As a health educator who works with teens and college students—and as a mom of three—I was happy to see the results of the Centers for Disease Control and Prevention’s most recent study on teen sexual health. It showed consistent declines on measures that we often associate with poor sexual health—including having sex before age 13—and a noteworthy increase in condom use the first time teens have sex.
Yet the United States still has the highest teen pregnancy rate among socially and economically comparable countries, and it still continues to see unprecedented rates of sexually transmitted infections, including HIV, in young people. Then there’s the precarious political situation since the 2016 election: devastating attacks on reproductive health and the renewed push by the current administration for federally funded abstinence-only education.
Given the political backdrop, those of us who work with or have teens feel like our hands are going to be increasingly tied. But while the future of teen sexual health can seem grave, there are things we can do if we want to help young people maintain some of the health gains they’ve achieved over the past few decades. Here are six:
1) Challenge the idea that sex is inherently dangerous for teens
We can’t ignore the fact that many Americans are uncomfortable with adolescent sexual expression. So one of the first things we need to do is to question some deeply held ideas about teens and sex.
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For example, a lot of people just assume that sex is both physically and emotionally dangerous for teens. These assumptions are understandable given the fact that we rarely hear about teens who have happy, healthy sexual experiences with caring partners—something that we know can actually boost self-esteem. Rarely do we hear about research that suggests that not only does teen sex have no link to drug use, truancy, and violence, but it could help teens develop better social relationships in early adulthood. Such research findings are less common, since it’s just harder to get funding to prove the positives, and these results are also often looked at with suspicion when they do appear.
The messages that teens often get about sex are negative ones, which don’t prevent kids from having sex, but conversely have been found to reinforce a lot of shame, fear, and anxiety about sexuality. In fact, shaming attitudes and policies have created a climate where a lot of teens have sex in unsafe ways, say by drinking or using drugs before sex or with little communication or accurate information. It is also a climate that encourages teens to have sex in secret and prevents them from going to parents, teachers, or health-care providers for help.
However, we consistently fail to grasp that so many of the negative outcomes of teen sex are not solely the inevitable consequence of a person’s age. Rather, they are often the product of our climate of fear and punishment.
2) Stop equating sexual activity with juvenile delinquency
Though many of us assume we are long past the days when pregnant teens were sent off to reform schools or homes for unwed mothers, things might not have changed as much as we imagine.
Indeed, today’s youth may still find themselves enrolled in a wilderness program or boot camp that views sexual activity in the same way it does substance use, criminality, and truancy. For example, one program lists “sexual promiscuity, unrestrained substance abuse, [and] reckless driving” as comparable examples of dangerous or risky behaviors. Another provides treatment for “behavioral issues that are interfering with [teens’] performance in school and life,” and then cites erroneous data about an increase in the number of sexually active teens before counseling parents that failing to intervene when a teen is sexually active, “can lead to long-term problems with intimate relationships, as well as the child’s physical health.”
It goes without saying that while some programs purport to treat any child with a sexual behavior problem, girls, sexual and gender minorities, and youth of color are often the focus in this arena.
3) Fight against abstinence-only education
Today’s abstinence-only-until-marriage education is the same old program it’s always been. This is a program that has been proven to be medically inaccurate, trans- and homophobic, sexist (see curricula that compare sexually active girls to everything from used tape to chewed up gum and a cup of spit). It’s been shown in multiple studies to fail, even at its problematic goal of preventing sex outside of heterosexual marriage.
And while curricular choices can seem out of an individual’s control, if a school in your area or one that your kids attend teaches abstinence-only education, consider bringing it up with the administrators. Plus, if this is a district-wide issue, attending a school board meeting and voicing your concerns can help bring this issue to the attention of people who can actually make changes.
4) Talk to teens about sex and then take action if needed
Despite being an advocate for openness around teens and sex, I would also argue that in this country, becoming sexually active isn’t actually the best idea for the majority of young people. We already have far too many teens who lack access to contraception and reproductive health care. We have far too many who are denied accurate information about sex, whether overtly, or as a result not of only of abstinence-only education, but also of parental silence or internet filters that censor basic health-care information. And we have far too many resulting situations where the sex that teens have is unwanted, unprotected, or deeply unsatisfying.
So what can adults do? One thing is to guide teens toward a decision about whether they are ready for sex in the first place rather than just informing them that they are not. To do that, you can have teens consider questions like:
- Do you want a committed relationship before you have sex?
- What if having sex turns out to be different than you expect?
- How might your feelings about your partner change after you have sex?
- Will you expect more commitment from your partner? What if you don’t get it?
- What if your partner wants more commitment from you?
- What if having sex ends your relationship?
- Do you know how to reduce health risks?
- Even if you know about them, are you able to access things like condoms, other forms of contraception, and health care?
- How do you feel about unintended pregnancy? Do you know how your partner feels?
- Are you feeling pressured into having sex?
- Can you let your partner know what you do and don’t like sexually?
If teens are sexually active, adults can also help them obtain contraceptives and condoms, and set up medical appointments. These actions can be incredibly important since confidential, accessible, and affordable health care is a cornerstone to sexual health for all of us. But for no group is this harder to access than for youth who simply aren’t afforded autonomy in this arena.
Indeed, though minors in many places legally have the right to confidential health care for things like reproductive health care and STI testing and treatment, actually obtaining this can be next to impossible. This is both the result of the limited number of teen clinics offering free or low-cost care, and also due to the fact that if teens use their parent’s health insurance, it is likely that a statement will arrive in the mail detailing their treatment. Plus, it is no secret that while it is difficult enough for adults to obtain an abortion, the roadblocks that are put in front of teens who may want to seek this service are often nearly insurmountable.
5) Consider letting teens have sleepovers or privacy with partners
Not too long ago, I showed a high school class the Advocates for Youth documentary, “Let’s Talk About Sex.” In it, a Dutch teen mentions that the first time he had sex, it was at home, in his bed, after he and his girlfriend had had dinner with his mom.
There were gasps from the class and one of my students said in horror, “They had sex when his mom was home!?”
While teen couple sleepovers may seem radical to American teens and adults alike, this is a practice that has been adopted by health professionals, politicians, teachers, and parents in countries across Western Europe. In the region, teens tend to have sex at the same age as Americans, but with measurably fewer negative outcomes.
But such messaging and active support can be tough to support when every time we turn around the headlines remind us that teen sex leads to STIs or pregnancy, mental health crises, or some sort of moral failing, just to name a few of the things Americans of all religious and political stripes tend to wring our hands over.
Reframing our view of the issue and allowing teens space to explore their sexuality can promote health far more than the alternatives. So if we really want to help American youth stay sexually healthy, we need to take a multipronged approach. We must fight for teens on a policy level, we must be actively involved in their health, and we must also re-evaluate our perspectives. Because, really, the most serious determinant of the sexual well-being of our youth is largely the conditions under which we force them to have sex.
6) Challenge the cis-hetero norm
Despite advances on our understanding of gender and sexual orientation, we still live in a climate that promotes a cisgender-heterosexual norm. Boys get the message that they must pursue sex with girls to prove their masculinity, while girls still learn that they must resist these advances to prove their virtue.
This is a standard that is portrayed in movies where we are accustomed to seeing a persistent guy doing everything he can to win over the reluctant girl (just think about any pre-Frozen era Disney plotline). It comes up endlessly in song lyrics where what women say is not to be believed, (recently, Justin Bieber singing, “When you nod your head ‘yes,’ but you wanna say ‘no,’ what do you mean?”). And we reinforce this message every time we teach girls that they don’t want to seem too eager or too easy, while telling boys that in order to deflect any questions about their heterosexuality, they need to be sexually accomplished with girls.
This standard denies the experiences of our LGBTQIA youth, and it harms young people of all genders who then understand problematic behavior as normal and often behave accordingly.
So what can we do? Check our assumptions, for one. While most of us have teens’ best interests at heart, a lot of us still default to some pretty traditional ideas about how to keep youth sexually healthy. This default is actually just doing young people a great disservice. Adults need to ask ourselves if we are reinforcing outdated messages with our youth and acknowledge that a lot of us have woven cis- and heterosexist ideas into our worldview. And we need to call out biased media, lesson plans, and language. Only when we do these things can we undo some of the harm that these seemingly entrenched notions perpetuate.