E-Cigarettes Bad for E-Rections

The last issue was about World AIDS Day and some of the progress we’ve made toward ending the HIV epidemic in this country. It felt vaguely optimistic (which is always hard for me). Unfortunately, as we were commemorating those we’d lost, celebrating the progress we’d made, and looking at creating a more equitable future—the Supreme Court was working on dragging us back to our death-by-abortion past.

Last Wednesday, the newly conservative court heard arguments in Dobbs v. Jackson Women's Health Organization, a case that stems back to Mississippi’s 2018 law banning all abortions after 15 weeks. The law has been on hold based on lower court rulings that said it violated the precedent set in Roe v. Wade where the court said laws prohibiting abortion before 24 weeks represented unconstitutional violations of privacy.

In the decades since Roe, states have tried to make abortions harder to get and have succeeded in many ways with laws that require patients to wait 48 hours, see the results of an ultrasound, or learn about debunked abortion stress syndrome before they are allowed to get an abortion, and TRAP laws that require providers and clinics to meet absurd standards (like widened hallways) before they are allowed to offer that abortion. Still, states have stopped short of total bans on the understanding that such laws would not hold up to precedent.

Only now, the court seems poised to overturn that precedent. In oral arguments, conservative justices suggested 15 weeks was surely enough time to make a decision, offered adoption as a viable alternative, and suggested that fetuses have an interest in having a life. Though we don’t know for sure what will happen—the decision won’t come out until next summer—these questions did not inspire confidence that the court would uphold Roe. 

Without protection from the court, states will be able to pass legislation like the Mississippi law in question and effectively outlaw abortion in their state. In fact, some states already have those laws on the books and will only have to ask lower courts to lift injunctions. An analysis by the Guttmacher Institute suggests that 26 states would ban abortion right away if Roe were overturned and more might follow suit.

With half the country living under abortion bans, providers in the other half would likely be unable to meet the increased need and women will once again turn to unsafe abortion. Of course, not all women will have to make that choice. My daughters—and the daughters of the white soccer moms in red states who continue to vote for anti-abortion candidates—will always have access to abortion because we can afford it. The impact of this decision will be felt most by low income black and brown women who don’t have the resources to travel hundreds of miles for a procedure. Once again, we will be punishing poor women for being poor.

There goes my optimism.

E-Cigarettes Bad for E-Rections

We’ve known for a long time that classic cigarettes (think Marlboro Reds or Benson & Hedges) are bad for you and your dick. Now, a new study suggests that e-cigarettes are no better. Researchers from NYU and Johns Hopkins analyzed data from over 13,000 men over 18 who participated in a tobacco use study and answered questions on erectile dysfunction.

One quarter of participants (24.5%) said they had ever used Electronic Nicotine Delivery Systems (ENDS) more commonly called e-cigarettes, 4.8% said they used them currently, and 2.1% reported using them daily.

A note before we continue to the penis part of the results. E-cigarettes were invented by a Chinese pharmacist in 2003 and introduced as a healthier, less smoky way to get your nicotine fix. Healthier is, of course, a relative term. The e-cigarette technology has given rise to (see what I did there) the vaping craze but while all e-cigarettes are vapes, not all vapes are e-cigarettes. Today people vape lots of things, most notably weed, CBD, or essential oils. This study only looked at people specifically vaping nicotine. 

Just over 20% of respondents had experienced erectile dysfunction (ED). Current daily ENDS users were 2.2 times more likely to report ED than never users. A history of cardiovascular disease and being over 65 were also associated with a greater incidence of ED while increased physical activity was associated with decreased incidence of ED.

The researchers also looked at a subset of participants who had experienced ED but had never had a history of cardiovascular disease to see if the correlation between ENDS use and ED held up. It did. About 10% of respondents in this group said they’d experienced ED and current daily ENDS users were 2.4 times more likely to report ED than never users.

So, like every other study of the past few decades this one comes down to if you want to be healthy (in this case to be able to get it up), exercise and don’t smoke cigarettes—even the fancy, new-fangled versions.

“Bob Dole Has Died”

I’d be remiss if I wrote an article on ED this week and didn’t mention Senator Bob Dole who died on Sunday at the age of 98. In shilling for Pfizer in the late 1990s, the former Republican presidential nominee brought discussions of erectile dysfunction into the mainstream and started the advertising trend of using initials to obscure every potentially embarrassing medical malady from IBS to GERD to RLS to BBS (which does, in fact, stand for Bashful Bladder Syndrome).

While I made merciless fun of him for his commercials (and his habit of talking in the third person), I suppose it took some courage for a once-powerful man to discuss his penis woes in public. Of course, his legitimacy also helped make Pfizer almost $2 billion dollars a year during a time when insurance would pay for erection medication but not contraception and I’m sure he didn’t do it for free. Thank you, Mr. Dole?

Coming Soon to a Subway Car Near You: Sex Toy Ads

Subway riders in New York City may start seeing new ads for sex toys as the MTA has settled an ongoing lawsuit with sexual wellness brand Dame. The ads are not exactly what the company had in mind when it first tried to purchase the space in 2018, but founder Alexandra Fine says she’s pleased the campaign is moving forward nonetheless.

Dame is a sex toy start-up which describes itself as selling sex toys by women for women in an effort “to close the pleasure gap.” The company initially tried to purchase subway space for a series of ads that showed pictures of sex toys with text like “91% of men get where they’re going while 60% of women…don’t.” The MTA refused the campaign through its media contractor saying that a new rule prohibited advertisements that promoted “sexually oriented” businesses. 

Fine and her team called bullshit on that, pointing out that past subway ads had promoted erectile dysfunction treatments, breast augmentation, and the Museum of Sex. In a 2019 federal complaint, Dame claimed that the MTA was inequitably applying its rules in a way that allowed for content about male pleasure (such as the ED ads and one featuring visuals of a cactus with a sexually suggestive tag line) but didn’t allow content about female sexual pleasure.

This isn’t the first sexual health or women’s health company to complain about the MTA’s advertising rules. The transit authority initially refused to allow Thinx (the period underwear brand) to run ads that used grapefruits as vulva stand-ins and did not approve another sex toy company’s ads because the visuals were too phallic. In both instances the MTA softened its stance, ultimately allowing the Thinx ads and offering space for sex toys ads if the company agreed to use less penis-evoking imagery (it did not).

In the Dame case, the settlement also involves a milder campaign. Instead of the cheeky text and product photos, the new subway ads have abstract art and the toned-down tagline “get in touch.” (When the ads run in other places they will read “get in touch with yourself.”) Fine admits that this win feels a little like a loss: “There’s a lot of this that feels like I settled, but then I remember why I am doing this: I want my company to be able to run ads on the subway. We’re getting to do that. And I think that doing something is part of how you make change, and I’m really proud of that.”

I have to admit, I’m not convinced that MTA’s bias is gender-related. We all know that advertising uses sex to sell everything, but for brands that sell sex-related goods and services the rules are murky at best. Network television rarely lets condom ads on before 10 pm and never during family football time. Yet all those Bob Dole-inspired ED ads—we’ve moved from elevators and office buildings to side by side bathtubs in fields of wildflowers—are considered perfectly appropriate game-day fodder. Facebook’s rules are even worse. Colleagues who have tried to advertise sex ed workshops and curricula, which are possibly the tamest of sex products, have been flat out rejected. 

I would love to see this change (and not only because I’d like to advertise Sex On Wednesday on Facebook). We live in a sex-saturated society and if we can use it to sell cars and hamburgers, we should be allowed to use it to sell underwear and vibrators.