Yeowtch!

PARENTAL WARNING: This post is going to involve a discussion of marital relations in their moral aspect. I intend to keep the discussion delicate, but parents should be aware of the particular nature of this post.

I figured that I’d need to do a follow-up post or two after yesterday’s NFP vs. contraception post, but I had no idea that so many ideas would be surfaced in the comments box. Let’s see what we can do to clarify matters:

1) Repentance following an act of sterilization.

There is no sin in having marital congress when one is infertile. Infertility is not the issue.

Period.

This is a settled point of Catholic moral theology. It does not matter what the source of the infertility is, whether it is due to age, accident, disease, surgery, or chemicals. Neither does it matter whether it is temporary or permanent.

If somebody sneaks up on you (e.g., when you are sick in a hospital) and sterilizes you against your will, the fact that you are now infertile does not mean that you can never again engage in marital congress.

The act of sterilizing you was a sin, and if you consented to the act then that was a sin, but having marital relations in a condition of sterility is not a sin. Therefore, once one repents of having solicited a sterilization one is morally in the same condition as one who is infertile through some other means. One has corrected the misuse of will that was sinful. The remaining infertility is a biological defect but not a moral one. Its historical origin is rooted in a moral defect, but the infertility itself is not a continuing sin. Neither is having marital congress in this state.

To suppose that there is continuing sin in having marital relations after being sterilized and then repenting involves committing the genetic fallacy (no pun intended).

Under no circumstances is it permissible to tell couples that are infertile due to sterilization that they cannot have marital relations. The Church has never made this requirement of them, and it would be regarded as gravely pastorally damaging.

2) Non-obligation to reverse sterilization.

The Church has not required couples that have been sterilized to have the procedure reversed. Reversal often is not possible, it entails risks, it frequently (especially in the case of men) can cause permanent side-effects (e.g., pain), and it involves expense that may exceed what a couple can prudentially afford.

That being said, it can be praiseworthy to reverse sterilization if it is possible and responsible for a couple to do so, but the Church has not required this of those who are penitent any more than it has required reparatory surgeries of those who have culpably mutiliated their bodies in other ways. At the present state of medical knowledge, it the risks and expenses involved in reparatory surgery often exceed what is reasonable for a person or a couple to undertake.

Suggestions, such as Kippley’s, that couples employ NFP or otherwise refrain from having intercourse for a certain period each month might be voluntarily undertaken by couples by mutual consent but also are non-obligatory.

Further, I could not recommend that such penances are undertaken without the continuing counsel of a competent spiritual director, as it is not pastorally prudent for individuals to engage in any long-term or weighty penances without such direction. The risk of a penitent being spiritually harmed by keeping his own counsel on such matters is too great. Everybody needs a spiritually mature outsider to keep tabs on their situation and make sure that such penances are helping rather than harming one.

3) "Non-coital" relations.

This one is particularly difficult to answer in a delicate manner, but I want to keep the blog (particularly its main page entries) discreet. I will therefore have to rely on the reader to understand what I am talking about here.

Strictly speaking, there is no such thing as marital relations that are completely independent of coitus. While other, related activities may be associated with coitus, they cannot be pursued independently of it and without reference to it. If a couple is engaging in relations that in no way involve coitus then they are doing something immoral. One can do things to prepare for,  assist, and augment coitus, but one cannot replace it with something else. To do so involves replacing God’s design for marital relations with a fundamentally alien construction. Every genuine exercise of marital relations must, therefore, involve coitus (barring, for example, cases where the marital relations are interrupted apart from the couple’s will).

If you need more specificity on this, e-mail me privately.

4) When NFP is illicit.

The Church has not given a detailed treatment of this topic and a range of opinion is permitted. However, those who convey the impression that NFP can be used only in the most extreme circumstances are putting a greater burden on couples than the Church does. The Catechism speaks of NFP being licit for "just reasons" (CCC 2368) rather than the "grave reasons" some have urged as necessary. "Just reasons" and "grave reasons" are two different orders of magnitude in ecclesiastical language, and as a matter of professional ethics I seek to ensure that the language I use matches the language the Church uses in its current documents on the subject. In the future the Church may clarify this subject further, but for now it speaks of a "just reasons" test for the use of NFP, and thus so do I.

5) Condoms.

Contrary to what one commenter was told by a priests, condoms are not okay "if one is open to life at all times." Condoms represent a deliberate closing of the sexual act to life and thus are not okay. What the priest told the commenter was clearly erroneous and would be regarded as such by every faithful Catholic moral theologian.

6) Homosexuality & Infertility.

The reason that homosexuality is wrong is not that it involves infertile relations. The fact that infertile relations are not intrinsicaly sinful is something I have been trying to drive home in this discussion. A married but infertile couple is not sinning by having relations.

God designed human sexuality (and, indeed, all sexuality) to be oriented to procreation. In the case of humans (as opposed to sea angels) this means a man and a woman having coitus. Any time you have a man and a woman having coitus and not doing anything to impede the act, you have an act oriented to procreation. For a variety of causes, the act may not produce offspring. Indeed, it may be impossible in a given case for the act to produce offspring (e.g., because the man and the woman are too old), but the act nevertheless retains the orientation that God gave it.

It therefore thwarts God’s design for human sexuality if you have (a) two men or (b) two women or (c) a man and a woman doing something other than coitus or (d) a man and a woman having coitus but in some manner seeking to block its procreative potential. Cases (a)-(d) destroy the orientation to procreation that the act has and that even an infertile act has. The fact that cases (a)-(d) are all infertile (or intended to be infertile) is not the issue. God designed us so that many acts of coitus are by nature infertile. His design includes room for infertile acts; it is the deliberate rejection of his design (one man, one woman, having coitus, without deliberately blocking its procreative potential) that is what is wrong.

7) Intent.

A point that is often the source of confusion in this discussion and that came up in the comments box was the question of a couple’s intent. Consider the following two intents:

a) "I intend to have marital relations and yet not have a baby."

b) "I intend to have marital relations and do something to myself or to the act itself in order to destroy its procreative potential."

The first intention is not sinful. Couples have this intention all the time. Indeed, sooner or later, every married couple (that stays together and keeps having marital relations) eventually reaches a point in life where the partners have intention (a). This intention is compatible with God’s design for human sexuality since it is not God’s will that we have a baby each time we have marital relations. A person who merely has intention (a) is not doing anything to thwart God’s plan.

Intention (b) is sinful. Unlike intention (a), intention (b) deliberately intereferes with God’s design for human sexuality and so is sinful.

The intent of having marital relations yet not having a baby thus is not intrinsically sinful. The intent of interfering with a marital act so that it won’t produce a baby is.

8) "Artificial Contraception."

Everybody, please avoid using the term "artificial contraception." This term is intrinsically misleading as it suggests that there is such a thing as "natural contraception." There ain’t. No such critter. All contraception is artificial. It is thus dangerously misleading to tell people that the Church opposes "artificial contraception" as it suggests to them that there may be forms of "natural contraception" that are okay (e.g., coitus interruptus). This is not the case. The Church opposes contraception. Please use this language.

(Incidentally, I should have caught that the initial questioner used this language and clarified at that point, but I didn’t. My bad.)

Hoooooooooo-kay! Y’all got all that now?

Good. Now run along and play outside. I gots work ta do.

Author: Jimmy Akin

Jimmy was born in Texas, grew up nominally Protestant, but at age 20 experienced a profound conversion to Christ. Planning on becoming a Protestant seminary professor, he started an intensive study of the Bible. But the more he immersed himself in Scripture the more he found to support the Catholic faith, and in 1992 he entered the Catholic Church. His conversion story, "A Triumph and a Tragedy," is published in Surprised by Truth. Besides being an author, Jimmy is the Senior Apologist at Catholic Answers, a contributing editor to Catholic Answers Magazine, and a weekly guest on "Catholic Answers Live."

29 thoughts on “Yeowtch!”

  1. Nice post . . . except for the “run along and play” stuff at the end – can’t say I cared much for that.
    It all seems clear enough to me . . . .

  2. Jimmy,
    Excellent post. Both tactful and balanced. I especially appreciate the way you phrase the discussion of ‘non-coital’ relations. That’s a tricky subject for most newlyweds these days, given that – for those who pay attention to the stuff kids are listening to and watching these days – coital relations are no longer the sexual act of choice among young people. We live in a twisted culture, but now even young Catholics are entering the honeymoon suite with all sorts of demented ideas about what sex is. But the pursuit of sexual deviancy always ends up as a self-defeating and self-frustrating pursuit, and more than a few good marriages are wrecked by it. Lots of good Catholics think that the whole gambit of ‘non-coital’ relations are fair game, and that path goes straight down to God knows where. We need catechesis. Especially pre-marital catachesis. When was the last time you heard this particular subject come up in pre-cana?
    Thanks, Jimmy.

  3. Abstracting the discussion a bit, a lot of this has to do with conscience, and I don’t mean in the warm fuzzy sense that it is often used. A lot of people have difficulty with the concept of unintended consequence and culpability. People for whatever reason want to equate culpability with desire when it should be equated with expected consequences. An example to consider would be a vehicular accident involving drunk driving. It was certainly not the drunk’s desire to cause an accident, but as far as the state is concerned, his action (drinking and then driving) means that he is culpable.
    Looking in James, we are told that if we tell a starving person to eat well and do nothing, we are guilty of sin. Certainly we did not intend for the person to starve, but we are still culpable. Our sexual actions regrettably tend to bring to the forefront problems we encounter when trying to be faithful to Christ.

  4. This is a settled point of Catholic moral theology. It does not matter what the source of the infertility is, whether it is due to age, accident, disease, surgery, or chemicals. Neither does it matter whether it is temporary or permanent.

    This is not strictly true. It is without question a sin to have marital relations when you have made yourself intentionally infertile, and have not repented of making yourself intentionally infertile. That is a settled point of Catholic moral theology.
    What is the authoritative source for saying that repentance is sufficient to render sex after intentional sterilization licit?

  5. I mean I do understand the argument as againt the genetic fallacy and all. It just doesn’t make any sense in this case. It would be ridiculous to claim that it is the act of putting on the condom that is sinful, but that the sex act which follows with the condom on is not sinful. Intentional sterilization is just a permanent condom; indeed suppose that it came in exactly that form (as arguably applies to an IUD). Wishing you had not put on the permanent condom does not make it come off.
    As far as I can tell there has been a counter-assertion but no counter-argument or evidence.

  6. Jimmy,
    A terminological note:
    First, thanks for your helpful clarification nailing down the proper use of the term “contraception” (which, as you note, is ALWAYS unnatural and always wrong, and therefore not in need of the modifier “artificial”).
    In a related vein, it may also be helpful to nail down the proper use of the term “natural family planning.”
    Correct me if I’m wrong, but my understanding is that NPF advocates take issue, and rightly so it seems to me, with the use of the term “natural family planning” as synonymous with “abstinance-based pregnancy avoidance strategy.”
    The argument is that “natural family planning” properly refers to having recourse to the best available means of determining fertile and infertile periods either to achieve or to avoid a pregnancy.
    Thus, perhaps, instead of speaking of “when NFP is illicit,” and saying things like “The Catechism speaks of NFP being licit for ‘just reasons,'” it would perhaps be better to say that the Catechism speaks of using NFP to space pregnancies for just reasons.
    Otherwise, brilliant post. Please carry on.

  7. Jimmy (or someone else): Could you provide any source texts for the teaching that all marital acts should assist, etc. coitus?
    Presumably there are things that are ‘marital acts’ (things that would be inappropriate to do with anyone but one’s spouse) that are licit but do not need to be ordered in any way towards coitus. (You know, like a playful pinch while passing in the hallway.)
    I take it that it would be difficult to define in a general way what’s licit, without providing a laundry list (which I don’t ask that you do). I’m mostly interested in source texts.
    Thanks!

  8. I disagree that using condoms is always sinful.
    By the principle of double effect, I think a couple could use condoms when on partner is HIV-positive.
    In this case, the husband is not using the codom to contracept, but to protect himself from the virus. The contraception is an uninteded effect of this.
    And to abstain from sex would be, for most couples, to put an undue strain on the marriage.
    I also question whether or not is sinful to contracept during fornication.
    Just my Humble opinion. So far as I know, these are still open questions among moral theologians.

  9. I think Genesis 38:8-10 clearly states that sex needs to end with coitus. A playful pinch or kissing between married couples CAN be a part of coitus, but can also stand alone as signs of affection. I think there is an obvious difference between the stimulation involved in coitus and little acts of affection.
    When I was first married, I was so overly paranoid about what was “right” versus “wrong” regarding sexual relations. For example, fretting over what positions were OK or what acts of stimulation are OK. I really think we actually can worry too much on this. The teachings are clear: sexual gratification must end in coitus. Acts of affection aren’t off limits unless coitus is involved.
    One thing I found helpful was reading Song of Solomon. there are so many sexual images used in that book, and it was helpful to know how holy and sacred and beautiful the marital act is in the eyes of God.

  10. Eric
    Besides the fact that fornication is sinful in itself, Pope Paul VI excludes any action specifically intending to prevent procreation: “Similarly excluded is any action which either before, at the moment of, or after sexual intercourse, is specifically intended to prevent procreation—whether as an end or as a means.” (Humanae Vitae, n. 14).
    On the question of whether condoms may be permitted in order to prevent the transmission of HIV, it must be remembered that the principle of double effect does not permit a person to do evil: “Though it is true that sometimes it is lawful to tolerate a lesser moral evil in order to avoid a greater evil or in order to promote a greater good, it is never lawful, even for the gravest reasons, to do evil that good may come of it — in other words, to intend directly something which of its very nature contradicts the moral order, and which must therefore be judged unworthy of man, even though the intention is to protect or promote the welfare of an individual, of a family or of society in general.” (ibid., my emphasis)
    For this reason, almost every textbook of moral theology explicitly states that double effect can only apply if the act is morally good or at least morally neutral.
    Condomistic intecourse goes against human dignity (see Cardinal Trujillo’s Reflection on Family Values versus Safe Sex) and the use of contraceptives is neither morally good or morally lawful. Hence it is not licit to engage in contraceptive intercourse in order to prevent the transmission of disease. To do so would be to do evil in order that good may come of it – which is strictly forbidden.

  11. “For this reason, almost every textbook of moral theology explicitly states that double effect can only apply if the act is morally good or at least morally neutral.”
    Having a piece of latex over the condom, even during intercourse, is not intrinsically evil. It’s evil insofar as it is intended to be contraceptive.
    In this instant, however (protecting against HIV), the condom is not a contraceptive, but instead a barrier against the HIV. The contraceptive effect is an unintended double effect.
    The Church allows women to take medications that have a contraceptive effect, because of the double effect principle. I don’t see why it can’t apply here.
    And quite frankly, we need to give these couples the benefit of all doubt.
    “Besides the fact that fornication is sinful in itself, Pope Paul VI excludes any action specifically intending to prevent procreation:”
    Of course I’ve no reason to believe that the Pope here has fornication in mind. Fornication isn’t proper sex anyways, so I don’t see why the normal rules apply.
    I rmember reading something from a theologian that said that this issue is a grey area among moral theologians, and in any event I think the benefit of the doubt must be given to all the potential children who might be born of these fornicating couples.

  12. In addition to not knowing what support there is for the notion that sex after intentional self-sterilization is licit (it has been asserted but not supported with argument or evidence), I am also very concerned about the pastoral consequences of teaching it as definite truth. If all that has to happen is to say “my bad” in the confessional, and then sterile sex is perfectly licit from there on out, that creates a terrrible temptation for a certain class of people.
    For example suppose (this is not a hypothetical by the way) that a man’s wife has a medical problem. She is perfectly – even abundantly – fertile. But because of her medical problem, pregnancy is effectively a death sentence. So the couple is practicing perfect continence.
    If (as seems coherent with justice) getting sterilized creates a situation in which sex becomes illicit, then there is not such a great temptation. If sex after intentional sterilization is just fine and dandy though, then there is a terrible temptation to take a “carpet bombing” approach using NFP and medical self-sterilization for both spouses. 30 more years of continence versus 30 years of carnal abandon and intimacy; and all it takes for the latter is a little snip and a trip to the confessional afterward.
    Now, obviously the pastoral implications of something have nothing whatsoever to do with truth or falsity per se, and obviously for the couple to yield to that temptation would be wrong. But I do question the presumption that the proposition that self-sterilization requires lifelong continence would, if true, be pastorally negative. It is a certainty that the suggestion of that possibility has been very helpful in the specific case with which I am familiar. Does Jimmy really mean it when he says that this has to be positively repudiated as a possibility? If so, I want to see the evidence and/or argument, not just an assertion.

  13. Anyone who is deliberately having sex with someone who is HIV positive is probably too stupid to understand moral theology.

  14. “In addition to not knowing what support there is for the notion that sex after intentional self-sterilization is licit (it has been asserted but not supported with argument or evidence), I am also very concerned about the pastoral consequences of teaching it as definite truth. If all that has to happen is to say “my bad” in the confessional, and then sterile sex is perfectly licit from there on out, that creates a terrrible temptation for a certain class of people.”
    This is the same thing Protestants say regarding Catholics and EVERY grave sin, from murder to sins of the flesh. If all that is necessary is for a fornicator to say “My bad” in the confessional before he dies, then naturally he’s going to be tempted to sin mortally, in the hopes that one some far date in the future he will repent.
    The operative principle here is contrition. Regardless of their sin, a truly contrite couple can continue having sterile sex. They won’t go unscated for it either. We know by faith that they will undergo punishment for their grave sin, if not in this life than in the next certainly.
    “If so, I want to see the evidence and/or argument, not just an assertion.”
    The burden of proof for this is definitely on the person arguing that post-sterilization sex is sinful. The benefitof the doubt must meanwhile be given to the married penitents. That’s just good sense.
    “Anyone who is deliberately having sex with someone who is HIV positive is probably too stupid to understand moral theology.”
    Unles they’re MARRIED to the person with HIV?!?!?!

  15. Eric,
    1. Fornication is sexual intercourse between persons who are not married to one another
    2. The Church teaches that any act comitted before, during or after sexual intercourse which is intended to prevent procreation is sinful.
    3. The Church teaches that the use of contraception during fornication is sinful.
    The first proposition above is based on the definition of fornication and the second proposition is based on Humanae Vitae n. 14. The third proposition is, I suggest, the logical consequence of the other two.
    As for the use of condoms to prevent the transmission of HIV, condomistic intercourse is disordered because it completely distorts both the unitive and procreative meanings of the sexual act. This is why the Catholic Bishops of South Africa in the context of preventing the spread of HIV have stated that “the use of condoms goes against human dignity” (quoted in the reflections of Cardinal Trujillo I mentioned earlier).

  16. “The burden of proof for this is definitely on the person arguing that post-sterilization sex is sinful.”
    I agree, or at least I agree that both assertion and counter-assertion require evidence and/or argument for support. I made my argument in the other thread.
    There are three possibilities:
    1) This area has not been authoritatively clarified by the Church, so we have to use our own reason and conscience to figure it out, and as a matter of objective fact sex after intentional sterilization is illicit;
    2) This area has not been authoritatively clarified by the Church, so we have to use our own reason and conscience to figure it out, and as a matter of objective fact sex after intentional sterilization is licit; or
    3) It is definitely licit to have sex even after intentional self-sterilization, and the Church has made this clear, aboru this specific case, with authoritative statements.
    Jimmy has asserted that #3 is the case but has not provided evidence to that effect; nor argument to the effect that #2 is the case, other than a brief allusion to the genetic fallacy which I dealt with above.
    I am not predisposed to disbelieve Jimmy. But the resolution of the question has real consequences for real people so I do want to see the evidence that the Church has pronounced authoritatively on this specific case.
    “Unles they’re MARRIED to the person with HIV?!?!?!”
    I do not consider that an exception to the rule, no.

  17. I take it that it would be difficult to define in a general way what’s licit, without providing a laundry list (which I don’t ask that you do). I’m mostly interested in source texts.
    Anything that doesn’t cause pollution or that you have reason to believe will cause pollution if you engage in it. Source texts? Outside of moral theology manuals I don’t know of any.

  18. Having a piece of latex over the condom, even during intercourse, is not intrinsically evil.
    O yes it is. The following is from Jone’s book on moral theology:
    759. – 2. Artificially, i.e., by the use of contraceptives.
    a) The method may be by the use of a device on the part of the man or woman to prevent insemination. When a male protector or sheath is used in intercourse it is unlawful from the beginning; hence, the wife may not even co-operate materially but must conduct herself in the same manner as if the husband intended to commit sodomy. [–Positive co-operation on the part of the wife in sodomitical commerce is never lawful, hence, she must at least offer internal resistance. However, she may remain externally passive, provided she has endeavored to prevent the sin. She thus applies the principle of double effect and permits the sin to avert the danger of a very grave evil which cannot otherwise be averted; it remains unlawful for her to give her consent to any concomitant pleasure.]
    [my emphasis]

  19. Excuse me for intruding without contributing content but what in the world is the meaning of *Having a piece of latex over the condom…*? Double prophylactics? Or, is *condom* being used as a code word for the male member? Someone please clarify.

  20. “When a male protector or sheath is used in intercourse it is unlawful from the beginning;”
    Jones is obviously assuming that the person is wearing a condom to contracept, not that he is doing so to protect himself from HIV, of which contraception is an unintended double effect.

  21. Jones is obviously assuming that the person is wearing a condom to contracept, not that he is doing so to protect himself from HIV, of which contraception is an unintended double effect.
    You are incorrect again. He says it is “unlawful from the beginning” — meaning that one can’t use it at all regardless of the intention. For example, one who did not intend contraception might use a condom but then later take it off in the course of coitus. But this is not permitted. The intention does not matter. Here’s a further citation from Jone:
    760 NB. Treatment of Onanism in the Confessional.
    a) Questioning the penitent is of obligation as often as there is a well-founded suspicion in this regard. In such instances the question may be: “Does your conscience reproach you in regard to the sacred character of matrimony?” “Have you done anything contrary to the purpose of marriage?”
    b) Instructing the penitent on the gravity of such sins is necessary, even though the penitent has heretofore been in good faith. Good faith will scarcely be found in this matter nowadays, except in extremely difficult circumstances, e.g., if a reliable physician tells a woman that another pregnancy will endanger her life. In such instances the confessor may omit the instruction if he foresees that sins which are now only material will become formal sins.
    c) Whoever is not firmly resolved to avoid the sin is not disposed and cannot be absolved. Being intrinsically evil, conjugal onanism is gravely sinful even when — to avoid it — married people would have to practice lifelong continence. From early times Christians were called upon to make heroic sacrifices. When God demands a sacrifice He gives the grace necessary to make it. [my emphasis]

  22. dcs: when asking for source texts, I mean the sorts of texts that Jone would site as authorities for his text. It’s not as though’Old Heribert’ himself speaks ex cathedra. Providing those might help with Eric’s issue as well.

  23. The Catechism speaks of NFP being licit for “just reasons” (CCC 2368) rather than the “grave reasons” some have urged as necessary. “Just reasons” and “grave reasons” are two different orders of magnitude in ecclesiastical language, ****
    Is there a resource describing the difference between “just reasons” and “grave reasons” and how it applies to the use of NFP? Thanks.

  24. “The Catechism speaks of NFP being licit for “just reasons” (CCC 2368) rather than the “grave reasons” some have urged as necessary.”
    I think this is interesting; it’s true, but I feel like you are bending over backwards to ignore the contracepting reality of this culture.
    Also, the Church doesn’t leave us totally in the dark like you imply. Note that Pius VI gives examples of some of these just reasons -“physical, economic, psychological…” – Pius VI talks as if these are regretable things. It’s easy to see this when one reads the whole “Regulation of Birth” encyclical. NFP is a necessary negative, like glasses for our eyes.
    And let’s also be realistic – most folk in the West simply don’t *want* as many kids as God has biologically created them to have (and natural law requires to sustain the population). It’s an anti-kid culture, and thus NFP should not be talked about apart from this.

  25. Let me see if I have this right. If a man wants to prevent the spread of AIDS to his wife and uses a condom in marital relations with his wife, it is gravely sinful because a condom renders the marital act infertile. But if a man wants to prevent the spread of prostate cancer within his own body and has a radical prostatectomy which necessarily sterilizes him, it is not sinful to have this surgery and it is not sinful to have marital relations with his wife even though the marital act is always infertile for them. This doesn’t make sense to me. In both cases his intention is to prevent the spread of disease, and in both cases he has deliberately acted in such a way as to render the marital act infertile.

  26. Anonymous:
    Your question: why, if you can be serilized to save your life, then why not condoms to save your life if you have AIDS?
    Simple logic: if you must be serilized to save your life, it’s unrelated to the sex act. Sex is still ok afterwards as you remain open to life every time you engage in sex and are doing nothing to prevent it, and thus do not degrade the sex act.
    If you have AIDS, you now have a choice besides a condom: you can abstain from sex rather than actively thwart the act of conception and degrade the sex act.
    An analogy: if you couldn’t have sex without seriously injuring yourself, you would abstain, wouldn’t you? Same thing – a condom injures the sex act, so you abstain. However, if you must injure yourself to save your life (like sterilization), you must do it, and why would this preclude licit sex acts in the future?

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