This week, Health Talk features Bruce Brown, M.D., a specialist in adolescent medicine and director of the new Teen and Young Adult Clinic at Eastern Maine Medical Center. The clinic was developed to meet the health needs of teens who often don’t see a physician as often as they need to. The clinic hold evening hours and can be reached by calling 945-7520. Dr. Brown focuses on the issues surrounding sex, sexuality and teens.

How common is sex for teens and how safe is it?

Most of the research done over the last 15 years in the United States shows that the rate of sexual intercourse in teen-agers has increased about one-third.

About 50 percent of the adolescent population have engaged in sexual intercourse by the time they reach age 19. The rates at age 14 are about 50 percent in males and about 17 or 18 percent in females. Little data is available on rural teen-agers, and most of the information that we have refers to teens who live in cities.

How safe is teen sex in the 1990s?

Sexual intercourse for most teens is not as safe as parents would like, especially in this age of AIDS, increasing incidents of gonorrhea and syphilis.

Only about 25 percent of females regularly use any form of contraception, and only 10 percent of males use condoms at every intercourse. If you ask teens who attend clinics whether they used a condom at their last intercourse, about 50 percent will say they have. Again, this data is based on teens who live in urban areas, and it is my suspicion that use of contraception is a good deal more frequent in rural populations.

Should you wait until the teen years to discuss sexuality with your child?

I think the answer is obviously no. Sexuality means a lot more than just having sexual intercourse. It involves gender identification — basically, whether you decide you are a male or a female — and that is finished by age 2 or 3.

Sexuality involves establishing a sexual orientation, which means deciding whether you are going to be more sexually oriented toward people of the same sex or the opposite sex. This process begins in grade school. Many teens are relatively confident of their sexual orientation by early adolescence.

Then there is the whole issue of sexual behavior, which involves both feelings and actions. Babies in utero have sexual feelings, and we know that sexual feelings and behavior continue through old age. It is important that parents anticipate the importance of having their children become well-educated adolescents. You have to start that process in childhood.

Should a parent anticipate sexuality and talk about it earlier than in the teen years?

Thinking about teaching a child about being sexual could be approached in the same way that you teach your child how to use the family car. Initially, you want to show the child how much you value the car and you want to give the child and the teen clear expectations about how you expect the car to be used.

You proceed to give the child or the teen access to facts about how the car runs, what signs of trouble might be and how you go about fixing it. Some youngters learn more by hanging around a mechanic and others learn best from books. I think you need to make all of those options available; in addition, all children will learn by experimentation.

After all, that is how we ask them to learn everything else in their life. I think we have to expect that they will learn about sexuality in the same way.

How should you react when your teens tell you they have become sexually active?

I think that it is important that you immediately acknowledge what an important admission this was for the teen — that it was tremendously difficult to decide and act on a decision to talk to you about this sensitive issue, and that you appreciate it enormously.

I do not feel that you need to say a whole lot more at that point. Many parents will need to regroup and make a decision about how to respond to your teen’s admission. Perhaps going for a walk, and certainly talking with your partner or spouse, would be important prerequisites before you sit down with your teen and continue the conversation.

At that point, you might consider setting some guidelines, similar to the guidelines you set up regarding use of the car. You need to be clear about what the family’s expectations and standards are for behavior, while acknowledging that you expect the teen will exhibit a good deal of independence in the decision-making process.

You need to assure the teen that you are committed to working together in minimizing the risks of that decision-making process and experimentation.

What resources are available to help the teen and the parent?

There are some excellent resources for both parents and teens. I am especially enthusiastic about two pamphlets that were put out by Family Planning of Maine called “Families and Children Talking About Sexuality.” It has been abbreviated to FACTS One and Two. One is for the younger teen, and one is for the older teen. It provides practical information for parents about how to deal with sexuality in their children.

These can be obtained through local family planning offices. For teens themselves, there are two excellent books. One for the younger teen is focused mostly on body changes but also deals with sexual feelings; it’s called “What’s Happening To Me?” The other book, aimed more at the older adolescent and covering the gamut of adolescent experiences, sexual and non-sexual, is called “Changing Bodies, Changing Lives.”