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Family Health Magazine
ADOLESCENT HEALTH

Teenagers and Risk-Taking Behaviour
Concerns over sexual issues in the teenage years

Parents these days are worrying more than ever about the safety of their teenagers. They are anxious to protect their youth from serious injuries, violence, suicide and abuse. They want the best for their children. A lot of the worry stems from some of the risk-taking behaviour of teens. They use drugs and alcohol more than in the past. An increasing number of teens, especially girls, are smoking cigarettes. They sometimes drink and drive. Some drop out of school or run away from home. Many get less exercise than in years gone by. This article will address some of the concerns over sexual issues in the teenage years.

Incidence of Sexual Intercourse

We live in a society where teenage sexual activity has become commonplace. Twenty-five per cent of teens under age 15 have had intercourse. That figure rises to about 80 per cent by age 19.

Parental Behavior

Many parents are afraid that early sexual activity will lead teens to serious mistakes. They will be at risk for unwanted pregnancies, STDs (sexually transmitted diseases) and psychological problems. Unfortunately, this fear drives some parents to be overly strict.

For example, parents may forbid a 14-year-old daughter to speak to boys on the telephone, tell her she can't date until she's older and intercept her mail and phone calls. They believe they are protecting her from harm, but this type of control can stifle normal development and damage their relationship with the teenager.

The opposite of this can be equally damaging. For example, parents may permit a child of 13 to date an older person with no restrictions. The teen receives little or no guidance and is at risk in a world without boundaries.

Parent should strive for good communication and a sensible balance between rigid control and unbound freedom. Searching for this balance with consistency is a challenge.

Information

Teenagers see sex (often with violence) on television screens, in movies and in books. Parents may assume that, as a result of this, their children have knowledge beyond their years. This is often not the case. Teens need basic information about sexual intercourse, STDs, birth control and sexual identity.

Many experts believe parents should let their teens know that sexual intimacy demands emotional maturity. It can lead to depression, great anxiety, guilt and fear if the teen is not ready.

Communication

Communication, the type of advice and how the advice is given are keys to the values that teenagers develop. Communication on sexual issues usually starts long before the teenage years.

A child who asks the question, "Where do babies come from?" should receive a clear, honest response. The correct words for the penis, vagina, breasts should be used. Slang or pet names for body parts can be misleading as they mean different things to different people.

This open style of answering paves the way for further communication as the child grows and the questions become more complex.

Dating

How do parents respond when a teenager wants to start dating? This, of course, depends on the situation. If a 17-year-old girl has been asked out but is nervous about her sexual interest in her boyfriend, it may help to reassure her that sexual interest is normal and can be a special part of life.On the other hand, the teen should be aware of the responsibility of dating and the need for partner to respect each others feelings and values.
The teen who starts dating needs to understand the possible consequences of sexual activity – both emotional and physical. Parents should discuss the chance that a partner will try to begin sexual activity so that the teen can think about this situation in advance.

Teens should be encouraged to say no to sexual activity when they feel it is unsafe, they are not ready for it or it violates their values.

When the teen is sexually active

Teens who have decided to be sexually active should understand that pregnancy and STDs carry added risks at a young age.

Pregnancy: Young teenage girls have a high rate of medical problems in pregnancy. They are at high risk for miscarriages and caesarean section. There is a greater chance of premature birth - when babies can be born too small and have serious lifelong problems. Still birth is a risk. These risks are made worse for those who smoke or drink alcohol in their pregnancies. Well supervised care through out the pregnancy is essential.
Discussions about abortion are incredibly complex and have tremendous emotional consequences. There are also significant physical consequences that need to be addressed. The arising family, social, religious and moral issues can be very difficult for everyone involved.

Sexually Transmitted Disease: Gonorrhea and Chlamydia infections in the uterus and tubes can lead to infertility. Human papilloma virus (a very common wart virus) can lead to cancer of the cervix. Herpes simplex virus can seriously harm a baby if present in the vagina at delivery. Infection with HIV can lead to AIDS and death. Syphilis can lead to major problems for an affected individual or fetus if left untreated.

All these infections can be spread by sexual activities and are more likely to occur when the number of sexual partners increases.

Contraception: Teens should know about the types of contraception. If they are sexually active, they should be encouraged to make sensible decisions. The choices include:

• Abstinence from sexual activity.
• Condoms to reduce the risk of STDs as well as pregnancy. A wise teen will use a condom for every sexual contact to prevent STD regardless of other methods of birth control.
• Contraceptive pills, which must be taken responsibly and which demand a commitment for compliance.
• Intra-uterine device, which is a small device that the doctor places inside the uterus. It is not often used in teens who have not been pregnant. There is a risk of infections which can be severe.
• Other barrier methods include the vaginal sponge, diaphragm, spermicidal gel and foam.

For more information, teenagers should talk to their doctors if they are unwilling or unable to talk to their parents. They can also visit local birth control clinics.

Confidentiality

When a teenager seeks the help of a doctor on sexual issues or other "private" concerns, an understanding should be reached at the outset about whether the information will be shared with a guardian - usually the parent.

Most doctors will encourage teens to discuss things openly with parents but some teens feel they must keep things secret. Most doctors believe in respecting the wishes of their teen-aged patients in order to provide better care for them.

Could I be gay?

While a very small percentage of teens acknowledge their homosexuality, it is not uncommon for teenagers to worry about being homosexual. For homosexual teenagers, life presents a number of difficulties. Professional help can guide them through this phase of development and make some sense of a confusing world.

Pornography

How does a parent react to finding pornographic magazines, books or pictures in a teen's room? Again open communication is called for. Parents should be able to give an opinion, even a very firm one, on how they feel about pornography. It is important, however, to avoid a war of angry, frightening and self-righteous threats and put-downs.

Other Pitfalls

How can a parent stop teens getting into the wrong relationship? Parents should not nag, plead, preach, threaten, belittle or forbid the friendships. These frequently intensify the commitments! It is important, however, for parents to state how they feel with sentences such as: "I'm afraid you might get hurt." "Sexual intercourse can be difficult to handle - I'm worried about that."

Communicating with teens in a positive fashion or at least listening without being negative will go a long way to helping them feel secure with this new area of their lives.