What's Going On At Shady Grove?

The citizens advisory committee made its recommendations for a new sex-ed curriculum, the school board voted unanimously to adopt it, and the CRC, as the DCist web site put it, "dropped a cluster bomb of crazy against the curriculum on their website, complaining that the new curriculum teaches kids that homophobia is wrong, and contends that the discussion of homosexuality will lead to teen suicide."

Prominent among the CRC's arguments was this, from one of their "cluster bomb of crazy" press releases:

... Both the school and the committee have rejected a petition signed by 270 Montgomery County physicians asking that the Surgeon General’s statement against condom use in anal intercourse be included. The Surgeon General warns that: “Condoms provide some protections, but anal intercourse is simply too dangerous to practice.” The petition and statement were rejected.

The petition that is mentioned was signed by physicians working at Shady Grove Adventist Hospital. Two hundred seventy of them, they say. One question is, why would Shady Grove physicians want to support the anti-gay CRC in adding this irrelevant, inaccurate, and obsolete statement to the curriculum? Why are Shady Grove doctors opposed to "condom use in anal sex," which is recommended by the CDC and medical experts everywhere?

We have already tracked down the CRC's quote-of-a-quote from Surgeon General C. Everett Koop, and discussed it HERE. This quote has been around since, as far as we could tell, 1987. It was officially published in a 1991 editorial about AIDS in the Journal of Family Practice, years after Koop was Surgeon General, not speaking as a government official.

The quote itself is medically ... wrong. Anal sex is slightly riskier than vaginal sex, because of three things: first, the anus does not secrete its own lubrication, meaning the tissue can be hurt more easily, and also probably (though there is no good research evidence) making it more likely that a condom will slip off; second, the lining of the rectum can be injured, allowing microbes to enter the bloodstream easily; and third, the tissues there are very absorbent anyway, which is why suppositories work.

Then it works like this. If your partner is uninfected, no problem, whether you're having anal or vaginal intercourse -- you can't catch something from somebody who doesn't have it. If your male partner is infected and you have receptive anal sex with him, your chances of catching the infection are slightly higher than if you have vaginal sex.

The prudent medical advice for not catching AIDS should be this: don't have sex with somebody who is HIV positive. I'm not being facetious, it's really that simple. And if you do decide to have sex with someone who carries the virus, you must be very, very careful. But that's a different thing -- they don't say "anal sex with people who are HIV positive is too dangerous," they're saying anal sex itself is too dangerous, and that's nonsense. More than a third of American adults (more than 40 percent of men, 35 percent of women) have had anal sex -- and survived without incident.

Though CRC's anti-gay motives are transparent and familiar, it isn't clear what motivated the physicians at Shady Grove Adventist Hospital to take a stand on this narrow issue. It does not appear that any group of doctors at any other establishment in the world has expressed an opinion on the topic, only Shady Grove.

The CRC's press release points to an FDA web site for the source of this quote. The FDA has recently changed the site to give a link to their source for it. They say the quote is...

referenced from "Understanding AIDS: A Message from the Surgeon General [PDF 1 MB]

The FDA added the citation very recently, probably out of embarrassment. Because, for one thing, at the present time there is no Surgeon General. There is an Acting Surgeon General, Rear Admiral Kenneth P. Moritsugu, but that's not the same, and anyway, he never said this.

Mainly, the FDA knows this quote is out of date and meaningless in today's context, and they want you to know they know. I imagine there is political pressure to keep it on the web site, even though it embarrasses them.

But the interesting thing is -- the quote isn't there. Go ahead and look. Instead, that document says things like:

The AIDS virus can be spread by sexual intercourse whether you are male or female, heterosexual, bisexual, or homosexual.

This pamphlet is actually quite famous. In 1988, Surgeon General Koop wrote this whole thing himself, and the Public Health Service mailed it to every home in the United States -- 107 million households got this. It was extremely controversial in its day, and was a brave move by a guy who didn't really approve of homosexuality himself but had to deal with an unforeseen epidemic in the gay population.

The brochure mentions anal sex as a risk factor, but it does not single it out as especially dangerous. Because ... it isn't.

Anal sex with strangers is a bad idea, but ... let's get this straight. If that's what the CRC is assuming, that people are having sex with strangers, well, they should mention that. Because, as the MCPS curriculum makes clear, having sex with strangers is a bad idea. Promiscuity is a bad idea. Abstinence and faithful monogamy are good ideas.

It has very little to do with what particular orifice is penetrated during any particular physical coupling. Casual fluid-swapping puts you at risk.

So it comes down to this. The anti-gay CRC and Shady Grove physicians are adamant that this statement should have been included in the sex-ed curriculum: The Surgeon General has said, "Condoms provide some protection, but anal intercourse is simply too dangerous to practice."

A former Surgeon General said this in an editorial, years after he had left the office. At the time this statement was published, Antonia Coello Novello was the Surgeon General of the United States. And Novello did not say this.

It doesn't matter that the statement was first made nearly twenty years ago, in the darkness and confusion of the new AIDS epidemic.

It doesn't matter that the FDA doesn't know where the quote on their own web site came from.

It doesn't matter that the statement is medically unsound, and factually incorrect.

They want it included as if it were a fact.

This reflects very badly on Shady Grove. Maybe that hospital has doctors who will sign anything without looking at it, maybe they have doctors whose advice is decades out of date... It is weird that this only happened at Shady Grove.

I emailed the Associate Vice President of Communications for Adventist HealthCare, Inc., Thomas Grant, to see if they had anything to say. Their statement was: The majority of physicians that work at Shady Grove Adventist Hospital are independent practitioners and have been granted privileges to work at the hospital and at other hospitals in the county. Their views do not necessarily represent the views of the hospital, nor do they speak on behalf of the organization.

OK, so Adventist HealthCare is not responsible for what their doctors do while they're working in the hospital, and doesn't care if their medical knowledge is current. It's good to know that.