Adults must act like adults to talk about sex with teens

Debates about sex in America are often so hot and breathless you would think we were having sex instead of discussing it. That’s especially common when adults are debating the issue of sexual activity among teenagers. Case in point: the recent controversy about a public middle school in Portland where the school-based health clinic has been allowed to prescribe birth control pills to sexually active girls without notifying parents.

While the few girls at the school who got the contraception were at least 14, girls as young as 11 attend the school and theoretically could also get contraception, so the proverbial doo-doo hit the fan. The national media have come calling, talk show hosts are in a frenzy, politicians are posturing, the local Catholic bishop is pontificating, and recall petitions against the school board members are being circulated.

Here is a better idea when it comes to these debates about teenagers and sex: We adults should stop acting like a bunch of hyperventilating idiots that no teenagers in their right minds would dream of asking about sex and birth control. Then we could have a grown-up conversation about this complex, difficult topic for which there is no easy answer. In order to do that we need to sit down, listen (including to the teenagers) more than talk, and keep a few facts in mind whether we like them or not.

Fact No. 1: We can wrap teenagers in love and duct tape, and preach to them until the cows come home, but some of them are still going to have sex, just as teenagers have been doing for thousands of years. More than half of all American teens will have sexual intercourse by their 18th birthdays, and while we might miraculously cut that rate in half over the next hundred years, we have to deal with the reality that some teens are going to have sex.

That’s the problem faced in every middle school in America; a small percentage of girls will have sex before they are 15, no matter how unfortunate that is, and no matter what we do as parents or communities or schools to prevent it. (Portland middle schools have had at least 17 pregnant students in the last four years, according to news reports.) So let’s stop wasting time arguing about how to prevent all teenagers from having sex and focus instead on the parenting and social issues that put girls at risk for premature sexual activity, and how to prevent teen pregnancy, HIV-AIDS, and other sexually transmitted diseases.

Fact No. 2: We need to remember that pregnant teenagers are less likely to graduate from high school, go to college, ever get good jobs, stay off welfare, etc. When we try to prevent American’s estimated 750,000 teen pregnancies annually we are also trying to prevent a lifetime of lost opportunity for many women. Facts 1 and 2 combined are why we have to spend at least as much energy preventing the complications of teenage sex as we do trying to reduce the likelihood young girls will become sexually active. It’s a bit like telling your kids to drive carefully, but also to buckle up just in case.

Fact No. 3: No matter how much they love and trust you, some of your teenagers are going to have sex without telling you parents. I know this because I know teenagers, and because some of your teenage daughters tell me things in my office or the ER they have not told you. I have delivered babies from teenage girls who lived at home and whose parents had no idea their daughter was pregnant until their grandchild was born.

Teenagers need someone to talk to when they won’t talk to parents. Those of us who talk to sexually active teenagers hiding this secret from their parents usually urge them to talk to their parents about what is going on. We want to include parents, but even more, we want your child to avoid pregnancy and be safe. Sometimes health care professionals have to choose between keeping the parent informed and taking care of the teenager.

Next, we should all know Fact No. 4: Study after study has shown that educating teenagers about sex, and providing those who have it with birth control, does not make teenagers more likely to have sex. If teenagers get good sex education – which includes teaching about abstinence, birth control, sexuality, etc. – they are not more likely to have sex, but are less likely to get pregnant and-or infected.

Fact No. 5: School sex education programs teaching teenagers only abstinence until marriage, and nothing about other birth control methods or STD prevention, just flat out do not work to decrease rates of teenage sexual activity, pregnancy and STDs. Access to good sex education and birth control, on the other hand, is largely why the rate of teenage pregnancy in the United States dropped from 115 per 1,000 women in 1990 to 75 in 2002.

In these debates about teenage sex we adults would do well to remember these facts, then heed the advice many parents and health care providers give teenagers thinking about sex; cool it, be careful, grow up a little, think past the moment, and have some fun just talking quietly. Then we as adults would actually be modeling the calm, thoughtful, collective problem-solving behavior we want to see in our teenagers, and be the kind of people teenagers might consider talking to about sex.

Erik Steele, D.O., a physician in Bangor, is chief medical officer of Eastern Maine Healthcare Systems and is on the staff of several hospital emergency rooms in the region.