Just two days ago, I blogged a story about Eastern Health
and their 40
denim bags full of condoms. But they still seem to be losing their Liberal (and
disgraceful) cause.
According to Michelle Cretella, family ties, not condoms,
protect teens’ health. Furthermore, she notes well that some paediatricians do
not agree with dishing out condoms to teen patients and summarizes her
findings:
Studies demonstrate that parents who promote abstinence and have a
history of open communication with their children are successful in delaying
sexual debut. The promotion and distribution of condoms and contraception by
physicians undermines the authority of parents and the strength of the
abstinence message. Instead, parents and physicians must work together
repeatedly offering clear, firm guidance regarding how to attain optimal health
while maintaining emotional warmth and connection.
Full
article follows:
Family ties, not condoms, protect teens’ health
Some paediatricians do not agree with dishing out condoms to
teen patients.
Michelle
A. Cretella | 29 November 2013
The American Academy of Pediatrics, a national organization
of pediatric healthcare providers, recently issued a position statement that
advocates pediatricians not only teach teens how to use condoms but also to
dispense them in the office. Intuitively, this makes sense. Used correctly and
consistently, condoms decrease the risk of acquiring sexually transmitted
infections (STI's) and unwanted pregnancies. Therefore, increased availability
of condoms coupled with more education should lead to decreased rates of
STIs and pregnancy among teens.
However, the reality is likely to be otherwise. This is why
another national pediatric organization, the American College of Pediatricians,
favors, instead of dispensing condoms, the aggressive forging of family
connections throughout childhood and adolescence.
As America approaches nearly four decades of condom and
contraception-centered sexuality education in schools and physician offices
across the nation with increased availability of condoms and contraception to
teens, how have American adolescents fared? The answer is: not well.
Adolescents now face a growing three-part epidemic of STIs, teen pregnancy and depression.
Sexually active adolescents and young adults under age 25
account for 50 percent of the 19 million new cases of STIs annually in the
United States. One in five Americans over age 12 is infected with genital
herpes, and one in four sexually active girls over age 13 is infected with at
least one STI. In short, America has failed to achieve a level of condom use
among teens that would come close to eliminating those STIs for which condoms
are most preventive (chlamydia, gonorrhea and HIV) let alone those for which
condoms are least preventive (herpes and human papillomavirus, or HPV).
Equally concerning, one in thirteen high school girls
becomes pregnant each year in America. Adolescent pregnancy results in
decreased educational and vocational opportunities for the mothers, increased
likelihood of the family living in poverty, and significant risk for negative
long-term outcomes for the children.
This paradoxical association of increased contraception
and/or condom use coupled with increasing rates of STIs and in some cases,
increasing rates of teen pregnancy, among adolescents is not limited to the
United States. Thailand experienced an increase in STI transmission rates
among its youth despite extensive promotion of condoms. Similarly, in Spain,
STIs have increased despite rates of youth condom use being among the highest
in Europe.
Since 2000 Britain, in addition to promoting condoms, has
provided the morning after pill to teens for free. What has followed is a 5
percent increase in STIs among the under-18 age group, and a 12 percent
increase among the under-16’s. At best, there has been no impact upon teen
pregnancy rates; at worst, some evidence points to a small increase in the
number of teenage pregnancies. There are two reasons for these trends: adolescent
cognitive development and risk compensation.
The frontal cortex of the brain is responsible for executive
functioning skills. In adolescents, this part of the brain is still in
development and unable to consistently control actions in emotional situations.
Thus, teens may repeat ad nauseum that condoms will only decrease risk of
disease and pregnancy when used correctly during every single sexual act, and
may prove they are skilled at applying a condom over a banana in a physician's
office, but this does not mean that they will take these precautions in the
throes of passion. In fact, most cannot.
A second reason for the paradox is the phenomenon of risk
compensation. Risk compensation is a theory of behavior which observes that
people behave less cautiously in situations in which they feel more protected.
Among those adolescents and adults who do use condoms and contraception
correctly and consistently, they may end up engaging in sex more frequently and
with more partners, thus negating the protection offered.
The bad news does not stop there, however. Even if
physicians could guarantee that sexually active teens escape STIs and
pregnancy, there is not now, nor will there ever be, a condom, contraceptive or
vaccine for the heart. Teenage sexual activity is an independent risk factor
for developing low self-esteem, major depression, and increased risk of
suicide.
In studies that controlled for confounding factors, sexually
active girls were found to be three times as likely to report being depressed
and three times as likely to have attempted suicide when compared to sexually
abstinent girls. Sexually active boys were more than twice as likely to suffer
from depression and seven times as likely to have attempted suicide when
compared to sexually abstinent boys. This is not mere coincidence.
Scientists now know that sexual activity releases chemicals
in the brain that create emotional bonds between partners. Breaking these bonds
can cause depression and make it harder to bond with someone else in the
future. Clearly, sexual abstinence is the only way to guarantee optimal sexual
and mental health for adolescents.
Studies demonstrate that parents who promote abstinence and
have a history of open communication with their children are successful in delaying
sexual debut. The promotion and distribution of condoms and contraception by
physicians undermines the authority of parents and the strength of the
abstinence message. Instead, parents and physicians must work together
repeatedly offering clear, firm guidance regarding how to attain optimal health
while maintaining emotional warmth and connection.
Michelle Cretella MD is the Vice-President of the
American College of Pediatricians and chairs the College’s Committee on
Adolescent Sexuality. She is also a member of the American Academy of
Pediatrics.
For more information visit the following websites:
American College of Pediatricians: www.Best4Children.org
Medical Institute for Sexual Health – Building Family Connections:
http://www.buildingfamilyconnections.org/
National Physicians Center - Prescriptions for Parents: http://www.physicianscenter.org/v1/videos.php
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