Bravo! to Dr. Laura Offutt and The College of Physicians of Philadelphia for their “global initiative to help teens take charge of their health” last week during Teen Health Week. The toolkits they created for important health issues encountered by teenagers — violence prevention (covered here on The PediaBlog last week), preventative care and vaccines, healthy diet and exercise, mental health, substance use and abuse, and oral health — provides an array of knowledge and resources for all. The Sexual Development and Health toolkit is no exception and provides a fascinating (and a little frightening) global perspective to the topic:

Teenagers experience major physical and emotional changes as they grow into adulthood. Sexual development is, of course, an essential part of human growth and development. It’s important that teens have access to accurate and unbiased information so that they can understand their bodies and the changes they are experiencing.

Healthy perspectives on sexuality — and a destigmatized approach to sexual development — are important to the holistic development of teenagers. The truth is, too many adolescents are unprepared for puberty and the physical changes that will occur. Too many are unaware of the details around sex and pregnancy, and how to prevent unwanted pregnancies and sexually transmitted infections. And most alarming, too many teens are unprepared to seek help or know where to find it when they need it.

Young women may disproportionately experience higher levels of unmet need for family planning due to lack of full knowledge of their contraceptive options, poor access to services (particularly those designed for young people), or an underestimation of the needs of youth in family planning programs.

 

The bottom line is this sentence: “The truth is, too many adolescents are unprepared for puberty and the physical changes that will occur.” How can teenagers possibly be prepared for a biological process where genes and hormones take charge and orchestrate extraordinary and rapid growth spurts of the mind and body? Having a discussion at home and at school, with family and with friends, about these facts would be a great place to begin. (It’s a long read — footnotes have been removed but references are available with each toolkit — but totally worth the time.):

  • On average, young people in the United States have sex for the first time at about age 17, but do not marry until their mid-20s.
  • The proportion of US young people having sexual intercourse before age 15 has declined between 1995 and 2013 from about 19% to 13% of never-married females, and from 21% to 18% of never-married males.
  • More than 1 in 10 births worldwide are to girls aged 15 to 19 years old. In fact, the leading cause of death for 15-19 year-old girls globally is complications from pregnancy and childbirth.
  • More than 2 million adolescents around the world are living with HIV.
  • Three percent of US males and 8% of US females aged 18–19 in 2006–2008 reported their sexual orientation as lesbian, gay or bisexual. During the same period, 12% of females and 4% of males aged 18–19 reported same-sex sexual behaviors.
  • Adolescent sexual activity may include behaviors other than vaginal intercourse. In 2007–2010, about half of US adolescents aged 15–19 reported ever having oral sex with an opposite-sex partner, and about one in 10 reported ever having anal sex with an opposite-sex partner. In a survey of more than 45,000 young people in Britain, among heterosexual couples, vaginal and oral sex are the most common sexual practices, but 1 in 4 report engaging in a combination of oral, vaginal and anal sex in the preceding year.
  • Adolescents in the United States and Europe have similar levels of sexual activity. However, European adolescents are more likely than US adolescents to use contraceptives (like condoms or the pill) and to use the most effective methods; they also have substantially lower pregnancy rates.
  • Adolescents and young adults aged 15–24 account for about half of new cases of STIs in the United States.
  • Adolescents across the world are exposed to unwanted pregnancy risk. For instance, in India, there are more than 240 million adolescents between the ages of 10-19. 1 in 3 sexually active adolescent females do not want a pregnancy, yet of those unmarried young women, 75% are not using any form of contraception. Only 13% use a condom. Of adolescent females in Peru, for instance, more than half of unmarried, sexually active 15-19 year-olds use no birth control (including depending on periodic abstinence and withdrawal).
  • Exposure to online pornography is common amongst teens, with rates of exposure increasing with age. One study of more than 1000 UK teens, which replicates findings seen in other countries, found that by 15 years of age, more teens were likely to have seen online pornography than to have not, and they were equally likely to deliberately look for it as to find it by accident. Reasons for deliberately looking at online pornography include searching for answers about sex and curiosity about sexual behavior and the body.
  • Gender identity refers to how a teen views themselves: as male, as female or in between. Different cultures view gender identity differently, so estimating rates of transgender identity is difficult. One study of middle school students in San Francisco found 1.3% of students identified as transgender; however, the World Professional Association for Transgender Health estimates between 1 in 12,000 to 30,000 youth are transgender based on patients who have sought medical care (thus represents an underestimate).

 

All the toolkits that are part of Teen Health Week are this packed of useful information that can lead to really important discussions with teenagers.  This in particular might be one to read, share, and discuss.

All the Teen Health Week toolkits are available on the College of Physicians website here.