This month’s column features our first guest-post from Dana Benyas. Dana followed the pre-med track at the University of Michigan, graduating with honors in Sociology when she earned her Bachelor’s Degree in 2014. Interested in increasing access to preventive healthcare, especially reproductive health care, Dana reports on the findings from her undergraduate thesis.

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Women who have unplanned pregnancies or contract sexually transmitted infections (STIs) are often incorrectly stereotyped as being promiscuous, poorly educated, from a minority group, or as having low self-esteem. It is dangerous but easy to indulge the rhetoric that “those kinds” of women have unplanned pregnancies or STIs because they made poor decisions.

Engaging in unprotected sex is fairly common among all women, with about one-third of U.S. women at risk for unplanned pregnancies reporting that they do NOT consistently and correctly use contraception. However, given sexual stereotyping of “at-risk” women, I questioned if social status would influence a woman’s autonomy in making sexual-safety decisions. In other words, would privileged, highly educated, and motivated women make risky sexual safety decisions when labeled with a diminished status in an isolated social status system?

I conducted interviews and anonymous surveys for my undergraduate thesis on how social status influences the sexual safety patterns of sorority women at an elite public university in the Midwest. At this university, the fraternal system has well-known rankings, whereby a woman’s sorority affiliation equates with a social status ranking (1 being the highest and 5 being the lowest). These rankings supposedly indicate coolness, greater wealth, attractiveness, and gregariousness. The vast majority of the 23 women I interviewed were from upper-middle class and upper class families. All were obtaining Bachelors degrees from an elite institution, and many planned to pursue Masters or Doctorate programs. They were born into a privileged status, but, within Greek Life, they did not necessarily feel privileged.

Sorority women’s sexual experiences varied greatly depending on their sorority’s rank. Women in lower ranked sororities felt more pressure to have sex and/or have unsafe sex with higher-ranked fraternity men:

We were at [a tier 1 fraternity]… It was my first time there and I was talking to this kid. My friends thought we were going to hook up. We ended up not… The next morning my friend was like, “Did you ever hook up with that kid?” and I was like, “No” and she said, “But he was in [a tier 1 fraternity]!

Generally, the women preferred condoms to be used, unless they were in exclusive relationships. Conversely, all women assumed that all men did not want to use condoms. These conflicts of interest were exaggerated since men, not women, were expected to carry condoms. Another interviewee elaborated on how power imbalances may translate to condom use.

It’s a hierarchy, so the [people] in the higher tiers have more power. I think that definitely manifests itself within their personalities and their actions…[fraternity guys] would think that they can just not use a condom if they don’t want to, especially if it’s a girl from a lower tier. It’s like her opinion doesn’t matter as much.

With these assumptions in mind, engaging in unprotected sex signified a woman’s concession to take more sexual risk than she preferred.

Unable to measure frequencies of unprotected sex, I measured women’s Plan B emergency contraception use and STI diagnoses as proxies. A limitation of these measures is that I did not control for timing or type of STI testing, so some STIs may have been underreported. In addition, Plan B use and STI diagnoses do not equate with unprotected sex: Plan B may be used to quell concerns of condom breakage, and some STIs may be contracted even with the correct and consistent use of male condoms.

The 71.4% of all STIs reported came from tier 2, compared to an even spread of the remaining 28% of STIs across all tiers. Additionally, 38.5% of all Plan B use was in tier 2, compared to an even spread of Plan B at 20% per tier. Women in tiers 2, 3, 4, and 5 saw men give preferential treatment to higher ranked women (i.e., invites to fraternity events and notably greater interest/effort by men in one-on-one interactions). Tier 2 women were invited to a few top tier fraternity events, so they witnessed the preferential treatment tier 1 women received: revered status felt like a missed opportunity. Contrastingly, lower ranked sororities had difficulty getting invites from fraternities of any rank. Those in the second highest tier being most marginalized aligns well with literature on high school cliques, where second tier “wannabes” put aside their own wishes to appease higher status peers.

Women in the lowest status, tier 5, were openly teased in social settings and excluded from romantic opportunities in Greek Life. The majority of tier 5 women I interviewed did not have intimate relationships. Therefore, it is difficult to say whether these women would have succumb to sexual pressures from men to have unprotected sex or have rejected the tier system to preserve self-esteem. To feel more power in sexual decision-making, women in tiers 3 and 4 commonly dated outside the fraternities or dating lower-tiered fraternity men.

Similar results come from studies about people with inferior status not negotiating sexual safety. Green’s research on gay hook-up culture found status rankings based on “erotic capital,” or a sense of power and skill within the sexual-social marketplace. High erotic capital provided men more desirability, more power, and therefore the right to select the kind of sex they wanted—protected or unprotected. Their partner was complaisant, because they felt lucky to have been selected for the sexual experience. England found women’s ability to stay on course with family planning depended on college enrollment, a  representation of socioeconomic status. She found that women with higher socioeconomic status more commonly followed a consistent contraception regimen, compared to women with lower socioeconomic status. Lower socioeconomic status made it more difficult to find suitable and affordable birth control, making consistent contraceptive use unrealistic. Also, women in a lower socioeconomic status felt they had less autonomy and became accustom to altering their lives to deal with challenges.

My study shows a correlation between diminished social status and greater likelihood of unprotected sex. Concession to unprotected sex is not a result of amoral character or a lack of sex education; rather it is a response to negotiating status imbalances between romantic partners.

Yet, there is a distinct difference between the women I studied who had unprotected sex and stereotypes about the kind of women who have unprotected sex. The majority of women I studied were diligently on oral contraceptives or LARCs, diminishing risks of unplanned pregnancies, but not of STIs. Those not using oral contraceptives or LARCs either identified as “virgins” or were in tier 1 sororities, where male partners easily consented to condom use. Finally, access to healthcare was unanimous across tiers: they could all easily manage the cost of oral contraceptives, emergency contraceptives, and STI testing. Coming from affluent families, health insurance and comprehensive sex education were norms in their communities.

Unwanted pregnancies and untreated STIs can negatively impact women and society at large. Without the luxury of high-quality, affordable healthcare, women who seem to fit negative stereotypes may simply lack access to contraception, abortion, STI testing, and treatment. Let’s stop inappropriately categorizing women who have unprotected sex, and instead work towards increasing access to sexual health education, reproductive health care, and birth control resources for all women.