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American Medical Association Family Medical Guide - American Medical Association [228]

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to be respected. If they are not, the teen should get out of the relationship. Teens who don’t want to have sex should not allow themselves to be pressured into having sex with coercive statements such as “Everyone is doing it,” “If you loved me, you would,” or “If you don’t have sex with me, someone else will.” Even if teens have already had sexual experiences, it isn’t too late to abstain from sexual activity until they feel they are ready to accept the emotional commitment and responsibility that a sexual relationship involves.

Sexual Activities Other Than Intercourse

While the percentage of teenagers having intercourse is falling, the percentage of teens who engage in other sexual activities seems to be on the rise. Many adolescents think that having oral sex or “outercourse” (mutual masturbation) rather than vaginal or anal intercourse is not actually having sex and will prevent them from being infected with STDs. Oral sex is not necessarily safer than sexual intercourse—any STD can be transmitted through oral sex. Using a condom or a dental dam for oral sex may help prevent some STDs, but few teenagers use these methods of protection. Sexual activities that involve mutual masturbation or mechanical sex enhancers (such as vibrators) pose a risk for some STDs such as herpes (see page 482), genital warts (HPV; see page 480), or scabies (see page 938).


Homosexuality

Most homosexual people realize that they are attracted sexually to people of the same sex during adolescence. A person’s sexual orientation is established in childhood through a combination of genetic, biological, psychological, and environmental influences. Although biology plays a major role, no specific hormonal or psychological influences have been identified. Parents have little influence on their children’s sexual orientation—and children raised by homosexual parents are no more likely to be homosexual than children raised by heterosexual parents. Kissing or holding hands or having sexual experiences with a person of the same sex during adolescence may simply be sexual experimentation and does not necessarily indicate that a person is homosexual.

Homosexual teenagers have an especially difficult time during adolescence because they fear the rejection of their family and friends. The biggest problems with their homosexuality are often social and emotional issues. A network of friends, especially from within the homosexual community, can give a gay teen the support he or she needs. If a teen is having a difficult time accepting his or her sexuality, he or she can benefit from talking to a counselor who specializes in helping people accept their sexual orientation and learn positive, healthy ways to deal with it.

Sexuality: What Can Parents Do?

The single most important thing you can do as a parent to help your child develop a healthy understanding of sex and sexual relationships is to be available and open in discussing the topic and answering questions. Having this knowledge can give your teen self-confidence and enable him or her to make responsible decisions about sex. Here are some tips:

• Make sure your children are well informed about sex.

• Encourage your children to ask questions about sex, and give them honest answers.

• Stress that there are other ways than sex to have a close relationship with someone. Suggest going dancing or to movies, plays, or sporting events; participating in sports; or going out with a group of friends.

• Explain the risks of oral sex. Many teenagers think they are “abstaining” from sex by engaging in nonintercourse sexual activities. They don’t realize that they can contract many sexually transmitted diseases (STDs)—including chlamydia, gonorrhea, herpes, genital warts, and HIV—through oral sex.

• Explain the risks of sexual intercourse, including pregnancy and STDs. Teenagers also need to know where they can be treated for STDs, and that not all STDs can be cured. Emphasize the importance of reporting an STD to a doctor so that all of their sexual contacts can be located and treated. Stress

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