Commentary Sexual Health

Film Review (Part Two): Let’s Talk About Giving Parents More Advice

Heather Corinna

Part Two of the reveiw of the documentary, Let’s Talk About Sex, has some of the advice parents might need to at least begin conversations about sex with their children and teens. 

A few weeks ago, I published a review of the new documentary, Let’s Talk About Sex, and I noted that it’s unfair of us to ask parents to take on this topic completely unprepared.  As promised, this second part of this commentary has some of the advice parents might need to at least begin these conversations. 

In the film, a young woman says something fantastic when taking about open sexual conversations with her mother. She voices that at first it feels very awkward, but that the momentary discomfort is worth it for the benefits that communication provides. Sex and sexuality are topics which most people, of all ages, have trouble communicating about, not just with youth and family, but with sexual partners, friends, and health care providers. Learning to communicate well about sex, and to get more comfortable with it, is a lifelong process for everyone.

As I often remind the young people I work with; parents are only people. They’re not gods, nor does becoming a parent magically bestow abilities and enlightenment that one did not have before becoming a one. I’m all about asking parents to step it up, but it’s important to be realistic in our expectations of all people, including parents, and not just to tell them what to do, but to help them find out how to do it, and how to do it well. We must also try very hard to empathize with their challenges, especially when we ourselves are not parents.

Being an adult or parent and doesn’t automatically come with knowledge and comfort about sexuality: would that it did!  If it did, even when we only look at sexual outcomes and behaviors like unwanted pregnancy and condom use, we’d see very different statistics for adults and young people.  Instead, they’re almost identical (actually, in the United States, teens currently have higher rates of condom use than adults).

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A big part of learning to talk about sexuality well for any adult involves really unpacking our own sexuality, our own sex lives, and our own feelings about and conceptualizations of sexuality, and until we’ve done a good deal of that, being able to talk about it in high-stakes settings is often going to feel very precarious and challenging, especially if and when we feel like we need to be an expert or guide. That’s hard work, that unpacking and processing. It’s easier for some people and more challenging for others, since no matter where we grew up, our sexual histories, including the ways we were reared with sexuality, vary widely. It’s important work, whether we parent or not, or work with young people or not, because our own sexuality and relationships will benefit, and our culture will benefit. But it’s hard, it takes time, and it also involves learning to be able to see sex and sexuality outside our own, often very limited, lens.

In much of this film, it was, I felt, easy to see areas where the filmmaker hadn’t himself done that.  For example, I had a hard time understanding why someone who worked as a photographer who creates the kinds of images he took big issue with right at the start of the film didn’t examine his own role in that. In fact, only once, briefly, does this issue even come up;  Dr. Santelli mentions that adults are limited by our own poor sex education. Saying what people need to do and should do, and showing why, is important.  But if we don’t also show people how (save moving to the Netherlands), that message isn’t very useful.

I think many parents are in the spot Kelsey’s mother was in in the film. She knows she should be open about it, and does her best to be so, but doesn’t know how to do it well. While she likely has the best of intentions, she’s without guidance in how to do so in a better way.  Guidance would have helped her understand the importance of  not presenting her own sexual choices in a way that her daughters hear them as an ideal they’re expected to meet, and which, if they don’t, they will need to keep secret from her so as not to disappoint her.

Doing sex education and sexual communication better also involves thinking about and leaving lots of room for how things are different for other people than they have been or are for us, or than we may perceive them to be for others. These differences are not just based on what nation someone lives in, but on things like gender, sexual orientation, embodiment, ethnicity, economic class, our smaller communities, and generational divides. It involves cultivating an awareness of our own double-standards, blind spots, and limited views, and working to expand those views and the behaviors and words that can stem from them. It also involves learning to listen to young people and to respond to what they’re really saying, not just what we want to hear or what they say that supports what we want to think or believe. 

I’m sorry to say that, overall, I found that the film failed to do this well. In failing to examine these difference, the film not only doesn’t show the how to communicate about sexuality well, but may even inadvertently enable some of the ways people do so poorly.

No one lives in a vacuum, and we don’t all live in the Netherlands. Excellent teachers here have lost their jobs trying to provide quality sex education. Sex education for youth as a whole has a shortage of male educators in large part because it’s not uncommon for them to find themselves accused of having ulterior motives; some of us who provide it here as women are often presented as slattern. The young man in the Netherlands who feels comfortable displaying his collection of 170 condoms and his family live in a different place than a mother who, in 2001 in Baraboo, Wisconsin, gave her teenage son, who had become sexually active with his also-teenage girlfriend, access to condoms. When her son, acting responsibly, sought to get tested for STIs, she found herself facing criminal charges for providing him those condoms. I’ve heard from progressive parents over the years who have gotten all manner of hell from their own families or communities for doing what I’d consider very right by their teens around sex and sexuality.

By all means, those kinds of outcomes are not what happens all the time, but they add more reasons for adults to feel very afraid of communicating to young people well about sex, and to take the kind of approaches validly applauded in the film.

Parents and other allies can’t change our cultural environment just by talking to teens, and our environment can create real barriers to that communication. So, it’s not just parents, churches, or schools who have to radically change; it’s our whole culture. Where we’re at with all of this right now isn’t something that happened because of media and the Internet or parents over the last decade or two. It’s something we’ve been cultivating since before the United States was established, with only a few brief times in history where we seemed to make some positive headway, only to lose ground again. For sure, it’s all a bit chicken and egg, but in this case, both have huge impacts.

It’s acknowledged in the film that talking about sex isn’t easy for parents. It also isn’t easy for teens to do with partners or other adults, or even with each other. It’s not easy for anyone, really, for all the reasons I’ve mentioned and more. I have talked with teens about sex and sexuality almost every day for over a decade, and you’re still never going to hear me say it’s easy or without a lot of challenges. It’s not easy and it is very challenging, even when you literally practice with thousands and thousands of young people over many years with training and education to do so.

Lest I not put my money where my mouth is, I want to offer up one starting place for parents (or filmmakers) who don’t know where or how to get started talking about sex—it’s just one simple phrase. Getting a little Zen here, I suggest cultivating a beginner’s mind. That phrase is, simply, “I don’t know.”

Expecting anyone to be an expert about sexuality who isn’t one (and is anyone, really?) is expecting too much, and can easily incline people to back away from even trying to take about it because it’s so intimidating. Expecting anyone to be greatly skilled at good communication, period, let alone about some of the toughest things we can talk about, is expecting a lot; many people, if not most, are not great communicators, in large part because no one has taught us how to be. Expecting anyone to know how to start talking about sex just because they know they should is neither a fair nor a realistic expectation.

But it’s okay not to know where to start. It’s okay not to know what to say, what to ask, or even what’s factual and what isn’t. It’s okay to be the parent or the adult, but not to be the expert. It’s especially okay when the other person you’re talking to doesn’t know a lot either, because setting up an environment where neither of you are expected to know it all, direct it all, or supply it all alone, but instead can find and figure it out together, is exactly the best kind of environment for both good communication and healthy sexuality. “I don’t know,” is a great place to lead to the next best step, which is “So, let’s find out together.”

For instance, together you can use the Internet, go to the library, or contact your community health care provider to seek out information on sex and sexuality, including things like what new methods of contraception are available, how condoms have changed since you last used them, or how any of this is or isn’t different for queer youth or youth of a certain gender. You can also do some media literacy work while you’re at it, learning and teaching how to sort out credible information from bunk or entertainment. You can seek out family therapy to get help from a pro about communicating better about difficult topics like sex, and to get any mediation you may need to improve your communication on the whole.  You can find out together about the curriculum a school uses for sex education, and look at and discuss it together. You can contact sex education experts like you saw in the film, people like myself, or people at organizations like Planned Parenthood to ask for help and resources: I’m always delighted to hear from parents who want some help and happy to take a few minutes to connect them with helpful books and online or local resources. You can watch a film like this together, because even if you find the same flaws I did, they’re all great things to talk about.

And you can—and should, as we all should of one another —ask each other (with the given you’re asking because you don’t know and can’t know without asking) what each of your experiences have been, what your sexual ideals are, what each of you wants and needs, what’s hard, scary, or challenging for each of you at any time about sex or sexuality, and how you can try and deal with it all well as a family, including just doing your best to assure that none of the ways you’re talking are more likely to create barriers to good communication and sexual well-being, rather than inroads.

News Politics

Clinton Campaign Announces Tim Kaine as Pick for Vice President

Ally Boguhn

The prospect of Kaine’s selection has been criticized by some progressives due to his stances on issues including abortion as well as bank and trade regulation.

The Clinton campaign announced Friday that Sen. Tim Kaine (R-VA) has been selected to join Hillary Clinton’s ticket as her vice presidential candidate.

“I’m thrilled to announce my running mate, @TimKaine, a man who’s devoted his life to fighting for others,” said Clinton in a tweet.

“.@TimKaine is a relentless optimist who believes no problem is unsolvable if you put in the work to solve it,” she added.

The prospect of Kaine’s selection has been criticized by some progressives due to his stances on issues including abortion as well as bank and trade regulation.

Kaine signed two letters this week calling for the regulations on banks to be eased, according to a Wednesday report published by the Huffington Post, thereby ”setting himself up as a figure willing to do battle with the progressive wing of the party.”

Charles Chamberlain, executive director of the progressive political action committee Democracy for America, told the New York Times that Kaine’s selection “could be disastrous for our efforts to defeat Donald Trump in the fall” given the senator’s apparent support of the Trans-Pacific Partnership (TPP). Just before Clinton’s campaign made the official announcement that Kaine had been selected, the senator praised the TPP during an interview with the Intercept, though he signaled he had ultimately not decided how he would vote on the matter.

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Kaine’s record on reproductive rights has also generated controversy as news began to circulate that he was being considered to join Clinton’s ticket. Though Kaine recently argued in favor of providing Planned Parenthood with access to funding to fight the Zika virus and signed on as a co-sponsor of the Women’s Health Protection Act—which would prohibit states and the federal government from enacting restrictions on abortion that aren’t applied to comparable medical services—he has also been vocal about his personal opposition to abortion.

In a June interview on NBC’s Meet the Press, Kaine told host Chuck Todd he was “personally” opposed to abortion. He went on, however, to affirm that he still believed “not just as a matter of politics, but even as a matter of morality, that matters about reproduction and intimacy and relationships and contraception are in the personal realm. They’re moral decisions for individuals to make for themselves. And the last thing we need is government intruding into those personal decisions.”

As Rewire has previously reported, though Kaine may have a 100 percent rating for his time in the Senate from Planned Parenthood Action Fund, the campaign website for his 2005 run for governor of Virginia promised he would “work in good faith to reduce abortions” by enforcing Virginia’s “restrictions on abortion and passing an enforceable ban on partial birth abortion that protects the life and health of the mother.”

As governor, Kaine did support some existing restrictions on abortion, including Virginia’s parental consent law and a so-called informed consent law. He also signed a 2009 measure that created “Choose Life” license plates in the state, and gave a percentage of the proceeds to a crisis pregnancy network.

Regardless of Clinton’s vice president pick, the “center of gravity in the Democratic Party has shifted in a bold, populist, progressive direction,” said Stephanie Taylor, co-founder of the Progressive Change Campaign Committee, in an emailed statement. “It’s now more important than ever that Hillary Clinton run an aggressive campaign on core economic ideas like expanding Social Security, debt-free college, Wall Street reform, and yes, stopping the TPP. It’s the best way to unite the Democratic Party, and stop Republicans from winning over swing voters on bread-and-butter issues.”

Roundups Sexual Health

This Week in Sex: The Sexually Transmitted Infections Edition

Martha Kempner

A new Zika case suggests the virus can be transmitted from an infected woman to a male partner. And, in other news, HPV-related cancers are on the rise, and an experimental chlamydia vaccine shows signs of promise.

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

Zika May Have Been Sexually Transmitted From a Woman to Her Male Partner

A new case suggests that males may be infected with the Zika virus through unprotected sex with female partners. Researchers have known for a while that men can infect their partners through penetrative sexual intercourse, but this is the first suspected case of sexual transmission from a woman.

The case involves a New York City woman who is in her early 20s and traveled to a country with high rates of the mosquito-borne virus (her name and the specific country where she traveled have not been released). The woman, who experienced stomach cramps and a headache while waiting for her flight back to New York, reported one act of sexual intercourse without a condom the day she returned from her trip. The following day, her symptoms became worse and included fever, fatigue, a rash, and tingling in her hands and feet. Two days later, she visited her primary-care provider and tests confirmed she had the Zika virus.

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A few days after that (seven days after intercourse), her male partner, also in his 20s, began feeling similar symptoms. He had a rash, a fever, and also conjunctivitis (pink eye). He, too, was diagnosed with Zika. After meeting with him, public health officials in the New York City confirmed that he had not traveled out of the country nor had he been recently bit by a mosquito. This leaves sexual transmission from his partner as the most likely cause of his infection, though further tests are being done.

The Centers for Disease Control and Prevention (CDC)’s recommendations for preventing Zika have been based on the assumption that virus was spread from a male to a receptive partner. Therefore the recommendations had been that pregnant women whose male partners had traveled or lived in a place where Zika virus is spreading use condoms or abstain from sex during the pregnancy. For those couples for whom pregnancy is not an issue, the CDC recommended that men who had traveled to countries with Zika outbreaks and had symptoms of the virus, use condoms or abstain from sex for six months after their trip. It also suggested that men who traveled but don’t have symptoms use condoms for at least eight weeks.

Based on this case—the first to suggest female-to-male transmission—the CDC may extend these recommendations to couples in which a female traveled to a country with an outbreak.

More Signs of Gonorrhea’s Growing Antibiotic Resistance

Last week, the CDC released new data on gonorrhea and warned once again that the bacteria that causes this common sexually transmitted infection (STI) is becoming resistant to the antibiotics used to treat it.

There are about 350,000 cases of gonorrhea reported each year, but it is estimated that 800,000 cases really occur with many going undiagnosed and untreated. Once easily treatable with antibiotics, the bacteria Neisseria gonorrhoeae has steadily gained resistance to whole classes of antibiotics over the decades. By the 1980s, penicillin no longer worked to treat it, and in 2007 the CDC stopped recommending the use of fluoroquinolones. Now, cephalosporins are the only class of drugs that work. The recommended treatment involves a combination of ceftriaxone (an injectable cephalosporin) and azithromycin (an oral antibiotic).

Unfortunately, the data released last week—which comes from analysis of more than 5,000 samples of gonorrhea (called isolates) collected from STI clinics across the country—shows that the bacteria is developing resistance to these drugs as well. In fact, the percentage of gonorrhea isolates with decreased susceptibility to azithromycin increased more than 300 percent between 2013 and 2014 (from 0.6 percent to 2.5 percent).

Though no cases of treatment failure has been reported in the United States, this is a troubling sign of what may be coming. Dr. Gail Bolan, director of CDC’s Division of STD Prevention, said in a press release: “It is unclear how long the combination therapy of azithromycin and ceftriaxone will be effective if the increases in resistance persists. We need to push forward on multiple fronts to ensure we can continue offering successful treatment to those who need it.”

HPV-Related Cancers Up Despite Vaccine 

The CDC also released new data this month showing an increase in HPV-associated cancers between 2008 and 2012 compared with the previous five-year period. HPV or human papillomavirus is an extremely common sexually transmitted infection. In fact, HPV is so common that the CDC believes most sexually active adults will get it at some point in their lives. Many cases of HPV clear spontaneously with no medical intervention, but certain types of the virus cause cancer of the cervix, vulva, penis, anus, mouth, and neck.

The CDC’s new data suggests that an average of 38,793 HPV-associated cancers were diagnosed each year between 2008 and 2012. This is a 17 percent increase from about 33,000 each year between 2004 and 2008. This is a particularly unfortunate trend given that the newest available vaccine—Gardasil 9—can prevent the types of HPV most often linked to cancer. In fact, researchers estimated that the majority of cancers found in the recent data (about 28,000 each year) were caused by types of the virus that could be prevented by the vaccine.

Unfortunately, as Rewire has reported, the vaccine is often mired in controversy and far fewer young people have received it than get most other recommended vaccines. In 2014, only 40 percent of girls and 22 percent of boys ages 13 to 17 had received all three recommended doses of the vaccine. In comparison, nearly 80 percent of young people in this age group had received the vaccine that protects against meningitis.

In response to the newest data, Dr. Electra Paskett, co-director of the Cancer Control Research Program at the Ohio State University Comprehensive Cancer Center, told HealthDay:

In order to increase HPV vaccination rates, we must change the perception of the HPV vaccine from something that prevents a sexually transmitted disease to a vaccine that prevents cancer. Every parent should ask the question: If there was a vaccine I could give my child that would prevent them from developing six different cancers, would I give it to them? The answer would be a resounding yes—and we would have a dramatic decrease in HPV-related cancers across the globe.

Making Inroads Toward a Chlamydia Vaccine

An article published in the journal Vaccine shows that researchers have made progress with a new vaccine to prevent chlamydia. According to lead researcher David Bulir of the M. G. DeGroote Institute for Infectious Disease Research at Canada’s McMaster University, efforts to create a vaccine have been underway for decades, but this is the first formulation to show success.

In 2014, there were 1.4 million reported cases of chlamydia in the United States. While this bacterial infection can be easily treated with antibiotics, it often goes undiagnosed because many people show no symptoms. Untreated chlamydia can lead to pelvic inflammatory disease, which can leave scar tissue in the fallopian tubes or uterus and ultimately result in infertility.

The experimental vaccine was created by Canadian researchers who used pieces of the bacteria that causes chlamydia to form an antigen they called BD584. The hope was that the antigen could prompt the body’s immune system to fight the chlamydia bacteria if exposed to it.

Researchers gave BD584 to mice using a nasal spray, and then exposed them to chlamydia. The results were very promising. The mice who received the spray cleared the infection faster than the mice who did not. Moreover, the mice given the nasal spray were less likely to show symptoms of infection, such as bacterial shedding from the vagina or fluid blockages of the fallopian tubes.

There are many steps to go before this vaccine could become available. The researchers need to test it on other strains of the bacteria and in other animals before testing it in humans. And, of course, experience with the HPV vaccine shows that there’s work to be done to make sure people get vaccines that prevent STIs even after they’re invented. Nonetheless, a vaccine to prevent chlamydia would be a great victory in our ongoing fight against STIs and their health consequences, and we here at This Week in Sex are happy to end on a bit of a positive note.