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Doctors urged to advise patients about risks of abstinence-centric sex education

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American Academy of Pediatricians’ new report is the clearest denouncement of the failures of not talking about STIs and pregnancy prevention

Across the US only 50% of high school students receive sex education that meets the recommendations of the federal Centers for Disease Control and Prevention.

Across the US only 50% of high school students receive sex education that meets the recommendations of the federal Centers for Disease Control and Prevention.

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The country’s largest organization of pediatricians entered fraught political territory on Monday, with a call for doctors to use their time with patients to combat the potential health consequences of abstinence-centric sex education.

In a new report, the American Academy of Pediatricians (AAP) issued its clearest denunciation yet of sex education programs that fail to offer comprehensive information on topics such as sexually transmitted infections (STIs) and pregnancy prevention.

“This is the mothership telling pediatricians that talking about sex is part of your charge to keep children and adolescents safe,” said Dr Cora Breuner, a professor and pediatrician at Seattle Children’s research hospital and the report’s lead author.

“These guidelines give pediatricians in communities where people might say, ‘We don’t want you talking to our kids about this stuff,’ permission to say, ‘No, I can talk about this, I should talk about this, I need to talk about this.’”

The report is broadly a call for pediatricians to help fill in the gaps left by the country’s patchwork sex education programs. It urges pediatricians to teach not only contraception and the benefits of delaying sexual activity, but to cover topics such as sexual consent, sexual orientation and gender identity with school-aged children who may not receive any information in the classroom and involve their parents.

But the authors single out abstinence-heavy education, which sometimes excludes information about contraceptives, as a key concern for doctors looking to help adolescent patients avoid sexually transmitted infections and unintended pregnancy. As a result, it is likely to fuel an already contentious debate.

Groups that have advocated for sex education to emphasize abstinence instantly found fault with the new guidelines.

“A health organization like the AAP should not be affirming a behavior that can compromise the health of youth,” said Valerie Huber, the president of Ascend, a group that promotes abstinence-centric sex education and advocates for federal funding. The group was formerly known as the formerly the National Abstinence Education Association.

“They recommend ‘responsible sex’ for young adolescents. Exactly what is responsible sexual activity for adolescents? … The science is clear that teens are healthier when they avoid all sexual activity.”

Moreover, Huber said, programs that “normalize teen sex” are unpopular with many parents.

“Most communities do not support the type of sex education they recommend,” she said.

Still, others embraced the report as bringing the AAP’s recommendations more in line with the reality.

“This is a fantastic move,” said Chitra Panjabi, the president of the Sexuality Information and Education Council of the United States (SIECUS), a research group that supports comprehensive sex education. “It’s really important that our medical providers are standing up and saying, hey, the youth in our communities are coming to us because they’re not getting the information they need. And so we need to step in.”

The US does not enforce national standards for sex education and schools in many states are not required to teach it. Across the country, SIECUS estimates, only 50% of high school students receive sex education that meets the recommendations of the federal Centers for Disease Control and Prevention. The other half of students receive anything from an incomplete sex education, to education that emphasizes abstinence, to abstinence-only education, with a focus on delaying sex until heterosexual marriage.

In February, Barack Obama proposed a budget for 2017 that eliminated the $10m the department of health and human services spends on abstinence-only programs every year. But funding continues to flow to those programs from other sources. Title V, an abstinence-only program, allocates $75m a year to abstinence-only programs, money that states match by 75%.

In the last quarter-century, programs emphasizing abstinence as the optimal way to avoid pregnancy and STIs have received more than $2bn in funding from the federal government. Comprehensive sex education, by contrast, has no dedicated federal funding stream.

“It’s a political climate where people don’t want to talk about these issues,” said Breuner. “But it makes our job so much harder when we cannot coordinate our efforts with the schools. It takes time away from the other safety issues we need to be discussing. Don’t smoke weed. Don’t text and drive.”

Recently, two major surveys of existing research on sex education concluded that there was no evidence or inconclusive evidence to show that abstinence-centric programs succeeded in delaying sexual activity. One of the surveys found that comprehensive sex education was actually more effective than abstinence education at delaying sexual activity in teens. (Ascend points to select studies which show the opposite.)

A long-term study found that teens receiving abstinence-only programs were less likely to use contraceptives or be screened for STIs, although rates of infections were not elevated.

The studies helped compel the AAP to issue its first major guidance on sex education since 2001.

“It’s important for pediatricians to have the backing to say, ‘Look, I can’t support telling this stuff to children,’” Breuner said. “I have to deal with the aftermath, which is a 15-year-old who’s pregnant, or a 16-year-old who has a sexually transmitted infection he’s going to have for the rest of his life.”

Breuner said a number of her patients have suffered consequences from abstinence-only education. Many of them are pregnant teenagers and girls who, in the absence of accurate information, came to believe in common myths about pregnancy prevention.

“They’ll say, ‘I thought you couldn’t get pregnant when you were having your period,’ or, ‘I thought it took two or three years after you get your period to be able get pregnant.’ It’s heartbreaking, because I know with education, this could have been prevented.”

Complete Article HERE!

Even Fewer Kids Are Learning Basic Things About Sex Ed

BY TARA CULP-RESSLER

sex ed

The United States, which has the highest teen pregnancy rate in the developed world, isn’t exactly known for its top-notch sexual health resources. But a new study suggests that our country’s sex ed has gotten even worse in recent years.

Even fewer teens are now getting basic sex ed information, like formal instruction about how to use birth control, according to researchers at the Guttmacher Institute who compared sexual health data over a seven year period.

The researchers compared data collected by the Centers for Disease Control and Prevention (CDC) during two of the agency’s survey periods: the 2006–2010 survey and 2011–2013 survey. These surveys included questions for teens about whether they ever received formal sex education materials — like how to prevent sexually transmitted infections, how to say no to sex, how to put on a condom, and how to use different methods of contraception — before they turned 18.

In the 2006-2010 survey period, 70 percent of girls and 61 percent of boys said they had received some information about birth control methods. But in the later survey period, those numbers dropped to 60 percent among girls and 55 percent among boys.

As time passed, fewer girls also reported receiving any formal education on how to prevent STDs and how to say no to sex. These declines were particularly acute in rural areas of the country, where teens already struggle with higher rates of unintended pregnancies.

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The study’s lead researcher, Laura Duberstein Lindberg, characterized the declines in sex ed instruction as “distressing.” She also pointed out that this data fits into a bigger pattern in the United States. Over the past two decades, the number of teens receiving formal instruction about birth control has been steadily declining, and abstinence-only classes that don’t include accurate information about sexual health have persisted.

“The United States is moving in the wrong direction,” said Leslie Kantor, the vice president of education at Planned Parenthood, the nation’s largest sex ed provider. “Sex education can make a real difference in adolescents’ overall health and well-being. The fact that young people are being deprived of information critical to their sexual health is unacceptable.”

Only 21 states and the District of Columbia currently require sex education and HIV education to be taught in public schools. An even fewer number, 18, explicitly require information about contraception in the classroom. On the other end of the spectrum, 37 states mandate that schools should focus on lessons about abstinence.

There’s a lot of evidence that providing teens with accurate information about sex ed helps them make healthier choices. Sex ed classes are actually linked to a delay in sexual activity — suggesting that, instead of spurring teens to become more sexually active, talking to them about sex actually helps them make more thoughtful decisions about their bodies.

“We need to right the ship, get back on track, and make sure all students receive quality sex education that prepares them to make informed and healthy decisions,” said Debra Hauser, the president of Advocates for Youth, a nonprofit group focusing on the reproductive health issues that are important to young people.

 Complete Article HERE!

When Did Porn Become Sex Ed?

Conversations between adults and teenagers about what happens after “yes” remain rare.

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porn:sex ed

THE other day, I got an email from a 21-year-old college senior about sex — or perhaps more correctly, about how ill equipped she was to talk about sex. The abstinence-only curriculum in her middle and high schools had taught her little more than “don’t,” and she’d told me that although her otherwise liberal parents would have been willing to answer any questions, it was pretty clear the topic made them even more uncomfortable than it made her.

So she had turned to pornography. “There’s a lot of problems with porn,” she wrote. “But it is kind of nice to be able to use it to gain some knowledge of sex.”

I wish I could say her sentiments were unusual, but I heard them repeatedly during the three years I spent interviewing young women in high school and college for a book on girls and sex. In fact, according to a survey of college students in Britain, 60 percent consult pornography, at least in part, as though it were an instruction manual, even as nearly three-quarters say that they know it is as realistic as pro wrestling. (Its depictions of women, meanwhile, are about as accurate as those of the “The Real Housewives” franchise.)

The statistics on sexual assault may have forced a national dialogue on consent, but honest conversations between adults and teenagers about what happens after yes — discussions about ethics, respect, decision making, sensuality, reciprocity, relationship building, the ability to assert desires and set limits — remain rare. And while we are more often telling children that both parties must agree unequivocally to a sexual encounter, we still tend to avoid the biggest taboo of all: women’s capacity for and entitlement to sexual pleasure.

It starts, whether intentionally or not, with parents. When my daughter was a baby, I remember reading somewhere that while labeling infants’ body parts (“here’s your nose,” “here are your toes”), parents often include a boy’s genitals but not a girl’s. Leaving something unnamed, of course, makes it quite literally unspeakable.

Nor does that silence change much as girls get older. President Obama is trying — finally — in his 2017 budget to remove all federal funding for abstinence education (research has shown repeatedly that the nearly $2 billion spent on it over the past quarter-century may as well have been set on fire). Yet according to the Centers for Disease Control and Prevention, fewer than half of high schools and only a fifth of middle schools teach all 16 components the agency recommends as essential to sex education. Only 23 states mandate sex ed at all; 13 require it to be medically accurate.

Even the most comprehensive classes generally stick with a woman’s internal parts: uteruses, fallopian tubes, ovaries. Those classic diagrams of a woman’s reproductive system, the ones shaped like the head of a steer, blur into a gray Y between the legs, as if the vulva and the labia, let alone the clitoris, don’t exist. And whereas males’ puberty is often characterized in terms of erections, ejaculation and the emergence of a near-unstoppable sex drive, females’ is defined by periods. And the possibility of unwanted pregnancy. When do we explain the miraculous nuances of their anatomy? When do we address exploration, self-knowledge?

No wonder that according to the largest survey on American sexual behavior conducted in decades, published in 2010 in The Journal of Sexual Medicine, researchers at Indiana University found only about a third of girls between 14 and 17 reported masturbating regularly and fewer than half have even tried once. When I asked about the subject, girls would tell me, “I have a boyfriend to do that,” though, in addition to placing their pleasure in someone else’s hands, few had ever climaxed with a partner.

Boys, meanwhile, used masturbating on their own as a reason girls should perform oral sex, which was typically not reciprocated. As one of a group of college sophomores informed me, “Guys will say, ‘A hand job is a man job, a blow job is yo’ job.’ ” The other women nodded their heads in agreement.

Frustrated by such stories, I asked a high school senior how she would feel if guys expected girls to, say, fetch a glass of water from the kitchen whenever they were together yet never (or only grudgingly) offered to do so in return? She burst out laughing. “Well, I guess when you put it that way,” she said.

The rise of oral sex, as well as its demotion to an act less intimate than intercourse, was among the most significant transformations in American sexual behavior during the 20th century. In the 21st, the biggest change appears to be an increase in anal sex. In 1992, 16 percent of women aged 18 to 24 said they had tried anal sex. Today, according to the Indiana University study, 20 percent of women 18 to 19 have, and by ages 20 to 24 it’s up to 40 percent.

A 2014 study of 16- to 18-year-old heterosexuals — and can we just pause a moment to consider just how young that is? — published in a British medical journal found that it was mainly boys who pushed for “fifth base,” approaching it less as a form of intimacy with a partner (who they assumed would both need to be and could be coerced into it) than a competition with other boys. They expected girls to endure the act, which young women in the study consistently reported as painful. Both sexes blamed the girls themselves for the discomfort, calling them “naïve or flawed,” unable to “relax.”

According to Debby Herbenick, director of the Center for Sexual Health Promotion at Indiana University and one of the researchers on its sexual behavior survey, when anal sex is included, 70 percent of women report pain in their sexual encounters. Even when it’s not, about a third of young women experience pain, as opposed to about 5 percent of men. What’s more, according to Sara McClelland, a psychologist at the University of Michigan, college women are more likely than men to use their partner’s physical pleasure as the yardstick for their satisfaction, saying things like “If he’s sexually satisfied, then I’m sexually satisfied.” Men are more likely to measure satisfaction by their own orgasm.

Professor McClelland writes about sexuality as a matter of “intimate justice.” It touches on fundamental issues of gender inequality, economic disparity, violence, bodily integrity, physical and mental health, self-efficacy and power dynamics in our most personal relationships, whether they last two hours or 20 years. She asks us to consider: Who has the right to engage in sexual behavior? Who has the right to enjoy it? Who is the primary beneficiary of the experience? Who feels deserving? How does each partner define “good enough”? Those are thorny questions when looking at female sexuality at any age, but particularly when considering girls’ formative experiences.

We are learning to support girls as they “lean in” educationally and professionally, yet in this most personal of realms, we allow them to topple. It is almost as if parents believe that if they don’t tell their daughters that sex should feel good, they won’t find out. And perhaps that’s correct: They don’t, not easily anyway. But the outcome is hardly what adults could have hoped.

What if we went the other way? What if we spoke to kids about sex more instead of less, what if we could normalize it, integrate it into everyday life and shift our thinking in the ways that we (mostly) have about women’s public roles? Because the truth is, the more frankly and fully teachers, parents and doctors talk to young people about sexuality, the more likely kids are both to delay sexual activity and to behave responsibly and ethically when they do engage in it.

Consider a 2010 study published in The International Journal of Sexual Health comparing the early experiences of nearly 300 randomly chosen American and Dutch women at two similar colleges — mostly white, middle class, with similar religious backgrounds. So, apples to apples. The Americans had become sexually active at a younger age than the Dutch, had had more encounters with more partners and were less likely to use birth control. They were also more likely to say that they’d first had intercourse because of pressure from friends or partners.

In subsequent interviews with some of the participants, the Americans, much like the ones I met, described interactions that were “driven by hormones,” in which the guys determined relationships, both sexes prioritized male pleasure, and reciprocity was rare. As for the Dutch? Their early sexual activity took place in caring, respectful relationships in which they communicated openly with their partners (whom they said they knew “very well”) about what felt good and what didn’t, about how far they wanted to go, and about what kind of protection they would need along the way. They reported more comfort with their bodies and their desires than the Americans and were more in touch with their own pleasure.

What’s their secret? The Dutch said that teachers and doctors had talked candidly to them about sex, pleasure and the importance of a mutual trust, even love. More than that, though, there was a stark difference in how their parents approached those topics.

While the survey did not reveal a significant difference in how comfortable parents were talking about sex, the subsequent interviews showed that the American moms had focused on the potential risks and dangers, while their dads, if they said anything at all, stuck to lame jokes.

Dutch parents, by contrast, had talked to their daughters from an early age about both joy and responsibility. As a result, one Dutch woman said she told her mother immediately after she first had intercourse, and that “my friend’s mother also asked me how it was, if I had an orgasm and if he had one.”

MEANWHILE, according to Amy T. Schalet, an associate professor of sociology at the University of Massachusetts, Amherst, and the author of “Not Under My Roof: Parents, Teens, and the Culture of Sex, ” young Dutch men expect to combine sex and love. In interviews, they generally credited their fathers with teaching them that their partners must be equally up for any sexual activity, that the women could (and should) enjoy themselves as much as men, and that, as one respondent said, he would be stupid to have sex “with a drunken head.” Although she found that young Dutch and American men both often yearned for love, only the Americans considered that a personal quirk.

I thought about all of that that recently when, driving home with my daughter, who is now in middle school, we passed a billboard whose giant letters on a neon-orange background read, “Porn kills love.” I asked her if she knew what pornography was. She rolled her eyes and said in that jaded tone that parents of preteenagers know so well, “Yes, Mom, but I’ve never seen it.”

I could’ve let the matter drop, felt relieved that she might yet make it to her first kiss unencumbered by those images.

Goodness knows, that would’ve been easier. Instead I took a deep breath and started the conversation: “I know, Honey, but you will, and there are a few things you need to know.”

Complete Article HERE!

More SEX WISDOM With Katie Querna — Podcast #427 — 09/10/14


Hello sex fans! Welcome back.

As you remember from last week, this week marks the end of my podcasting career. I’ve done 427 shows in just under eight years and I’ve decided that’s plenty. While I am exceptionally proud of the quality programming I’ve brought to you, my international audience, it’s time to call it quits. But I’m happy to report, all my podcasts are archived right here on my site and they will remain so for the foreseeable feature. So I hope you will visit often.

For my last show I welcome back my good friend, colleague, social worker, and real life neighbor, Katie Querna for Part 2 of her appearance on this the SEX WISDOM show.IMG_6200

But wait, you didn’t miss Part 1 of this conversation, did you? Well not to worry if ya did, because, like I mentioned above, all my podcasts are archived here. All ya gotta do is use the search function in the header; type in Podcast #426 and Voilà! But don’t forget the #sign when you do your search.

Katie and I discuss:

  • Sex pairings and sex role stereotyping;
  • Gayle Rubin’s “Charmed Circle”;
  • The disparity in access to reproductive and sexual health care for women and men;
  • Fear of sex and sexuality;
  • Children, teens, sex, and gender;
  • Learning is a lifelong process.

Katie invites you to visit her on her site HERE!

BE THERE OR BE SQUARE!

Look for all my podcasts on iTunes they will remain archived there as well. You’ll find me in the podcast section, obviously. Just search for Dr Dick Sex Advice.

Today’s podcast is bought to you by: Dr Dick’s Stockroom.

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Teenage Sexual Assault

Name: TC
Gender: Female
Age: 13
Location: indiana
I really dont know that much about sex, so i let my boyfriend do it all. He keeps calling me a scardy cat cuz i wont touch his dick or give him any pleasure, and he is getting really bored with me

I am so sorry to hear of the trouble you are having with your boyfriend. Actually, he’s no friend at all. Real friends honor their friend’s limits and boundaries, and he’s not doing that.

You can’t be expected, at your tender age, to know much about sex. Hell, you don’t even sound like you are particularly interested in the topic. You don’t mention your boyfriend’s age, but it sure sounds like he is way more advanced than you, at least when it comes to his interest in sex. Unfortunately, he’s not so advanced that he’s man enough to leave you alone when you ask him to. And that really makes me angry. Bullying, belittling or harassing someone for sex, particularly when it’s clear that person is not ready or not interested is abuse. And that is never a good thing.

I hasten to add that in the eyes of the law he is a criminal. He is taking advantage of an underage person for his own sexual gratification and that’s against the law. If you guys get busted, there will be hell to pay.

I know the kind of pressures you are experiencing. You want a BF and you want your BF to like you. But if you let him take advantage of you, it’s not the same thing as him liking you. It’s more an indication that he’s focused on his needs and desires, not yours. I don’t think his behavior indicates he cares for you, but he is showing you that he has power over you and is able to manipulate you into doing what he wants. And what kind of relationship is that?

Listen, TC, you don’t have to submit to him. You can stand tall and tell him NO. He will, in the end, respect you more for your courage to defy and deny him than if you just cave in to his will.

I’m not sure I know what you mean when you say that you “let your boyfriend do it all.” But it sure doesn’t sound like a good thing to me. If he’s having his way with you, even though you are being very passive about it, doesn’t make it right. I hope this isn’t how you intend to interact with other males who will come into your life in the future. And there will be plenty of them. If they sense that you are weak and vulnerable, you will be a goner for sure. You could easily wind up being a victim for the rest of your life. Please, TC, don’t let that happen to you.

I know you’d probably rather be thinking about a lot of other stuff at this time in your life, but the situation with your BF demands that you grow up fast and get savvy about the fundamentals sex right away. I’ll have a number of resources for you in a second, but I can’t emphasize enough how important it is for you to wise up about pregnancy protection. I wish I didn’t have to say that to you, but I must. If you are being sexually active, even if you are just letting your BF do everything, you absolutely must protect yourself from an unwanted and unplanned pregnancy. If you don’t you will find that you will be the one having to deal with the consequences. If your BF is not considerate enough to respect your wishes when it comes to sex in general, you know for sure that he’ll not be around to look after you and your unborn child.

Ok, here are those resources I mentioned. Planned Parenthood, SCARLETEEN, Sex Ed 101 and Midwest Teen Sex Show.

Promise me that you will take this seriously. That you’ll not just roll over (literally or figuratively). Promise me that you will respect yourself and take a stand and not allow your BF to manipulate you into anything you don’t want to do. More hangs in the balance than you can comprehend. You’ll have to trust me on this.

One last thing, if you were wise enough to find my sex advice website and you were mature enough to write to me, then I believe you are strong and resourceful enough, despite your tender age, to stand up to your BF. Do it now. Demand that he respect you, your body and your wishes.

Good luck