Tag Archives: Sex Education

Talking With Both Daughters and Sons About Sex

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Parents play a key role in shaping sexual decision-making among adolescents — especially for girls.

A 2016 review of more than three decades of research found that teenagers who communicated with their parents about sex used safer sexual practices. Likewise, new research from Dutch investigators who studied nearly 3,000 teenagers found that young adolescents who reported feeling close with a parent were unlikely to have had sex when surveyed again two years later.

Notably, both research teams found that daughters benefited more than sons, and that the effective conversations and relationships were typically had with mothers.

According to Laura Widman, lead author of the review study and an assistant professor of psychology at North Carolina State University, “parents tend to talk about sex more with daughters than with sons, and we can speculate that that’s what’s probably driving these findings. Boys may not get the messages as frequently or have the kind of in-depth conversations that parents are having with girls.”

Given the results of her research, Dr. Widman said that she “wouldn’t want parents to get the idea that they only need to talk to daughters. In fact, it may be the opposite. We need to find a way to help parents do a better job of communicating with both their sons and daughters so that all teens are making safer sexual decisions.”

That parents have more frequent conversations with their daughters about sex and sexual development may be prompted by biological realities. Menstruation, HPV vaccination (which remains more common in girls than boys), and the fact that birth control pills require a prescription might spur discussions that aren’t being had with sons.

Yet experts also agree that gender stereotypes play a powerful role in sidelining both fathers and sons when it comes to conversations about emotional and physical intimacy. Andrew Smiler, a psychologist who specializes in male sexual development, noted that women generally “have a better vocabulary for talking about feelings and relationships than boys and men do. Fathers may be a little more stoic, more reserved and more hands-off.” And, he added, “they may play to the stereotype of trusting boys to be independent and able to care for themselves.”

These same stereotypes can also tend to steer the conversation in one direction with daughters and another direction with sons. When parents do address sexual topics with their teenagers, they typically adopt a heterosexual frame with boys playing offense and girls playing defense.

“We usually view our girls as potential victims who need to be protected from pregnancy and rape,” says Sheryl Ziegler, a psychologist who provides mother-daughter seminars on puberty and sexual development, while boys are often cast as testosterone-fueled prowlers looking for nothing but sex. These assumptions often drive how parents approach the conversation. Dr. Mary Ott, an associate professor of pediatrics at Indiana University and the author of a research synopsis on sexual development in adolescent boys observed that, “when parents talk with boys, there’s an assumption that they’ll have sex and they are advised to use condoms. Whereas for girls, there’s more of a focus on abstinence and delaying sex.”

Parental concern about the negative consequences of adolescent sexual activity can reduce “the talk” to a laundry list of don’ts. Don’t get a sexually transmitted infection, don’t get pregnant or get a girl pregnant and don’t proceed without gaining consent. Critical as these topics are, Dr. Ziegler points out that they can “become the focus, so much more than having a quality conversation about why we are sexual beings, or talking about all of the ways we can express love.” And failing to acknowledge the pleasurable side of sex can, according to Dr. Smiler, hurt the credibility of adults. “When parents only acknowledge the scary side of the story,” he said, “teenagers can devalue everything else the parents have to say.”

So how might we do justice to conversations with both our daughters and sons about emotional and physical intimacy?

Over the years in my work as a clinician, I’ve come to a single tack that I take with adolescent girls and boys alike. First, I prompt teenagers to reflect on what they want out of the sexual side of their romantic life, whenever it begins. Why are they being physically intimate, what would they like to have happen, what would feel good?

Following that, I encourage each teenager to learn about what his or her partner wants. I urge them to secure not just consent, but enthusiastic agreement. Given that we also grant consent for root canals, gaining mere permission seems, to me, an awfully low bar for what should be the joys of physical sexuality. Dr. Smiler adds that any conversation about consent should avoid gender stereotypes and address the fact that boys experience sexual coercion and assault and “include the idea that boys can and do say no.”

Finally, if the parties are enthusiastically agreeing to sexual activity that comes with risks — pregnancy, infection, the potential for heartbreak, and so on — they need to work together to address those hazards.

Research suggests that this shouldn’t be a single sit-down. The more charged the topic, the better it is served, and digested, in small bites.

Further, returning to the topic over time allows parents to account for the rapidly shifting landscape of adolescent sexual activity. We should probably be having one conversation with a 12-year-old, an age when intercourse is rare, and a different one with a 17-year-old, half of whose peers have had sex.

Is it better for mom or dad to handle these discussions? Teenagers “want to have the conversation with someone they trust and respect and who will show respect back to the teen,” Dr. Smiler said. “Those issues are more important than the sex of the person having the conversation.”

How families talk with teenagers about their developing sexuality will reflect the parents’ values and experiences but, Dr. Ott notes, we’re all in the business of raising sexually healthy adults.

“We want our teenagers to develop meaningful relationships and we want them to experience intimacy,” she said, “so we need to move our conversations about sex away from sex as a risk factor category and toward sex as part of healthy development.” And we need to do so with our sons as well as our daughters.

Complete Article HERE!

Why Young Men Don’t Get The Information They Need About Reproductive And Sexual Health

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Some men may not know as much about their own sexual health because women’s health dominates that public conversation.

That could be important because the Centers for Disease Control and Prevention recently reported that sexually transmitted diseases like syphilis, chlamydia and gonorrhea — all of which can be cured with antibiotics — are spreading more than ever. Gay and bisexual men and young people were particularly affected by the infection increases.

Dr. Arik Marcell, a professor of pediatrics at Johns Hopkins and the paper’s first author, said in the statement that it shows “no one particular factor is responsible for young men’s lack of engagement” in getting sexual and reproductive health care. “We need to think about working at multiple levels to effect change rather than focusing solely on the individual level, which may place undue blame on the individual.”

Study results show that the young men surveyed talk to people in their lives, like their mothers and friends, about their health but didn’t always know where to go for care. Self-consciousness also played a role in their care: “Some participants also discussed needing greater self-confidence when asking and answering questions about their health in general, especially about their sexual health,” the university said.

The authors suggest that a lack of knowledge or health care could have a gender basis: According to the study, the culture around health care in the U.S. is “focused on women’s health” and males are influenced by “traditional masculinity scripts.”

“Few men also have received sexual and reproductive care because historically, few clinical guidelines have outlined care that providers should deliver to this population, and few public health efforts have focused on engaging this population,” Johns Hopkins said.

 

Care is not the only way men lag behind women when it comes to sexual and reproductive health. Another recent study showed that men don’t know a lot about their own fertility. A survey of hundreds of Canadian men found they were generally not aware of many of the factors that could reduce their sperm counts. And the authors of that study suggested one of the reasons could be that men are not are likely as women to ask questions about their own health.

Although the new study shows men have less knowledge and receive less care than women when it comes to their sexual health, some are getting a level of care. According to Johns Hopkins, about half of the men they surveyed had health insurance and a regular source of health care, and a majority had received a physical exam in the last year. Additionally, 35 of the 70 were tested for HIV.

Complete Article HERE!

New study finds girls feel unprepared for puberty

Girls from low-income families in the U.S. are unprepared for puberty and have largely negative experiences of this transition, according to researchers at Columbia University’s Mailman School of Public Health and the Johns Hopkins Bloomberg School of Public Health. Their latest paper on the puberty experiences of African-American, Caucasian, and Hispanic girls living mostly in urban areas of the Northeastern U.S. shows that the majority of low-income girls feel they lack the information and readiness to cope with the onset of menstruation. The research is one of the first comprehensive systematic reviews of the literature on puberty experiences of low-income girls in the U.S.

The findings are published online in the Journal of Adolescent Health.

“Puberty is the cornerstone of reproductive development,” said Marni Sommer, DrPH, MSN, RN, associate professor of Sociomedical Sciences at the Mailman School of Public Health. “Therefore, the transition through puberty is a critical period of development that provides an important opportunity to build a healthy foundation for sexual and reproductive health. Given the importance of this transition, the research is striking in its lack of quantity and quality to date.”

The investigators used Qualitative Research guidelines to review the data from peer-reviewed articles with a qualitative study design published between 2000 and 2014. They used a quality assessment form as a further check of the data.

The age of breast development and menarche has declined steadily in the U.S. during the last 25 years, with 48 percent of African-American girls experiencing signs of physical development by age 8. “This trend may mean that increasing numbers of African-American girls are not receiving adequately timed puberty education¬, leaving them uninformed and ill-prepared for this transition,” said Ann Herbert, doctoral candidate at the Bloomberg School of Public Health.

Although many of the girls reported being exposed to puberty topics from at least one source—mothers, sisters, or teachers—most felt that the information was inaccurate, insufficient, or provided too late. Girls also reported being disappointed in the information they received from mothers; meanwhile many mothers said they were unable to fully address their daughters’ needs. Mothers were uncertain about the right time to initiate conversations, uncomfortable with the topic, and uninformed about the physiology of menstruation. The timing of puberty also influenced girls’ puberty experiences.

The researchers noted that despite a strong focus on adolescent sexual health outcomes, such as sexually transmitted infections and teen pregnancy, clinicians and practitioners in the U.S. have yet to capitalize on the issues of puberty onset and menstruation as a window of opportunity to improve adolescent sexual and reproductive health. In addition, the current body of research leaves out many topics entirely. “For example, missing are the voices of adolescents with non-conforming gender role and sexual orientation,” Herbert said.

Earlier research showed that irrespective of race, higher-income girls had more knowledge about puberty, were more prepared for menarche, and had more positive attitudes about menstruation, strongly suggesting socioeconomic disparities related to preparation for puberty.

“Findings from the current review suggest that low-income girls today expressed a sentiment similar to girls studied in the 1980s and 1990s—a feeling that they were largely unprepared for puberty and menarche,” noted Herbert.

“Our review makes it clear that there is a need for new more robust interventions to support and provide information about for low-income , something we are considering for the coming years,” said Sommer.

Complete Article HERE!

Caught in the modesty bind: Why women feel shy to consult doctors for their sexual well-being

By Aditi Mallick

“I was 17, when I first got sexually intimate with my boyfriend,” says Kriya (name changed), a 23-year-old IT professional from Hyderabad, while speaking to The News Minute.

“Later we were very scared, as it was the first time for both of us,” she recalls. She missed her periods that month. The 17-year old who had never once been to hospital alone, was scared and unsure of what to do next.

Trying to glean more information online just added to her worry over getting pregnant. Finally she discussed the issue with her boyfriend, and both of them decided to consult a gynaecologist.

“I was already very scared. After I told the receptionist my age, she kept staring at me. It made me so uncomfortable. While other patients were called by name, when it was my turn, she said ‘Aey, hello.…go!’ I felt so bad.

I expected at least the doctor to act sensitive. She first asked me what happened. When I told her, she started lecturing to me about our culture, and how young I am. It was a horrible experience. After the check-up, once I reached home, I burst out crying,” she shares.

From then on, Kriya has always felt too scared to discuss any sexual health problem with a gynaecologist. She is now 23, but in her view, nothing much has changed.

“Last month, I had rashes all over my vagina right up to my thigh. I just could not walk. It was painful. In the beginning, I used anti-allergic medication and antiseptic cream. But I was finally forced to go to a doctor. But even this time, I was ill-prepared for those weird looks.

The receptionist first asked for my name, then my husband’s name. For a moment, I panicked. After a pause I said, I am unmarried.”

Kriya feels that such unnecessary queries have nothing to do with a particular health problem and should not be asked: “We are adults and should not be judged for such things. After all, it is my decision. But society does not think so.”

Dr Kalpana Sringra, a Hyderabad-based sexologist agrees:“Doctors should not interfere in a patient’s personal life. But sadly, some do. A few are open-minded. They do not care whether the patient is married or not. We do at times have to ask about how frequently they have sex to ascertain the cause.”

Kalpana believes the rigid cultural restrictions and undue secrecy about anything related to sex are what makes patients uncomfortable sharing sexual health issues with their doctors.

Prapti (name changed), a 21-year old second year engineering student says: “Ï had  quite a few relationships, and faced initial problems like bleeding and pain during sex. I sometimes lose interest while having sex, due to this immense pain in the vagina.”

But she does not want to consult a doctor: “I prefer advice from friends. At least, they will not judge me.” She remembers the time she had to consult a doctor two years ago, when after having sex, the pain persisted for a whole day.

“The doctor did not even try to explain the reason. I kept asking her whether it was anything serious. But she deliberately chose to ignore me. Later I heard her murmur ‘this generation….uff’! When I shared this with my friends, I realised they too had been in similar situations.

According to Kalpana, only ten percent women come forward to consult a doctor for sexual well-being, of which the majority are planning to get married soon and want to get themselves checked for infection and related advice.

No woman ever goes to the doctor for this, unless it is absolutely avoidable. Not just unmarried women, but even married ones are ignorant in this regard. Young unmarried women are only more hesitant to ask or seek medical help, fearing society and parents, she says.

“Both married and unmarried women are not comfortable. They mostly come with their partners. To make them feel comfortable, we talk to the women alone. After a while, they open up about their problems.”

She also claims that 20% of women who suffer from vaginal infection like UTI and rashes after marriage too feel shy to discuss it with the doctor: “Men seem more comfortable discussing their sexual problems. 90% of our patients are men. But they tend to come alone.”

That was not the case with Jayesh (name changed), a 27-year old. He used to earlier hesitate to talk about his sexual health: “It was only a year back that I consulted a doctor for premature ejaculation, something that I suffered from the age of 23. I used to think if my friends get to know, they would make fun of me.”

The common issues that men in the age group of 18-80 are premature ejaculation and erectile dysfunction. “Most men confess that they force their wives to use contraceptive pills, as they do not want to wear condoms,” Kalpana says.

Gaurav (name changed), a 29-yearold unmarried man insists that he has never forced his girlfriend to use contraceptive pills, but they do sometimes prefer pills over condoms.

Gaurav who is sexually active does not feel ashamed or uncomfortable consulting a doctor, but that is not the case with his girlfriend: “Four years back, she once started bleeding after we had sex. Honestly, I was clueless how to handle the situation and whom to contact. We did not go the doctor, fearing prejudice.

My girlfriend is not at all comfortable consulting a doctor. She usually avoids going to a gynaecologist, as they ask whether we are married or not. It makes her uncomfortable. It happened a few times with us in Hyderabad. That’s why sometimes she prefers to use emergency contraceptive pills rather than consult a doctor.”

“Sex jokes are allowed, but people are otherwise shy talking about sex. Parents do not talk freely on the topic. It is still a taboo for Indian society,” Gaurav remarks.

When Preeti (name changed) -who is now doing an event management course- was in her final BCom year, she led an active sex life:

“I went for a party and got drunk. That night my friend and I had sex. I did not then realise that we had forgotten to use a condom. After missing my periods, I freaked out. I was confused and went to see a doctor. They first asked if I was married. I lied.”

She also admits to feeling uncomfortable while buying I-pills, condoms or pregnancy test devices: “Once a medical shopkeeper asked whether it was for me, with those around giving me judgmental looks.”

Fearing societal disapproval, several unmarried women tend to take medications, after consulting the internet.

“They go to medical stores or send their partners to buy medicines without consulting a doctor. Emergency contraceptive pills have several side-effects like, dizziness, vomiting etc. Some even try to abort through pills, which is life-threatening and can affect their health in the long run,” warns Kalpana.

Complete Article HERE!

Sexual Health

from Health World Education

Publish – Sexual Health – Trailer from Health World Education on Vimeo.

Publish – Sexual Health – CHAPTER_01 – 12/16/16 from Health World Education on Vimeo.

 

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