Chapter 12 Sexuality During Childhood and Adolescence

1. Chapter 12Sexuality During Childhood and Adolescence

2. Infant sexuality • Capacity for sexual response present from birth • Infants engage in self-pleasuring activity • Pelvic thrusting, rubbing genital area against an object (doll, pillow, etc.) • In some cases, infants have been observed to experience what appears to be orgasm • Unable to differentiate sexual from sensual pleasure • Many natural everyday activities, breast-feeding, bathing, diapering, involve pleasurable tactile sensation

3. Childhood sexuality • Normative behavior not well studied • Research limited by political squeamishness over what “might be interpreted as exploiting children or introducing sexual ideas to them” • Difficult to get funding or approval for research on childhood sexuality • Much of what we know about childhood sexuality relies on recollections of adults about their childhoods • Sexual behavior is normal part of development • Important to remember that adults tend to interpret childhood experiences in terms of the meanings that adults attached to them--to the child, it’s not “masturbation w/the goal of climax;” it’s just pleasurable self-touching

4. Childhood sexuality (cont.) • Masturbation (rhythmic genital manipulation; not just rubbing) starts at 2-3 years • Important for parents to express acceptance and reinforce idea of privacy that most kids already understand • Sex play starts 4-7 years • Curiosity about sexual parts, sexual behaviors • 5-7 year olds begin to enact marriage (heterosexual)scripts • Ex: playing house

5. Childhood sexuality (cont.) • Emergence of homosociality 8-9 years • boys and girls play separately, though may have romantic interest in other sex • Interest in reproduction and sexuality is high • Interest in bodily changes starts at 10-11 • May be self-conscious about their bodies • Separation from other sex is still common • Children of this age often strongly protest suggestions of romantic interest in other sex • Sex play w/children of same sex is common-- may be a transition to heterosexual orientation or may reflect homosexual or bisexual orientation • Important for parents to avoid responding negatively or labeling the activity according to adult labels of sexual orientation

6. 12-A Discussion question: Assume that you are a parent of a 7-year-old and that one day you find your child playing doctor with a playmate of the same age of the other sex. Both have lowered their pants, and they seem to be involved in visually exploring each other’s bodies. How would you respond? Would you react differently according to the sex of your child? What about if the other child was of the same sex as your child?

7. Physical Changes of Adolescence • Puberty: period of rapid physical changes in early adolescence during which the reproductive organs mature • onset between 8 to 14 years; 2 years earlier in girls • triggered by release of pituitary gland hormones called gonadotropins • Chemically identical in males and females • In males, cause testes to increase testosterone production • In females, cause ovaries to increase estrogen levels

8. Physical changes during puberty • Primary sex characteristics: physical characteristics in genital development that indicate sexual maturity • females: • thicker vaginal walls • larger uterus • enlarged labia • vaginal secretions • menarche around age 12 to 13; age has fallen • males: • larger prostate, penis, seminal vesicles, and testes • 1st ejaculation around 13

9. Changes in age of puberty onset in girls • From 1840 to 1960, the average age of menarche fell sharply from 17 to 13 years. • Thought to be due to improved health and nutrition • Over the past 40 years, average age of menarche has declined slightly and is now at 12.3 years. • Ethnic differences exist in age at menarche (see Table) • Average age of onset of breast development was 11.5 years in 1970; by 1997, age was < 10 for Caucasian girls and <9 for African-American girls Table 12.2: Age at menarche

10. Physical changes during puberty • Secondary sex characteristics physical characteristics other than genital development that indicate sexual maturity • both sexes: • pubic hair, • growth spurt (earlier in girls) • genitals enlarge • axillary oil-secretion • females: - males • breast buds • voice deepens • voice changes • facial hair

11. secondary primary Physical changes during puberty

12. Sexual behavior during adolescence • The sexual double standard • Different standards of sexual permissiveness for women and men--more restrictive standards are applied to women • Recent evidence suggests that double standard exists but may be diminishing • Males • focus of sexuality = conquest • peers reinforce aggressive & independent behaviors • females • focus of sexuality = relationship • dilemma: need to appear sexy to attract males, but does not want to appear “easy”

13. Sexual behavior during adolescence • Masturbation • increase in frequency & numbers • By the end of adolescence, almost all males, and ~3/4 of females have masturbated • safe sexual release • learn about self • Noncoital sexual expression • Noncoital sex: physical contact excluding coitus (i.e. kissing, touching, and manual or oral-genital stimulation) • oral-genital activity has increased • how far to go often an issue • learning about sexual intimacy • technically can “stay a virgin”

14. Sexual behavior during adolescence • Ongoing sexual relationships • more common at this age than in past • narrowing of gender gap: females less likely to "save themselves" for marriage; males more likely to want an affectionate relationship • Sexual intercourse • incidence of teen coitus: strong upward trend from 1950s through the 1970s Upward trend has leveled off, & even decreased in last two decades

15. 9 10 11 12 Sexual behavior during adolescence • From 1991-2005, overall % of h.s. students in U.S. who had ever had intercourse declined somewhat for all grade levels • Condom use among sexually active h.s. students  somewhat SCAN IN FIG. 12.4, p.333

16. Sexual behavior during adolescence Reasons for having first intercourse

17. Early intercourse Low SES/poverty Family conflict/marital disruption/single-parent or reconstituted family Low parent education and supervision Substance abuse Low self-esteem, hopelessness Poor academic performance Exposure to TV w/high sexual content Previous sexual abuse Later intercourse Higher SES Religious beliefs Spiritual interconnectedness w/friends Good relationship with parents, and perception of parental disapproval of teen intercourse good school performance Late onset of puberty Factors that predispose teenagers to:

18. American ethnic diversity in adolescent sexual experiences • African American teens are more likely to engage in coitus than either white or Latino American teenagers • Ethnic differences in adolescent sexual experiences may be related more to socioeconomic status than to race/ethnicity • African American adolescents raised in more affluent homes are more likely to abstain from intercourse than their poorer counterparts

19. 12-B Discussion question: Assume that you are a parent of a teenager who asks, “How do I know when I should have sex?” What would you answer, and why?

20. Homosexual identity & experiences during adolescence • Same-sex sexual contact between peers common • May reflect experimentation or may be an expression of a lifelong sexual orientation • Some gays & lesbians do begin to define their homosexuality as teens • frequently experience adverse societal reactions • Double rebuke--b/c they are sexually active in the 1st place and b/c of their sexual orientation • Reconciling orientation can be difficult; are often rejected by peers and family • Adolescents who are thought to be homosexual are sometimes bullied, harassed, or physically assaulted • Disproportionately high rates of depression, substance abuse, and suicide attempts among gay teens

21. Homosexual identity & experiences during adolescence • Support for teens with same-sex orientation is increasing • Gay-Straight Alliances now exist on many high school and college campuses • Clubs composed of gay and straight people who exchange information and support, work to change anti-homosexual attitudes in their schools

22. Effect of AIDS on teen sexual behavior • Largest % of AIDS cases in US are people in their 20s and 30s who were infected w/HIV in their teens and 20s. • People < age 25 account for 50% of new HIV infxns. • Most teens know the basic facts about AIDS and other STDs, but falsely believe that they are not at risk • Don’t change their behavior to protect against HIV, other STIs • condoms viewed more as BC than as STI protection • No protection used for anal sex, oral sex

23. Adolescent Pregnancy • The U.S. has the highest teen pregnancy rate in the Western industrialized world--roughly 4x higher than in several W. European nations, even though the levels of teen sexual activity in these countries are ~ the same • 1 in 5 sexually active teens becomes pregnant each year • Of these: 51% result in live births, 35% in induced abortion, and 14% in miscarriage or stillbirth • impacts teen mother's and baby’s physical health • More complications in pregnancy in teen moms • Pregnant teens are very unlikely to use protection against STDs • impacts SES and education • Teen moms often drop out of school, many do not return • Future employment options limited, often dep. on social services • impacts quality of parenting • Children of teen moms are more likely to have physical, cognitive, and emotional problems; problems in school, etc.

24. Contraceptive use among teens • Teens less likely to use BC consistently or correctly; Why? • Lack of adequate knowledge about BC options • Abstinence-only sex education programs in schools • Teach teens that abstinence is the only option w/o providing any positive information on effective contraceptive methods • Planning ahead implies loose morals? • Fear of pelvic exam; embarrassment about seeking BC • Confidentiality concerns • Less stable relationships • Difficulty communicating with partner • Positive note: contraceptive use among teens is higher today than it was 10 - 20 years ago.

25. More likely to use BC In stable relationship; good communication w/partner Able to communicate with parent about BC Feel competent and have good self-esteem Have families which stress personal responsibility Have access to BC info Good performance in school and have well-educated parents Less likely to use BC Not in stable relationship; sporadic intercourse Teen women involved w/older (3+ yr) partner Teens who have sex at earlier ages When intercourse occurs after alcohol consumptn. Lack of sexual confidence & assertiveness (esp. in teen women) Factors correlated w/teens who are:

26. Strategies to reduce teen pregnancy • Free, confidential contraceptive services • Family planning clinics, school-based health clinics • Compulsory national sex-education • Should occur before most teens are sexually active • Safe expression of teen sexuality should be treated as a health issue rather than a political or religious issue • Focus on shared responsibility for BC • Teen males often consider BC to be female’s responsibility • Survey: teens that believe that responsibility for BC should be shared are more likely to have used BC effectively • Relax governmental restrictions • Research shows that making condoms available in middle schools and high schools increased condom use by sexually active teens, but did not contribute to any increase in teen sexual activity

27. Sex education: parents • Most kids begin to ask how babies are made by ~4 • Important not to blunt their curiosity (i.e. “You’re too young to learn about such things” • Try to respond w/a sense of ease and naturalness; ok to express if you feel uneasy discussing sex • Keep answers direct, honest, and at the child’s level of understanding • Let child know that you are open to more questions • If child’s questions don’t arise spontaneously, parent may want to initiate a discussion about sex • Some open-ended questions: • What do you think sex is? • What do you know about how babies are made? • What are some of the things that your friends tell you about sex?

28. Sex education: parentsINITIATING CONVERSATIONS ABOUT SPECIFIC TOPICS • Some topics don’t get discussed unless parents take the initiative • Make child aware of physiological changes before they actually happen • Menstruation, first ejaculation, nocturnal orgasms, etc. can come as quite a shock to someone who is unprepared • Most young people prefer that their parents be the primary source of information about sex • Adolescent children who have open, positive, and frequent communication w/parents are more likely to have fewer sexual partners and later and less frequent sexual activity than teens who don’t talk to their parents about sex

29. School-based sex education • 52% of school districts, and 57% of school require sex education at the elementary school level (2001) • Quality of programming varies • Many programs leave out info about how BC, STIs, discussions of interpersonal aspects of sexuality (stick to “safe” topics, like reproduction and anatomy) • Most parents support sex ed in schools • Poll: 93% of adults support sex ed in h.s., and 84% support sex ed in middle school • Majority of adults reject abstinence-only approach to sex ed and believe teens should be given info about how to avoid STIs and unplanned pregnancies • Research shows that comprehensive sex ed programs do not increase sexual activity, but they do decrease high-risk behaviors

30. Abstinence-only sex education • Survey of nationally representative sample of school districts • 35% taught abstinence only sex ed (discussion of BC is prohibited, or BC is simply said to be ineffective) • 14% taught comprehensive sex ed (includes info about sexual maturation, BC, abortion, STIs, relationship issues, and sexual orientation) • Congressional report (2004): majority of federally funded abstinence-only programs presented inaccurate and misleading information, failed to separate science & religion • So far, $900 million federal tax dollars have been spent to fund abstinence-only sex ed programs, and $0 has been spent on comprehensive sex ed • Data shows that: • abstinence-only programs have no effect on adolescents’ attitudes toward sex or when they begin engaging in sexual activity • No reduction in teen pregnancy and spread of STIs