OFFICIAL WASHINGTON is a city of the sly evasion, the artful misdirection—spin, we like to call it—but seldom of the outright misstatement. You don’t often see a public official rise in his official capacity to make an official statement that is flatly, demonstrably, unmistakably contrary to the world as it is. It just isn’t done, for heaven’s sake. David Satcher, the surgeon general of the United States, held a press conference at the end of last month to issue a new report. Issuing reports is what surgeon generals do. Since his appointment by President Clinton in 1998, Dr. Satcher has released reports on mental health (in favor of it), women and smoking (strongly against smoking, strongly in favor of women), children and oral health (in favor of both equally), and suicide prevention (pro-prevention, anti-suicide). The report issued last month was titled The Surgeon General’s Call to Action To Promote Sexual Health and Responsible Sexual Behavior. Such a large, grandiose title invites sweeping claims to be made on its behalf, and after Satcher had surveyed his report’s findings about the social problems associated with sex, from unwanted pregnancies to sexually transmitted diseases, he made perhaps his most sweeping claim of all: "We have created an environment"—he meant we as in us, Americans in the United States—"where there’s almost a conspiracy of silence when it comes to sexuality." Now, it is difficult to imagine how a statement could be more untrue. Americans started talking about sex pretty much constantly about 40 years ago and have yet to pause to take a breath. I wonder how many reporters at Dr. Satcher’s press conference wanted gently to take him by the arm and walk him to the nearest cineplex for a screening of any movie rated beyond PG-13, or sit him down for a night of watching reruns of Friends or Will & Grace, or hand him a "literary" novel by John Irving or a "trashy" novel by Jackie Collins or any women’s magazine at all, or let him flip through an issue of Maxim or Esquire, or, for that matter, make him squirm with a couple of long passages from the Starr Report. If this is a conspiracy of silence, it is absolutely deafening. What was Dr. Satcher thinking? Well, he is a highly skilled report-issuer. He knows the need for a hook. He knows that publicity—a puffer on the front page of the New York Times, a patty-cake interview with Katie or Matt on Today—follows a report that bravely challenges the status quo. A surgeon general can’t just hold a press conference and say, "My fellow Americans, this day we are issuing a report—a report that boldly conforms to the conventional wisdom being voiced by nearly everybody—a report that dares to tackle a subject that is already constantly talked about—a report so courageously predictable in its implications that my publicist will be lucky to get a call-back from the producer at The Early Show with Bryant Gumbel." Since there’s not much to challenge when it comes to sex nowadays, the surgeon general had to invent a "conspiracy of silence," for the purpose of fearlessly breaking it. It worked, too, by the way. Katie gave him four minutes—an eternity in Today time—right at the top of the hour, and for the next two weeks Dr. Satcher did nothing but talk about sex. There is another step to the report-issuing process. If a government report pretends to upset the status quo, it must somehow generate what newspaper editorial writers call an "outcry." Outcries, as a technical matter, are ex post facto; they are said to arise after a report is issued, even if they don’t. In this instance, since Dr. Satcher is a liberal and his report was a longish paraphrase of liberal conventional wisdom—promoting the wide distribution of condoms among teenagers, for example—the outcry had to come from the right. And what do you know! "How else to explain the outcry from conservative groups?" wondered the Seattle Times, a few days after the report was issued. "David Satcher is under attack," warned the St. Louis Post-Dispatch. "Conservative groups jumped on Satcher," said the New York Daily News. "The report has right-wing and family-values organizations in an uproar," said the Baltimore Sun. Most colorfully, if yuckily, a columnist in the Seattle Post-Intelligencer lamented "the profusion of venom that has been spewed since Satcher disclosed his findings." Unfortunately, there wasn’t really an outcry: Few attacks were launched, scarcely a loogy of venom was spewed, barely a blip disturbed the outrage-o-meter. Bush administration officials fell into the elaborate choreography of feet-shuffling, throat-clearing, and fingernail-staring that Republicans always resort to when an acquaintance does something liberal in public. The president’s spokesman said, "The president understands that the report was issued by a surgeon general that he did not appoint." Satcher’s proximate boss, Tommy Thompson, the secretary of health and human services, sent his spokesman out to tell everyone that he, for one, had nothing to do with it: The report "was a completely independent document." Among conservative groups with a particular interest in sex—not the largest category in the world of public policy—the reaction was also relatively mild. Several of them seemed to understand that they were supposed to demand Satcher’s resignation, but they couldn’t quite bring themselves to do it. A spokesman for Focus on the Family said the report "calls severely into question the surgeon general’s ability to remain the chief medical officer of the United States." A spokesman for the Family Research Council said, "We wouldn’t be disappointed were he asked to leave." There are several reasons the report was a dud. For one thing, Satcher is a Clinton appointee whose term is up next February, and there’s little point in firing a man who’s about to leave anyway. For another, though it is only 16 pages long, it was written over the course of two years, with contributions from hundreds of people brought together in no fewer than three conferences, and this elaborate bureaucratic process kept the report from being interesting in the way reading about sex is usually interesting. The report is instead uninteresting in the way federal government reports are usually uninteresting. It is written in the prose characteristic of reformers. Every discussion is a dialogue, no two entities can cooperate without partnering, nothing influences anything without impacting it, every difficulty is a challenge, no idea arises unless it is a solution that is complex, and so on. This inflated mode of expression—never use a simple word when a more pompous one is within reach—is meant to convey the impression of vast learning and hard-won expertise. Strangely enough, even as we become famously candid in sexual matters, we continue to rely on euphemism to discuss them. Baby boomers have dispensed with pornography, for example; sleazy old men use porn, well-to-do boomers savor erotica, as they would a single malt Scotch. In the same way, the surgeon general’s report almost never mentions sex. The word itself occurs four times. A Call to Action is a report about sexuality. The distinction is absolutely crucial. Sexuality is a much bigger word than sex, obviously—an imposing five syllables to a blunt one. According to the Oxford English Dictionary, it was first used in 1800 by the periphrastic poet and critic William Cowper, who was insane and was, in any case, referring to the reproduction of plants. Sexuality, in fact, was a word applied exclusively to plants and insects, never to humans, until very recent times. Earlier generations—so confused and unsophisticated about sex—tended to call it sex. In our own era, however, the term sexuality has been appropriated by people who want very much to talk about sex without sounding as though they are talking about just sex. The multiple and nameless sexologists who actually wrote A Call to Action share this aspiration. Sexuality is sex-plus. Plus what, no one will say. The bigger word is not only more scientific-sounding but also vaguer, and so might be passed off as somehow more comprehensive. Since no one can be quite sure what sexuality means besides sex (which is already a pretty roomy word), its use has a liberating effect, especially on a fellow who thinks he is breaking a conspiracy of silence. You can say things about sexuality that, if said about sex, would seem silly. For example, when Dr. Satcher writes in his introduction that the report is— "… a call to begin a mature and thoughtful discussion about sexuality. We must understand that sexuality encompasses more than sexual behavior, that the many aspects of sexuality include not only the physical, but the mental and spiritual as well, and that sexuality is a core component of personality. Sexuality is a fundamental part of human life. Human sexuality also has significant meaning and value in each individual’s life…." —you can tell he’s waving those extra four syllables as though they were his Ph.D. dissertation. Without them—if he just said sex instead of sexuality—he wouldn’t sound like a surgeon general. He would sound like an old fellow with a not-terribly-unusual preoccupation with sex. Laymen, ordinary people, talk about sex. Social reformers, scientists, government officials, learned and well-meaning people, on the other hand, dialogue about sexuality. Preferably in conferences and government reports. Most importantly, the high-flown language enables the sexologists to recast sex as an issue fit for governmental intervention—and not merely fit for it, but crying out for it. Your sex life may not be a bureaucrat’s business, but our sexuality is. The report opens with a brief nod toward the "pleasures and benefits" of sex but then quickly moves on to its horrors. Sexuality, as understood here, involves an almost endless series of pathologies: racial discrimination and child abuse and maldistribution of income; rape and disease and abortion and unkind remarks directed at homosexuals—all alike are entangled with sexuality. The statistics marshaled by the surgeon general range from the genuinely alarming (40,000 new HIV infections annually, 1.3 million abortions a year) to the implausible. He reports, for example, that "an estimated 22 percent of women [in the U.S.] have been victims of rape." This figure has been frequently repeated in press accounts since Dr. Satcher issued his Call, but in fact the study from which the claim is drawn is far more ambiguous than the surgeon general is letting on. In a random sample of 3,500 men and women between the ages of 18 and 59, taken ten years ago and published in a book called Sex in America, 22 percent of the women said they had been "forced to do something sexually by a man." In 96 percent of these cases the man was an acquaintance, a boyfriend, or a husband. Rape falls into this category, of course, but so does much else. Only 3 percent of men, incidentally, reported that they had ever forced a woman to "do something sexually." Dr. Satcher and his authors need alarming statistics, both the real and the sensationalized, to justify their call to action. In an interesting coincidence, their view of sex closely resembles that of the conservative sexologists, "family advocates" at organizations like the already-mentioned Focus on the Family and the Family Research Council. Both sides share a vision of sex as a dark and deadly peril, a jungle teeming with mortal dangers. Spokesmen for the Family Research Council, for example, commended several aspects of Dr. Satcher’s report, especially his emphasis on sexually transmitted diseases in general and, in particular, the Human Papillomavirus, which has been linked to cervical cancer. HPV, as it’s called, has become a great favorite of conservative sexologists in recent years. The reason has to do with the debate about sex education in the schools (or "sexuality education," as the report calls it; the word sex has been banished even in adjectival form). Though united in their view of sex’s harrowing consequences, conservatives and liberal sexologists differ on how to instruct schoolchildren to avoid them. The conservatives, including President Bush, advocate federal funding for "abstinence-only" sex ed, which teaches that abstinence until marriage is the only certain way to escape the deadly hazards of sex; in abstinence-only sex ed, no mention is made of condoms, even as a second-best way to protect against disease and unwanted pregnancy. The liberal sexologists of the Satcher report, by contrast, point to the effectiveness of "comprehensive" sex ed, which gives a nod to abstinence but goes on, usually in graphic detail and quite often with bananas, to describe the uses of condoms and other forms of birth control. Conservatives used to object to comprehensive sex ed on the grounds that it would induce children to have sex earlier than they might otherwise. They have been forced to retire this argument, as study after study has failed to sustain it. A welter of research shows, in the words of the surgeon general’s report, "that providing information about contraception does not increase adolescent sexual activity, either by hastening the onset of sexual intercourse, increasing the frequency of sexual intercourse, or increasing the number of sexual partners." HPV, however, along with some other sexually transmitted diseases that are resistant to condoms, has given new hope to the anti-condom camp. If, as both conservative and liberal sexologists agree, sex is a perilous jungle, then even youngsters who enter it festooned with condoms are defenseless against many of its dangers, like HPV. This, the conservatives say, bolsters their case for preaching abstinence alone. At bottom the chief difference here is between two views of the good life, or, more precisely, the good sex life. For the conservative sexologists, the good sex life takes place exclusively within marriage; for the liberals it matters less where it takes place, as long as someone is wearing a condom. The surgeon general’s report is infused with the liberal view. It mentions marriage, but only as one form of the "committed, enduring, and mutually monogamous relationships" that will help people escape the disasters of unbecondomed sex. Satcher and his allies claim theirs as the "realistic" view; they see themselves as pragmatists, undeluded by the idealistic conservative supposition that all young people, properly trained, will abstain from sex, and then marry. But the conservative sexologists don’t suppose that all young people will do this; only that they should. Besides, Dr. Satcher and his allies have an idealistic supposition of their own. Surely he knows that not all young people will use condoms during sex; many, if not most, will even make a conscious decision not to, for reasons that seem compelling at the time. But he continues to insist that they be taught to use them just the same. Both sides in the sex-ed wars are idealists equally, and equally realists. They differ only in the values they wish to convey through education—the ideal of marriage, or the ideal of safe sex. Above all, they are united in the delusion that they can have a profound effect on the behavior of adolescents either way. The final reason that A Call to Action failed to raise a genuine outcry is that it is, as a Family Research Council spokesman put it, "the last gasp of the Clinton era." By this I think she meant that it is mostly balloon juice. Whenever one of President Clinton’s hundreds of panels issued a "call to action" and formulated an eight-step "action plan" and devised a "strategy for action," what it really meant, as a practical matter, was that everybody should just keep talking—in workshops, in conferences, in strategizing sessions and war rooms and break-out groups, in press releases and backgrounders and in neatly bound, mass-produced, unreadable reports. The near-total lack of efficacy was a great comfort. In the same way, the surgeon general’s only practical consequence will be to advance the case for federal funding of "comprehensive" sex ed against the "abstinence only" variety. But the effect is likely to be mild, and it’s unclear how conservatives, having conceded the larger point that the federal government should pay for teaching children about sex, will defeat liberals who want to do the same thing. Or even that they should. For despite all the media coverage that Dr. Satcher was able to generate, amidst the counterfeit outcry and the bogus silence-breaking, the most remarkable aspect of the report went amazingly unremarked: the fact that it should have been written at all. Liberals and conservatives alike are united these days in their assumption that sex—for reasons of morality or of public health (which is the modern substitute for morality)—is a proper subject for governmental jawboning. We are all sexologists now, apparently. Whether the jawboning leads to free condoms from Uncle Sam or to stern lectures about marriage from the Nanny State is a question of subsidiary importance. There is a third possibility. Rather than engage in a national dialogue about sex—"mature and thoughtful," as the report puts it, "adult with adult, adult with child"—we could all agree to shut up about it for awhile. Who knows what might happen? Instead of being the squalid transmission belt for abortion and disease, which is what it has become over the last 40 years, sex could return to the status it enjoyed for millennia—a private matter, a sacred bond between caring adults, and the steaming source of resentment, cruelty, envy, and recrimination that God intended. Andrew Ferguson is senior editor at The Weekly Standard.
Next Page