When the government shouldn’t stay out of the bedroom

Some time ago, I wrote a piece called ‘MPs should stay out the bedroom’. I need to qualify that. There are instances where MPs – or more specifically, the government – should get into the bedroom, and that’s where public health issues are concerned. To be blunt, on matters of morality the government should butt out, but health is a different matter.

Information campaigns on safe sex have been contentious in Malta since 1990, when the world was still coming to terms with Aids. Back then, the Department of Health wanted to carry out an information campaign telling people to wear a condom, but it was aborted after sustained pressure from the morality police and the Curia, who saw it as the promotion of contraception by the government in Catholic Malta. The net result was a campaign composed of ambiguous posters and television advertisements showing euphemistic scenes of romantic strolls, waves lapping on sandy beaches, and candles flickering in a draught. Nobody was having any sex there, still less wearing a condom. I used to watch them and laugh.

Then for years there was nothing, while sexually transmitted diseases continued to be, well, sexually transmitted. Like most of my girlfriends, I knew pretty much all there was to know about the matter from reading British women’s magazines, which were pretty explicit. It wasn’t as though we learned about it at school, or off the television, with all those flickering candles. And then suddenly it occurred to me at the time that only a minuscule percentage of young Maltese women read those magazines, so how on earth were older Maltese women and Maltese men of all ages getting their information about sexually transmitted diseases? The short answer was that they weren’t getting any information at all, except for a few old wives’ tales and folk-medicine anecdotes here and there.

Then some time in the mid- to late 1990s, a specialist in venereology, who had retired from a long career with the British Army (or so I vaguely recall, having interviewed him that many years ago) returned to live in the country of his birth and, because he was still fairly young, decided to volunteer his services to the Department of Health, having noticed to his surprise that there was no state-run genito-urinary clinic in Malta.

So Philip Carabot, with a tiny team and the barest amount of assistance, set to starting up and running Malta’s first dedicated clinic for sexually transmitted diseases, where those who present themselves or ring for an appointment are seen without delay, because of the nature of what’s involved. Before that, women would have had to pay quite a high specialist’s fee to see a gynaecologist privately, or have their names put down on a long waiting-list to see one at the state hospital. Men usually ended up at their GP, and then got a referral to a specialist.

Lots of people still go for those options, which work. The gap that the genito-urinary clinic seems to have filled is with the very young. Girls of 16 don’t have a gynaecologist. Boys of 17 might have a problem turning up at the family doctor’s clinic and announcing that something odd is happening to their private parts. With this clinic, they can just walk in off the street, find total discretion, and nobody who is going to ask awkward questions or get censorious. It makes a big difference.

The result is that the genito-urinary clinic and those who run it now have unparalleled access to information on the sexual life of Maltese teenagers. While it is true that this picture might be skewed, because by definition they get to see only those who have had sex and suspect they have contracted a disease, at the same time the figures the clinic is putting forward are really quite perturbing.

Parliament’s committee on social affairs has been sufficiently alarmed by a report from the genito-urinary clinic to actually discuss the matter. As could be predicted, this committee of MPs from both sides of the house has agreed that sexually transmitted diseases are best fought by means of “responsibility and fidelity” – oh yes, and education, too, but that came third.

The committee met Philip Carabot and other professionals who work in the field. Carabot told them that the clinic is seeing more patients every year. This doesn’t necessarily mean that the number of people infected with sexually transmitted diseases is increasing. It could mean that his communication efforts are successful, and that more people are discovering the clinic and its services and using them, instead of going to their GP or to no one at all, and hoping that the problem will solve itself.

And yet, I don’t think so. I think he might be right, and that it is not so much the improved popularity of the clinic that accounts for the annual rise in those presenting themselves, but rather too much casual sex among the very young. As recently as the 1980s, Maltese girls didn’t have sex. It was understood that if Maltese boys wanted to have sex, they would need to wait until the summer and the usual influx of French, Italian, Scandinavian and British girls. Maltese girls had it drummed into them from birth that they should give their virginity away only in return for a wedding-ring. Maltese boys took this for granted.

The net result of this taboo on sex before marriage was that lots of people of my generation and older never realised they were homosexual, or suspected it but weren’t sure. It wasn’t seen as a bad thing that they never felt the slightest urge to pounce on their girlfriend or boyfriend. It was a good thing. They were behaving well. The trouble came later, and it came, too, for those who were not homosexual but who discovered, on the big honeymoon night, that maybe this was somebody with whom they didn’t want to share a bed, after all – not even once, let alone for the rest of their lives. The morality police like to think that it’s money and financial pressures that are causing the breakdown of so many marriages. Those are contributing factors, yes, but at root it’s all to do with sex and people just don’t talk about it because it’s too embarrassing. You’ll generally find that most couples who split up haven’t touched each other for years before doing so. And when people split up just a few weeks or months after the honeymoon, there can be only one major reason, really: the realisation that they don’t want to have sex with that person ever again.

Ah, but now we have headed off in the opposite direction, just as we have done with so many other matters that involve morality and civic responsibility. This is one of my favourite hobby-horses, so I won’t go into it again, except to repeat this: when you teach morality and civic responsibility only in the context of religion, then when people ditch or disregard that religion, they ditch or disregard morality and civic responsibility along with it. So what has happened now is this: because whole generations of Maltese people were taught that sex outside marriage is a bad thing because the Catholic Church says so, full-stop and no further discussion about the various permutations of different situations, then as they began to care less and less about the teachings of Catholicism, they found themselves bereft of any moral code and even of the barest modicum of common sense.

Girls of all ages, women included, refuse to understand that while society has moved on and the world has changed, one thing remains the same for them: the more they sleep around, the less chance they have of finding somebody who will consider them a suitable candidate for a serious and steady relationship, unless they leave their community and reinvent themselves somewhere else.

This is not a popular opinion (and to me, it’s not even an opinion, but a matter of fact). Whenever I give voice to it, I am slapped down by women who do sleep around rather a lot, and who make it seem that it’s personally my fault that women can’t behave like men do without suffering that sort of consequence. Some men get cross, too, and describe this attitude as old-fashioned. But when you ask them if they would consider settling down with a woman who’d had sex with 30 men – or even with a much smaller number if these happen to be people they know and meet on a regular basis – they bridle. I’ve noticed that the more of a libertine a man is, the more likely he is to settle down at some great age with somebody young enough to be his daughter, or even grand-daughter, and who has had the time and opportunity for as few lovers as possible.

In the space of a decade and a half, we have gone from no sex before marriage – or maybe some sex with an engagement ring on – to viewing the sexual act with even more careless detachment than prostitutes do. A shag is now the equivalent of what a French kiss was for my generation, except that a shag has consequences that a French kiss does not.

Philip Carabot told the house committee that 10 per cent of the 2,221 patients seen by the genito-urinary clinic were under 18. I’m not shocked at the thought of people having sex at that age. It would be odd if they didn’t, given that the drive to do so is at its strongest then. Only social and religious repression can stop older teenagers having sex, and I don’t think any of us should be feeling nostalgia for those days, which resulted in so much sexual confusion and so many ill-fated unions.

Nor am I shocked because they didn’t use a condom. I can still remember that wonderful feeling of being 18 and thinking that you’re immortal, that nothing can ever harm you, that bad things happen only to other people, and that you will live forever. So no, that teenagers don’t wear condoms doesn’t surprise me at all, just as it doesn’t surprise me that they drink and drive, try addictive drugs in the belief that they will avoid addiction by dint of their teenage super-humanity, and take part in other high-risk activities.

What shocks me is that they’ve been infected. You don’t expect a young teenager who sleeps with another young teenager to contract a venereal disease. Venereal diseases used to be the preserve of older people, people who slept around a lot, or who didn’t sleep around but who had the misfortune of a chance encounter or even a relationship with somebody who had what used to be called ‘history’.

Carabot went on to say that 43 per cent of the clinic’s patients said they had casual sex, and 70 per cent said they didn’t use protection. I don’t find this surprising, either. It should be obvious that if they didn’t have casual sex and they used protection, they wouldn’t be there in the first place. Indeed, I suspect that the 30 per cent who claimed to use protection were fibbing. How were they infected if they used protection? On the other hand, it is perfectly possible to contract a disease even if you only ever sleep with one person, if that person has a fair amount of extra-curricular activity going on.

Carabot told the house committee that the majority of those presenting with an infection couldn’t remember the person they had sex with, usually because they were drunk or drugged at the time. Again, I’m sceptical about this. While drunkenness loosens our inhibitions and causes us to do things we wouldn’t do if we weren’t drunk, you have to be very, very drunk not to remember who you had sex with, and it does seem rather strange that they remember they had sex (unless it was a case of “Oooh, where did this infection come from?”) but not who with. Usually, it’s the other way round: you remember that you were with that person, but you don’t remember what you actually did or didn’t do.

I think there’s more fibbing involved here, all linked to that absence of civic responsibility that marks the Maltese amoral code. There’s a track-back process when you’re diagnosed with a sexually transmitted disease. The clinic asks you to contact those people who you may have infected unwittingly, and even the person who may have infected you, to inform them so that they may seek treatment too, and meanwhile refrain from having sex and infecting others. STD clinics don’t check that you’ve done this, but they ‘strongly advise’ you to do so. I suppose most people find it easier to say that they don’t remember who they slept with. Of course, if they feel this way, they might as well say the truth and then lie about their willingness to do the responsible thing and contact the others. But you know how it is in Malta: people operate a policy of imparting as little information as possible, unless that information can serve their purposes while harming others.

Of course, not all those who are infected with a venereal disease turn up at the clinic. Many just go to their own doctor. Others might not even know they are infected (and infectious) because there are no symptoms. Chlamydia is the most notorious of these diseases: it ravages a woman’s reproductive system, creeping up bit by bit over the years, until she is infertile, and all the while without causing any pain, discomfort or external symptoms. A woman contracts the disease at 20, starts trying for a child in her early 30s, and can’t conceive. She blames her loss of fertility on her age, and then finds out it was Chlamydia all along. Using the World Health Organisation formula, Carabot calculates that the number of those infected with sexually transmitted diseases in Malta is around 13,000 each year. And no, I don’t find this figure incredible. I think it’s very plausible, when you consider what’s going on out there.

The house committee also heard the views of Charmaine Gauci, the health department’s director of health promotion. She explained that a group of professionals have got together and are working out a national strategy on sexual health, focussing on public awareness, responsibility, educating children and parents, monitoring, treatment and research. The aim is to educate people about the use of contraceptives. I wish they would stop being mealy-mouthed and using that word when they mean condoms. They’re the only contraceptives that act as a barrier to the transmission of disease. The pill doesn’t. The IUD doesn’t. The cap doesn’t. And neither does this new hormonal implant that lots of women have begun to use over the last four years. So please stop saying ‘contraceptives’. It’s misleading. Just get over yourselves and say ‘condoms’.

Another healthcare professional said that ‘youths’ – and please stop it with the ‘youths’, too, because in British English it means young men and not young people in general – are being spurred on to having ‘adventurous’ sex by what they see or hear through the media and pornography. Oh, I don’t know about that. Teenagers always want to have sex. They’re not normal if they don’t. It’s just that the social and religious inhibitors have gone, and Maltese society is now going through what Britain, North America and most of Europe north of Rome went through in the late 1960s and early 1970s.We joined the sexual revolution 40 years too late. We woke up to sex and experimentation 20 years after those societies which had their sexual revolution in the era of Woodstock had gone almost full circle, having got it out of their systems, largely thanks to the spectre of Aids and the realisation that too much sleeping around makes you used goods (the women) and speaks volumes about your lack of integrity (the men).

The house committee and the health professionals can stop looking for explanations. There’s only one. The Swinging Sixties have arrived in Malta.