Thursday, June 05, 2008

Teenage Sex

In the past 16 hours, I've removed extensive perineal condylomas (laser ablation) from a 14 year old and removed a tubal ectopic pregnancy (laproscopic excision) from an 18 year old. Well, I "assisted" with the procedures... Ectopics occur in 2% of pregnancies, are fatal to the fetus and very dangerous to the mother. They must be removed ASAP - hence the call at 10:30 tonight. Genital warts are far more common. I think every human is infected with at least one of the more than 100 human papillomaviruses (HPV). Some of these viruses cause plantar warts, others are to blame for genital warts, yet others predispose women to cervical cancer. If you have an immune deficiency, the virus can turn you into a tree. HPV ranges from benign to deadly. (GUESS WHAT! There's a vaccine for the HPV's that most often lead to cervical cancer! If you're reading this, you're too old - you've already been exposed. But your 10 year-old-daughters haven't. Give them Gardasil. They'll thank you...)

But this gets me back to the point of this entry. Teenagers are having sex. Remember back in the '90's? There was lots of talk about safe sex, safer sex, harm reduction, and a catchy little phrase, "safe, legal and rare." What was the outcome of such openness? Some say there was hypersexualization of pop culture. Wait a minute... Wasn't it an earlier generation that subscribed to free love? Hmmm... It turns out that a concerted campaign to educate teens of the risks of sex and ways to make it safer ACTUALLY reduced the amount of sex teenagers had. Whoa...

Any scientist who's tried to publish the results from a new knockout mouse knows that showing an effect of the intervention is not enough. You need to also show the 'rescue.' Basically, turn the mouse back to the way it was before the change and see if the outcome reverts. Well, whadaya know? The last 8 years HAVE BEEN JUST THAT! Abstinence only, no talk of condoms, no pregnancy preparation no nothing with public money have all combined to flip the culture from the previous decade. That decline in age of first intercourse and encounter frequency stops. It's been in a holding pattern. Well, at least kids aren't having more sex... yet... Teen pregnancy is up this year (first time in 15 years!) and 1 in 4 teenage girls have an STD.

It doesn't take the chairman of the department of population and family health at Columbia University to point out that "abstinence education spends a good amount of time bashing condoms. So it's not surprising, if that's the message young people are getting, that we're seeing condom use start to decrease." But John Santelli went ahead and stated the obvious in a Washington Post article that got me all riled up after a day of medical treatment of the effects of teen sexuality. Sure, comprehensive sex ed will be blamed. (Hey, Jimmy! we sure learned some swell things in school today - you want to do some homework later?) Oh, and don't forget about R-rated movies. And the internet. And hormones. And those perverts at Planned Parenthood.

Humans cannot divide asexually. If we don't talk about the consequences of our species' tendency to rely on genetic recombination, someone else will. It will be your kids' doctors, delivering their babies or treating them for gonorrhea, HPV or worse.

"Just say no!" didn't work for drugs. It looks like it doesn't work for sex, either.

Let's talk...

7 comments:

Mike Haubrich, FCD said...

Regarding Gardasil; I read a poster in the clinic the other night (while we waited for X-rays of my son's thumb,) which explained that adolescent boys should also be vaccinated against HPV because of the rising incidence of certain types of...

mouth and throat cancer.

Good boys! (Just be careful and get that shot!)

LoveLife said...

Talking about sex with our kids...very important to be sure. Here's a potential conversation with Junior.

"I know you're not dumb. I know and you know that the most sure way to avoid unplanned pregnancy and STDs is to practice abstinence. But, come on, let's be realistic. You don't actually think you can do that, do you? In fact, I'm so sure that you'll fail, I'm going to vaccinate you so that when you're potentially exposed, you'll be protected from cervical cancer. And, as your parent, I'm going to make sure you have access to condoms, birth control, whatever you like. Of course I support you in your goals. You want to be president? Go for it. Major league baseball player? Shoot for the stars. But this sex thing...you might as well not even try. There's just too much pressure."

Come on...let's expect more from our kids.

By the way...I have no idea what the results would be or even that it would mean or change anything. But, does anyone have a breakdown of teen pregnancy/STDs for groups of kids that were given abstinence education versus those that weren't? Just curious.

thomas said...

Hi Lovelife,

I'm not sure what you mean in your post. I can't tell which part you are serious about and which lines are jokes.

Thanks for the comment, though!

Anonymous said...

My teen daughter just finished her Gardasil vaccinations. Does commenter lovelife understand that the HPV protection last beyond teen years?

I was surprised when a mom friend (PhD) said she wouldn't vaccinate her daughter, saying the pharma industry is merely trying to scare us into buying more vaccines.

To commenter mike, wow - what a poster! :)

Drugmonkey said...

http://scienceblogs.com/drugmonkey/2008/02/attitudes_on_drug_risk_a_lesso.php


I think the evidence on whether "just say no" approaches work is considerably more complicated than our gut feeling about whether it worked on us individually.

the above post doesn't get into it too specifically but I encourage people to follow the links to the Monitoring the Future data and look at the general trends across and within drug classes. there are long term trends that might be attributable in part to just-say-no, dare and similar efforts...

gay CME guy said...

I used to be a certified HIV Trainer and Train the Trainer for The Red Cross. One of the videos produced by ARC, had a woman talking about condom use and talking with her son. The jist was, "When my son learned to walk, he was taught that he was not to cross the street with out an adult. If for some reason he had to cross the street, w/out an adult he was to look both ways before crossing. This was NOT giving him permission to cross the street alone. It was educating him on what was necessary, should he be in that situation. I always found that analogy to be quite impactful.

acmegirl said...

I'm not sure why so many people think that vaccinating your children against a virus that can cause cancer somehow translates to saying that you don't think they can be responsible in their sex lives. HPV can be spread by ANY sexual contact. That includes with your life partner, if by chance they were exposed before you met. And condoms are not particularly effective at preventing transmission.

Nobody would say that having a flu vaccine means that you don't know how to cover your mouth when you sneeze, would they?

And regarding talking with your kids about sex - I made a conscious choice to be as open as possible with my girls. I started when they were old enough to ask questions. My older one was naturally fascinated with the hows when I was pregnant with the younger one. Now we are just starting to talk about the whys. My goal is for them to ask me questions FIRST for as long as possible, so I can get all the real information in there before they get exposed to the nonsense that kids spread among themselves. It's a process, not just a single conversation.