Indian Fertility Centers Offer Hope, But at What Price?

Robin Marty

As India expands its reputation as a fertility center, woman over the age of 60 are becoming the newest clients, and potentially casulties, in a quest for heirs.

The desire to have a baby is something that is ubiquitous to all cultures, although the societal pressures driving it may be different in some regions than in others. 

When it comes to infertility treatments in America, often the controversial issues tend to center around how many embryos should be implanted or encouraged, as was seen during the great Octomom saga of last year.  But occasionally, you will hear discussions of at what age it becomes too difficult or risky for women to try and have babies, as many have discussed in regards to the recent pregnancy announcements of Celine Dion and Kelly Preston.

With the newest developments in science, women can have babies far later than they could a decade ago.  And as fertility treatments continue to advance, that age will advance, too, with the help of donor eggs, donor sperm, surrogates and other support.  But should it?  It appears to be a question everyone has an individual answer, until a specific age is proposed.

And in this case, that age is 66.

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Bhateri Devi is by no means the first case of a 66 year old woman giving birth, although she is the first to birth triplets.  One Romanian woman gave birth at 66 in 2005. A British woman in 2008 also gave birth at 66 after going to a clinic in the Ukraine. And in 2006 a 66 year-old Spanish woman gave birth to twins after telling a California fertility clinic that she was only 55 years old, their maximum age for treatment.

The risks are high for both the women and the fetuses, and in countries like the United States and the United Kingdom, the costs can be overwhelming.  But as Nicole Broomfield reported earlier this month, India has transformed itself into a haven for reproductive tourism, providing such low cost options for surrogates and egg donors that some are now looking into allegations of human rights violations or, at the very least, a definite taking advantage of financially struggling women.  Services that can cost tens of thousands of dollars locally can be purchased in the country for as little as a few thousand dollars, and with little oversight many boundaries can be pushed – especially those of age.

It’s easy access to lower cost fertility treatments combined with a cultural and religious need to provide offspring, especially sons, that is moving invitro fertilization into dangerous grounds in the country.  Those two conditions together may best explain the fact that many of the most recent extremely advanced maternal-aged mothers in the last few years are coming from India.

First, there is the oldest documented mother, India’s Omkari Panwar.  Reported to have given birth at the age of 70 (although records are unclear), Panwar conceived twins with an IVF procedure that cause her family to spend their entire savings and take out a loan.  One twin was the boy they desperately wanted as an heir, in order to pass on the family name, have someone to perform funeral rites, and inherit the land. 

Now, they have a boy to carry on their legacy.  They also have no money, and a “burden” of a daughter to deal with, as well, according to the Times Online.

Mrs Panwar said: “We paid all this money to the doctors for a son, but now we have the extra burden of another daughter as well.” Mr Singh, meanwhile, is realistic that his son is unlikely to ever be in a position to support his parents – he said he wanted a boy to carry on the family name and to inherit the family plot of land.

Just a few months before Panwar, Rajo Devi Lohan, another Indian woman, also gave birth at the age of 70.  In Lohan’s case, the Telegraph reports, many precautions were taken to reduce the risk, especially to guard against multiples.

[Dr Anurag Bishnoi] said his parents and wife, all doctors, performed the procedure together. “The major concern for us was that in case the woman conceived twins, she may not be able to carry them through the full term of pregnancy. In that case, all over efforts would have failed and the woman’s life would have been in danger,” Bishnoi said.

To avoid multiple pregnancies, the doctors used blastocyst culture, where a single potential embryo is transferred to the uterus instead of the normal two to three embryos. “This embryo is transferred after five days in this technique, while in normal cases it is done in two-three days,” he added.

Although she attended the same clinic and had the same doctor, Tha Indian says that those same safeguards were not in place for Bhateri Devi. 

“Bhateri Devi was coming to us for the last many months for the treatment. She has become mother for the first time and conceived only in our third attempt through IVF technique,” [Anurag Bishnoi] said.

“For the first two attempts, only two embryos were transferred in each cycle. But in third attempt three embryos were transferred in her uterus, resulting in the birth of three children by a caesarean process.”

So what happens to the women who have pushed themselves (or perhaps been pushed) to give birth so late in life?  The Spanish woman who lied about her age died three years later, possibly of a tumor, and left her boys orphaned. Lohan’s family, like Panwar, is destitute, having spent all of their money on treatment.  Also, Lohan is likely dying of complications according to the New York Daily News, allegedly too weak to recover from her daughter’s birth, although her doctor claims there is no relation between the two.

Her doctor, Anurag Bishnoi, denied there was any connection between her pregnancy and her illness and instead emphasized how important Naveen’s birth had been for Lohan. “She does not have to face the stigma of being barren,” he said.

While Lohan may not live to see her daughter’s second birthday, for now she has no regrets.

“I dreamed about having a child all my life,” she told the Daily Mail. “It does not matter to me that I am ill, because at least I lived long enough to become a mother.”

The stigma of being barren.  Not leaving behind an heir.  These are great fears in Indian society, and Bishnoi’s clinic seems to cater to these fears to entice clientele.  “Becoming parents (parenthood) is the greatest pleasure of life and thus procreation is considered as a basic ‘civil right of man’ (U. S. Supreme Court),” his website declares

[U]nfortunately there are millions of infertile couples who fail to procreate and thus cannot have this pleasure. We salute those women who endanger their lives when opting for IVF for becoming mother and getting rid of the stigma of infertility[emphasis added]. Becoming pregnant at advanced age has its own hazards. National Fertility Centre has given the best results by blessing Infertile couples of advanced age with children — these couples could never dream of becoming parents.

The site touts the extremely advanced maternal age success stories.   “[I]f the lady has uterus, she can become mother,” it boasts.

Any lady with a uterus can become a mother.  But at what cost?  Financially, very little, although it is enough to reduce the local population to ruin in order to participate. 

Physically, however, the costs are enormous, and the price for one heir seems to slowly be rising to the life of one mother.

Analysis Abortion

Ideological Crisis Pregnancy Centers Receiving Hundreds of Thousands in Federal Funding

Sofia Resnick

Federally funded crisis pregnancy centers bring mazes, game shows, and questionable health information to teens.

Published in partnership with The American Independent

To bring down the high rate of chlamydia among teenagers in Tennessee, an anti-choice pregnancy center in Athens, Tenn., has proposed spending federal tax dollars on a life-sized version of the Game of Life.

The “Teen Life Maze” is just one of the ideas put forth by a cluster of crisis pregnancy centers that are receiving government grants to conduct abstinence education as part of President Obama’s health-care reform law.

Records obtained by The American Independent show that the government is paying for abstinence programs run by centers that promote dubious medical information. For example, crisis pregnancy centers (CPCs) receiving funding through the program claim that “reliable studies” have shown a link between abortion and breast cancer.

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One of the centers says it seeks to help students understand “the lack of effectiveness of condoms/birth control in STD protection and pregnancy.”

TAI previously reported that a South Dakota anti-abortion CPC that requires its volunteers to be Christians received funding under a program created by Obama’s stimulus bill.

Between 1996 and 2009, taxpayers spent more than $1.5 billion on abstinence-only education, paid for by federal grants and state matching funds, according to the Sexuality Information and Education Council of the United States (SIECUS). In 2004, Rep. Henry Waxman (D-Calif.) released a report that found that these programs often contained false or distorted information about sex and reproductive health, such as claiming that condoms have a high failure rate at preventing HIV and pregnancy, women who have abortions have a high risk of becoming sterile, and HIV can be transmitted through sweat and tears.

Shortly after taking office, Obama moved to cut off federal funding for most abstinence-only education.

However, during the intense negotiations over the health-care-reform bill in 2009 and 2010, Congress attached a $250 million grant program for abstinence-only instruction (granting up to $50 million annually, through 2014). Under the program, state health departments apply for abstinence funding and can then allocate sub-awards to various organizations across the state, including county health departments, schools, community groups, and faith-based nonprofits.

So far, at least three anti-abortion CPCs have received funding through this provision. They’re all in Tennessee, which has the nation’s 11th highest teen birth rate, according to new data from the Centers for Disease Control and Prevention (CDC).

In January, the Tennessee Department of Health announced it was dividing $3.2 million in abstinence funding among 13 agencies through 2014 to “support comprehensive, evidence-based and medically accurate community-based education programs.”

A total of about $650,000 of that money was awarded to the three CPCs: Full Circle Women’s Services in Athens, Life Choices Pregnancy Support Center in Dyersburg, and Women’s Care Center of Rhea County, Inc., in Dayton. Per the terms of the grant program, each grant recipient has to match 75 percent of the award.

When they’re not teaching teens not to have sex, these centers are seeing women – sometimes teens – facing unplanned, and often unwelcomed, pregnancies. They seek to discourage abortion, offering women various services including counseling and free pregnancy tests. The websites of two of the centers – Full Circle Women’s Services and Life Choices Pregnancy Support Center – feature an array of misinformation about abortion, including claims that abortion causes breast cancer and depression.

Despite widespread rejection of an abortion-breast cancer link from major medical institutions such as the American Cancer Society, the American Congress of Obstetricians and Gynecologists, and the National Cancer Institute, these CPCs continue to mislead women on this connection, claiming on their websites that “a number of reliable studies have demonstrated connection between abortion and later development of breast cancer.”

According to the American Cancer Society, “At this time, the scientific evidence does not support the notion that abortion of any kind raises the risk of breast cancer or any other type of cancer.”

Both Full Circle Women’s Services and the Women’s Care Center are affiliated with Care Net, a national network of crisis pregnancy centers that prohibits its members from recommending, offering, or referring “single women” for contraception.

Whereas proponents of comprehensive sex education encourage teaching teens how to protect themselves against unplanned pregnancy and diseases while acknowledging that condoms are not guaranteed to work 100 percent of the time, abstinence-education advocates often claim that teaching about proper condom use offers young people a “false sense of security.”

On their websites, Full Circle, Life Choices Pregnancy Resource Center, and the Women’s Care Center cite identical statistics emphasizing what they portray as the lack of effectiveness of condoms. These centers tell readers that “consistent” condom use during vaginal sex reduces the risk of “HIV by 85%”; human papillomavirus “by 50% or less”; and gonorrhea, Chlamydia, herpes, and syphilis “by about 50%.” The statistics come from various studies compiled by the Medical Institute, a nonprofit organization whose advice for preventing STDs is: “Avoid sexual activity if you are single. Be faithful to one uninfected partner for the rest of your life.”

Richard A. Crosby, a professor and chair at the Department of Health Behavior at the University of Kentucky College of Public Health, told TAI that these statistics are misleading.

“These are not statistics that are widely supported by the literature,” Crosby said. “They are confounded by a lack of accounting for the correct use of condoms. Consistent use alone is not enough. … When you do not account for the correct use, you have an underestimate of the effectiveness.”

Crosby, who has received federal grants to conduct research on HIV prevention, is currently working on a “highly controlled, rigorous” study funded by the National Institutes of Health to determine the value of consistent and correct condom use in preventing three common STIs: Chlamydia, gonorrhea, and trichomoniasis.

“All of these numbers are way low,” Crosby said, referring to the pregnancy centers’ statistics (with the exception of the rate of condom-use effectiveness at preventing HPV, which he said is supported by studies). He said the claim that condoms are 85 percent effective in reducing HIV infection is “really misleading” and not supported by many research studies that isolate for consistent and correct use.

“Innovative Approaches”

Full Circle Women’s Services – awarded $154,200 – is the anti-abortion pregnancy center that proposed trying to curb teen sex with a giant “Teen Life Maze.” The center cited the game as one of its “innovative approaches” to abstinence instruction in a grant application submitted to the Tennessee health department in May 2011. The maze is described as:

“[a] large game board of rooms designed to let teens experience the consequences – both positive and negative – of life choices. It is effective in that teens get to play along in seeing firsthand the results of good decisions and bad decisions ranging from making trips to the doctor for a lifelong STD or the satisfaction in staying on course and graduating from high school.”

In a subsequent document, the center explained that inspiration for the game comes from Georgia, where life mazes have been hosted in several schools across the state, and that Full Circle was “in the planning stages of bringing this event to Athens.”

Other innovative approaches proposed by Full Circle include hosting a game show about the risks of having sex and screening the film Look Before You Leap, described in the proposal as “an adrenaline rush of drama, action, and humor that takes relationship education to extreme heights.”

Full Circle, founded in 1998, has been offering privately financed abstinence-education services to mostly elementary and middle schools in McMinn County for a few years now. In its grant proposal, the center explained that the extra cash would be used to hire more educators. Currently, the center’s program, called On TRAC (Teaching Teens Responsibility and Consequences), relies on abstinence curriculum called “Think on Point” and “Life on Point,” created by On Point, a youth-development group in Chattanooga, Tenn. 

“Think on Point” is a five-day program offered once a year to sixth- through ninth-graders during physical education class. According to the program description:

“[t]he curriculum includes homework assignments, in-class handouts, role-playing activities, and focused small-group discussion. … Lessons at every grade level discuss the topics of abstinence, sexually transmitted diseases, media influence, and standards and boundaries; other more specific themes include pregnancy, pornography, abuse, value and self-worth, and the essence of real love.”

“Life on Point” is designed to dig deeper into risky activities. The center also proposed bringing five-day abstinence instruction to older teens in high school life skills and health classes.

All of the abstinence-only programs funded under Tennessee’s Affordable Care Act grant had to submit short- and long-term program objectives. Full Circle Women’s long-term goals include curbing rates of teen pregnancy, school dropouts, and STDs in McMinn and Meigs counties, and also a “decrease in percentage of children being raised by single mothers below the poverty line.” Short-term goals include “increased knowledge of STDS and pregnancy risks” and “understanding the lack of effectiveness of condoms/birth control in STD protection and pregnancy.”

To make the case for giving Full Circle money to target 10-to-17-year-olds in McMinn, Meigs, and Polk counties (in southeastern part of the state), Full Circle’s grant application cited statistics showing STD rates among teens are high in the area, including “Tennessee Department of Health reports that the number of reported cases of Chlamydia in McMinn County has increased a staggering 1200% from 1994-2007.”

Full Circle Women’s Services Executive Director Anne Montgomery turned down TAI’s request for an interview.

In line with the eight-point federal guidelines of abstinence education, the other two CPCs receiving Affordable Care Act funding similarly offer plans to educate teens about the repercussions of sexual activity and advocate abstinence as the only means to avoid those repercussions. 

Here is part of how the Women’s Care Center promotes its abstinence program, called The Edge:

While “until marriage” may sound like practically forever, let’s get a little perspective on this. The average age of initial marriage in the United States is 26 years old. That gets even lower in more rural areas. And the payoff of sexual abstinence is that you have the rest of your married life to enjoy your sexuality without having to suffer the consequences of emotional baggage, crotch-crippling STDs, or teen pregnancy. That sounds to me like a pretty good deal.

Among the desired outcomes of Life Choices Pregnancy Resource Center’s abstinence-until-marriage program, Right Choices of West Tennessee, are “increased knowledge regarding the effects of teen sexual behavior and sexually-transmitted diseases” and “increased commitment to abstinence until marriage.”

The directors of Life Choices Pregnancy Support Center and the Women’s Care Center did not return requests for interviews.

Earlier this month, the CDC released new data showing that America’s teen birthrate is the lowest it has been since 1946. The Guttmacher Institute, a proponent of comprehensive sex education, credited that drop, in part, with improvements in contraceptive use.

But Valerie Huber, executive director of the National Abstinence Education Association, said high rates of STDs among teens means the abstinence-only message is still necessary.

“While teen birth rates have reached historic lows, STD rates among teens are at historic highs, so condom-centered education is certainly not sufficient to deal with even the physical consequences of sexual activity since 2 of the 4 most common STDs are easily transmissible with a condom,” Huber told TAI in an email. “Sexual Risk Avoidance (SRA) abstinence education makes sense from a public health perspective and also as an approach that both resonates with teens and protects them from any of the consequences of sexual activity, not the least of which is pregnancy.”

Analysis Sexual Health

Teen Sex: Who? What? When? And What Would Change Look Like?

Martha Kempner

This article is part two in a series on facts and realities of teen sexual behavior in the United States.  Here, we take an even closer look at what the data in a recent report is telling us about teen sexual behavior.

Part One of this series, “More Teen Virgins? Not So Fast!,” examined new data on teen sexual behavior and suggested that the media’s fascination with the rising number of virgins is off-target at best.  As promised, in Part Two, we will start by taking an even closer look at what the data is telling us about teen sexual behavior. 

When, Who, and How Often Do Teens Have Sex

The question of “when” teens have sex most often refers to the age at which young people begin having sex.  Again, even though they are one demographic for the purposes of most surveys, when it comes to societal acceptance of their sexual behavior, 15-year-olds and 19-year-olds are nothing alike.  In fact, even teens themselves have different standards based on age.  Teenagers in the U.S. found that 68 percent of male teenagers and 60 percent of female teenagers agreed that it was okay for unmarried 18-year-olds to have sex if they have strong affection for each other, but only 39 percent of males and 27 percent of females said the same about 16-year-olds. (To give teens credit for behaving true to their beliefs, the percentages of teens that are having vaginal intercourse at 16 match these numbers pretty well.) 

Of course, we all hear stories about super-young teens having sex, which send shivers down the spines of middle school parents everywhere, but for the most part it is not the youngest that are having sex. Sexual Behavior 20062008 found that the proportion of females who had engaged in vaginal sex rose steadily as they aged; 23 percent of 15-year-olds, 34 percent of 16-years-old, 44 percent of 17-year-olds, and 62 percent of 18- to 19-year-olds.  The numbers are similar when it comes to oral sex which jumps from 23 percent among 15-year-old girls to 63 percent among females ages 18 and 19.  Males also become more experienced with age.  The percentage of males who have had vaginal intercourse jumps from 21 percent at 15 to 66 percent at 18 and 19, and whereas 27 percent of 15-year-old boys have had oral sex, by the time they are 18 and 19, 70 percent have done so.

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As for the “who is having sex,” or more accurately “whom they are having sex with,” believe it or not, most teens are experimenting with sex in the context of a relationship.  While today’s teens are portrayed as unable or unwilling to really bond with another person and interested in sex but not relationships, the data suggest otherwise.

In fact, only 14 percent of females and 25 percent of males described their first partner as “just friends” or someone they had just met.  And, according to Teenagers in the United States the most common first partner for vaginal intercourse (for 72 percent of females and 56 percent of males) is someone with whom they were “going steady.” According to the National Survey of Sexual Health and Behavior (NSSHB), more than two-thirds of females 14 to 17 reported that the last time they had received oral sex, given oral sex, or had penile-vaginal intercourse their partner had been a boyfriend/
girlfriend. A substantial proportion of males (49 percent), however, did report receiving oral sex from a partner other than a boyfriend/ girlfriend. Dennis Fortenberry, professor of pediatrics at Indiana University and one of the authors, explains:

“It is true that a fair number of teens report sexual interaction with someone they’ve only just met but the majority of the time they do not have vaginal intercourse.”  

In fact, when it comes to vaginal intercourse, most teens do not have a large number of partners.  Teenagers in the U.S. (which limited its data to vaginal intercourse) found that most teenagers (26 percent of females and 29 percent of males) had had 2 lifetime partners and that only a few (14 percent of females and 16 percent of males) had had more than 4 partners in their lifetime.  The number of partners does not increase drastically when you also take oral and anal sex into account.  Sexual Behavior 20062008 found that 23 percent of 15- to 19-year-olds had 1 lifetime oral sex partner, 8 percent had 2 such partners, 16 percent had 3-6 partners, 4 percent had between 7 and 14 partners, and only 1 percent had more than 15. 

And finally, let’s discuss how often.  Most teens are also not having sex all that frequently.  While 42 percent of never-married teens had ever had vaginal intercourse, only 30 percent had done so in the three months prior to the survey, and only 25 percent had done so in the prior month.  The NSSHB had similar findings.  While 21 percent of all teenagers 14 to 17 had engaged in vaginal intercourse in their lifetime only 14 percent had done so in the 90 days prior to the study.    

My former colleague, Monica Rodriguez, president of the Sexuality Information and Education Council of the United States (SIECUS), would chastise me for this section, which, while satisfying the requirements for a lead paragraph in a local news article, may very well have missed the point.

“We are way too focused on who is sticking what body part where and how often,” she says, “but without understanding the relationship between the two people this is not all that informative.” 

Logan Levkoff, sexologist and author of Third Base Ain’t What it Used to Be, agrees:

“I don’t care so much about what they’re doing as I do about why they are doing it.  Are they making smart, healthy decisions about sex and learning about their own bodies and their partners bodies?” 

Unfortunately, the research is light on questions that would help us put these behaviors into perspective. About the closest we get is a question on the NSFG that asks teens to recall how they felt about the first time they had sex.  According to Teenagers in the U.S., 47 percent of never-married females ages 15 to 17 said they had mixed feelings about the first time they had sex “part of me wanted it to happen at the time and part of me didn’t” though a similar number (43 percent) said they “really wanted it to happen at the time.”  Not surprisingly, the older a teen was when she first had sex, the more likely she was to say she really wanted it to happen.  And though never-married teen males were more likely to report they “really wanted it to happen” (62 percent), the same trend holds true for guys; those who waited until they were at least 15 to 17 were more likely to say this. 

If we change our goal from preventing all teen sex to preventing sex that teens will regret later, we can work to make sure that all teens wait until the right experience (the one that they “really wanted to happen at the time”) comes along.  Fortenberry suggests that rather than just concentrating on whether teens had sex, we should be worried about whether the sex was “safe and consensual,” and whether it “served them, their pleasure, and their relationship.”

Are they Being Responsible?

Though questions about pleasure are rare, we do ask about whether it was safe in as much as we ask a lot of question about contraceptive use. In this arena, young people actually tend to behave better than their adult counterparts. 

Teenagers in the U.S. found that 84 percent of sexually active, never-married female teenagers used contraception at their most recent intercourse; 55 percent used a condom, 31 percent the pill, and 21 percent used both a condom and a hormonal method (the pill, the shot, the patch, and the contraceptive ring are all hormonal methods).  Sexually active, never-married males reported even better rates of contraceptive use; 93 percent used some method at last intercourse with 79 percent using condoms, 39 percent the pill, and 35 percent both a condom and a hormonal method. 

The data on contraceptive use at first intercourse was also encouraging as 79 percent of sexually active, never-married females and 87 percent of their male peers used some form of contraception the first time they had vaginal intercourse. This is a particularly important statistic because research has shown that using a contraceptive method at first sex is a good indicator of future use.  In fact, Teenagers in the U.S. found that teen females are almost twice as likely to have a birth before reaching age 20 if they did not use a contraceptive method at their first sex. 

The news on condom use is also good; 95 percent of sexually active, never-married teenagers report having used a condom at some point and it is the most common contraceptive used both at first intercourse and most recent intercourse.  Use of condom at first intercourse among sexually active, never-married males actually increased from 71 percent in 2002 to 82 percent in 2006–08. Perhaps the most impressive statistic about condoms, however, is that among those never-married males who had had sex within the month prior to the survey 71 percent of males used condoms 100 percent of the time. Obviously we would want that number to be closer to 100 percent of males 100 percent of the time (and we definitely want to see improvement in this for their female counterparts only 51 percent of whom could say the same thing) but this is a good start. 

That said, there were no significant changes in the percent of teenaged females or males using contraception at first intercourse or most recent intercourse.  In fact, the increases in contraceptive use that had been seen between 1995 and 2002 did not continue.  One has to wonder if our unique and seemingly single-minded emphasis on getting teens to avoid (or delay) sexual activity has gotten in the way of encouraging teens to be responsible when they do become sexually active.

YES, BUT…

At this point, having read all of my good news on teens behaving responsibly, I would not be surprised if you paused and asked, “Okay, but, if they’re behaving so well, why are rates of teen pregnancy and STDs still so high.” 

It is a fair question and the answer is both simple and very complicated.

First, they’re not perfect.  Teens are behaving well— in many cases, better than adults— but they are not behaving perfectly.  For example, an earlier analysis of NSFG data on contraception use for both young people and adults found that only 81 percent of teen women who are “at risk of an unintended pregnancy” were using contraception during the month they were interviewed for the study.  (The NSFG labels most women who had had intercourse in the past 3 months as “at risk.” The only women who are considered “not at risk” are those who were currently pregnant, trying to get pregnant, sterile for health reasons, had never had intercourse, or had not had intercourse in the last 3 months.)  So we know they are not using methods consistently.  What we don’t know is whether they are using their reported method correctly.  Fortenberry suggests that teens may be having:

“Trouble with access, trouble with cost, trouble with adherence.  The truth is that a lot of the methods are a little hard to put up with even for adult women.”

And, while the news on condom use among teens is particularly encouraging, in order to prevent STDs, young people have to be using condoms consistently (every time, which we know they are not doing) and correctly (which we have no way of truly tracking).  Dr. Anajali Chandra, the lead author on Sexual Behavior 20062008, also points out that teens, like adults, rarely use condoms for oral sex.  While it may not be that today’s teens are having more oral sex than their parents, the risks have definitely gone up: 

“The difference is that today there is more meaningful risk of STDs, some of which, like Herpes and HPV, can be transmitted quite effectively through saliva.  What used to be invisible is no longer invisible or consequence-free.” 

Second, we have to remember that teens are not all the same.  While we might like to attribute all of their behavior to their youth or their raging hormones, in truth it is much more complicated than that.  The disparities in health, wealth, and education that exist in communities have significant impact on young people.  The data show differences in sexual behavior and outcomes based on race/ethnicity, socio-economic status, and family structure, among other characteristics.  For example, Teenagers in the U.S. found that both female and male teenagers whose mothers had their first birth as a teenagers, and those who did not live with both parents at age 14, were more likely to be sexually experienced than those whose mothers had their first birth at age 20 or older, and those who lived with both parents at 14.  In order to fully address teen pregnancy and STDs, we need to understand and fix many of these underlying issues.

Finally, and most importantly, we’re not helping.  As Monica Rodriguez explains:

“By just focusing on what we believe as the negative aspects of their behavior we send teens a clear message that nothing they do will ever be good enough which undermines their efforts to be responsible and in the end also undermines our goals of helping them grow up to be healthy, independent adults.”

Teens in Europe have similar levels of sexual activity but they have substantially lower pregnancy rates.  Many believe that this is because adults in Europe tend to approach teen sexuality from an entirely different perspective; as a normal part of growing up.

The experts I spoke to agree that it’s time we change our views and our messages as well. Fortenberry suggests that we reject the idea that virginity is important in anyway and start viewing sexual behavior as a healthy part of growing up, “We want them to develop skills and an understanding and we have to engage the fact that they have sex as part of the fact that we want them to be safe.” Rodriguez adds that we have to give them more credit for what they are doing right and figure out ways to support them and build on their strengths. At a minimum, she says this means, “More education that is realistic and meets their needs and more access to sexual health services, including contraception.”

WHAT WOULD CHANGE LOOK LIKE

Before I knew him, my husband was part of a peer education group that would go into high schools and provide sexual assault prevention programs.  He always said that the moment he got the young people in the audience (young men in particular) to listen to him was the moment he pointed out that he wasn’t going to say “I don’t want you to have sex,”  he was simply going to say, “I only want you to have good sex.”

What if we were to adopt a similar tone?  Instead of saying we want young people not to have sex, we go on the record as saying “we want young people to have good sex.”  Sex that is safe, consensual, non-exploitative, and dare I say, pleasurable.  How would our conversations with young people change if this were our underlying message?  How would our education programs and our public policies change?  How would our media messages change?  There is no doubt that this is a political landmine, and some will argue, possibly rightfully, that doing so will actually undermine efforts to improve sexual health among adolescents. Others will say, it’s time to stop be scared of the politics and the opposition.

This is something that Rewire is going to explore in the coming months as we ask experts in adolescent health and sexuality education to reframe the issue for us. One thing is for sure, if we make these changes, “more virgins,” will never be our only good news again.