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Entries in adolescence (7)

Wednesday
Apr032013

What’s the Connection (If Any) Between Adolescent Drinking and Rape and Violence?

@RHRealityCheck

When two adolescent boys were found guilty earlier this month of raping a teenage girl in Steubenville, Ohio, there was much discussion about rape culture, social media, and whether taking advantage of a passed out girl is just boys’ nature. Many media reports highlighted the drunken state of many of the kids present at the rape, and some argued that the girl’s drunkenness made her at least partially responsible for the abuse she suffered. Meanwhile, the boys’ drunkenness either was not mentioned at all, or was seen as making them less responsible for the attack.

One thing that didn’t elicit much disagreement was the issue of teenage drinking itself. “Where were the parents?” was a frequently asked question. “Why were these kids allowed to drink?” Alcohol and bad parenting, many people agreed, were the real culprits of this rape.

But is that really true? Does alcohol lead to rape and violence? And are parents responsible for adolescent drinking?

The answers to these questions are less straightforward than one might expect.

It is certainly true that a large proportion of violent crimes involve alcohol use. This has been attributed to a variety of factors, including the fact that alcohol inhibits self-control and limits the ability to assess risk, and the fact that some people consume alcohol in preparation for their involvement in violent acts because they believe it will make them braver and stronger.

It is also true that people under the age of 21 consume alcohol regardless of the legal U.S. drinking age, and that many young people binge drink, that is, drink a lot of alcohol over a short period of time.

Younger adolescents are, however, less likely to be involved in alcohol-related violence than they are to be involved in any other violent crimes. And when you look at violent crimes committed by a male perpetrator on a female victim, there is no significant difference between the proportion of women attacked by men under the influence and the proportion of women attacked by men who did not appear to be drunk.

In other words, the fact that a man drinks does not make him any more or less likely to attack a woman.

The influence of parenting and parental drinking on teenage behavior is also not a straight shot when it comes to alcohol and violence. While adult binge drinking in the larger community is a strong predictor for binge drinking in teenagers and college students, parental problem drinking is not—or at least not directly. To summarize a number of quite complex family studies, drinking is not a problem for adolescents in and of itself, though it is obviously not healthy in excess. Rather, the problems are how they drink, how (not if) they see their parents drink, and what they learn to do generally about their emotions and conflicts.

Parenting matters, but, especially for older teenagers, so do peer pressure, societal norms, and genetic susceptibility to using alcohol.

My motivation for looking into the correlation between these issues is not merely academic. I come from Denmark, a country where alcohol use is normalized, even celebrated, among citizens, including teenagers. As I recall it, the main drink served at high school dances back home was beer. Did that make us rape each other? My recollection is that it did not.

This recollection seems to be substantiated by facts. In a recent survey of industrialized countries, Denmark topped the teenage drinking list, while the United States came in last. But rape estimates from Denmark and the United States suggest that women and girls are equally likely to be raped in both countries, or even slightly less likely to be raped in Denmark than in the United States. To put it differently, drinking more does not make Danish people rape more.

My point is not to say that alcohol was irrelevant to the Steubenville rape case. Obviously, the girl’s alcohol-induced unconsciousness enabled the crime in some way (not that it at all excuses the violent acts). I am also not trying to exonerate these teens’ parents of responsibility. I would like to think we have some influence over our children’s sense of right and wrong, and by that I include the notion that we have a responsibility to help people who cannot help themselves.

I do take issue with the notion that alcohol and bad parenting are what caused this crime. Alcohol is a poisonous substance that does damage to your health when consumed in large or even not so large quantities. Bad parenting has much the same effect. But neither ensures that you will commit a crime.

Thursday
Oct182012

It's Official: The HPV Vaccine Will Not Turn Girls Into "Sluts"

@RHRealityCheck

On October 15, the New York Times reported that adolescents who are vaccinated against human papillomavirus (HPV) aren’t more promiscuous than those who don’t get vaccinated. HPV is a sexually transmitted disease that raises the risk of some cancers. It’s not surprising that a vaccine has no effect on adolescent sexual behavior. What is surprising is that fear of “sluttiness” is the number-one reason parents decide not to vaccinate their kids against HPV.

Put another way: A large proportion of parents in the United States are more afraid of their kids having sex than they are of their kids getting cancer.

In fact, “slut-shaming” and negative messaging about female and non-straight sexuality could themselves be compared to a viral infection. A study published in November 2011 found that nearly half of students in grades seven through 12 experienced sexual harassment, and that most of the harassment is directed at girls for being either “slutty” or “prudes” or against kids who are suspected of being gay.

Seeking to shame someone because of her or his real or perceived sexual activity and desire is prevalent among teens and constitutes a type of bullying that is extremely damaging. The 2011 study noted that students reported being particularly negatively affected by slut shaming. Research consistently shows that LGBTI youth have a much higher rate of suicide or suicide attempts than the general population, with a strong correlation between depression or self-harm and gay bashing.

But teenagers are not solely responsible: Slut shaming and gay bashing originate with adults. I don’t mean just adults who tell children that all sex outside marriage is bad or consign LGBTI kids to celibacy, or banish them to hell. I mean adults who refuse to have a real conversation with teenagers about sex and all that comes with it—good or bad. The sex-negative culture we have created by not having real conversations about sex and relationships affects everyone.

Here’s how:

When we tell adolescents that sex is not something they should desire or like, we are telling them to set aside their own experiences in favor of a lie. Spoiler alert! A study looking at trends in premarital sex from the 1950s until now shows that the majority of Americans have sex before marriage. One of two things happens next, and sometimes both simultaneously:

On one hand, adolescents stop listening to the adults who tell them scare stories, because they see for themselves that the adults are wrong. Not everyone who has sex before marriage gets pregnant, contracts AIDS, or dies. And sex can feel amazing. When the adolescent-adult relationship is breached, children can lose their lifelines to trusted adults, who could have guided them through the mess that is puberty.

And some kids start doubting their own instincts. When we tell them that something that feels good to them is “bad,” they start thinking they, themselves, are bad. In this sense, slut shaming creates a culture of self-hatred in which girls in particular are only too willing to see themselves as deserving abuse.

It‘s crucially important that we teach children to trust their own feelings about sex and relationships. Instead of telling teenagers not to have sex at all—a completely outlandish notion in a post-post-Madonna world—we need to acknowledge that sexual desire exists, and that consent, not shame, is key. Only a teenager who is taught to respect and acknowledge his or her own feelings will know when touching feels wrong, and therefore when they need to say no. This is one of the few things my parents got right. My mother told me more than once that the only rule about sex in our house was that I should never have sex I didn’t want to have.

Slut shaming and gay bashing come from the same place: adult discomfort with sex. This can translate into adolescent date rape, teenage pregnancies, and sexually-transmitted-infection rates that are through the roof for those under the age of 24. Shaming someone for having sex that he or she wants to have constitutes bullying and teaches teenagers to ignore their own feelings about sex, potentially pushing them to unprotected and unhappy encounters.

In short: The sex-negative culture that has parents denying their children access to cancer prevention is the same culture that may expose these children to a sexually- transmitted, cancer-inducing virus. It’s time to get real about sex.

Friday
Oct122012

Teenagers Have Sex: Deal With It

@RHRealityCheck

This week, a two-year-old program allowing New York City schools to distribute emergency contraception (EC) in high schools finally made news, and not in a good way. Though schools allow parents to “opt out” of the program, some parents say they should have been asked to “opt in.”

This would make it even harder for kids to access EC (sometimes known as the “morning-after” pill). This is a serious mistake. I don’t think parents should be asked at all. They should be informed when their child enters high school that EC is available, and again if or when their daughter needs it. The health professional should also have the option of not informing parents at all, if the child expresses compelling reasons not to do so.

First, some context for how the program was conceived and implemented.

New York State has the eleventh-highest teenage pregnancy rate in the nation, with almost 60 pregnancies per 1,000 girls, ages 15-to-19 each year. Thirteen percent of U.S. teens have had sex at age 15, and about 70 percent by the time they are age 19. In New York State, approximately 40 percent of high-school students are sexually active. While 85 percent of teenagers say they use contraception during their first sexual encounter, contraception has been known to fail (and teenagers have been known to exaggerate.) Then there are the remaining 15 percent (plus) who don’t use any protection.

Clearly, high school—and potentially middle school—is ground zero for prevention. New York City has stepped up to the plate in recent years with the morning-after pill program and a city-wide sex-education mandate.

The teen-pregnancy rate in New York and other states with similar rates is not likely to drop anytime soon. A month ago, a New York Civil Liberties Union report on sex education in New York state revealed how little and how poorly students are being prepared for the sex they are having. And at what cost. Those under the age of 19 account for approximately one-third of all newly diagnosed sexually transmitted infections in the state. And not surprisingly, teen mothers are much less likely to graduate from high school than their peers who are not pregnant.

Here are a few other thoughts on why comprehensive sex education should be mandatory, and the morning-after pill available to all high-school students, regardless of where they live.

  • Many teens have sex, whether you tell them about it or not. And telling them not to have sex definitely does not work. Abstinence-only sex education has been proven to fail time and again. My devoutly Catholic adoptive mother, a lifelong education professional, told me more than once that working in middle schools made her want to stand in the hallways and hand out condoms.


  • The majority of teenagers, especially younger ones, do talk to their parents about sex. Those who do not usually have good reasons not to. Studies have shown that kids are very good at predicting their parents’ reactions. Even those who do talk to their parents don’t always get the full picture. More than three-fourths of teenagers don’t know how to bring up sexual-health issues that their parents haven’t already addressed. If parents do not bring up the morning-after pill or any other contraceptive option, teenagers may have to depend on piecemeal (and often incorrect) information from peers.

     
  • The morning-after pill safely prevents pregnancy after a condom has broken; after a sexual encounter in which the partners were too embarrassed to ask about contraception; after rape; or in any other emergency. But the morning-after pill is effective only when used within a narrow time frame. If EC is readily available in schools, it can speed up the process.

The fact is, I can't imagine what would possess a parent to prevent his or her child from accessing information or health care they might need.

More important, I don’t believe parents have the right to do so. Children are entitled to be heard, and to have their interests protected. If there is anything I have learned from interviewing teen mothers across the Americas, it’s that we cannot assume that parental decision making in the area of sexuality is always in the child’s best interest.

I am not a disinterested party. My daughter, if things go as planned, will be a New York City high-school student in five years. Statistically speaking, she is likely to have sex at some point shortly thereafter. I want her and her classmates to be able to negotiate safe, consensual, and enjoyable sex. I want her to have access to the morning-after pill as soon as possible, should she need it—whether at school or over the counter at the pharmacy.

The real news flash of the week should have been: Teenagers have sex. Deal with it.

Wednesday
Apr112012

Deserving vs. Undeserving? Everyone "Deserves" Human Rights

@RHRealityCheck

Most of the issues highlighted during this year’s run-up to the US presidential election are framed in terms of separating the deserving from the undeserving. Abortion for rape victims, but not those who want to have sex. Immigration for the politically persecuted, but not those who move across borders because they need to find a job. Marriage benefits for those who have sex with the right people in the right way.

This debate misses the point in two key ways.

At the most basic level, the issues at hand are basic human rights and not dependent on who "deserves" what: we have a right to access to abortion, health care, work, and freedom and movement because we are humans, not because we deserve it.

But also as a political process, it is ineffectual to focus policy debates on whether or not specific people deserve the services and public goods they clearly need.

I was reminded of this the other day as I was boarding a plane and the flight attendant asked me about the meaning of my t-shirt which read: “Immigration is the sincerest form of flattery.”

"But does that mean you are for it or against it, though,” he asked. I was stumped for words.

Immigration is a reality, just like so many other issues people insist on declaring themselves “for” or “against.” Abortion, adolescent pregnancy, sex outside marriage, sex work, identifying as lesbian, gay, bisexual, transgender, or intersex… the list could go on.

None of these issues is fringe. One in three women in the United States will have an abortion by the age of 45. Every year, 750,000 girls between the age of 15 and 19 get pregnant in the United States. Ninety-five percent of all Americans have sex before they get married (or have sex and may never get married). While it is difficult to estimate the number of sex workers, the National Task Force on Prostitution estimates that over one million people in the United States have worked as sex workers. And a 2011 study shows that almost 9 million adults identify as lesbian, gay, bisexual,transgender, or intersex, i.e. about 4 percent of the US population. As for immigration, very few people in the United States do not trace their ancestry—even their recent ancestry—to immigration.

But more to the point, none of these issues will change through declaring them good or bad. The focus for a policy maker should be how to generate policies that most effectively guarantee the maximum level of welfare and human rights-enjoyment for everyone. And from that perspective, whether someone is “deserving” or not is irrelevant.

Abortion and adolescent pregnancy numbers depend on access to comprehensive sex education and contraception. Choices about sex work and immigration to a large extent depend on available work and whether individuals are able to provide for themselves and their families in any other way. And those who believe they can change someone’s sexual orientation or gender identity just by saying they “don’t believe in homosexuality” are more delusional than most. Even those who make a career out of not believing in homosexuality can’t change their own (completely legitimate) sexual orientation.

There is, of course, an enormous difference between the issues high-lighted here: some are medical procedures, some life experiences, some innate traits. However that may be public policy on health, sexuality, immigration, and employment should not be designed to punish us for being who we are or for doing what we feel we need to do, but rather make sure everyone is equally empowered to make the best choices for themselves.

Tuesday
Feb072012

New Pornography Regulations In LA: Are They Addressing the Right Problem?

@RHRealityCheck

On January 25, the mayor of Los Angeles signed regulation that requires the use of condoms by all performers in adult movies filmed within the city’s borders. The regulation conditions the issuance of film permits for adult movies on compliance with existing California worker safety rules, which already require barrier protection for workers exposed to blood and other potential contaminants (including semen). The ordinance spells out what these state safety rules mean in the context of the adult film industry, and requires producers to pay enough for film permits to finance workplace safety inspections.

Public health advocates have not surprisingly celebrated the regulation. Adult film producers have equally predictably been less enthusiastic, citing safe sex films as being less popular with viewers and actors alike, and threatening to move their filming elsewhere. This would not be too hard since the ordinance applies only to Los Angeles City and not to the broader Los Angeles County.

But there are other reasons the ordinance may not be as effective as one might hope.

The first is that fewer adult movies are filmed and produced professionally than was the case ten years ago. Over the past decade, free internet sites driven by home videos and other amateur content have taken over a growing slice of the porn image and film market. While it is clear that these sites are not posting free content for philanthropic reasons—indeed, online porn is said to be worth $5 billion a year—it is equally clear that the majority of US-produced porn content streamed online is not and will not be subject to filming permits.

As a corollary to this, the ordinance will not be very effective at influencing the overall depiction of sex in imagery and media. This outcome is all the more lamentable because encouraging condom use is so important. Let’s look at the facts.

Fact number one: young people in the United States act particularly clueless about the cause-and-effect links between unprotected sex, the spread of sexually transmitted infections (STIs), and unplanned pregnancies. In the United States, about half of the 19 million individuals newly diagnosed with an STI every year are between 15 and 24 years old. In addition, about 800,000 girls and young women between 15 and 19 years old get pregnant every year, mostly unplanned. Only about 60 percent of sexually active high school students say they used a condom during their last sexual encounter.

Fact number two: frighteningly few teenagers and pre-teens in the United States receive effective information and guidance about sex, despite the fact that 9 out of 10 kids in public secondary schools will receive some form of sex education at least once during their time from 7th to 12th grade. This is partially due to the fact that the federal government has invested several billion dollars in abstinence-only programs since 1997, including $5 million in the 2012 federal appropriations bill alone. Abstinence-only sex education teaches sexual abstinence until marriage as the only viable option for teenagers to avoid STIs and pregnancy. Under this logic, condoms are not only ineffective but also immoral because they “make” teenagers have sex. (Study after study has proven abstinence-only sex education to be ineffective at best and harmful at worst).

Fact number three: the internet is where kids go for the information they feel they need, including about sex. Successive Youth Internet Safety Surveys have shown that children between 10 and 17 years old are increasingly exposed to sexual content on the web, and, in fact, that to a growing extent they seek this content out. This is not surprising. Teenagers will always be curious about sex, and the availability of internet viewing on portable computers and other mobile devices such as MP3 players makes it easier for them to seek out sexual content in privacy.

The scary bit is that those children and adolescents who depend on the internet for information about sex—that is, those who do not receive effective sex education at school or at home—are more likely to be influenced by what they see. Already a desk study commissioned by the US Department of Health and Human Services notes that the general effects of pornography on the viewer include more permissive sexual attitudes, including a heightened tolerance for unprotected sex.

Which brings us back to condom use in pornographic movies and imagery. We cannot really prevent children from seeking out or inadvertently being exposed to explicitly sexual content online, including from porn sites. And we cannot mandate parental support for comprehensive sex education or even just an understanding attitude towards sex. As a result, if most online porn content depicts unsafe sex as the norm, a scarily large proportion of teenagers will see it as such.

We are not, however, as powerless as the Los Angeles City ordinance. We can think of creative ways to support adult content that features safe sex—for example, government-sponsored awareness campaigns or guidelines for amateur porn, potentially supported by financial incentives. And, by mandating comprehensive age-appropriate sex education in all schools, we can make sure that no teenager will have to depend on the internet for information on sex.