Teens are having more sex--and getting more diseases. But is telling them to wait the answer?
"With [the abstinence-only program], you have to agree not to teach a more comprehensive approach," says James Greenwood, a Pennsylvania Republican who, along with Reps. Lynn Woolsey and Barbara Lee, California Democrats, has introduced legislation calling for $100 million for comprehensive, "medically accurate" sex education. "It's a case of substituting rigid, untested ideology for well-tested and scientifically defensible measurements of how young people behave," he adds. "It's insanity. It's nuts."
Rep. Ernest Istook, an Oklahoma Republican, who proposed the abstinence-only program that stands to get the largest funding increase under the proposal, disagrees. "Too often, the government has failed to stand up for values held by most Americans." Teaching contraception, he adds, amounts to "a self-defeating attitude. It's like giving up before you start."
What nearly everyone agrees on is that STDs and risky "anything but intercourse" behaviors are rampant among teens--and that what to do about it is a very complicated question. Across the country, clinicians report rising diagnoses of herpes and human papillomavirus, or HPV (which can cause genital warts), which are now thought to affect 15 percent of the teen population. Girls 15 to 19 have higher rates of gonorrhea than any other age group. One quarter of all new HIV cases occur in those under the age of 21. "It's a serious epidemic," says Lloyd Kolbe, director of the CDC's Adolescent and School Health program. "We're worried."
Bringing it home
At the Health Interested Teens Own Program on Sexuality (HiTOPS) clinic in Princeton, the only adolescent health clinic in the state of New Jersey, Monday is the busiest day of the week, as teens flock in after coed sleepovers and weekend trysts. Fortunately, says Claire Lindberg, a nurse at the clinic, her most common diagnosis is "nothing to worry about." That's what Kate was told when she recently went to the clinic, afraid she might have contracted an STD from her boyfriend, whom she suspected of cheating. But running a close second at HiTOPS are chlamydia and herpes. Lindberg has also seen "lots and lots" of abnormal Pap smears, most often caused by HPV and increasingly common among adolescents.
"Kids come in thinking they have strep," says Marla Kushner, a physician who runs a school-based adolescent health clinic in Chicago. When they find out they actually have gonorrhea of the throat, she says, "They're grossed out--and they're devastated. They have no idea that these sorts of things even exist."
Those sorts of things, on the whole, are the result of an expansion of risky behaviors in which kids are increasingly dabbling--at increasingly young ages. According to several surveys, as many as half of teens ages 13 to 19 say they have had oral sex. "I don't think many people would quarrel with the suggestion that oral sex among young people is much higher than it was 10 years ago," says Kolbe. And most often, Kushner adds, the kids are convinced that their choices are risk free.
Then there are the teens--and preteens--too young to fathom the consequences, both emotional and physical, of their behavior. Lynn Ponton, a professor of psychiatry at the University of California-San Francisco and author of The Sex Lives of Teenagers, says that this early initiation into sexual behaviors is taking a toll on teens' mental health. The result, she says, can be "dependency on boyfriends and girlfriends, serious depression around breakups and cheating, lack of goals--all of these things at such young ages."