Sex education and birth control

The change in attitude to chastity and pre-marital sex has led to a rapid increase in adolescent pregnancy in the developed world. One survey in the United States showed that half of sexually active adolescents did not use contraception on the last occasion they had intercourse. Several hundred thousand teenagers obtain abortions for unwanted pregnancies every year in the United States.

A reason for many unwanted pregnancies is that adolescents experiment with sex to find out what it is like, or they want to feel ‘grown up’ and sophisticated. Sex education is often not widespread enough to warn them of the potential dangers. The withdrawal method of contraception (coitus interruptus), often used by teenagers, is risky; to be effective to some extent, those practising it need to know the details of the menstrual cycle, which most do not. The chance of pregnancy is high with this technique. Some sperm may leak out before the boy reaches orgasm, resulting in pregnancy. Despite the inadequacy of much current sex education , the use of contraceptives among girls of mid to late adolescence is becoming widespread, the Pill being the commonest form. Controversy exists over prescribing the Pill, because sexual problems. Others believe excessive masturbation leads to bodily weakness, lack of concentration and mental decay. Masturbation is sometimes said to be a sign of immaturity, but people who are sexually well adjusted and mature may also indulge in it.

Petting

Another form of physical sexual stimulation, which stops short of intercourse, is ‘petting’. The North American term is now widely accepted. Among adolescents petting is common, particularly when both or one of the partners is a virgin, and does not intend to have full sexual intercourse. Light petting usually involves passionate kissing and limited touching of the partner’s body. Certain zones may be forbidden, such as the breasts or genitals. ‘Heavy’ petting involves kissing, caressing of the genitals and breast stimulation; the clitoris may be stimulated to orgasm or the penis to ejaculation. Petting has an important role in the development of sexual behaviour, since it allows boys and girls to explore each other’s bodies and to communicate sexually. It is also a means of enjoying sexual pleasure without full intercourse.

Pre-marital intercourse

Although masturbation and petting are often accepted activities, sexual intercourse between adolescents can give cause for concern to parents and to the young people themselves. Pre-marital sex of any form can be distressing to those families who hold firm beliefs that there should be no sex before marriage. Other parents may have a set of values formed when sexual intercourse before marriage was totally unacceptable but petting was allowed. The attitude towards sexual relations among adolescents has changed dramatically in the last 25 years. The move came in the 1960s, and sexual intercourse between adolescents is more common now than before. The average girl loses her virginity at the age of 19; fewer than 6 in 100 women remain virgins until they marry. It is considered by many to be important for parents to come to terms with this change in values so as not to alienate their children. Parents, it is said, should make sure their children understand about birth control and where to get contraceptives. The consequences of ignorance of the ‘facts of life’ among adolescents can include unwanted pregnancies, requests for abortion, and crisis-torn families. According to law in most countries, there is a minimum age before which sexual intercourse is illegal. These laws are intended to protect children and young adolescents from the consequences of an act they may not fully understand.

In Western societies, however, older teenagers on the whole regard sexual intercourse as normal social behaviour.

Doctors sometimes have to decide whether to prescribe it for an adolescent girl. Many doctors, on religious or moral grounds, still will not prescribe the Pill. There is also the problem of how old a girl must be: should the doctor prescribe it for a 13-year-old whom he thinks too immature to understand the consequences of taking it, and he considers too young to have a sexual relationship? Or should the doctor prescribe it to prevent this young girl getting pregnant because she is probably going to have sex anyway? These dilemmas have prompted much public debate, along with whether doctors should tell, or have to tell, parents that their daughter is on the Pill. Ignorance about the use of the Pill may result in an unwanted pregnancy. Girls have been known to take two Pills in a day if they forgot one the day before. This does not work; the instructions for the several types of Pill have to be strictly followed. Evidence that some forms of the Pill may be harmful has led many girls to consider different forms of contraception. The intra-uterine device, inserted by a doctor, prevents pregnancy occurring but may have various side-effects.

Another contraceptive device is the diaphragm or Dutch cap, a thin rubber dome that the girl covers in spermicidal jelly and inserts in her vagina to cover the cervix completely before sex. A doctor should show a girl how to fit the appliance.

Sheaths (condoms) are another form of barrier contraceptive. Adolescent boys are known to dislike using sheaths, often because they are too embarrassed to buy them or are ignorant of their use. Sheaths should be used with some spermicidal cream in case they burst during intercourse.

From the girl’s point of view, it is safer to use a contraceptive rather than rely on a boy who is probably less concerned about the consequences of unprotected sex than she is.