Response to testosterone injection study and Fisher's concerns - reply to an article by William A. Fisher in this issue, p. 35

Journal of Sex Research, Wntr, 1997 by Leonore Tiefer

In response to the ethical questions about this study raised by one reviewer, I, another reviewer, offer my thoughts:

Reviewers of JSR have not previously judged research studies from a public health point of view. Our evaluation of research project ethics has been focused on whether study participants were treated improperly or harmed in any way. Extensive education, preparation, and debriefing of study participants have usually sufficed to meet ethical research standards. Any further impact of a research project on participants, readers, authors, or the community at large has not been examined. It seems inappropriate suddenly to raise a new ethical standard for this research study without considering and announcing a policy change that would apply to all studies published in JSR.

The mere presence of reported unprotected anal sex tells us nothing about the moral context of those acts, and therefore it is premature and presumptuous to call such acts immoral. Risky, even life-threatening behavior is undertaken by individuals, couples, and groups every day in hospitals and schools, at sporting and entertainment events, on streets, and in planes, and we only criticize those acts when individuals are subjected to risks unknowingly or coercively. I do not believe that the negotiation of private sexual activity is a matter of researchers' concern, but it is important to point out that there is no evidence that the risky sexual behavior reported in this study was undertaken in a way that would violate community standards of informed consent. But, again, I feel this point is subordinate to the larger consideration discussed previously.

Sexology has an unfortunate history of confusing sex moralism with sex theory, research, and education. Many scholars have criticized sexology for its adherence to and promulgation of traditional and conventional sexual values in our texts, sex therapy, and sex research. There is considerable merit to this point of view, and it behooves us to examine our values and the interests they represent. This study depicts researchers endorsing a positive view of sexuality for men with HIV disease, a welcome theme in the face of the sex negativism and restrictions promoted by many social sectors.

The AIDS epidemic, with its incendiary blend of public health crisis and moral panic, offers a difficult situation within which to navigate professional ethics. In my opinion, offering our professional knowledge and privileges in the service of compassion is an appropriate guiding principle, and this study is within that framework.

Address correspondence to Leonore Tiefer, Ph.D., 163 3rd Avenue, #293, New York, NY 10083.