What’s the difference between sexually transmitted diseases (STDs) and sexually transmitted infections (STIs)? Technically, the word disease implies symptoms whereas infections can go unnoticed. But the word disease also implies stigma. In reality, the majority of STIs never reach the level of disease, causing damage to the body’s cells. Still, judgment and shame surround them. Especially for women. So let’s talk about it.

Can I ask you a personal question?

👩‍⚕️ The State of STIs

It’s equally comforting (if you’ve been there before) and scary (if you haven’t) to hear that it’s more likely than not that you’ll contract a sexually transmitted infection (STI) in your lifetime. But with more than half of people in the U.S. having to deal with an STI at some point, you’d think it’d be a little less…hush-hush. And in a classic case of this-topic-is-perfect-for-Not-That-Personal, women are disproportionately affected both in terms of being more likely to contract an STI, but also more likely to suffer from serious consequences. Why is that, you ask? Partly genetics. Women’s urogenital anatomy is more exposed and thus more vulnerable to STIs. We’re also less likely to have symptoms and less likely to get checked (because it’s…harder to check), leaving us untreated for longer. This can lead to some scary stuff - like pelvic inflammatory disease from chlamydia and gonorrhea, (which can cause infertility) and cervical cancer from HPV (but hopefully you got that three-dose Gardasil vax in middle school and are less susceptible). 

Speaking of HPV, it’s actually the most common STI in the U.S. - there are over 40 different types of HPV infections, but most are harmless and you never even know you have them. Chlamydia and gonorrhea are also up there, but both are curable with modern antibiotics (though like we said before, they can develop into something more serious without treatment). The one you really have to watch out for is herpes which you unfortunately have to deal with for life once infected. But luckily, it’s only spreadable when you have flare-ups - which, like with any chronic condition, can be managed (so no, your sex life is not over - and don’t let anyone tell you differently).

🍆 So condoms aren’t cool?

So how’d we get to a point where half the population is contracting STIs? Well, remember how everyone says young people aren’t having sex? It turns out that when they do choose to get between the sheets, they are less likely to use condoms as the rates of STIs are rising with the largest concentration in those ages 15 to 24. By how much you ask? Well, from 2014 to 2018, rates of chlamydia rose by nearly 20% and gonorrhea by over 60% (yikes). So while young people might be having less sex, they’re also having less protected sex (probably partly because contraception has become nearly universal and we forget that avoiding pregnancy isn’t the only reason we might want to wrap it up). Seems like we might need the brains behind the Gen Z-approved Julie emergency contraceptive and Overdrive drug testing strips to swoop in and make condoms cool again, too.

😞 Why the stigma? 

Despite being quite normal, STIs are nowhere near normalized, especially for women. Of course, the same is true for sex itself, let alone STIs. We hardly need to remind anyone of the gendered double standards surrounding sexual experience that are still more or less the societal norm. And they have been. For a long time. The Scarlet Letter was published in 1850, after all. More recently, though, we think Taylor Swift’s The Man puts it quite nicely, as she muses about how she and her romantic relationships might be perceived differently by the public if she were instead a man:

And they would toast to me, oh
Let the players play
I'd be just like Leo
In Saint-Tropez

Moral of the story: when men have numerous sexual partners, they’re seen as experienced, as someone to aspire to; when women have numerous sexual partners, they’re seen as easy, to put it mildly. Even though men report having roughly double the number of sexual partners throughout their lifetime, they rarely have to worry about being called derogatory slurs and suffering the accompanying judgment.

And when it comes to STIs, well, they implicitly call attention to the fact that multiple sexual partners have, at some point in time, been had. (Of course, you don’t have to sleep with multiple people to get an STI, but that doesn’t stop a nosy third party from thinking it.) So it makes all too much sense that women, who are shamed simply for their existence as sexual beings, shoulder more of the stigma surrounding STIs. And there are tangible health consequences of this stigma beyond just the mental wellbeing of those dealing with it. Multiple different studies have shown that shame and stigma surrounding STIs are directly correlated with the choice not to seek STI testing or care.

💗 You’re not alone 

All of the stats and figures aside, we think the most important part of the discussion around STIs is normalizing the experience. If you’ve dealt with it before or are dealing with it now, remember that there are millions of amazing women like you dealing with the same thing. Take it from a fellow NTP reader:

🎧 Worth a listen: On a recent episode of Call Her Daddy, Alex Cooper tells her story of flying to meet a man she’d met on Raya, having an extremely uncomfortable time with him, contracting HPV from the experience, and learning how to deal with and communicate about it in the years moving forward. No matter who you are, as a woman, we’re pretty sure that some part of her story will feel all too relatable.

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💌 Up Next

That’s all for today! If you liked this edition of Not That Personal, we think one of your friends probably will too – refer one (or two or three) below.

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Up next? So…why are women expected to never age?

See you next week ;)

💖 S & J