The Doctor Weighs In

By Pat Salber, MD

I know all of us parents like to think that we can keep our children as pure as the first driven snow – up to at least age 35 or 40 - if only we could be good enough parents and/or we just try hard enough.

The truth is, however, teen life is very complicated nowadays and parental control, no matter how much we wish otherwise, is diluted by the many influences shaping the thoughts and actions of today’s teens. There is TV, radio, CDs, the movies, the internet, text messaging, magazines, video games, the mall, a norm of sexy dressing, other stuff I don’t even know about.

I don’t mind any of it, really. It is how our culture has evolved. And besides, it is fun to watch, but it can also have serious consequences.

I believe our parental goal should be that we have helped our offspring to navigate this challenging “new world”  so that they get through their pre-teen, adolescent, and young adult years safe and as happy as possible. We should aim to help them keep as many options open for their future as is feasible. If we are able to accomplish that, well then, I think it is pretty good parenting, and more importantly, I think our offspring will have developed some important life skills that will serve them well into adulthood.

It shouldn’t surprise you then that my world view is this: If we are to be credible to teens as their adults, we have to provide them with a lot of information combined with ample opportunity to talk to us about what that information means. We should not censor any information that could be used to help them make the right decisions for themselves.

That gets me to the topic of today’s post: The increase in teen birth rates as reported on 12/5/07 by the Centers for Disease Control (CDC). My take away from the press coverage of this report is that censorship by adults of information that kids need to keep themselves safe (and un-pregnant) is probably not a good thing – no matter how well intentioned.

There is a fair amount of analysis out there now that supports the idea that abstinence- only education has been a futile exercise. It denies teens access to credible information from trusted sources (our teachers) about the many and varied choices out there to avoid teen pregnancy. Many – if not most - abstinence-only programs teach that there is only one way to avoid getting pregnant (or avoid getting a sexually transmitted disease). Just DON”T DO IT. But now your daughter is out with the boy of her teen-dreams. She has had some beer (even though you told her not to). And then he kisses her and, and, and, and….even us older adults can remember that scenario.

Now, your baby girl is trying to decide – Sex? Or no sex? Or partial sex? Or safe sex? The hormones are raging…please, tell me, isn’t there something else you want her to know about…condoms, for instance? Knowing about condoms did not get her into that situation. Normal, ordinary, teen-age life did.

If your child is a boy and he is being “Powered by Hormones,” don’t you want him to protect himself from sexually transmitted diseases or teenage fatherhood. Of course you do.  Guys, remember back to your own teen years, were your brains the part of the body that was driving most of your actions????  Would it have helped to have condoms be the norm before sex?

Now to the science. The above rant was sparked by my reading the report on CNN.com about teen birth rates being up for the first time in 15 years. According to the report, there have been an extra 20,000 births to teen mothers since 2005. On a state-by-state basis, states with the highest birth rates teach abstinence-only instead of comprehensive sex education – this is according to the Planned Parenthood Federation of America .

Of course, teen pregnancy rates reflect more than just sex education, but it is an undeniably important component and one that we can impact easier than some of the other influencing factors, such as poverty, and violence.

I really hope we can have an intelligent conversation about sex education going forward.  Perhaps this report will serve as the stimulus to have an evidence-based conversation about how to help our teens  make intelligent INFORMED choices about sex and sexual safety.

As far as I know, censorship of information has never been good long term policy in any arena. I grew up believing that “knowledge is power.” The more I know about all of my options, the better choices I can make for myself. Knowledge doesn’t drive choices – it facilitates choices. 

So, if this is the case, why are we so afraid to empower our teens with valuable knowledge that they can use when they are most vulnerable (for example, when she is out with the hot guy she has been dreaming about? ) This is a particularly relevant question in the information age when teens can find out anything they want with the click of a mouse, but may be reluctant to use that information to protect themselves because they don’t want to disappoint us.