The researchers speculate this is attributable to increased exposure to pornography:

One potential explanation for a historical decrease in AFS is the increasing role of the media in creating a ‘sexualised’ culture, and its use as a sexual education and empowerment tool for young people. Young people surveyed at the Big Day Out in 2012 stated that they were equally comfortable sourcing sexual health information from both a website and a doctor. Sexualised content such as pornography has become normalised in today’s society, and provides a private and easily accessible way for young people to learn about sex and sexual norms. Furthermore, in a study by Brown et al., early exposure to sexualised content predicted oral sex and sexual intercourse (Vella et al, 2014, citations omitted).

There are so many things wrong with this.

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At this point I want to take a detour for a moment and talk about research practice and policy discourse.

Previously I’ve written here about how public health as a practical discipline tends only to be informed by a couple of social scientific disciplines: epidemiology and psychology.  Social public health refers to a form of public health practice informed by a broader palette of knowledge practices, including sociology, anthropology, cultural studies, etc (Kippax & Race, 2003).

From pretty early on in the HIV response in Australia, prevention was informed by a multi-disciplinary social public health approach.

More recently though, I was at a conference in social research and saw postgrad students doing things like lumping together all Asians into one category because there were too few of them to analyse statistically in separate groups based on country of origin.  Sure, you can get results from that, but what would you do with them?  Make a campaign poster in Chinese Restaurant Menu font to signal ‘hey, Asians, we’re talking to you’?

At that research conference I really appreciated when a senior colleague, a sociologist, fired up and pointed out the problems in that classification.  It scared the living hell out of the postgrad student, but I wondered why nobody had pointed this issue out to them.  The answer was, probably, there’s a growing divide in many research centres between quant people and qual people, positivist and critical theory perspectives.  Projects in which these disciplines actually converse, rather than work side-by-side, are getting rarer than before.

As well, what the quant people recognise and the qual people often don’t is that low quality research can nonetheless (a) get published, obviously and (b) exert considerable policy influence just because it’s simple.  When it gets passed up through the hierarchy at a health department for sign-off, it all gets reduced down to a single page memo, so insisting on nuance/complexity can be a liability.

If a senior policy officer were writing up the findings of that postgrad student’s research, they might not even put “Asian” into that memo.  It might come out saying “cultural diversity”, because in policy language specific detail is dangerous.  The more specific it is, the smaller the group affected, the more it looks like special treatment, the harder it is to fund.

Policy is another discourse that has infected strategy-writing in Australia’s BBV responses.  In my contribution to a working group writing Australia’s testing strategy for hep B, a condition that overwhelmingly affects migrants from countries where infant vaccination isn’t universal, I had a massive fight on my hands to get specific detail about cultural safety, use of interpreters, and relevant cultural understandings into the final document.

The problem is partly about policy people hating specific details and partly about educated middle-class white people feeling uncomfortable with the symbolic violence inherent in producing knowledge about non-white people…. as if that discomfort ethically outweighs the imperative to prevent non-white people dying from hepatitis B related liver cancer.

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I think that squeamishness is similar to what George Lakoff is describing in the quote that opens this post, and a similar kind of squeamishness is holding smart, progressive, sex-positive people back from adding their voices in a robust manner to media discourse about sex.

During the week, I received an e-mail asking if I knew anyone who wanted to comment on the ‘early first sex’ paper, for a short news article exploring whether the same applies to same sex attracted young people.  I replied saying no thanks, but hey, maybe someone could mention ‘sensation seeking‘ as a personality trait that predicts both porn use and early first sex.

I got an e-mail back from a senior colleague, someone I trust and respect, saying ‘you should be very cautious because the concept of sensation seeking is subject to contestation’.

There is nobody I would trust more to give me a run-down on how a particular concept or theory was problematic for academic use.  But I want to spell out here why I think that concern for fidelity to the complexity and history of social scientific debates sometimes backfires when it comes to media engagement.

In a short news article, the genre conventions rule. You’ve got one sentence to meet the journo’s brief — in this case, yes/no, does the finding apply to same sex attracted kids?

And, if you phrase it really well, you can get another sentence or two, towards the end of the article, to, as they say in politics, ‘put a context around’ the initial findings.  It could go something like this:

There are personality traits that make some people more likely to attend a music festival, take drugs, use porn and have earlier sex than the rest of their cohort.  The initial findings are interesting but we would like to see the research explore those possible confounding factors.

As someone originally trained in cultural studies, one of the more challenging things for me about the social psychological literature on HIV prevention is what we could call its naturalistic epistemology — the idea that phenomena like porn exist in an external, objectively measurable reality, as things with causal influences in their own right.

Like any cultural product, the effect of porn is necessarily mediated by what we call active reception by the audience.  The mimetic or ‘monkey see monkey do’ theory of media effects has been thoroughly discredited, but how many epidemiologists — like the crew at Burnet — are reading books and papers in media and communication studies?

Even journalists — who probably do have some exposure to this research — would face an impossible task trying to render these complexities in a 600 word news piece.

So to combat sex-negative crap like ‘porn is making teens have sex earlier’, psychological concepts with their technical-sounding names and plain English definitions and above all, their naturalistic epistemology that matches that of journalism, are often the best resource to draw on.

When Dr Megan Lim from the Burnet Institute was interviewed on Radio National, she said:

“People who watched pornography more often were more likely to have sex without condoms, more likely to engage in behaviours like anal intercourse, and also to have sex at a younger age. But, I guess, from this study, we definitely can’t conclude that pornography is a causal factor, just that the two behaviours are correlated.”

The interviewer James Carlton went straight to the point:  “And if it’s not a causal factor, what might be the factors behind its correlation?”  In response Dr Lim made the point where sensation seeking is relevant:

“Yeah, well, I think probably just the fact that people who are more sexually aware, sexually developed, more interested in sex are those that are more likely to watch pornography and also the ones who are more likely to engage in sexual behaviours.”

Sensation seeking is a useful concept there because it makes the story about diversity among individuals, whereas a conservative Christian school board member listening to that interview could have easily concluded that comprehensive sex education is what leads to young people being “more sexually aware, sexually developed, more interested in sex”.

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Simplistic, sensationalist, sex-negative ‘findings’ get extensive media coverage and three years later somebody writes a smart, sensible book or discourse analysis in academic language in a peer reviewed publication and nobody in the news media, the policy or mainstream communities ever gets to hear about it.

Sex-negativity wins in a default because the sex-positive advocates are too afraid to show up.  Or worse, we get represented by counsellors who do most of their work with people having problems and that becomes the narrative. Rather than sensation seeking — a curious, exploratory, energetic drive — we get stories about sexual compulsivity and porn addiction.

I wrote the paragraph above on Friday, and on Saturday I found this article about porn addiction by Julia Medew (of course) in The Age (of course).  Some experts estimate… some doctors believe… a growing number of sexologists have reported…  This is a Fox News version of health reporting.  All the ingredients you need to write that story are there:

  • A factoid: one in ten people who use porn becomes addicted, apparently.
  • Some human colour: “Like most men, Hugh Martin’s first encounter with porn was accidental.”
  • An expert opinion: “A leading sex therapist” says “I believe the brain is plastic”.

For all we know, Medew shopped around any number of academics looking for a quote to fit her hackneyed angle, and all of them, perhaps wisely, refused to provide one, or gave one that didn’t fit the narrative and so didn’t get a mention.

For academics, engaging with the media around sex and sexuality must be incredibly frustrating.  There is no shortage of really shitty reporting about sex.  The challenge calls to mind a distinction made by de Certeau: elites have strategy, the rest of us have only tactics.  There is no ‘media strategy’ that will, once and for all, ‘address the problem’ of sex-negative media coverage.  That’s wishful thinking.

Instead, it’s like one big game of whack-a-mole, slapping down crappy articles with whatever works in the moment.  Thank goodness there’s nothing really serious at stake — just the future of comprehensive sex education in schools and policy support for frank, sexy HIV prevention campaigns.  It’s a game we need to get good at, and that will only happen when we get out on the field.