Less than two years ago, I was having fun casually dating someone and hadn’t yet realized this person was both distractingly hot and a judgmental hypocrite (the blissful lack of awareness fairly common during the early stages of dating). Then he called me one afternoon and said he’d tested positive for chlamydia. Halfway through my reply that I was sorry to hear that, he interrupted me: “You gave it to me.”
Taken aback, I initially tried to laugh off this blunt assumption, saying something along the lines of “There’s no way you can know that for sure.” But he persisted: Yes, it had to be me. There was no other possibility.
Feeling frustrated and less assertive than I wanted to be, I told him I’d get tested and ended the conversation.
After a negative result, I was duly smug, thinking this would put an end to his insistence that I was the STI “purveyor” in the relationship. Even as someone who knows that the stigma around STIs is hurtful and outdated, the fact is that someone bluntly and judgmentally claiming I passed an infection to them is a quick way to make me (or anyone) feel dirty and desperate for vindication. I shared my negative result, but he stuck to his guns and switched to another stance: “You must have it in your throat.”
I outright chuckled. I thought to myself, he is so desperate to believe I’ve given him chlamydia that he is trying to convince me I somehow grazed his penis with my unknowingly infected throat? We’d had maybe two encounters that could have possibly led to this precise moment of contact, and I could think of maybe three to four seconds in which his penis had actually touched any part of my throat. I’d barely heard about throat STIs in my sex education, but this fact alone made me scoff. There was no way.
I called up my women’s clinic, the same one that had given me the previous STI test, and asked if they ever tested throats for chlamydia.
I was met by a less than comfortable silence as the nurse apparently pondered a question she’d never heard before. She said she’d have to ask a doctor and put me on hold. When the doctor came onto the call, I was left with no clearer information than I’d had before: “We never even really do throat tests, but you can come in just in case.” Yet I felt an unearned confidence; clearly this whole throat chlamydia thing was basically an urban legend.
I was getting tired of long trips to inconveniently located women’s clinics trademarked by plenty of intrusive and repetitive paperwork, so I was annoyed when I arrived for my throat swab appointment. A nurse walked me to the room where she’d poke my throat with a massive Q-tip and asked me why I was doing this test; she also seemed to be unfamiliar with it. I explained that a partner was adamant I’d infected him via means of my secretly chlamydia-ridden throat, and that I was here to clear up that possibility. She laughed aloud and said, “Sounds like you should dump him.” So I said “I already did.” (And I had.) It was a moment of unadulterated sisterhood with a stranger and, once again, I was reassured. If there was any chance that his theory would pan out, this woman of science obviously would not have laughed it off.
So, of course, the only natural conclusion to this build up is that a few days later the nurse called me and confirmed that, indeed, I had throat chlamydia.
Of course, the chlamydia itself wasn’t really the issue. I picked up a pill the same day, swallowed it, and that was that. It was so easy to fix, but I was feeling a mélange of bad vibes circling around my already anxious brain. Much as I didn’t want it to, the stigma had gotten to me. Worse, the complete lack of reliable information and answers about throat STIs expounded upon my anxiety, making me feel like a failure.
How had I not known this was possible? And why hadn’t medical professionals even seemed to think it was?
The real kicker was the fact that my ex had potentially been right for saying I gave him chlamydia. I had been so ready to “prove him wrong.” He had bitterly accused me of having an infection with so much certainty — just as he’d said so many judgmental things to me — that I automatically wanted it to be untrue. Beyond that fact, there are upsetting implications when someone accuses you of spreading an STI. There is an idea that you’re “promiscuous,” “easy,” “sleeping around” — whatever euphemisms you prefer. I’m not ashamed of any of that, but someone implying it to your face with visible disdain is another thing.
Another implication is that you were irresponsible or had blatantly lied about being tested or practicing safer sex. I had no interest in letting him assume these things about me because the fact was I did get tested often and I had every reason to think I was STI-negative. No doctor had ever even suggested a throat swab.
Ultimately, I settled on writing a text I didn’t want to send to my ex; I told him that I had tested positive. I put off sending it, knowing he’d already taken his pill and thinking maybe it wasn’t really that important for him to know. I had no desire to give any fuel to his judgment, and besides, it still seemed just as likely that he’d actually passed it to me.
Then, upon successfully treating the infection with a pill and getting past the metaphorical bitter pill-swallowing, I realized there was more to consider. I’d never had my throat tested before — how long might I have had chlamydia lurking in there without my knowledge? Years? How likely was it that I’d passed this to any prior partners? (Those odds had seemed infinitesimal to me before, but they started to increase exponentially in my head.) How far back in my sexual history should I be contacting people? I mean, did the guy I hooked up with in my dorm one time four years ago need to know? What were the long-term effects of having an untreated throat STI? I knew untreated vaginal chlamydia could lead to a whole host of future problems, but infertility seemed like a long shot with an infection living exclusively in my throat — even if it had set up shop a while ago.
Inundated by my own internal questions, I called the clinic back to get some answers. I felt empowered by my own self-advocacy.
My expectation was a sympathetic ear on the other end of the call, assuring me they had the answers and providing them with gusto. Instead, after explaining my situation and politely listing my questions, all I got was a long sigh (yes, really) and a snippy, audibly annoyed retort: “Tell any partners from the last three months to get tested. If you actually want to know about the other things, you’d have to ask a doctor.”
The doctor was never available when I called and never called me back, and I gave up on ever knowing anything.
What I’ve discovered since, in my many hours of online research and conversations with knowledgeable sex educators, is that the world in general seems to know shockingly little about throat strains of STIs. For something that clearly exists (here I am, the living example), the lack of education and reliable information about these infections — and even the misinformation from medical professionals — is jarring. As a society, we’ve subtly been trained to accept not understanding much about our own bodies and what might happen to them when we have sex. The sexual health mindset in many schools and clinics is more “Take this pill and use condoms,” than “Here’s why this is happening to you.” Even worse, other topics are blatantly missing information — throat STIs being one of them.
In a final hail mary attempt to get some answers, I talked to two sex and health educators about the mysterious concept of throat STIs.
The same conclusion came from both of them — throat strains are so undiscussed that people don’t even know to ask about them. Gigi Engle, sex coach and author, tells O.school. “I don't think I've ever been asked about STIs of the throat because most people don't know that they even exist. Whenever I tell someone about the prevalence of HPV-related throat and oral cancers, they are flabbergasted.” Madeline Haupt, Phoenix-based health educator, has had similar experiences in her work. She tells O.school that it is possible to contract a host of STIs (including herpes, HPV, HIV/AIDS, gonorrhea, and chlamydia) through oral contact, but less likely in some cases.
Engle and Haupt advise a deeper education around throat strains for the safety of those who partake in oral sex. Both strongly encourage condom use during oral sex with people who have penises, and to the majority of people who may scoff at this idea, Haupt stresses that “there are ways to make condoms more pleasurable.” As for the off putting latex taste, flavored condoms and lube exist for a reason.
And since throat infections often present no symptoms — or only present symptoms easily mistaken for something else — my own advice is more of a plea. Oral sex appreciators of the world, if a doctor doesn’t offer you a throat swab in your STI test, occasionally ask them to perform one anyway. At least then you might avoid a more costly appointment and any long-term effects, and you can care for your health and the health of any partners. Take it from me.