Have regular talks with teens about sex

Parents may shudder at the prevalence of sexually suggestive teen clothing and popular stores that target girls with T-shirts like "I do my own nude scenes" and "Milk me," or, for boys, "Rises to the occasion." But the fact is, many teens are sexually active and are more sexually knowledgeable than their parents want to admit.

While it's tempting to have your teen hibernate until fashions at least cover belly buttons, experts say that educating yourself and becoming a proactive, approachable parent are two of the most powerful protections you can offer your teen against early sexual relations, sexually transmitted diseases and pregnancy.

Discussions with teens about sexual issues should occur regularly and do not need to be formal, recommends Sharon Schnare, RN, FNP, CNM, MSN, a clinical instructor at the University of Washington. Values regarding what sex is -- as well as the emotional ramifications of various sexual activities -- also should be addressed, she adds.

Schnare says that thinking through a sexual scenario ahead of time empowers teens to know their values and stay true to their convictions. She recommends turning the discussion into a game called "what if," where parents present their kids with a scenario and encourage them to problem solve. For instance, they might ask "What if you were out with a bunch of kids who were drinking and you saw a boy dragging a girl into a room?" Or, "What if your girlfriends were pressuring you to have sex with your boyfriend?"

Parents should play the "what if" game with teens leaving for college, Schnare says, noting that binge drinking is more common in college and that she sees teens devastated by sex with multiple partners at alcohol-laden parties.

Teens and young adults also need to understand what coercion is. "Coercion is someone saying 'If you don't do what I want, I will leave you,'" Schnare explains. "To a teenage girl who is in love, that is a very powerful thing. I have had girls tell me, 'He said he will leave me if I don't perform sexual favors.'"

Ted Buchanan, a freshman at Western Washington University and a graduate of Sammamish High School in Bellevue, says he knows many girls who were coerced into performing sexually, adding that "Sex lingers as an insecurity for friends in high school who got sexually involved too young or with an older guy."

While a recent study indicates that sexual activity among teens has dropped slightly, almost half of teen boys and girls age 15-19 say they have had sex. Another study released in December by The National Campaign to Prevent Teen Pregnancy indicates that 37 percent of teens say their parents are the biggest influence regarding sexual decisions, and 33 percent say friends are their biggest influence. Additionally, 91 percent of adults and 87 percent of teens agree it would be easier for teens to delay sexual activity and avoid teen pregnancy if they could talk to their parents about sex; however, 37 percent of teens say they have never talked to their parents about sexual issues.

Schnare says that masturbation is "totally normal" and allows teens "to learn about sexuality -- about how they feel and how their genitals work. If parents have religious prohibitions, then kids should follow a family's values. But it is important to talk about why that is, so they have a deeper understanding."

Oral and anal sex are occurring more often among teens in an effort to explore sexuality while reducing pregnancy risk. "What they are thinking is they know the penis and vagina make a baby, so if we put it somewhere else it won't make a baby, but the problem is you have a higher risk of infection," Schnare says. She notes that there is a higher transmission of AIDS via the rectum, and condoms do not protect from herpes or wart virus, which can be contracted in the anus or throat. While many may stereotype anal sex as a homosexual activity, it is occurring frequently among heterosexual teens as well.

A local 18-year-old high school student agrees with the experts who say oral sex is very casual among teens, saying, "I personally don't believe oral sex is sex. I believe sex is a much bigger deal," adding there is a large generation gap in this area with parents and teens.

Buchanan disagrees, saying, "I have heard every excuse for saying it is not sex. There is a lot of justifying that goes on, but oral and anal sex can cause the same kind of emotional problems that actual sex does."

On the medical side, girls need to have a pelvic exam annually when they become sexually active or by age 18, and boys need to have annual physicals that include a testicular exam. Schnare says that parents and teens must also be aware of the emergency contraception called Plan B, available by prescription. It is important in case of rape, date rape, incest or unprotected sex.

According to Schnare, Plan B is a pill best taken within 72 hours of sex, but can work up to five days after sex. It does not cause abortion. If a teen girl is actually pregnant, Schnare adds, "it won't alter the pregnancy, and there is no problem with the fetus if she takes it. It is very safe. If she hasn't ovulated yet, it will prevent her from ovulating."

The local high school student believes teens need better and more comprehensive sex education and is opposed to President Bush's abstinence-only curriculum. The student created a bill for a mock congress in a senior issues class at Inglemoor High School in Kenmore proposing sex education that includes abstinence and contraception.

When a friend contracted an STD, the student says she realized there was a lot she didn't know. "I think there is a big misconception that if he is a good person, then there is no way he would have an STD. When I pictured STDs, I pictured big sores on the mouth, but a lot of times it doesn't show at all," she says.

Buchanan thinks parents should talk about their sexual values with teens. "You get the rundown on how it works, but not really what a mature approach to relationships is -- the 'when a man loves a woman' part."

Adds Schnare, "The main thing for adults...is for them to be able to give support and really appreciate the child they have."

Buchanan agrees, saying, "Teaching kids self-esteem is valuable. Help them find their place and know that you are OK with them. Reassure them that it is OK if they mess up.

Jolene Gensheimer is a freelance writer, mother of two and a former high school teacher.

Resources for Parents

Books

Bodies and sexuality:

It's Perfectly Normal, by Robie H. Harris
The Bare Naked Book, by Kathy Stinson
Are You a Boy or a Girl, by Karleen Pendleton Jimenez

Sexual abuse prevention:

A Very Touching Book for Little People and For Big People, by Jan Hindman.

Videos:

PBS video "What Kids Want to Know About Sex," available through the King County Library System, or for purchase through Select Media.
"Raising Healthy Kids: Families Talk about Sexual Health," available for purchase through Advocates for Youth.

Classes:

Seattle Children's Hospital and Regional Medical Center holds classes for pre-teens and teens, plus offers an online database of sex educational materials.
"Our Whole Lives: Lifespan Sexuality Education Curricula for children and Parents," developed by the Unitarian Universalist Association and the United Church of Christ. Courses are taught nationwide, or the education materials can be purchased for home use.
Many churches and synagogues also offer courses for parents and children.
As Boys Grow Up: Aspects of Puberty, Sex Education and Relationships at Overlake Hospital in Bellevue. Call 425-688-5259 for more information.
As Girls Grow Up: Aspects of Puberty, Sex Education and Relationships at Overlake Hospital in Bellevue. Call 425-688-5259 for more information.

Other Websites:

The Family Planning Program at Public Health-Seattle & King County
SIECUS (Sexuality Information and Education Council of the US) Families Are Talking Project

Online Resources:

The National Campaign to Prevent Teen Pregnancy offers current articles, research and information about abstinence and contraception. They sponsor the National Day to Prevent Teen Pregnancy, which is May 4, and they encourage teens to take a poll on the Web site that day.
Kidshealth.org offers information in the Growth and Development and Teen section. Claims to be the largest and most visited site on the web with doctor-approved information for teens.
The U.S. National Library of Medicine and the National Institutes of Health offers a medical encyclopedia, articles on adolescent development and research on a variety of medical topics.
Teengrowth.com focuses on educational health issues for teens, with all information reviewed by a medical advisory board.
Dadsanddaughters.org is a national advocacy nonprofit group for dads to help "inspire, understand and support your daughter." Site contains articles and links, and dads can sign up for a newsletter.
This Washington Post article provides an enlightening account of moms and daughters and puberty.
Plannedparenthood.org includes information about reproductive health and Planned Parenthood health centers, which offer free birth control, STD and pregnancy testing, and annual exams.
The American Social Health Association for teenagers that provides information about STDs and sexual health.
Afraidtoask.com was created by a doctor and includes graphic photos of STDs as well as in-depth information.
Coolnurse.com is staffed by volunteers and created by a nurse, this site provides current and historical information about sexual issues. It is designed for teenagers and young adults, but is informative for parents.