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Latter-day: What 'Premarital Exams' Can Teach About Sex Education In Utah

Doodle illustraton of wedding rings.
Renee Bright / KUER

Mormon culture influences nearly every aspect of life in Utah. But these days, many long-held values are being challenged, even by the faithful. KUER’s new series “Latter-day” examines how Mormon culture is — and isn’t — changing in response. 

Premarital exams are a thing in Utah. They’re even advertised by the two largest state medical providers, Intermountain Healthcare and the University of Utah Hospital. We called around the country to see if anyone else offered them. Short answer: No. The name — even the idea — didn’t register. In fact, a woman at a clinic in Georgia laughed at us. 

So, what exactly is a premarital exam? 

“Basically it's an annual exam,” said Dr. Melanie Harker, a gynecologist and professor at the University of Utah. “I've never heard it classified as a premarital other than in the state of Utah.” 

Harker said the main difference between a regular visit with the gynecologist and a premarital exam is terminology. The idea is that a woman — and this is just for women — who has waited to have sex until marriage might need a little education and some preparation for their wedding night. Harker said it’s typically the mother who schedules the visit and a large number of the women expect to be given a dilator to make sex less painful. 

“They bring up [needing a dilator], at which point I haven’t even considered that as a thought of something that they’d need,” Harker said. “It medicalizes something that is very normal and physiologic and part of normal human development.”

To discuss what premarital exams teach us about how Utahns and Mormons approach to sex in general, KUER’s Lee Hale spoke with Kristin Hodson, a sex therapist based in Salt Lake County. 

Photo of Kristin Hodson.
Credit Courtesy Kristin Hodson
Kristin Hodson is a sex therapist based in Salt Lake County.

Lee Hale: How did you first come across the phrase premarital exam?

Kristin Hodson: So this was a thing when I was growing up in Utah. I thought it was your rite of passage into marriage and adulthood. As a sex therapist, I started having clients talk about the necessity of going to the premarital exam and I started to question the necessity and wonder why they needed an exam. Because you don't need an exam to have sex. 

LH: What happens during a premarital exam? 

KH: I would have to believe that every doctor's office is going to be a bit different. But the general idea is that you’re checked out to make sure you're prepared for intercourse. Which means some will be put into stirrups and have an internal vaginal exam. And I know that there is sex education that occurs and oftentimes vaginal dilators are prescribed or suggested as a way to stretch and prepare for sex on the honeymoon.

LH: Is this only for women? 

KH: I do not know of a male that has been recommended or guided to do a premarital exam. And when I look at different websites for providers, I don't see them being offered for men.

LH: Is this just a Utah thing?

KH: To my knowledge it is a Utah thing. A little bit into Idaho maybe down into to Arizona, but outside of that realm I do not see it occurring. So, the “Mormon Corridor.” 

LH: It does seem like an odd concept, but what's bad about seeing a gynecologist before having sex for the first time? That doesn’t sound like a bad idea. 

KH: I would agree that it is a good idea for people that don't have any background on sex education. For people who do not have a baseline around their own sexual health, meeting with a provider to talk contraceptive options and ask questions can be helpful. We think of a doctor's office as a safe place to ask questions. However, this then points to why are we not getting education a lot earlier? Why is there this medicalization around sex and the female body?

LH: What does the premarital exam in Utah teach us about sex education in the state?

KH: There is a big gap. Not only in the schools but there are a lot of parents that aren't talking about it in their home. So we rely on doctors and the medical system to have these conversations. It could be happening a lot earlier — not right before someone's first sexual experience.

LH: What do you say to a Utah parent who is concerned about the lack of sex education? 

KH: Get involved with legislation. It's always a big issue every year. Check out what's going on at the state capitol. Become an empowered parent. Become the sex expert of your home, which means then you probably need to get the education that you never got as a kid. Going to a doctor for a “premarital exam” can be an option, but it's not a requirement. It's not a necessity. Helping our kids navigate that earlier would be better.

Lee Hale began listening to KUER while he was teaching English at a Middle School in West Jordan (his one hour commute made for plenty of listening time). Inspired by what he heard he applied for the Kroc Fellowship at NPR headquarters in DC and to his surprise, he got it. Since then he has reported on topics ranging from TSA PreCheck to micro apartments in overcrowded cities to the various ways zoo animals stay cool in the summer heat. But, his primary focus has always been education and he returns to Utah to cover the same schools he was teaching in not long ago. Lee is a graduate of Brigham Young University and is also fascinated with the way religion intersects with the culture and communities of the Beehive State. He hopes to tell stories that accurately reflect the beliefs that Utahns hold dear.
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