On STIs

I’ve alluded at various points over the last three months to the positive impact marathon training has had on my body. Running 30 miles a week has not just helped me to lose a bit of weight, it’s firmed up my arse and legs, flattened my stomach, and increased my stamina in all respects, including sexually. None of that will last, of course – I’m not nearly disciplined enough to keep that half-stone from finding its way back onto me somewhere – but it’s been a nice, temporary reward for all the hard work, as well as an alternative to my spreadsheet as a way to track progress.

Of course, putting the body through this sort of exercise regime isn’t all rainbows and lollipops. I’m lucky enough to have feet that don’t easily blister, but the damage has steadily built up in other areas. Micro-tears in my left hamstring and calf. Sore, swollen nipples. Knees that creak and groan whenever I go up or down stairs. More body hair. Bad skin…

At 34, it’s always quite depressing to find a new spot taking root on my face or back. When I was a teenager, and actually taking Roaccutane because my acne was so bad, I used to dream of the time when I’d never have to worry about my skin again. Turns out that time never really comes. Instead, I’ve spent my 20s and 30s discovering all the different places where blemishes can appear – and just the other week, I found a new one. My cock.

I feel gross just typing that. I got a zit on my penis. Right smack bang in the middle of the shaft, between two veins. The sort of thing that would look ugly enough on my nose, but on my dick? Ewwww. Seriously – I’d post a photo of it, but some of you might be eating while you read this.

So yes, the bastard just appeared one morning, unannounced and definitely uninvited. I poked and prodded it for a while, then tried to squeeze it, in the hope it might magically disappear. It didn’t. For the rest of that day and all of the next, I examined it periodically, hypersensitive to any change in appearance or size, and worried that at any moment another one might come along to join the party.

It took a little more than 48 hours from the moment I noticed the spot for me to call the local sexual health clinic. It had been six months since my last check-up, so making an appointment was already on my ‘to do’ list; the presence of something that might or might not be a symptom merely bumped it up to the top.

Later that day, I was waved into one of the examination rooms at the Mortimer Market Centre, where a friendly young doctor listened patiently as I described what I’d found.

“I think it’s just a spot,” I said. “It’s right on a hair follicle, and I’ve been doing a lot of exercise lately. A lot of sweating. I know one thing for certain though – it’s not a Molluscum. I’ve had one of those before.”

~

My Dad is scared of dentists. His generation grew up at a time when dentistry was a more brutal, less forgiving area of medicine, and the psychological scars have never really healed. When he reached his late 30s, he started to ‘forget’ to book his half-yearly check-ups; my Mum decided not to press the issue, and after a while he just stopped going altogether. It was only in his mid-50s, after a particularly painful bout of toothache, that he decided to risk going back, and the results were…well, predictable. Predictable and very expensive.

I am not scared of dentists. As a child, check-ups merely meant an opportunity to get a new sticker for the side of the bath, and when I needed my first filling at 21, it was embarrassing rather than painful – as if my lazy brushing was a personal affront to the nice man who had to fix the damage I’d caused. Even the root canal surgery I needed last year to repair a fractured tooth wasn’t scary; boring and costly, yes, but never more than vaguely unpleasant in physical terms.

On the other hand, the first time I went for an STI test I was terrified. I was 24, and in a relationship that was just starting to get serious. She’d suggested it, and I hadn’t been able to think of a reason to say no. Even though I’d been sexually active for over three years by that point, it had never occurred to me to get tested – because I hadn’t done anything wrong. As far as I was concerned, you only went to the GUM clinic when you’d fucked up: maybe you’d slept with someone who was a ‘bit of a slut’, or got drunk and done it without a condom. You definitely had to have a rash of some kind, or maybe a sore, or a weird discharge. Just by walking through the clinic door, a cloak of shame would wrap itself around your shoulders, and the whole world would swivel to stare and point. To mark you as dirty.

The fact that I still believed those things at 24, and that I had such a crappy attitude towards sexual health issues, is tied pretty closely to my gender, sexuality, and limited experience; but like my Dad with the dentist, it also says a lot about the time and place in which I grew up. Sex education in the late 80s and early 90s was a complete mess – even more than it is now – and both the fear and the stigmatisation of HIV/AIDS were deeply embedded in most cultural narratives about sexual activity. There was no internet and certainly no social media, so what I learned about STIs came directly from teachers, friends, newspapers and TV. By the time I went to university in 1999, I’d heard of diseases like Chlamydia and Herpes, but knew enough only to think of them as scary things that happened to other people. If you caught them, you were in serious trouble – and if you got HIV, you were dead.

That first visit to the clinic in Oxford did little to change my preconceptions about STI testing. I was so nervous and defensive that every part of the process felt laced with humiliation and judgement. I couldn’t look the doctor in the eye, and I certainly didn’t want to talk to any of my fellow patients, most of whom I felt sure must be carrying a disease of some kind. Leaving the clinic felt like being released from prison, and when I got my negative results the following week I practically waved them in my girlfriend’s face, as if to say “Look! There’s nothing wrong with me! Why did you make me go to that place?”

Over the next six years, my sexual health check-ups were few and far-between – and usually at someone else’s behest. I didn’t talk about STIs with partners, because I never felt the need to do so; they weren’t a part of my world, and certainly didn’t intrude on my relationships. I was blasé about condoms, determinedly ignorant about transmission, and hazy on the basic terminology for even discussing the subject in a responsible way. It was such a big, scary thing that the best way to avoid getting freaked out was to refrain from thinking about it entirely.

Finally, in the spring of 2011, my luck ran out. I woke up one morning to find, yes, a spot on my penis. It was dome-shaped and dimpled, and while I didn´t know what I’d done to deserve something so disgusting just appearing on my dick like that, I also wasn’t really worried about it. Not at first. When it hadn’t gone away, or at least diminished in size, a week later, despite daily washing with Clearasil, I thought about going to see my GP…but the prospect of having to show that to another human being was so mortifying that I quickly dismissed the idea. Instead, I battened down the hatches, and waited for it all to blow over.

My head stayed resolutely buried in the sand for just shy of a month, before I finally admitted defeat and went to the GUM clinic. By that time I’d scared myself half to death researching all the worst-case scenarios, and when the doctor looked up from my dick and gravely informed me that I had an STI, it seemed like all my fears were about to be realised.

“It’s called Molluscum contagiosum,” he said. “It’s a skin infection. It’s not serious – you’ll be fine.”

It’s not serious. You’ll be fine. With those six words, the doctor turned upside-down everything I’d ever believed about STIs. He went on to explain that yes, the molluscum was infectious, and yes, I’d probably got it from a sexual partner, but no, nothing was going to fall off or stop working…and no, it wasn’t something to be ashamed of.

“We only get embarrassed when we talk about STIs because they involve sex. As a society we have an unhealthy attitude towards sex, which inevitably means we have an equally unhealthy attitude towards STIs. ”

It was a genuine lightbulb moment, and one I remember vividly to this day. One that materially changed me, in fact. For the first time, I was able to confront the whole issue of sexual health in a way that wasn’t guided and coloured by my own fear. With that largely dispelled, I stopped thinking of STIs as one big, amorphous ‘other’ – and as a result, stopped seeing the people who had them as damaged in some way.

~

At the Mortimer Market Centre the other week, I lay on a bed and watched the doctor run a gloved finger over the spot on my dick. She checked the texture and the colour, had a brief go at freezing it, and stood back up, apparently satisfied.

“Yep, just a pimple. I can’t make it disappear, I’m afraid, but I can give you a soap to use that should accelerate its departure. Just make sure you keep showering straight after you exercise, and hopefully you won’t get any more.”

After giving my blood and urine samples, I walked out of the clinic and got on with my afternoon. By the time the text arrived 10 days later to confirm my negative results, the spot had all but gone.

~

“We don´t see things as they are. We see them as we are.”

Anais Nin.

No disease – sexually-transmitted or not – should be underestimated or taken lightly. There are STIs that really are serious and scary, and STIs that have massive public health implications if we allow them to become widespread. However, we won’t prevent that happening by fostering a culture of fear and shame around those diseases. By the same token, we won’t encourage people to have safer sex, or talk to their partners about sexual health, by treating them as social pariahs when they are diagnosed with an STI.

My Dad didn´t go to the dentist for 15 years, because he was terrified of what would happen if he did. I avoided sexual health check-ups for the best part of 9 years for similar reasons. Both of us turned what should have been a routine, practical, proactive way of managing our health into something that ultimately put it at risk – and in my case put other people’s health at risk too.

I like to think that the ‘younger generation’ – people in their late teens and early 20s – is as unafraid of the GUM clinic as I am of the dentist. That the spectre of AIDS has grown a little less menacing; the dialogue around STIs a little more open and constructive. I see some of the impressive resources available to young people these days, online and offline, and I talk to activists like the brilliant Ella Dawson about the work they’re doing to reduce stigma and improve awareness, and it gives me hope that the goalposts are at least starting to shift.

Even with all of that though, I’m not sure we’re there yet. The language we use to discuss STIs is still disproportionately charged; wider understanding of different conditions still hazy and limited. As a result, we find it extremely difficult as a society to talk about sexual health in a responsible, honest and helpful way. Where that conversation doesn’t take place, individuals will only gain understanding through their own – often traumatic – experiences, if they gain it at all.

I was able to approach and deal with the recent spot on my dick in a timely, responsible manner because I’ve had an STI before. It shouldn’t take a positive diagnosis to get people to that point, but my reluctant conclusion is that for many of us that’ll continue to be the case. As I said earlier, even writing about having a zit ‘down there’ made me feel gross, in a way that it never would if it had been on my shoulder or forehead.

Few things contribute more to the spread of STIs than our basic inability to discuss them sensibly. It seems we are culturally conditioned to treat our sexual organs – and by extension, our sexual health – in a completely different way to how we treat the rest of our body; until that changes, it’s hard to be too optimistic about the future of that dialogue.