Safe Sex is No Sex

As a fertility specialist, Dr. Joe McIlhaney used to mend the sterility that preyed upon women longing for children. But as time went on, his attention shifted from curing infertility to trying to prevent it. In December 1995, he walked away from his "dream" obstetrics/gynecology practice to run his Medical Institute for Sexual Health (MISH) full-time and promote his new National Guidelines for Sexuality and Character Education. Those guidelines argue that for reasons of health, emotional security, and the stability of American society, only the message of sexual abstinence for unmarried persons will do.

"I couldn't stand to see people hurt anymore," he recalls.

And he's on a roll. McIlhaney just returned from a successful two-week blitz in Washington, D.C., where he met with 25 legislative aides about his guidelines. His first efforts in community education began in the late 1980s with his self-published slide talk, Safe Sex, which rattles off alarming statistics about sexually transmitted diseases (STDs), alleging that condoms are unreliable against them, and features photos of victims suffering advanced stages of STDs as a result of their miseducation.

Widely admired by religious conservatives, the Safe Sex show is often brought into communities taking an abstinence-only tack on sex education.

Though evangelical Christians happily claim him, McIlhaney maneuvers easily between the secular and religious worlds. His books on health matters, including 1250 Health-Care Questions Women Ask, Sexuality and Sexually Transmitted Diseases, and Safe Sex, are published by Baker Book House, a Christian press. But the latter two titles are actually the same book -- Safe Sex is a "secular" version of the Scripture-bolstered Sexuality and Sexually Transmitted Diseases, in which, for example, he writes: "The `solid concrete' of the Bible guards us from the shifting sands of culturally defined standards, providing an unchanging basis for our every action."

McIlhaney himself says that his Christian faith plays a part in his work, but that it's all a matter of integrity, not ideology. He doesn't feel it's disingenuous not to mention straight away that besides being Dr.-McIlhaney-the-Gynecologist, he is also Joe-McIlhaney-the-Devout-Christian. Some critics continually ask how his version of Christianity could not influence his view that non-marital sex eventually brings about an emotional/spiritual, if not bodily, death. He answers by saying that yes, sex is best experienced within marriage, but that's not the whole story -- he believes the physical evidence comes down squarely on the abstinence side as well. "We have to approach this from a medical, not ideological perspective," he says.

Accordingly, it is on the accuracy of his information that McIlhaney is most frequently challenged. In 1995, former Texas Commissioner of Health David Smith, M.D., issued a report on the aforementioned Safe Sex slide talk, charging that "Many of the items in the presentation are misleading." One such item deals with condom efficacy and HIV transmission. McIlhaney calculates the "relative risk" of using condoms to prevent the transmission of HIV at 20% -- and he thinks it could be as high as 31%. The Texas Dept. of Health report counters that "When used correctly and consistently, latex condoms are highly effective for prevention of HIV infection and other STDs." And Herbert Peterson, Chief of Women's Health and Fertility at the Centers for Disease Control, places the rate of transmission of HIV at 1% when condoms are used properly.

While Smith believes that abstinence for teens is the ideal solution for good health, he thinks that it cannot encapusulate the whole message about sexuality. "Ignorance is not bliss when you're talking about STDs," says Smith, who is now president of the Texas Tech Health Sciences Center in Lubbock. He says he and McIlhaney could probably agree 90% of the time on most matters. But McIlhaney's approach "could be too simplistic," says Smith. "We all look for magic bullets. But this is about kids and their lives."

McIlhaney would agree -- kids' lives, yes! That is the point! And that's why he'll press on, shrugging off critics as acting only on "philosophic" grounds. No, the future looks too bright to stop, and he's willing to make a prediction. "I think that in the next 10 years, as a result of groups like us [MISH] and others around the country, we're going to see about 70% of young people choosing to remain abstinent," he says. "And about 30% may continue to be involved in sexual activity that's going to hurt them with disease and pregnancy." -- R.A.