You're Teaching My Child What? by Miriam Grossman

Introduction:
    Shocked
    H AVE YOU EVER CROSSED PATHS with someone momentarily, exchanged a few words, and then discovered you can’t forget their face, or something they said? That’s what I’m going through now. Several months ago, I gave a talk about sexual health to college students, and a girl in the audience made an astonishing comment. Her words, and her eyes, haunt me to this day.
    I’d been invited to speak at a small private college outside Philadelphia. The auditorium was filled to capacity, with students sitting in the aisles and leaning against the walls. It was a lively crowd, but when I stepped up to the podium it fell silent.
    They knew I wasn’t there with another “safer sex” talk. Why fly me in from across the country to tell them things they can recite in their sleep? They invited me because I’m the doctor bringing the science they’d never heard. The biochemistry of trust and attachment. How ovulation is affected by a man’s scent. Why a young cervix is easily infected. They’d learn that evening that with or without protection,
sex is a serious matter—especially for girls. That a single encounter can have profound, life-long consequences.
    I was there to teach the biology that was omitted from their “safer sex” training. It was a no-nonsense, politically incorrect approach to a subject close to their hearts, and they hung on to each word from start to finish.
    Afterwards I asked for questions, and a number of hands shot up.
    â€œWhat about the HPV vaccine?”
    â€œThere’s reason to hope it will prevent a great deal of disease,” I said, “but it’s not a cure-all. Girls,” I told them, “you should be vaccinated even if you’ve already been sexually active.”
    Next came a complaint:
    â€œYou assume everyone is heterosexual. You should be less hetero-normative.”
    This was not the right time for a discussion about the politically correct notion of “heteronormality,” so I just thanked the student for his comment and added that the highest rates of sexually transmitted infections are found in gay men and bisexuals, and the lowest in lesbians. 1
    Then a dark-haired girl in the front row raised her hand.
    â€œI’m a perfect example of what you talked about. I always used condoms, but I got HPV anyway, and it’s one of the high-risk types. I had an abnormal Pap test, and next week I’m going to have a culposcopy.”
    She sounded mellow, but there was panic in her eyes.
    I felt a wave of sorrow. This young woman was going in for a biopsy of her cervix because atypical cells were present—a result of infection with a high risk strain of HPV. I knew what that meant: she probably had HPV-16, the type that’s most difficult for her body to clear, 2 and most likely to cause malignancy. If the infection persisted, her risk of developing cervical cancer was at least 40 percent. 3
    â€œBut I thought it over,” she continued, “and I decided that the pleasure I had with my partners was worth it.”

    The audience was silent. How does one react to such a declaration? With applause? High fives?
    â€œI hope all goes well next week,” I said, “and that you’ll never have to worry about this again.”
    But I knew it wasn’t so simple. In a few days she’ll lie on a table with her feet in stirrups, a large electronic microscopic inches from her vagina. With a bright light illuminating the site, the gynecologist will examine her cervix. He’ll say something like “this might be uncomfortable,” then excise abnormal areas with a scalpel. It will hurt. She might have pain and discharge afterwards. Then she’ll wait for a call with the results: is she okay, or not?
    The way I saw it, her story was a double catastrophe. For a young woman—she couldn’t have been over 20—to even worry about having cancer was the first