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Point By Point: A Look At Paul Cameron’s Medical Consequences of What Homosexuals Do

Part 3: “Rectal Sex”

In Which a Popular Urban Legend Makes Its Appearance

Jim Burroway

January 31, 2006; revised October 15, 2006

Now that Dr. Cameron has explored the familiar territory of oral sex, he is ready to launch into a more lurid description of anal sex (or “rectal sex”, as he prefers to call it). Unlike the previous topic, the typical reader will likely find this section of Medical Consequences rather gruesome. Dr. Cameron feeds on this squeamishness by describing this topic in particularly shocking and violent terms. The way he describes it, most gay men may find these descriptions disturbing — and alien. So prepare yourself; this is not for the weak of stomach.

Surveys indicate that about 90% of gays have engaged in rectal intercourse, and about two-thirds do it regularly. In a 6-month long study of daily sexual diaries,3 gays averaged 110 sex partners and 68 rectal encounters a year.

Rectal sex is dangerous… Since sperm readily penetrate the rectal wall (which is only one cell thick) causing immunologic damage, and tearing or bruising of the anal wall is very common during anal/penile sex, these substances gain almost direct access to the blood stream. Unlike heterosexual intercourse (in which sperm cannot penetrate the multilayered vagina and no feces are present),7 rectal intercourse is probably the most sexually efficient way to spread hepatitis B, HIV, syphilis and a host of other blood-borne diseases.

Tearing or ripping of the anal wall is especially likely with “fisting,” where the hand and arm is inserted into the rectum. It is also common when “toys” are employed (homosexual lingo for objects which are inserted into the rectum — bottles, carrots, even gerbils8)… Fisting was apparently so rare in Kinsey’s time that he didn’t think to talk about it. By 1977, well over a third of gays admitted to doing it…

3. Weinberg George. Society and the Healthy Homosexual. (New York: St. Martin”s Press, 1972): Preface.

7. Mavligit, Gloria M.; Talpaz, Moshe; Hsia, Flora T.; Wong, Wendy; Lichtiger, Benjamin; Mansell, Peter W.A. “Chronic immune stimulation by sperm alloantigens: Support for the hypothesis that spermatozoa induce immune dysregulation in homosexual males.” Journal of the American Medical Association 251, no. 2 (January 13, 1984): 237-241.

8. Cecil Adams, “The Straight Dope,” THE READER (Chicago, 3/28/86) [Adams writes authoritatively on counter-culture material, his column is carried in many alternative newspapers across the U.S. and Canada]. (sic. - ed.)

Dr. Cameron appears to have mistakenly cited reference #3 when he should have cited reference #5:

5. Corey Lawrence; Holmes, King K. “Sexual transmission of hepatitis A in homosexual men.” New England Journal of Medicine 302, no. 8 (February 21, 1980): 435-438.

Once again, Dr. Cameron refers only to gay men, and continues to ignore lesbians in this section.

The details of the Corey & Holmes study were first discussed here.

“In a 6-month long study of daily sexual diaries, gays averaged 110 sex partners and 68 rectal encounters a year.” This statistic from the “daily sexual diaries,” is referenced to the wrong source. It should refer to Corey & Holmes (#5), which, as we discussed in the previous section, consisted of 96 STD clinic patients, and only supported an average of less than 24 sexual partners per year.

“…sperm readily penetrate the rectal wall (which is only one cell thick)… Unlike heterosexual intercourse (in which sperm cannot penetrate the multilayered vagina…), rectal intercourse is probably the most sexually efficient way to spread hepatitis B, HIV, syphilis…” For this assertion, Dr. Cameron cites Mavligit, et al. (#7), which he misspells “Manligit” here and in many other publications. Mavligit, et al. does not assert that the sperm “readily penetrates the rectal wall (which is only one cell thick)”. Instead they note that under certain circumstances, sperm may leak through lacerations and bruising of the wall, but they don’t claim that this occurs every time. They don’t even speculate on whether this may be a common occurance or not.

Furthermore, Mavligit, et al. does not claim that anal intercourse is “the most sexually efficient way” to spread the long list of diseases that Dr. Cameron cites. But Mavligit, et al. did guess that HIV might be more readily transmitted by anal intercourse. They based their guess on the hypothesis that the presence of sperm was lowering the immune systems of gay men. (This report was written before researchers learned that AIDS was caused by a virus.)

The arguments put forward by Mavligit, et al. hinge on the presumed vulnerability of the “delicate” rectum, despite the fact that it is a highly elastic organ designed to pass material of a variety of sizes and textures without injury, even under conditions of constipation.

Medical professionals are just as vulnerable to biases and erroneous assumptions as the general public, and these biases were more pervasive twenty-five years ago than they are today. Before the onset of the AIDS epidemic, homosexual activity was rarely studied and researchers were more likely to be unfamiliar and uncomfortable with descriptions of sexual activity.

This image of the “vulnerable rectum” verses the “rugged vagina” was accepted as fact by many researchers in the 1980’s. This led many to conclude that AIDS would remain a gay disease spread by anal sex. They believed the “rugged vagina” would protect women from the disease as long as intercourse was “normal” and non-violent.OO

Today, we know that heterosexual women can become infected with HIV through unprotected vaginal intercourse. In 2004, 33% of all new HIV/AIDS diagnosis in the United States came from heterosexual contact.PP Meanwhile, 59% of all HIV/AIDS diagnosis in Great Britain were heterosexually acquired,QQ and HIV/AIDS has always been a predominantly heterosexual epidemic in Africa (where the disease originated) and in parts of the Caribbean.RR

If the vagina were so rugged, how could this happen? According to the Centers for Disease Control, “the lining of the vagina can sometimes tear and possibly allow HIV to enter the body. HIV can also be directly absorbed through the mucous membranes that line the vagina and cervix.”SS When it comes to disease, the vagina is quite vulnerable.

“It (tearing or ripping) is also common when “toys” are employed (homosexual lingo for objects which are inserted into the rectum — bottles, carrots, even gerbils.” Dr. Cameron provides an unusual definition of “toys”, ignoring the far more generally understood definition to include vibrators, phalluses (“dildos”), and other sexual aides which are used among heterosexuals as well. These “toys” are manufactured to be used safely by heterosexuals as well as homosexuals, and are subject to the same product liability laws which result in everything from safe cars to safe stepladders. Characterizing “toys” as “bottles, carrots, even gerbils” is an obvious attempt to disgust the reader.

“…even gerbils.” Yes, he even brings out the famous gerbil legend. His citation of Cecil Adams’s (#8) “The Straight Dope” column is unusual, to say the least. I have left Dr. Cameron’s source citation as he wrote it, with its odd endorsement that “Adams writes authoritatively on counter-cultural material.” This is certainly a different tone of authority than the scientific studies that Dr. Cameron prefers to use. Perhaps it is because he wasn’t able to find a single documented instance in all of the medical literature of “gerbiling”.

But it appears that in Dr. Cameron’s zeal to document this juicy tidbit, he neglected to actually read Cecil Adams’ column. If he had, he would have read Mr. Adams describe his search for the source of this story this way:

I have checked with numerous sources in both the gay and medical communities, and though everybody has heard about gerbil stuffing, every attempt to track down an actual case has come to naught. The whole business sounds completely nuts, and implausible to boot.”TT

Dr. Cameron attempts to document this “fact” with a source that actually asserts the opposite!

The details of Jay & Young’s The Gay Report were first discussed here. More information can be found in our review of The Gay Report.

“By 1977, well over a third of gays admitted to doing it (fisting).” For this, he appears to direct the reader’s attention to column 2 of the table of “Homosexual Activities” where he combines “fisting” with “toys”. But according to his table, only 22% of this population is “doing it” by 1977, not over a third. And remember, Jay & Young (#13) was the informal survey that generated a response rate barely over 1%, leading critics to question the motivations of the very few who participated.

The details of the Paul Cameron’s ISIS survey were first discussed here.

The details of the Jaffe, et al. study were first discussed here.

And if, by chance, he intends to direct the reader’s attention to either column three or four, then we still have problems with this statistic. His own ISIS survey for column three suffers from a response rate of only 23.6% (along with several other methodological problems), and the Jaffe et al. study for column for four was based on a study population in which three-fourths were drawn from STD clinics. So no matter which column of his table he’s referring to, there is simply no valid support for this statistic.

Is Dr. Cameron Believable?

You be the judge. Not only is the entire “Rectal Sex” section composed of statistics which are not representative of the general gay male population, we see that in the case of “gerbiling” his reference directly contradicts his claim.

But let’s not deny the obvious: very large numbers of gay men engage in anal intercourse. As uncomfortable as this fact may be for some, it is undeniable — even though the precise numbers cannot be known. But by focusing the reader’s attention towards the “ickiness” of gay men having sex, Dr. Cameron reinforces his straight audience’s squeamishness on the subject. And since many straight male readers don’t find the idea of lesbians having sex to be “icky” (indeed, many find it eroticUU), lesbians have been completely absent so far. The pamphlet’s focus on the “ick” factor follows a very familiar pattern in anti-gay literature.

But not all straight couples find anal sex “icky.” In Melbye, et al. (#31), which Dr. Cameron cites elsewhere in Medical Consequences, (and which is his only source that is based on a truly randomized sample) 21.7% of heterosexual women reported that they participated in anal sex with their male partners.VV Dr. Cameron finds it convenient not to mention this.

Other surveys report similar numbers. The 1991 National Survey of Men was a nationally representative study of 3,321 men aged 20-39 in the United States (response rate: 70%), 20% reported having had anal sex with a woman at least once in the previous ten years.WW The 1992 National Health and Social Life survey, another nationally representative study of 3,159 adults between the ages of 18-59 (response rate: 80%), reported that 25.6% of men and 20.4% of women reported having had anal sex with an opposite-sex partner at least once.XX And in the 2002-2003 National Survey of Family Growth conducted by the CDC, 12,571 adults between the ages of 15 and 44 years of age (response rate: 79%) reported that 34% of men and 30% of women reported having had anal intercourse with the opposite sex.YY

But if Dr. Cameron didn't know about these nationally representative surveys, he surely knew the results of his own (“Effect of Homosexuality Upon Public Health and Social Order”, #6), which shows 36% of 1,261 heterosexual men participating in anal sex with women.ZZ If true, there are far more straight couples engaging in anal sex (466 in his survey) than gay male couples (only 38). If anal sex is really as dangerous a health hazard that Dr. Cameron says it is, then he completely misses his own data which shows that heterosexuals engage in this activity in far greater numbers than homosexuals.

And finally, despite all that you may have heard, the gerbil story is truly an urban myth.

Please continue with:

Part 4: “Fecal Sex”. Where Dr. Cameron’s creativity really shines.


OO. Triechler, Paula. How to Have Theory in an Epidemic (Durham, N.C.: Duke University Press, 1999): 239-241. [BACK]

PP. Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report 16 (Atlanta: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2005): 10. Available online at (PDF: 990KB/46 pages). [BACK]

QQ. The UK Collaborative Group for HIV and STD Surveillance. Mapping the Issues: HIV and other Sexually Transmitted Infections in the United Kingdom: 2005. (London: Health Protection Agency Centre for Infections, November 2005): 13. Available online at (PDF: 4,925KB/120 pages). [BACK]

RR. Joint United Nations Programme on HIV/AIDS UNAIDS 2004 Report on the Global AIDS Epidemic. (2004). Also available online at For a discussion on the spread of HIV/AIDS among the heterosexual population in Africa, see Chapter 2, page 30. [BACK]

SS. Centers for Disease Control and Prevention, Divisions of HIV/AIDS Prevention. Can I Get HIV From Vaginal Sex? Web page, from the Frequently Asked Questions section at (accessed February 2, 2005). [BACK]

TT. Adams, Cecil. “Is it true what they say about gerbils?” The Straight Dope. (Undated). Web page posted online at (accessed March 18, 2004.) [BACK]

UU. Whitley, Bernard E., Jr.; Wiederman, Michael W.; Wryobeck, John M. “Correlates of heterosexual men’s eroticization of lesbianism.” Journal of Psychology and Human Sexuality 11, no. 1 (1999): 25-41. [BACK]

VV. Melbye, Mads; Biggar, Robert J. “Interactions between persons at risk for AIDS and the general population in Denmark.” American Journal of Epidemiology 135, no. 6 (March 15, 1992): 593-602. [BACK]

WW. Billy, John O.G.; Tanfer, Koray; Grady, William R.; Klepinger, Daniel H. “The sexual behavior of men in the United States.” Family Planning Perspectives 25, no. 2 (March 1993): 52-60. [BACK]

XX. Lauman, Edward O.; Gagnon, John H.; Michael, Robert T.; Michaels, Stuart. The Social Organization of Sexuality: Sexual Practices in the United States (Chicago: University of Chicago Press, 1994): Table 3.6. [BACK]

YY. Mosher, William D.; Chandra, Anjani; Jones, Jo. “Sexual Behavior and selected health measures: Men and women 15-44 years of age, United States, 2002.” Advance Data from Vital and Health Statistics no. 362 (Atlanta: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2005): Table 7. Available online at (PDF: 1,235KB/56 pages). [BACK]

ZZ. Cameron, Paul; Cameron, Kirk; Proctor, Kay. “Effect of homosexuality upon public health and social order.” Psychological Reports 64, no. 3 (June 1989): 1167-1179. [BACK]