Long-time ASHA colleague Martha Kempner writes on rewire.com about recent key hires with the U.S. Department of Health and Human Services that may bolster the reemergence of abstinence-only sex education programs.
“[Girls] have told by society that sex is great but that’s not their experience. They don’t know how to talk about that disconnect, there’s a certain amount of shame that shuts down their voice….for me, sexual empowerment for girls is helping them to find a voice in their sexual relationships.”
In a compelling TED Talk video (available below), nurse practitioner Jane Epstein makes the case that our efforts are sadly lacking with it comes to talking to teen girls and young women. In this episode of ASHA’s podcast we delve deeper into the topic with Ms. Epstein on not only what to say when talking to young females about sex, but how to help them speak up for themselves.
Jane Epstein is a Yale graduate and a clinician who sees teenagers at a high school-based health clinic where, as part of comprehensive health care, she provides sexual health care including contraception services to teens.
ASHA’s Sex+Health podcast is on iTunes. Subscribe today!
ASHA joins national sexual health organizations in urging Facebook and other social media platforms to say no to censorship.
The need for accurate, unbiased sexual health information is clear. There are close to 20 million new sexually transmitted infections diagnosed each year and nearly half of all pregnancies are unplanned.
Where do people turn for information on sexual health? Increasingly, the Internet—according to the Pew Research Center, 72% of internet users say they looked online for health information within the past year. But while that information is available on websites like ours and other sexual health organizations like Advocates for Youth, it is often censored on popular social media platforms.
For example, an ASHA Facebook campaign to increase the awareness vaginismus—a health condition that can cause painful intercourse for women—was flagged by the site as promoting a “sexually explicit product.” Advocates for Youth’s Facebook ad for the organization’s Great American Condom Campaign was similarly denied for violating ad guidelines about “adult content.”
In an effort to raise awareness of the problem and encourage a policy change, Amber Madison, author and lecturer, has launched a petition on change.org to urge to Facebook, Twitter, Pinterest, YouTube, Yahoo, and Google “to stop censoring sex education content from health organizations trying to provide people with the information they want and need to be healthy.”
As Amber outlines the problem: “There’s a big difference between an ad that encourages people to get tested for sexually transmitted infections and one that links to the latest celebrity sex tape—but Facebook and the others treat them as if they were exactly the same.”
If you agree that sexual health information should not be censored, then make your voice heard! Join ASHA and sign on to the petition today.
As most of my calls here at ASHA are about genital herpes, I thought I’d clear the air. TV shows, movies, and society as a whole create this stigma around herpes when really, there’s not too much to be scared of. Most of the time, genital herpes is a mild skin condition that can be managed very effectively.
- It is estimated that 1 out of 6 people have genital herpes. About 90% of them don’t know it.
- Herpes (oral & genital) cannot be spread through inanimate objects such as spoons, glasses, razors, towels, bed sheets, etc. Herpes can only be passed through direct skin-to-skin contact with the infected area such as kissing, oral sex, genital-to-genital rubbing, vaginal, and anal sex.
- Herpes (both oral & genital) can be spread even when there are no symptoms or sores. This is called asymptomatic shedding. Suppressive antiviral therapy significantly reduces asymptomatic shedding (and outbreaks). Valacyclovir taken daily can reduce risk of transmission to a partner by as much as 50%.
- Herpes is a very manageable skin condition and does not cause any damage to internal organs.
- People with herpes have very normal romantic and sexual relationships. After diagnosis, you may feel like your life may never be the same again but you will feel better soon. There are countless online communities and support groups for you with people who’ve been in your shoes.
Approximately half of the 20 million new cases of sexually transmitted infections (STIs) in the U.S. each year occur in teens and young adults ages 15-24. Dig a little deeper and you’ll see that about a fourth of adolescent females are infected with at least one of the more common STIs (human papillomavirus, chlamydia, herpes, and trichomoniasis). Overall, chlamydia rates among both men and women are highest among those in their early 20s; gonorrhea rates are also highest in teens and young adults and it seems like we could go on and on.
Just why are STI rates so high among young people? For insight we chatted with Dr. J. Dennis Fortenberry, a Professor in the Department of Pediatrics at the Indiana University School of Medicine. Dr. Fortenberry, who is also a member of ASHA’s Board of Directors, specializes in both adolescent medicine and internal medicine.
ASHA: What makes teens and young adults so vulnerable to STIs?
Dr. Fortenberry: There’s no simple answer to your question. In the U.S. most young people begin having sex in their middle to late adolescence and that’s a time when they’re having new exposures, forming new relationships and in many ways they’re learning how to understand both the risks of sex within the context of these new relationships along with their potential for infection.
It’s important to remember that most of the young people who start their sexual lives in their adolescence and early adulthood years don’t get STIs, so we keep in mind the differences between risk and the people that actually get infected. The statistics you mentioned earlier cover a 10-year period from age 15 to age 24, and as I said there are a lot of changes in young people’s lives over that time. Many of those infections are actually occurring in the group of people ages 18 to 24, so the rates of infections may be very different in those under age 18. We should really sort out the statistics a little bit before we get too overwhelmed by how bad the data look.
What about biological changes; how do they impact a young person’s susceptibility to STIs?
No one has fully sorted out the intersection of young people, biological changes, and increased susceptibility to sexually transmitted organisms. Studies have identified potential factors such as the relative immaturity of the cervix making young women more susceptible to infection. It’s also been suggested that the immune system itself in young people is less prepared to respond when exposed to sexually transmitted organisms. It’s not known that any of those potential factors are truly part of the story in terms of truly understanding younger people’s risks, though.
As best as we can tell the major factor driving STI’s in young people is exposure through sexual encounters, especially those that don’t involve a barrier like condoms. Environment plays a role, too, such as young people choosing partners in communities that have high rates of STIs.
Are we doing a good job in school-based sex ed programs?
I think the issue of how well we do with sexual health education is really quite varied, and you see sharp variations not only between states, but even between cities and from school-to-school. There’s data showing that states that don’t do as well in terms of offering comprehensive sexuality education actually have higher rates of STI that are common in young people (like gonorrhea and chlamydia). Not surprisingly, then, states that do a better job with comprehensive education actually have lower STI rates. Those are important indicators that give a clear message: when we empower young people with education, knowledge, and understanding of their own sexuality, when we help them understand how to experience their sexuality in developmentally appropriate ways, we reduce their risks of infections.
What advice would you give parents when they’re having discussions about the birds and the bees? They often are unsure how these conversations should even begin…
I think it’s really critical for parents to recognize they are the primary source for information and values, the main influence in their child’s sexual health development. Parents often don’t think about their kids in terms of sex and sexual health until they hit puberty or become teen-agers, but it’s important for parents to understand that the influence they have on their teens’ sexuality begins very early, starting with conversations that go on almost from the time they begin to interact with their children. This has to do with how kids learn to take care of themselves, respect themselves, and understand about their own genitals. Later, this includes understanding the differences between people and, as the child grows older, they begin to understand the way relationships work between people, and then how sex interacts with those relationships.
So it’s not one conversation, it’s not even ten conversations, it may be a hundred conversations that really connect young people to their parents and really help the young people accept their own parent’s perspectives on things.
Let’s talk for a second about healthcare providers: what do we need to do to educate providers to think more about sexual health and STIs in their patients, but especially young people?
We’ve just finished a study that showed providers often don’t talk to young people about sex even during an annual check-up, and when they do these conversations may last less than half a minute. I think we can do a better job of educating physicians about how to do address these issues with parents and their adolescents. Part of this involves us doing a better job as parents: we need to communicate to providers just what our expectations are regarding the sexual health care of our adolescents. Also, there’s a need to establish confidential visits with young people so that sex can be discussed.
All of this allows the parent and physician to work together to make sure concerns and questions are appropriately and effectively addressed.