Waiting for the Right Time: Teen Abstinence -- Tamara Kreinin -- 11/13/03.
By Tamara Kreinin
Whether you're a concerned parent or a curious teen, read our discussion about teen abstinence when our guest was Tamara Kreinin, president of SIECUS (Sexuality Information and Education Council of the United States).
The opinions expressed herein are the guest's alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.
Moderator: Welcome to WebMD Live. Today's guest is Tamara Kreinin, president of SIECUS (Sexuality Information and Education Council of the United States).
Member: As a school nurse I deal with teen sexuality and pregnancy. What have you found to be the best way to approach them and the method they seem to respond best to?
Kreinin: I think that what's critical for young people is to have a combination of medically accurate information and skills. We want to work with them over time to develop critical thinking skills, decision-making skills, negotiating skills and refusal skills. And we want them to both understand the risks of sexual activity and that it is a natural and healthy part of life. We know from numerous studies that a comprehensive approach to sexuality education with information both about abstinence and contraception delays sexual activity, reduces the number of partners, and once a person is sexually active they use contraception more readily.
Moderator: Let's take about those skills you mentioned. What kind of skills do you feel teens need to have to keep themselves sexually safe?
Kreinin: Let first say I think it's important to remember that our teens are going to learn about sex and sexuality and we need to pose the question, Where do we want them to learn from? Do we want them to learn from TV? From the playground? From graffiti? From their friends?
Or from a knowledgeable adult?
We know from research that young people change their behavior and stay sexually safe when they are given accurate information and programming over time that allows them to be interactive and to practice. So the kinds of skills we want them to practice would be refusal skills, communication skills, negotiation skills, and critical-thinking skills so that they can make good decisions and learn how to negotiate relationships. We also know that young people want to talk with their parents and with other adults, not just about the mechanics of sex, but about love and relationships and values.
Member: Is pregnancy more common among teens that are among the ages of 12-15 or 15-18 or can it go younger? And why is it more common among a particular age group?
Kreinin: The first thing to know is that the U.S. continues to have the highest rates of teenage pregnancy of any industrialized nation, even though over the last 10 years our rates have decreased.
The way the numbers are kept, generally, we have a 10 to 14 age group, 15 to 17 age group, and an 18 to 19 age group. The majority of teenage pregnancies are in the 18 to 19 category. What's also important to know is that in the younger ages, the 10 to 14 ages, many of those kids were sexually abused. It's not necessarily true that the perpetrator caused the pregnancy, but frequently when the girl gets pregnant that young, she learned about sex through sexual abuse.
Member: As a teacher in a religious school, I am teaching eighth-grade students about sexual decision making. I am appalled at the number of students who haven't a clue as to what their parents' values are or feel they can't talk with their parents about sexual issues. Any advice?
Kreinin: Best advice is to hold a forum for the parents and let the parents know that overwhelmingly their kids want to hear from them and that many studies tell us that when parents think they've talked to their kids, the kids don't think they've heard from the parents. And that we need to get the message to the parents that the sex talk doesn't work. It needs to start early and stay late. So parents need to start talking to their kids at a young age and communicating that it's OK to talk and ask questions about sexuality and the conversation needs to last well into the teen years.
You might suggest to parents that they look for what we call teachable moments for opportunities to broach subjects around sexuality with their kids. You might also suggest that parents examine their own values and decide together what they want to impart to their kids and you might want to tell them that it's OK to be uncomfortable and to tell your kids that you're uncomfortable. And it's also OK to say you don't know the answer to something and to suggest that you find out together. That might be by going on the web, or going to library, or going to your pediatrician, or going to your local health department.
Something that's also interesting for parents to know is that most parents in this country and most Americans want comprehensive sexual education. They want their kids to be taught about abstinence and about contraception.
Member: Teen abstinence seems like an unattainable goal. It's just not possible to expect every teenager to wait to have sex. Especially if adults are telling them to! And they think they are immortal so no amount of slide shows of STDs will stop them. So why do we grownups continue to think we can convince them to abstain?
Kreinin: We do know that about half the kids in this country are sexually active and we have to assure that they have information and access to contraception and we know that about half the kids are not sexually active. What we want for all our young people is to grow up with a lot of information about healthy sexuality and the skills to make responsible decisions whenever they decide to become sexually active.
Moderator: Don't you think it is also important to support those teens who have decided to remain abstinent?
Kreinin: Yes. It's important to support all our teens.
Member: Even though my kids know their parents insist on abstinence until marriage, I'm afraid they'll WANT to have sex when dating because of the messages from music and movies.
Kreinin: What's most important for parents is that they give them honest and accurate information and express their values. It may not delay sexual activity until they're married, but it certainly will get them to think about their choices. And we do know that when parents have a connected relationship with their kids and talk to them about their sexuality, young people are more likely to delay sexual activity. I think it's important for parents to acknowledge what young people see in the movies and media and to talk to kids about what they're seeing and how it relates to their own lives and the lives of their friends.
It's also important to remember that kids will change developmentally throughout their teen years and will incorporate messages from society, the media, and the movies differently as they grow older. And a parent or another adult in a young person's life can help them reflect critically on what they're seeing around them. Ultimately, it's important to remember that we all are sexual beings and that if we give young people good information and respect them to make good decisions, they are likely to do so.
Member: It is difficult to help my son decipher what he's seeing when it's something like the new Christina Aguilera music video.
Kreinin: I think that's where it's critical for a parent to express their views and values. And kids are smart and if you express your views and values enough they'll start to look at these things critically. What I think is important is to use those situations as an opportunity because it's often very difficult to shield kids, entirely.
Member: What is "teen sexuality" if we're promoting abstinence?
Kreinin: Teen sexuality can be broadly defined. What's important about that question is that kids and adults often have different definitions of many sexual terms and they go unclarified. For example, when adults talk about abstinence, they usually mean abstaining from vaginal intercourse and anal and oral sex. When kids talk about abstinence, they think they're talking about abstaining from vaginal intercourse, which is one of the reasons that comprehensive sexuality education is so important, so that kids have an opportunity to discuss all types of language and have their questions answered without judgment.
It's unfortunate that the federal government has spent over a half a billion dollars on abstinence only until marriage programs that tell kids that sex outside of heterosexual marriage can be psychologically or physically damaging, and, also, frequently give kids misinformation about condom failure rates. The result being more kids not using condoms but continuing to be sexually active.
We at SIECUS are very concerned that there is a new trend in this country toward using shame and fear and misinformation as a way to get young people not to have sex outside of marriage. My fear is that we will see a stark increase in the rates of HIV/AIDS as a result of these types of programs that have no scientific basis. We know from one study of virginity pledges that while they delayed sexual activity under very specific conditions for eighteen months, once a pledger becomes a non-pledger they are 30% less likely to use contraception. We considered this great health harm for our young people.
Moderator: The one part of condom use that has always bothered me, is the part where parents say, "Well, if you're going to have sex, use a condom," but never teach their kids how to use them!
Kreinin: Good point. I think the most important point for parents to know is that we have over 30 studies that tell us giving kids messages about abstinence and teaching them about contraception, including how to use a condom, in no way increases sexual activity, and in many cases it delays sexual activity. So parents frequently fear talking about sex and, particularly, the use of contraception because they think, "If I talk about it it's an invitation to have it." But we know that's not the case. So it's very important for parents to assure that their kids know how to use condoms and where to get them. They may want to view this as a skill to give their kids for life.
Member: What modeling behaviors are important for parents? We can talk until we're blue in the face, but our actions always speak louder.
Kreinin: That's a good question. I think it's important for parents to assess their own values around sexuality when they first have children and to model those behaviors. Everyone is going to have their own values, I think being affectionate is important, being appropriate is important, and being consensual, and having good communication around issues related to sexuality. The best way a parent can model this is by being open and honest and beginning at a young age, giving kids positive messages about their bodies and about sexuality. Giving them messages that their bodies are strong and beautiful and giving them messages that they have the right to say who does and does not touch their bodies, and to protect themselves from unwanted touch or sexual advances.
Moderator: Some studies show that teens with goals are delaying the onset sexual behaviors.
Kreinin: Very good point. We now have about five studies that tell us that giving kids something to say yes to, something positive in their lives, delays sexual activity, which often means giving them some type of after school or youth development program that teaches them skills and helps them formulate goals for their future.
Member: As I said earlier I am a school nurse. I am also only 21 and deal with the high school population. I seem to reach the girls as they see me as more of an equal, where the boys are timid, shy, and embarrassed. Is this a normal reaction or could the age be a factor in my job as a sexual educator?
Kreinin: It is a normal reaction. Kids are oftentimes timid about talking about sexuality. Certainly age might be a factor, but what's most important is your own level of comfort and that you communicate to them a willingness to educate them and to talk with them. And, in fact, we have studies of sexuality education programs that show that they are more successful when a teacher not only knows the subject manner, but also is comfortable talking with kids about sexuality. Don't worry about your age; what you're doing is incredibly important. It's also not bad to bring somebody else to give the kids an alternative person to talk with, no matter who you are, so that they have a couple of choices in seeking out advice and help.
Member: To be honest, when I was in high school we boys had a "list" of girls that we'd like to marry and girls we'd like to have sex with. Crude, but reality. What, if any, steps are taken by groups like yours to help boys de-objectify girls? Would that help cut back on teen sex rates?
Kreinin: A really good sexuality education program would address issues of gender stereotypes in an honest and open way and would address those issues head-on with all the kids. It's going to take significant changes in our society to erase some of those points of view. But I do think we've made some progress in that direction by having open and honest conversations about sexuality.
Member: You have mentioned values several times. Can you speak about the role of religious institutions in teen sexuality education?
Kreinin: Religious institutions, as all our community institutions, have an important role to play in teen sexuality education and in educating and supporting parents and caretakers to talk with their teens. Many religious denominations have their own curricula for sexuality education that are quite good. For example, The Unitarian Church has a widely respected sexuality education curriculum.
Member: A recent study of the NIH concluded that condoms are of very limited effectiveness. For example, against HPV, the major cause of cervical cancer, which kills more women each year than does AIDS, there is no evidence that condoms are of any effect. Do you believe we should withhold this information because it might discourage use of condoms?
Kreinin: First of all, it is important to look to other interpretations of the research on condoms such as the Centers For Disease Control and Prevention and contraceptive technology, which tell us that if used correctly condoms have very low failure rates in preventing pregnancy and most sexually transmitted diseases, including HIV/AIDS. It is certainly important to give young people all the accurate facts about condoms and, in fact, while we don't yet know about the impact of condoms on HPV, we know that it is in only a few cases that HPV leads to cervical cancer. So we don't want to use unverified information as a scare tactic.
We certainly want young people to know that the only 100% way to stay safe is abstinence. However, we know that in many cases abstinence has failure rates, too. And if a young person is going to be sexually active, we want them to have as much protection as possible. It is critical for our young people to have accurate information about condoms and access to condoms and the information about how to use them.
Moderator: Before we wrap up for today, do you have any final comments for us, Tamara?
Kreinin: In wrapping up, I invite everyone to visit the SIECUS website, www.SIECUS.org. There is a special section for parents. We know that most Americans believe that young people deserve accurate information about abstinence and contraception. They deserve high quality, comprehensive sexuality education. And we know that most kids want to hear from adults in their lives about sexuality. It is critical for the well-being of our young people, in terms of their physical and emotional health, that we don't deny them information and that we spend our public dollars and our energy on giving them non-judgmental, non-fear or shame based sexual education. We hope that parents across the country will raise their voices on behalf of our young people and that the federal government and state governments will allocate money to support programs that most Americans want, rather than the ideology of a small, but vocal minority.
Moderator: Unfortunately, we are out of time. Thanks for joining us members, and thanks to Tamara Kreinin for being our guest.
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