"Richard T. Nolan" wrote:

I teach an undergraduate ethics course at Palm Beach Community College. During the unit on sexual ethics, the issue of heterosexual and homosexual anal penetration (intercourse) came up. It seems to me that at the very least this is a medical issue. Is there any statement I could use from proctologists that would settle whether this sexual practice is or is not harmful to the body?

Richard T. Nolan, Ph.D.

From: "Dr. Rick Shacket"
To: "Richard T. Nolan"
Subject: Reply: Anal Intercourse
Date: Wed, 28 Mar 2001

Hello Richard T. Nolan, Ph.D.:

Anal intercourse is potentially physically harmful. It can cause anal fissures (cracks), thereby allowing the quick transfer of blood born diseases such as hepatitis and HIV. There are also other consequences of fissures.

I believe that there has been some research that suggests that the rectal wall does not provide much of a barrier to the AIDS virus, and that the recipient of anal intercourse is quite vulnerable to contracting the disease if the penetrator has the disease and ejaculates.

Less widely known is the fact that men who engage in receptive anal intercourse have a higher rate of anal cancer than the general population. This may be associated with the fact that men who have sex with men also have a greater incidence of anal human papillomavirus (HPV) infection.

Feces contain bacteria, which can cause a urinary tract infection (urethritis), in men who do not wear condoms. Women can also get urinary tract infections or vaginal infections if the feces laden phallus comes into contact with the female genitalia. Furthermore, the bedding may also become contaminated with these same bacteria if care is not taken to clean up immediately after anal intercourse.

The anal area is rich with nerve endings. Many people find this to be a pleasurable sexual activity. The difficulty is that the tissue wasn't designed for this sort of use. You may be interested to know there have been reports of "fist fucking" being performed on stage in New York between consenting homosexual participants. The receiving participant reportedly takes a muscle relaxant to allow this violent form of penetration. This is an extreme form of sodomy, which combines violence with sexuality. As you might imagine, the effect on the tissue will have something to do with the level of aggressiveness of the penetrator.

Also, different people have different levels of susceptibility to anal problems such as fissures. So, I don't think that I can settle whether this is harmful to the body. It would depend upon the care of the participants to ensure that injury was minimized, the susceptibility of the recipient to anal problems, and the disease status of the participants - particularly the disease status of the penetrator. I personally don't think it is a good idea. But that is just an opinion.

A friend who is an expert on sexual violence said that many rapes involve anal penetration. Since rape is not about sexual pleasure and more about anger and domination, this might give your students some pause regarding the merits of sodomy.

Rick A. Shacket, DO
Diplomate American Osteopathic Board of Proctology

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