Adolescent sexuality

Adolescent sexuality refers to sexual feelings, behavior and development in adolescents and is a stage of human sexuality. Sexuality is a vital aspect of teens' lives.cite book | title=The Sex Lives of Teenagers| last=Ponton| first=Lynn| year=2000| pages=2| isbn=0452282608|publisher=Dutton| location=New York] The sexual behavior of adolescents is, in most cases, influenced by their culture's norms and mores, their sexual orientation, and the issues of social control such as age of consent laws.

In humans, mature sexual desire usually begins to appear with the onset of puberty. Sexual expression can take the form of masturbation or sex with a partner. Sexual interests among adolescents, like adults, can vary greatly. Sexual activity in general is associated with a number of risks, including sexually transmitted diseases (including HIV/AIDS) and unwanted pregnancy. This is particularly true for adolescents as most are not emotionally maturecite journal | author=John R. Chapman| title=Adolescent sex and mass media: a developmental approach.| journal=Adolescence| year=2000| volume=Winter| pages=799–811] or financially self sufficient.

Teenage pregnancy

Adolescent girls become fertile following the menarche (first menstrual period), which occurs in the United States at an average age of 12.5., although it can vary widely between different girls. After menarche, sexual intercourse (especially without contraception) can lead to pregnancy. The pregnant teenager may then miscarry, have an abortion, or carry the child to full term.

Pregnant teenagers face many of the same obstetrics issues as women in their 20s and 30s. However, there are additional medical concerns for younger mothers, particularly those under 15 and those living in developing countries; for example, obstetric fistula is a particular issue for very young mothers in poorer regions. [http://bmj.bmjjournals.com/cgi/content/full/328/7449/1152-a Pregnancy and childbirth are leading causes of death in teenage girls in developing countries] ] For mothers between 15 and 19, age in itself is not a risk factor, but additional risks may be associated with socioeconomic factors; for example pregnant teenagers are less likely than women over 20 to receive early prenatal care. Makinson, C. (1985). [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=2431924&query_hl=21&itool=pubmed_docsum The health consequences of teenage fertility] . "Family Planning Perspectives, 17 (3)", 132-9. Retrieved May 29, 2006.]

Worldwide, rates of teenage births range widely. For example, sub-Saharan Africa has a high proportion of teenage mothers whereas industrialized Asian countries such as South Korea and Japan have very low rates. [http://globalis.gvu.unu.edu/indicator.cfm?IndicatorID=127 Indicator: Births per 1000 women (15-19 ys) – 2002] UNFPA, State of World Population 2003, Retrieved 22 January 2007.] Teenage pregnancy in developed countries is usually outside of marriage, and carries a social stigma; teenage mothers and their children in developed countries show lower educational levels, higher rates of poverty, and other poorer "life outcomes" compared with older mothers and their children. The National Campaign to Prevent Teen Pregnancy. (2002). PDFlink| [http://www.teenpregnancy.org/resources/data/pdf/notjust.pdf Not Just Another Single Issue: Teen Pregnancy Prevention's Link to Other Critical Social Issues] |58.5 KB. Retrieved May 27 2006.] In the developing world, teenage pregnancy is usually within marriage and does not carry such a stigma. [Population Council (2006) [http://www.popcouncil.org/publications/popbriefs/pb12(1)_1.html Unexplored Elements of Adolescence in the Developing World] "Population Briefs", January 2006, Vol. 12, No. 1. Retrieved April 18 2007.]

Legal aspects of adolescent sexual activity

Many countries have an age of consent, the minimum age at which a person is considered to be capable of legally giving informed consent to any kind of sexual behavior with an adult. But sexual intercourse between adolescents with age difference within 2-3 years are generally not prohibited under law in many countries. The legal age of consent has varied from being age 13 in Japan, age 14 across Canada, and age 16-18 in many states in the United States. In some jurisdictions, the age of consent for homosexual acts may be different from that for heterosexual acts. The age of consent in a particular jurisdiction is typically the same as the age of majority or several years younger. The age at which one can legally marry is also sometimes different from the legal age of consent.

Sexual relations with a person under the age of consent are generally a criminal offense in the jurisdiction in which the crime was committed, with punishments ranging from token fines to life imprisonment. Many different terms exist for the charges laid and include statutory rape, illegal carnal knowledge, or corruption of a minor. In some cases, sexual activity with someone above the legal age of consent but beneath the age of majority can be punishable under laws against contributing to the delinquency of a minor.

ex education

Sex education, also called "Sexuality Education" or informally "Sex Ed" is a broad term used to describe education about human sexual anatomy, sexual reproduction, sexual intercourse, human sexual behavior, and other aspects of sexuality, such as body image, sexual orientation, dating, and relationships. Common avenues for sex education are parents, caregivers, friends, school programs, religious groups, popular media, and public health campaigns.

Sexual education in different countries vary. For example, in France sex education has been part of school curricula since 1973. Schools are expected to provide 30 to 40 hours of sex education, and pass out condoms to students in grades eight and nine. In January, 2000, the French government launched an information campaign on contraception with TV and radio spots and the distribution of five million leaflets on contraception to high school students. [http://www.unesco.org/courier/2000_07/uk/apprend.htm Britain: Sex Education Under Fire] "UNESCO Courier"]

According to SIECUS, the Sexuality Information and Education Council of the United States, in most families, parents are the primary sex educators of their adolescents. They found 93% of adults they surveyed support sexuality education in high school and 84% support it in junior high school. [SIECUS Report of Public Support of Sexuality Education(1999) [http://www.siecus.org/school/sex_ed/sex_ed0002.html SIECUS Report Online] ] In fact, 88% of parents of junior high school students and 80% of parents of high school students believe that sex education in school makes it easier for them to talk to their adolescents about sex. [Sex Education in America.(Washington, DC: National Public Radio, Henry J. Kaiser Family Foundation, and Kennedy School of Government, 2004), p. 5.] Also, 92% of adolescents report that they want both to talk to their parents about sex and to have comprehensive in-school sex education.Fact|date=March 2008

Almost all U.S. students receive some form of sex education at least once between grades 7 and 12; many schools begin addressing some topics as early as grades 5 or 6. [cite journal|coauthors=David J. Landry, Susheela Singh and Jacqueline E. Darroch |year=2000 |month=September/October |title=Sexuality Education in Fifth and Sixth Grades in U.S. Public Schools, 1999 |journal=Family Planning Perspectices |volume=32 |issue=5 |pages= |id= |url=http://www.guttmacher.org/pubs/journals/3221200.html |accessdate = 2007-05-23 ] However, what students learn varies widely, because curriculum decisions are quite decentralized. cite web |url=http://www.kff.org/youthhivstds/upload/Sex-Education-in-the-U-S-Policy-and-Politics.pdf |title=Sex Education in the U.S.: Policy and Politics |accessdate = 2007-05-23 |year=2002 |month=October |format=PDF |work=Issue Update |publisher=Kaiser Family Foundation ] Two main forms of sex education are taught in American schools: comprehensive and abstinence-only. A 2002 study conducted by the Kaiser Family Foundation found that 58% of secondary school principals describe their sex education curriculum as comprehensive, while 34% said their school's main message was abstinence-only The difference between these two approaches, and their impact on teen behavior, remains a controversial subject in the U.S.cite web |url=http://www.advocatesforyouth.org/publications/stateevaluations/index.htm |title=Five Years of Abstinence-Only-Until-Marriage Education: Assessing the Impact |accessdate = 2007-05-23 |last=Hauser |first=Debra |year=2004 |publisher=Advocates for Youth] [cite press release | title =Mathematica Findings Too Narrow | publisher =National Abstinence Education Association | date =2007-04-13 | url =http://www.abstinenceassociation.org/newsroom/pr_041307_mathematica.html | accessdate = 2007-05-25] Some studies have shown abstinence-only programs to have no positive effects. [ [http://www.topix.net/content/ap/2007/11/report-abstinence-not-curbing-teen-sex Report: Abstinence Not Curbing Teen Sex] ] Other studies have shown specific programs to result in more than 2/3 of students maintaining that they will remain abstinent until marriage months after completing such a program [ [http://www.chattanoogan.com/articles/article_116666.asp Why Know Says They Are Effective In Increasing Teen Abstinence] ] ; such "virginity pledges," however, are statistically ineffective, [Bearman PS, Brückner H. Promising the future: virginity pledges and first intercourse. American Journal of Sociology 2001; 106:859-912.] [Brückner H, Bearman PS. After the promise: the STI consequences of adolescent virginity pledges. Journal of Adolescent Health 2005; 36:271-278.] and over 95% of Americans do, in fact, have sex before marriage. [Finer L. Trends in premarital sex in the United States, 1954-2003. Public Health Reports, 2007; 23: 73.]

In Asia the state of sex education programs are at various stages of development. Indonesia, Mongolia, South Korea and Sri Lanka have a systematic policy framework for teaching about sex within schools. Malaysia, the Philippines and Thailand have assessed adolescent reproductive health needs with a view to developing adolescent-specific training, messages and materials. India has programs that specifically aims at school children at the age group of nine to sixteen years. These are included as subjects in the curriculum and generally involves open and frank interaction with the teachers. Bangladesh, Nepal and Pakistan have no coordinated sex education programs. [http://www.unescap.org/esid/psis/population/icpd/sec7.asp Adolescents In Changing Times: Issues And Perspectives For Adolescent Reproductive Health In The ESCAP Region] United Nations Social and Economic Commission for Asia and the Pacific ]

Adolescent sexual behavior

In the United States

Changes in the expression of adolescent sexuality in the United States find their origins in the sexual revolution and is a focus of the "culture wars." The U.S. federal government policy under George W. Bush has emphasized sexual abstinence or pre-marital chastity, particularly in sex education with a focus on abstinence-only sex education rather than the harm reduction approach of the safe sex focus. It has extended this approach to foreign policy, using foreign aid to pressure NGO's into ending condom education in third-world countries. There is an ongoing debate between those advocating comprehensive, medically accurate sex education and those seeing anything other than abstinence-based education as opposed to "the values held by most Americans".

According to the US Centers for Disease Control and Prevention, fewer than half of all US high school students have had sexual intercourse. In 2007, 47.8% of US high school students reported that they had ever had sexual intercourse. This number has shown a downward trend since 1991, when the figure was 54.1%.cite web |url=http://www.cdc.gov/HealthyYouth/yrbs/pdf/yrbs07_us_sexual_behaviors_trend.pdf |title=Trends in the Prevalence of Sexual Behaviors|accessdate=2008-07-02 |work=The National Youth Risk Behavior Survey (YRBS) 1991-2007 |publisher=US Centers for Disease Control and Prevention |year=2007 |format=PDF] According to a survey commissioned by NBC News and People magazine, the vast majority of 13- to 16-year-olds, 87%, report that they have not had sexual intercourse, and 73% report having not been sexually intimate at all. Three quarters of them say they have not because they feel they are too young, and just as many say they have made a conscious decision not to.Cite web| url=http://www.msnbc.msn.com/id/6839072|title=Nearly 3 in 10 young teens 'sexually active'|accessdate=2007-01-21|publisher=MSNBC|year=2005|author=Katie Couric|format=html]

The same survey found that, while only 27% of 13- to 16-year-olds had been involved in intimate or sexual activity, 8% had had a casual sexual relationship, which has been described by one journalist as a "profound shift in the culture of high school dating and sex."cite journal | author=Alexandra Hall| title= [http://www.bostonmagazine.com/articles/the_mating_habits_of_the_suburban_high_school_teenager/ The Mating Habits of the Suburban High School Teenager] | journal=Boston Magazine| issue=May 2003] In his book, "Why Gender Matters", researcher Leonard Sax states that teenage sexual encounters are increasingly taking place outside the context of romantic relationships, in purely sexual "hookups."cite book | title=Why Gender Matters| url=http://www.whygendermatters.com| last=Sax, M.D., Ph.D| first=Leonard| year=2005| pages=132| publisher=Doubleday| isbn = 038551073X] In 2002, the National Longitudinal Study of Adolescent Health reported a "dramatic trend toward the early initiation of sex." [Adolescent Sexual Behavior and Sexual Health, Renee E. Sieving, Jennifer A. Oliphant, and Robert Wm. Blum, Pediatrics in Review 2002 23: 407-416.] According to the American Academy of Pediatrics "early sexual intercourse among American adolescents represents a major public health problem. Although early sexual activity may be caused by a variety of factors, the media are believed to play a significant role. U.S. teens rank the media second only to school sex education programs as a leading source of information about sex." [ [http://aappolicy.aappublications.org/cgi/content/full/pediatrics;107/1/191 Sexuality, Contraception, and the Media] , PEDIATRICS Vol. 107 No. 1 January 2001, pp. 191-194]

The US teen pregnancy rate is much higher than in many other developed countries.cite web |url=http://www.guttmacher.org/pubs/fb_ATSRH.html |title=Facts on American Teens' Sexual and Reproductive Health |accessdate=2008-07-02 |work= |publisher=Guttmacher Institute |year=2006 |month=September ] After declining steadily since 1991, the teen pregnancy rate rose 3% in 2006, to 41.9 births per 1,000. This followed a 14-year downward trend in which the teen birth rate fell by 34% from its 1991 peak of 61.8 births per 1,000. [cite press release |title=Teen Birth Rate Rises for First Time in 15 Years |publisher=National Center for Health Statistics, Centers for Disease Control and Prevention |date=2007-12-05 |url=http://www.cdc.gov/nchs/pressroom/07newsreleases/teenbirth.htm |accessdate=2008-07-02]

Public health officials express concerns that STDs and risky behaviors that include "anything but intercourse" are "rampant" among teens.cite journal | author=Anna Mulrine| title=Risky Business| url=http://www.guttmacher.org/media/pdf/news2002/0528_clip.pdf | journal=U.S. News & World Report| issue=May 27, 2002|format=PDF] Of the 18.9 million new cases of STIs each year, 9.1 million (48%) occur among 15- to 24-year-olds, even though this age group represents only one-quarter of the sexually active population. According to a 2008 study by the CDC, an estimated 1 in 4 teen girls has at least one STD at any given time. [cite press release |title=Nationally Representative CDC Study Finds 1 in 4 Teenage Girls Has a Sexually Transmitted Disease |publisher=US Centers for Disease Control and Prevention |date=2008-03-11 |url=http://www.cdc.gov/STDConference/2008/media/release-11march2008.htm |accessdate=2008-07-03 ]

Increasing rates of oral sex among teens have been reported. However a study released in 2008 by the Guttmacher Institute found that, while oral sex is slightly more common than vaginal sex among teens, the prevalence of oral sex among teen opposite-sex partners has held steady for the last decade.cite web |url=http://www.guttmacher.org/pubs/JAH_Lindberg.pdf |title=Non-coital sexual activities among adolescents |accessdate=2008-06-30 |last=Duberstein Lindberg | first=Laura | coauthors=Rachel Jones, John S. Santelli |publisher=Guttmacher Institute|format=PDF] According to the study, slightly more than half (55%) of 15– to 19-year-olds have engaged in heterosexual oral sex, 50% have engaged in vaginal sex and 11% have had anal sex.

Among sexually active 15- to 19-year-olds, 83% of females and 91% of males reported using at least one method of birth control during last intercourse.cite web |url=http://www.kff.org/womenshealth/upload/3040-03.pdf |title=Sexual Health Statistics for Teenagers and Young Adults in the United States |accessdate=2008-07-02 |publisher=Kaiser Family Foundation |year=2006| month=September |format=PDF ] The most common methods of contraception are condoms and birth control pills. In 2007, 61.5% of high school students reported using a condom the last time they had sexual intercourse, up from 46% in 1991.

The CDC also tracks the percentage of students who say they used drugs or alcohol before sex. While this risk behavior increased between 1991 and 2001, the trend has been declining since then. In 2007, 22.5% of high school students reported this risk behavior, down from 25.6% in 2001.

Most teenagers (70%) reported that they received some or a lot of information about sex and sexual relationships from their parents. Other sources of information included friends at 53%, school, also at 53%, TV and movies at 51% and magazines at 34%. School and magazines were said to be used as sources of information more by girls than by boys, and sexually active teens were more likely to cite their friends and partners as information sources.

In Britain

In 2006, a survey conducted by The Observer showed that most adolescents in Britain were waiting longer to have sexual intercourse than they were only a few years earlier. In 2002, 32% of teens were having sex before the legal age of consent of 16; in 2006 it was only 20%. The average age a teen lost their virginity was 17.13 years in 2002; in 2006, it was 17.44 years on average for girls and 18.06 for boys. The most notable drop among teens who reported having sex was 14 and 15 year olds.cite journal | author=Denis Campbell| title=No sex please until we're at least 17 years old, we're British| journal=The Observer| date=January 22, 2006]

A 2008 survey conducted by YouGov for Channel 4 showed that 40% of all 14-17 year olds are sexually active. 74% of sexually active 14-17 year-olds have had a sexual experience under the age of consent. 6% of teens would wait until marriage before having sex.Cite web|url=http://sexperienceuk.channel4.com/teen-sex-survey|title=Teen Sex Survey|accessdate=2008-09-11|publisher=Channel 4|year=2008]

Of Western European countries, Britain has the highest rate of teenage pregnancy and sexually transmitted diseases are on the increase.Cite web|url=http://www.netdoctor.co.uk/sex_relationships/facts/childrenandsex.htm|title=Talking to pre-adolescent children about sex|accessdate=2007-01-17|publisher=Net Doctor|year=2005|author=Christine Webber, psychotherapist and Dr David Delvin|work=Broaching the subject|format=html] One in nine sexually active teens has chlamydia and 790,000 teens have sexually transmitted infections. In 2006 The Independent newspaper reported that the biggest rise in sexually transmitted infections was in syphilis, which rose by more than 20 per cent, while increases were also seen in cases of genital warts and herpes.cite journal | author=Jonathan Thompson| title= New safe sex ads target teens 'on the pull'| journal=The Independent| date=November 12, 2006]

In Canada

One group of Canadian researchers found a relationship between self esteem and sexual activity. They found that students, especially girls, who were verbally abused by teachers or rejected by their peers were more likely than other students to engage in sex by the end of the 7th grade. The researchers speculate that low self esteem increases the likelihood of sexual activity, "low self-esteem seemed to explain the link between peer rejection and early sex. Girls with a poor self-image may see sex as a way to become 'popular,' according to the researchers." [ [http://www.nlm.nih.gov/medlineplus/news/fullstory_55689.html Peer rejection tied to early sex in pre-teens] ]

In India

In India there is growing evidence that adolescents are becoming more sexually active outside of marriage. It is feared that his will lead to an increase in spread of HIV/AIDS among adolescents, increase the number of unwanted pregnancies and abortions, and give rise to conflict between contemporary social values. Adolescents have relatively poor access to health care and education. With cultural norms opposing extramarital sexual behavior "these implications may acquire threatening dimensions for the society and the nation."Cite web|url=http://iussp2005.princeton.edu/download.aspx?submissionId=50332|title=Socio-psychological Constructs of Premarital Sex Behavior among Adolescent Girls in India|accessdate=2007-01-21|publisher=Princeton University|author=R.S.Goya, Indian Institute of Health Management Research, Jaipur, India|work=Abstract|format=pdf]

;Motivation and frequency:Sexual relationships outside marriage are not uncommon among teenage boys and girls in India. By far, the best predictor of whether or not a girl would be having sex is if her friends were engaging in the same activities. For those girls whose friends were having a physical relationship with a boy, 84.4% were engaging in the same behavior. Only 24.8% of girls whose friends were not having a physical relationship had one themselves. In urban areas, 25.2% of girls have had intercourse and in rural areas 20.9% have. Better indicators of whether or not girls were having sex were their employment and school status. Girls who were not attending school were 14.2%(17.4% v. 31.6%) more likely and girls who were employed were 14.4%(36.0% v. 21.6%) more likely to be having sex.Cite web|url=http://iussp2005.princeton.edu/download.aspx?submissionId=50332|title=Socio-psychological Constructs of Premarital Sex Behavior among Adolescent Girls in India|accessdate=2007-01-21|publisher=Princeton University|author=R.S.Goya, Indian Institute of Health Management Research, Jaipur, India|work=Abstract|format=PDF]

In the Indian sociocultural milieu girls have less access to parental love, schools, opportunities for self development and freedom of movement than boys do. It has been argued that they may rebel against this lack of access or seek out affection through physical relationships with boys. While the data reflects trends to support this theory, it is inconclusive. The freedom to communicate with adolescent boys was restricted for girls regardless of whether they lived in an urban or rural setting, and regardless of whether they went to school or not. More urban girls than rural girls discussed sex with their friends. Those who did not may have felt "the subject of sexuality in itself is considered an 'adult issue' and a taboo or it may be that some respondents were wary of revealing such personal information."cite journal | author=Dhoundiyal Manju & Venkatesh Renuka| title=Knowledge regarding human sexuality among adolescent girls| journal=The Indian Journal of Pediatrics| year=2006| volume=73| issue=8| url=http://www.ijppediatricsindia.org/article.asp?issn=0019-5456;year=2006;volume=73;issue=8;spage=743;epage=743;aulast=Dhoundiyal| pages=743| doi=10.1007/BF02898460]

;Contraceptive use:Among Indian girls, "misconceptions about sex, sexuality and sexual health were large. However, adolescents having sex relationships were somewhat better informed about the sources of spread of STDs and HIV/AIDS." While 40.0% of sexually active girls were aware that condoms could help prevent the spread of HIV/AIDS and reduce the likelihood of pregnancy, only 10.5% used a condom during the last time they had intercourse.

ee also

*Age disparity in sexual relationships
*Child sexuality
*Family planning
*Sex education
*Teenage pregnancy

References