"Partner Count Doesn't Matter" vs. Medical Reality

Before I begin, a little disclaimer: I'm just a young dumb cis shitlord MD who will be staff before 28 so take whatever I say here with a grain of salt.

It seems that any discussion about the divorce risk, emotional problems, or other "soft" social markers surrounding the debate about women who CC-rode in their 20s seems to devolve into accusations of insecurity, immaturity, misogyny, Other Standardized Buzzword to Enforce PC Thinking(tm). Nauseating counter quotes include inanities such as "Past is past!", "She chose you now, what does it matter who she fucked before?", "Stop being so insecure!", "It only matters in so far as sexual health is concerned, otherwise I don't give a shit".

Ok, fair enough. I can understand, from a purely rational standpoint, why gold digging CC riders and their cheerleaders have such a vested interest in preventing an epidemic of slut-averse beta bucks from occurring, for obvious reasons. God forbid those betas get standards and disqualify them from the gold rush, because that would totally suck for them.

But if you're a patient telling me that partner count or sexual practices doesn't matter when you're in my office asking about your vaginal discharge or swollen, painful labia, you get labelled Big Fucking Idiot in my head, and I thank you, because I look forward to seeing you again for another future 5 minute visit in a couple months that will net me another 60 bucks. Tack on another 20 for a sick note.

Let's get specific. Just what are some of the lovely medical sequelae that present CC riders are at increased risk for?

1. Gonorrhea is the second most common disease (never mind STI) in the US; the highest incidence is in the sexually active female population 15-19, the second highest is males 20-24, but here's the kicker - the female rate is underestimated because infection is often asymptomatic in women. Risk factors? Multiple sexual partners, previous infection, being unmarried. Again, just a Dumb Cis Shitlord, just spouting agenda, not facts, oh wait - this was from the CDC and the American Journal of Epidemiology. But so what? What if I'm asymptomatic! Except gonorrhea can lead to, and accounts for, up to 40% of pelvic inflammatory disease, which is an upper genital tract infection that can cause chronic pelvic pain, infertility, or in severe cases, life threatening abdominal sepsis. Hur dur, we has antibiotics now, we is good to keep on slutting! Ok, fair enough, 90% of cases can resolve with first or second line agents, but past behaviour predicts future behaviour, and I've already had more than one tearful counselling session with an unfortunate who is now infertile "I never thought this would happen to MEEE!!". Repeat customer, beat it each time, until Mother Complications decided to show up and exert her dominance. But but but condoms! Routine barrier contraceptive use reduces gonorrhea transmission rate by up to 50%, not 100%. And yet an early 2000s CDC survey showed only 30% of early 20s women reported regular condom use. Oh well, there's always cats!

2. HPV-related oropharyngeal cancer - AKA human papilloma virus, sub type 16 to be specific. Most common STI worldwide, infection spreads shortly after onset of sexual activity. In decades past the primary domain of smokers, but now thought to account for up to 50-80% of North American oropharynx cancers. Risk factors: early age of sexual activity onset, multiple partners. In graphic terms, if you had a choice between eating out a former slut wife vs. a low count/virgin and chose the former, you are literally at higher risk for throat and mouth cancer. Sure, you will probably beat the odds, unless you're one of the unlucky ones that ends up losing part of his tongue and a radiated wooden neck. Double sucks if you get divorced too.

3. Herpes - an incurable, but non-fatal viral infection that causes intermittent painful open sores on genitalia. Same family as cold sore virus. Traditionally, your oral herpes are caused by HSV 1, genital herpes by HSV2. With the prevalence of oral sex, you are finding both subtypes on both areas. Still transmissible even if partner is not symptomatic with active sores. HSV 2 generally causes worse symptoms, so woe to you if you get it on your mouth from your dear "past doesn't matter" Special Snowflake. Bonus points if you somehow get it in your eye.

I haven't even begun to scratch the surface of why it's objectively, from a strictly medical and health standpoint, a worse decision to wife up or make a former slut your new monogamous partner. Cervical cancer risk, chlamydia, prolapse, rectovaginal fistulas (essentially, you go number 2 out the vagina), ectopic pregnancy risk, salpingitis, etc etc.

Student health clinics are a gong-show. I get students coming in treating "the clap" like a joke, like it's just a routine cold you're supposed to get like clockwork per year. I love prenatal visits where the husband comes in with the wife, I ask the mom about previous STIs or sexual history, she denies, and at future visits she spills the beans when alone. I actually had one obese diabetic who has poor insulin compliance because, I shit you not, it's a form of fat shaming. Well, if preventing blindness, rotting feet, and kidney failure is fat shaming, call me Dr. Fat-Hating Shitlord. Every week brings at least one Maury-like moment, and it's hilarious. Telling a hysterical patient in ER matter-of-factly and stone faced that she has genital herpes, while watching her faithful boyfriend's expression slowly change as I discuss the possible transmission routes makes the hours worth it.

The best part is getting paid well to get a front row seat to this daily dose of human stupidity. So, buy into the flow of PC bullshit about not being a judgey douche if you want, but don't worry, I'll be there with some antibiotics and antidepressants when it all goes to shit. Just pray the bacteria doesn't become resistant before you've had your fun.

Fuck I love my job.