Adolescent Sexuality by Dr. Karen Rayne

McCain Can’t Explain Voting Against Birth Control

I generally don’t venture into trouncing one campaign or another in this space. But - you knew there was going to be a but - I can’t go silent in this particular presidential election. John McCain has such a poor record when it comes to voting pro-women or pro-sexuality.

You’ve got to watch this short clip from CNN.

I’m stunned - stunned! - that McCain actually said he would rather not talk about or even think about about whether health insurance companies will pay for birth control. I mean, yah - me too and stuff. But I’m a woman, and I’m in my reproductive years, and so I have to. Just like millions and millions of teenagers and adults in this country.

This is an issue that cuts across age, race, and education. Fight for your daughter’s reproductive choice. Kick McCain to the curb.

Is it awkward to whip out a banana or a cucumber (or even better, a penis model) and tell your teenager you’re going to show her the steps on how to put on a condom? Yep, no doubt. But there’s really no other good place for your teenager to learn how - except for trial-and-error, which really no one wants.

So here are the steps:

1. Check the expiration date on the condom package. Even brand new condoms can be expired.
2. Open the package with your fingers. Teeth or scissors can tear the latex and you won’t necessarily realize it.
3. Figure out which way the condom rolls down. Put it on the head of the penis correctly.
4. Pinch the reservoir tip to squeeze the air out. This ensures that there’s space for the sperm to go in.
5. Roll the condom all the way down the penis.

And here’s the second half of the lesson that regrettably sometimes gets missed:

1. After the male orgasms, he needs to hold the condom on to the base of his penis and withdraw his penis before it becomes flaccid.  This makes sure that the condom doesn’t slip off when the penis becomes smaller.
2. Slip the condom off the penis while still holding it at the base so that the sperm isn’t spilled.
3. Tie off the open end of the condom.
4. Throw the condom in the trash.  (Not in the toilet or on the ground.  That’s just gross.)

These few moments spent together may have the effect of horribly embarrassing both the parent and the teenager.  But it may also have the effect of improving the teenager’s effective use of a condom.  And as a parent, it’s completely worth it.  Because you never want to hear the words “Ummm…because we didn’t know where the condom was when we were…you know…finished.”
And if you just can’t make yourself do it, here’s your out: YouTube, Planned Parenthood, or Our Whole Lives sexuality classes all also teach teenagers how to properly use condoms. So you’ve covered your bases if you’ve made sure that your teenager got the information from somewhere.

Yes, Virginia, there ARE teenagers who want to have a baby.

Yesterday Mommy B sent me to this story about Gloucester High, where the fad last year was to try and get pregnant. Is this a new trend? Nope. Is it surprising? Maybe, if you haven’t been paying attention. And will the school’s attempts to offer free birth control without parental permission help the situation? Absolutely not. But they should do it anyway.

I am not surprised by a group of girls making a pact to raise children together. High school girls have been trying to get pregnant since I was in high school fifteen years ago, although I doubt it was a new trend then. I understood the draw of deeply wanting a baby in high school, although I never went so far as to actually try and conceive one until just a few years later.

And here is where this issue gets deeply personal for me. I was young, by many standards, when my partner and I started trying to conceive. I was 21 when I got pregnant, but perhaps I looked younger. I got many snide comments from strangers about making choices because of what I wanted rather than what a baby would need. I got crass questions from acquaintances about whether I knew what caused this sort of “thing.”

And I have never taken well to anyone who calls my daughter a “thing.”

So I was a young mother. And many took me to be a young teenage mother. So they asked me, rudely, why I wanted to have a baby. I tended to give vague answers I thought would get them off my back as quickly as possible about wanting to care for the younger generation, etc. But the truth was, I wasn’t really sure why I wanted to have a baby. But I knew it in the same way I knew my partner and I were meant for each other. Could I justify myself? Not really. How can you ask someone to justify something that there is no justification for? When it comes down to it, what is the “right” reason for wanting to have a baby?

Two Gloucester High students who were willing to be interviewed postulated that the girls were trying to get pregnant because:

“They’re so excited to finally have someone to love them unconditionally.”

and

“No one’s offered them a better option.”

And those are probably not great reasons to want to have a baby. But as I’ve said: when it comes right down to it, what is a great reason?

Teenage girls who want to have babies will probably give much the same rambling, unsure answers to the “Why” question that I did. Some might say something vague about wanting someone to love and someone to love them back. But what do much older moms-to-be say about why they want a baby? Oh, that’s right, they’re not asked. It’s assumed that an older woman either has her reasons for wanting a baby or that it’s rude to ask. My point is that, unless you’re the woman’s therapist or partner, it’s rude to ask or conjecture about why teenagers or older women want babies.

However, there are often serious underlying issues when young women decide that they want to get pregnant. It is rarely a teenage woman who feels happy, supported, and loved who decides she wants to have a baby. But nothing can be gained from judging these young women’s choices - they have probably had their choices judged far too often already in their lives. And a pregnancy can not be stopped by providing a mother-to-be with birth control, because she won’t use it, regardless of her age.

So what to do?

Young women need to feel that they are (1) in control of their lives, (2) can make a positive impact on the world, and (3) that they are loved for who they are and who they are becoming. For that matter, young men need the same thing. And note the careful wording: Teenagers need these things, they are not casual desires.

Part of providing the control in need 1 is having access to free, effective birth control without parental knowledge or consent. Another part is providing more extensive sexuality education beyond the first year of high school. And there are lots of really cool ways to engage young women to meet need number 2. (Feel free to e-mail me if you need some suggestions!) As for need 3, I am sad that this is not among the most understood and most often met needs for teenagers. It can be parents, teachers, friends, siblings. Each of us needs someone to love us completely, but teenagers are in such a state of identity flux that they particularly need that kind of encompassing and supportive love.

Regrettably, the answer I am giving to the Gloucester High problem is not simple or easy to dispense for free (unlike condoms). But it is potentially life-changing for everyone involved.

The Dinah Project recently had a post about how to carry a condom, and ended the post with a good argument for why girls should carry their own condoms. It’s a good post. Straightforward, interesting, and educational. You should forward it on to the teenagers you know, so they’ll be one step closer to using condoms correctly.

Here’s a few excerpts from the post:

To this day, carrying condoms in wallets and back pockets are common choices for men. It needs to be said that fantasies aside, your luck with shine through so much better when your contraceptive is intact. There is something to be said for not having to fumble around for a condom when the time comes, but pulling out a shabby, old prophylactic isn’t going to impress a soul.

…

Besides all this logic and practicality, sharing the condom load between the sexes inspires other creative benefits. For example, it can be the ultimately cool way to overcome the awkwardness of covering the bill in these times when having him pay up just doesn’t always feel right. Dinner is on him, condoms are on you. Well, sort of.

So go read the whole post! You might learn something, and you can pass that knowledge on to so many people in so many places!

(Written by Guest Blogger JustAnotherTeen.)

Let’s face it, my girlfriend and I are far from the poster children of safer sex practices. Sure, we are not that bad, and try to use two forms of birth control, but no one could argue that they are the safest ways to go. When we first had sex, she had already been on the pill for awhile to regulate her cycle after she lost an ovary. That was at least one line of defense, but I was adamant that we have two. So at first we used condoms. But, unfortunately, no matter how thin the condom, there is still a difference. Sure, not enough that it should have stopped us. So instead we switched to pulling out as the second line of contraception. And yes, I know, horrible is it not? Pre-cum has semen, it is hard to pull out in time, sometimes you lose the will to, etc etc. But it was just the second line of defense so I did not worry about it too much. Fortunately, we got lucky and never even had a scare. Now she is off the pill for a bit and we have started using condoms with spermicide. Not as much protection as I would like, but definitely better than just pulling out! And lets face it, condoms are some of the most accessible and most effective forms of birth control.

That said, I don’t think teens know enough about them. Can they become less effective if kept in your pocket or a warm car? Do the cheap ones in bathrooms work as well as any off the shelf in your local drug store? Honestly I do not know for certain the answers to these two questions (if I had to guess I would be pretty confident saying yes and no, respectively.) But some teenagers know far less than I do about them, and that is just sad. Furthermore, some teens probably don’t have access to condoms, and that is even more sad.

What forms of birth control do you/have you used in the past? Had any failures or scares? Comment back and let me know. Oh yeah, and feel free to berate my bad second line of defense!

(Written by Guest Blogger JustAnotherTeen.)

Let’s face it, my girlfriend and I are far from the poster children of safer sex practices. Sure, we are not that bad, and try to use two forms of birth control, but no one could argue that they are the safest ways to go. When we first had sex, she had already been on the pill for awhile to regulate her cycle after she lost an ovary. That was at least one line of defense, but I was adamant that we have two. So at first we used condoms. But, unfortunately, no matter how thin the condom, there is still a difference. Sure, not enough that it should have stopped us. So instead we switched to pulling out as the second line of contraception. And yes, I know, horrible is it not? Pre-cum has semen, it is hard to pull out in time, sometimes you lose the will to, etc etc. But it was just the second line of defense so I did not worry about it too much. Fortunately, we got lucky and never even had a scare. Now she is off the pill for a bit and we have started using condoms with spermicide. Not as much protection as I would like, but definitely better than just pulling out! And lets face it, condoms are some of the most accessible and most effective forms of birth control.

That said, I don’t think teens know enough about them. Can they become less effective if kept in your pocket or a warm car? Do the cheap ones in bathrooms work as well as any off the shelf in your local drug store? Honestly I do not know for certain the answers to these two questions (if I had to guess I would be pretty confident saying yes and no, respectively.) But some teenagers know far less than I do about them, and that is just sad. Furthermore, some teens probably don’t have access to condoms, and that is even more sad.

What forms of birth control do you/have you used in the past? Had any failures or scares? Comment back and let me know. Oh yeah, and feel free to berate my bad second line of defense!

(Written by guest blogger JustAnotherTeen.) 

“You seem very open, honest, and liberal, but you depict your parents as fairly rigid and conservative. How much do you think your parents impacted who you are and how did they do that? I like the person you present yourself as and I sense that you like yourself as well. Do your parents like you as you are or do you hide most of what you have shared with us?”

As I mentioned in the response above, I think some of my attitude and outlook on life are simply the opposite of my parents because I saw them every single day and I wanted to be different. For instance, my parents are often late everywhere they go, so therefore I have a tendency to be early for everything. I think my parents impacted me a lot in some ways, mostly because I consciously tried to be different than they are. My parents know somewhat that I am do not hold their values, but not the scale of which I disavow their narrow-minded ideas. For instance, they do not know that I am bi-sexual. They do not fully realize that I have had sex. I did not even tell them I was dating someone for half a year.

“What do you think are the basic criteria for people (teens) to have and be competent at in order to be able to make a healthy decision to be fully sexual? When do you think teens are harmed by sex too early or with the wrong people? Have you seen much of the problems that can be created by inappropriately early sexuality or do you think there is such a thing as inappropriately early sexuality?”

I think that the age of sexual maturity (being able to make the decision to have sex for the right reasons, not just peer pressure or such) depends greatly on the individual person, the way they were raised, and their partner. I think both partners need to understand that although sex feels good on a physical and emotional level, there can be serious consequences no matter what form or forms of protection are used. They need to understand different forms of contraception and be comfortable with each other and themselves. It should not be a spur of the moment thing in my opinion, but something that is discussed with maturity. That said, I doubt very seriously that any teenage couples are really that prepared, myself and my girlfriend included! I think teens can easily be harmed by sex with the wrong person, especially if there is a large age gap or something else that gives one partner authority. That is not to say that a 15 year old and a 17 year old should not be having sex, again it comes back to the individual relationship. As for problems with early sexuality, I think they are often the same for sex at any age: unwanted pregnancy and STIs, etc. Also, I believe younger people in general have a higher risk of being emotionally scarred but when I think about it, and I have no experience with this, it seems like older people (i.e. Over 20) can be scarred as well from bad relationships, sexual or otherwise.

“Your girlfriend’s mom seems to have ‘come around’ and is coping adequately with your relationship. Do you think there is a down side to this arrangement? What would be the parameters you would want to set up today if you were the parent of a teenager yourself?”

If there is a downside, it would be that she sometimes seems overbearing about making sure we have birth control. I am fully capable of getting my own protection so it just gets annoying when she keeps asking if we need condoms, although I think she has realized in the past few months that I am capable of getting my own and has stopped asking. If I were a parent, I would want to be open about all matters of sexuality but also I would understand if they did not tell me when they started having sex or something like that. I would like to know their partners but also understand that this may not always happen. I think a parent of a teenager should be more of an advisor than a dictator, there at all times to talk but not to rule. However, as I get older my views may change but I hope to be a good father (of adopted children) one day.

Again, I really appreciate everyone who sent in questions, I really had to think about my answers! I enjoyed blogging here for the past two weeks and would like to do it sometime in the future if I or someone else can come up with ideas for new posts! Thanks to Karen for allowing me this opportunity, and if anyone still has questions, that e-mail address is still usable!

(Written by guest blogger JustAnotherTeen.) 

As many great teachers as my school may have, there is one that I absolutely cannot stand. I was supposed to take Health Education in my sophomore year and I really wish I had. Unfortunately it would not fit in my schedule till my junior year. The coach that left at the end of my sophomore was a relative legend with the students. Despite being 70 years old, he had great relationships with students and was a very good coach. His version of teaching sex education as part of his class, according to other students, included having a table full of different contraceptive options on display and he would teach about all of them. Purportedly he sprayed spermicide all over the room on accident one day, and this was a room with carpet! Our next coach was not so open. In fact, he was quite the opposite. When it came time for reproductive health, it was clear that he was not at all comfortable with the subject despite having taught the material before at another school. He misspelled and butchered no less than five anatomical words, created a new hormone called proestrogen (progesterone), thought cervix was spelled cervex, and thought boys had a vas difernes (vas deferens), just to name a few. In addition to not being able to even say or spell the terms correctly, he refused to teach anything about contraceptives, saying that state law didn’t allow him to even give statistics. This didn’t sit well with me and I looked it up and printed an article that actually said the state requires contraceptive statistics to be taught. He blew this off in our class but I noticed he had made a poster with statistics on it for the next term of classes. Although I personally know enough about contraceptives to not be too worried about his refusal to teach us, I do worry for the others in the class that may have needed to know this information. As much as I think schools should be responsible for educating young teens about contraceptives, we know that some will not and totally ignore the fact. Even if you are not comfortable with the subject, I suggest finding some good information online and printing it for your son or daughter. It may be awkward, but it is far less so that finding out you are going to be a grandparent in a few months!

So the liberal blog-o-sphere is simply agog with the CDC announcement that the adolescent birth rate has risen for the first time in fourteen years (it had been steadily falling). Bush’s abstinence-only “sex education” policy has been taken to the cleaners with this announcement. Here’s a quote from the CDC announcement that I think sums everything up nicely:

The report shows that between 2005 and 2006, the birth rate for teenagers aged 15 - 19 rose 3 percent, from 40.5 live births per 1,000 females aged 15-19 in 2005 to 41.9 births per 1,000 in 2006. This follows a 14-year downward trend in which the teen birth rate fell by 34 percent from its all-time peak of 61.8 births per 1,000 in 1991.

However, if you read deeper into the announcement, you find (as the Reverend Debra Haffner points out), that births rose among all women - not just teenagers. In fact, the total fertility rate is at the highest point is 1971, and is above replacement rate for the first time since then. The other serious numbers that come out of this announcement is that the Cesarean delivery rate rose again - indicating a 50% increase over the last 10 years. This is coupled with a rise in preterm births and a rise in low birth-weight. These are all much more alarming statistics than a very slight increase in the adolescent birth rate.

Now, I am not one to miss an opportunity to slam abstinence-only “sex education.” In general, I am just color-me-pink when big-time statistics like this come out indicating that the 1990’s had better sex education than the 2000’s. But I don’t agree that these numbers are enough to do that. The rise actually just takes us back to the 2004 adolescent birth rate (and is still lower than the 2003 adolescent birth rate). Many more questions need to be asked here: Did the abortion rate change? How many of these pregnancies were planned? (Yes, teenagers do plan pregnancies, and the biggest increase was among 18 - 19 year olds, who are the most likely teenagers to plan a pregnancy.) Did condom or hormonal birth control usage change among teenagers between 2004 and 2005? What about access for teenagers to abortion, condoms, or hormonal birth control?

I am also suspicious of people who rail against teenage births in general. Teenage parents aren’t all bad, and I’m tired of them being portrayed that way. The real issue for me is unplanned pregnancies, and yes, most teenage pregnancies are unplanned. The real issue is lack of real information, lack of access to reproductive health care, lack of self-efficacy around sexuality, and the highly overblown image of sex that prevails in our culture. None of these failures are exclusively the result of abstinence-only “sex education” (although it certainly hasn’t helped).

All of us - even those who support comprehensive sex education - need to acknowledge the role that we play, every day, in our society’s sex education. Do we talk openly and appropriately with people of all ages about sex and sexuality? Are you comfortable bringing up the topic of birth control when a young person you know gets into a serious relationship? Are you comfortable providing that birth control?

This is an area where you are either part of the solution or part of the problem. Where do you stand?

Thanks so much to Heather Corinna from Scarleteen for this information.

Planned Parenthood is now dispensing the pill without a pelvic exam. You can read more about it.

This is a relatively unusual program. Planned Parenthood’s requirements are that you do not have:

• certain conditions that make it inadvisable to use a hormonal method [of birth control]
• symptoms that must be evaluated with a pelvic exam

Now, there is some argument against getting yearly pap smears, for reasons of cost and the potential of false positive results of pre-cancerous cells. However, Heather suggested to me that Planned Parenthood is providing the pill without a pelvic exam simply in order to reach young women who are scared of their first pelvic exam, and are using that as an excuse to not use birth control. There is no indication on the PP website of why they have decided to stop requiring a pelvic exam.

For tomorrow: much discussion about the new CDC findings that teen pregnancy rates have started rising for the first time since 1991. (Yes, you are free to go into the appropriate tizzy of outrage at this information. While you wait for my comments, there’s lots to read about it: here and here and here are good places to start.)