Myth: Sexuality is just about reproduction.
Fact: Sexuality includes; all aspects of being male or female. A person’s sexuality is influenced by attitudes, values, beliefs and culture.
Sexuality is an integral part of being human. It begins at birth and develops throughout a person’s lifetime. It carries the awesome potential to create new life. It can build intimacy as well as bring pleasure to relationships. Sexuality includes what people believe is expected of them as men or women and how they take care of their sexual health.
Sexuality also can have negative aspects, including unintended pregnancy and sexually transmitted disease (STD), including HIV/AIDS. For some, sexuality is associated with shame, guilt and discomfort. Human sexuality is often surrounded by an array of myths, fears, distortions, prejudices and mixed messages.
To enjoy healthy sexuality, individuals must take steps to protect their sexual health, as well as that of others. Sexual health isn’t just the absence of disease or dysfunction, it’s the ability to understand and weigh the risks, responsibilities and impact of sexual actions, and to practice abstinence when appropriate. Sexual health also includes individuals’ ability to integrate sexuality into their lives and to reproduce if they choose.
To be sexually responsible, people need to:
* Understand and be aware of their sexuality and sexual development.
* Respect themselves and their partners.
*Avoid physical or emotional harm to themselves or a partner.
* Ensure that pregnancy occurs only when welcomed.
* Recognize and tolerate the diversity of sexual values within any community.
The Dimensions of Sexuality
Any comprehensive study of sexuality is based in biological understanding. But sexuality includes all aspects of being male or female. It’s impossible to study human reproduction without also discussing cultural, psychosocial and ethical considerations. All parts of sexuality are interconnected and overlapping.
Sexuality has at least 4 dimensions:
■The biological dimension involves physical appearance, including the development of physical sexual characteristics; sexual desire and response to sexual stimulation; the ability to reproduce or control fertility; and general growth and development. This dimension develops rapidly during adolescence. Although humans cannot reproduce until puberty, sexual functioning begins at birth and lasts a lifetime.
■The psychosocial dimension refers to people’s feelings and attitudes about themselves and others. Through their experiences, people learn how to express emotions and behave as sexual beings. This learning involves not only what people do, but how and why they do it. Regardless of whether their experiences are positive or negative, people’s learned responses become inseparable from their sexuality.
During puberty, bodies often develop faster than cognitive abilities. Adolescents sometimes aren’t ready to deal with the social and emotional implications of their physical development.
■The ethical dimension is concerned with values that affect sexuality. Values are built as people ask questions about behavior and make decisions about what is right or wrong, based on religious beliefs, family values or some other ethical system.
As young people grow and mature, they begin to internalize a sense of ethics. Adolescents are often in the middle of this process.
■The cultural dimension is the sum of various external influences, both historical and contemporary, that affect people’s thoughts and actions. Many beliefs about sexuality are relative to time, place and circumstance. Sexual customs, gender roles and laws regulating sexual practices are all functions of culture. Primary cultural influences on sexuality today include the media, social institutions, interpersonal relationships, and family practices and standards.
Trends in Adolescent Sexual Behavior
Today’s adolescents face difficult challenges in making choices about sex, but there is evidence that most young people make healthy choices.
■ Abstinence and sexual intercourse: Studies show that 2 out of 3(66%) of high school students are currently abstinent. The number of teens who have had sexual intercourse has declined in the United States over the past 10 years, from 54% in 1991to 46% in 2001 (CDC, 2002b).
Sexually active teens are more likely to be at risk for pregnancy, STD and HIV for several reasons:
*They may have multiple partners rather than a single long-term relationship.
*They may be more likely to have unprotected sex.
*They may have partners who are at higher risk.
■Teen pregnancy rates: U.S. rates of teen pregnancy and birth have been steadily declining since the early 1990s. In spite of this decline, the United States has one of the highest teenage pregnancy rates in the developed world-twice as high as that of England, Wales or Canada, and 9 times as high as the Netherlands and Japan (Alan Guttmacher Institute, 2002).
More than 1 million American teens become pregnant each year-nearly 1 in 5 of those who are sexually active (Alan Guttmacher Institute, 1999). Over a period of a year, a sexually active teen who does not use contraception has a 90% chance of becoming pregnant (Strong et al., 2002).
■ Sexually transmitted disease (STD): Each year, 4 million teens develop an STD (Alan Guttmacher Institute, 2002). In the United States, 1 out of 4 teens who have had sexual intercourse will get an STD (Kaiser Family Foundation, 2001).
More than 25 infectious organisms can be transmitted through sexual activity. Most of these infections can be treated, and many can be cured. But some STDs cannot be cured, and some are deadly. STD also causes serious illness and complications that can be irreversible, such as infertility and cancer.
STDs common among teens include:
*Chlamydia
*Genital herpes
*Gonorrhea
*Human papilloma virus
*HIV
Birth control: Abstinence is the healthiest choice for teens. But those young people who do choose to be sexually active need information to make good choices about using birth control. Some current statistics:
* More teens are using contraception (birth control) the first time they have sex. However, the number of teens using contraception the last time they had sex is declining (National Campaign to Prevent Teen Pregnancy, 2002).
* Of the 33% of teens who are sexually active, 58% reported that they or their partner used a condom at last sexual intercourse, and 18% used birth control pills (CDC, 2002b).
* Teaching teens about birth control does not make them have sex. In fact, research shows it seems to delay sexual activity (National Campaign to Prevent Teen Pregnancy,2000).
Influences on Teen Sexuality
Young people’s choices about sexuality are influenced by many factors, including family, peers, use of alcohol and other drugs and the media.
Family: Experts report that teens who have been encouraged to talk to their parents about sex are more likely to wait longer before having sex and to use some method of protection when they do. Among sexually active teens, 56% say they never talked with their parents about sexual health issues.
Peers: Many teens say they feel a lot of pressure about sex from peers and partners (Kaiser Family Foundation, 2003b). When teens believe their friends are choosing to be abstinent or use condoms, they are more likely to do so themselves. When they believe their friends are having sex or not using condoms, teens are more likely to be sexually active.
Alcohol and other drug use: Substance use increases the chance that a teen will engage in unprotected sex. In 2 national surveys:
* Among the 33% of teens who are sexually active, 26% had used alcohol or drugs at last sexual intercourse (CDC,2002b).
* Of the students who reported using substances, only 35% of boys and 23% of girls used a condom, compared with 78% of boys and 67% of girls who reported never using a substance (Kaiser Family Foundation, 2002d).
*Fifty-five percent of teens say that having sex while drinking or using other drugs is often a reason for teens having unplanned pregnancies (Kaiser Family Foundation, 2002d).
Media: According to a survey by the National Campaign to Prevent Teen Pregnancy (2002), more teens say they’ve gotten information or advice about sex in the past month from the media (61%) than from other sources such as friends (57%) or parents (55%).
Television programs, movies, music videos, video games, magazines and the Internet are saturated with sexual content. The media rarely depict sexual behavior in the context of along-term relationship, use of contraceptives or negative consequences of having sex.
The average American teenager spends about 20 hours a week watching television. TV and other media shape teens’ ideas of what others their age are doing, saying and thinking. Heavy exposure to sex in the media is associated with teens perceiving increased frequency of sexual activity among their peers (American Academy of Pediatrics,2001b).
R-rated movies contain more explicit portrayals of sexual behavior than television shows, and music videos often portray suggestive sexual behavior, aggression or violence.
In addition, while many Internet sites contain information about healthy sexuality and offer a convenient way for teens to get information, the Internet also can expose teens to hard-core pornography or unwanted sexual advances in chat rooms or other meeting venues.