Why Cosmopolitan, Youth, and Sexual Health Don’t Mix

Children and adolescents exposed to media with sexual content engage in sexual activity at younger ages and with greater numbers of partners, thereby placing themselves at great risk for contracting sexually transmitted infections (STIs) and suffering significant harm.

Cosmopolitan magazine glamorizes sexual promiscuity in every issue and promotes sexual behavior that can lead to deadly consequences for young people.

All material that encourages having multiple sexual partners threatens the physical health of adolescents in general and of young women in particular. There are two main reasons for this: the immaturity of the adolescent brain and the immaturity of the adolescent cervix. Neuroscientists now know that the pre-frontal cortex, the “chief executive officer” of the human brain, is not fully formed until the mid twenties. The pre-frontal cortex is crucial for risk assessment, critical thinking, and self-control.

In terms of sexual health, the result is that while adolescents are capable of memorizing how to use a condom as they pore over a magazine article, they won’t necessarily be able to use it correctly or at all in the midst of passion. Dr. Daniel Weinberger of the National Institute for Mental Health (NIMH) has described the adolescent brain as “similar therefore to the manifestation of mental disability within an adult brain.” Consequently, the 9.5 million annual cases of STIs in teens, including 25% of the annual cases of HIV, are not primarily due to lack of information, but to lack of judgment. For women 21 years of age and younger, it is also due to their cervix not being ready for sex.

The cervix of an adult woman is more difficult to infect than the cervix of a woman under age 21. The adult cervix has twenty to thirty layers of protective cells. Teens, in contrast, have a cervix covered by a fragile single cell layer transformation zone (T-zone). The T-zone is dramatically easier for bacteria and viruses to penetrate compared to a mature cervix, but the bad news does not stop here. There are immune cells in the cervix designed to eradicate unwelcome viruses and bacteria which are in lesser supply in the teen cervix. When adolescent cervixes become infected with HPV, the most common STI and number one cause of cervical cancer, that virus can incapacitate those immune cells. Additionally, birth control pills enlarge the T-zone. So an adolescent girl on birth control increases her already elevated risk of acquiring an STI, pelvic inflammatory disease (which can cause infertility) and cancer of the cervix.

As if this were not bad enough, the March issue of Cosmo went so far as to encourage anal sex. From a medical standpoint, anal intercourse, in contrast to vaginal intercourse, poses a serious risk to its participants regardless of age. For example, unlike with vaginal intercourse, the insertive partner in anal intercourse is exposed to fecal matter, and also likely to be exposed to the receptive partner’s blood. This puts him at increased risk for STI’s, including HIV, urinary tract infections, and pyelonephritis (kidney infections). The greatest dangers, however, are by far for the receptive partner.

The rectum differs from the vagina with respect to suitability for penetration by a penis or inanimate object (sex toy). The vagina is designed to expand, is supported by a network of muscles, and produces natural lubricants. It is composed of a mucus membrane with a multi-stratified squamous epithelium that allows it to endure friction without damage. The anus, in contrast, is designed to allow passage of fecal material out of the body. It is composed of small muscles and significantly more delicate tissues. The anus and rectum are not designed to accommodate repeated friction and stretching. Consequently, anal intercourse often results in anorectal trauma, bleeding, chronic or recurrent hemorrhoids, and chronic or recurrent anal fissures. Over time, the anal sphincter also loses its tone, which may result in chronic leakage of fecal matter. How sexy is that?

As unglamorous as those consequences are, at least they won’t kill you; AIDS and rectal cancer, however, will. Since receptive anal intercourse often results in trauma and exposure to blood, the risk of acquiring STI’s, especially HIV, is significantly greater than the risk associated with receptive vaginal intercourse. In truth, the estimated HIV risk with a single sexual exposure through receptive anal intercourse is 31 times greater than that of receptive vaginal intercourse.

There’s more bad news for the receptive partner: semen has immune-suppressant activity that makes this already vulnerable tissue more prone to infection and the development of cancer. Rectal carcinoma results from infection with a carcinogenic strain of Human Papilloma Virus (HPV).

And, contrary to Cosmo’s assurances otherwise, there isn’t enough lube or latex in the world to make anal sex safe. Cosmo’s practice of glamorizing sexual promiscuity and promulgating medical falsehoods that lead to deadly consequences for our youth is cause enough for the magazine to be restricted to adults only.

Michelle Cretella, M.D. is president of the American College of Pediatricians.


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