When talk turns to teen sex, the focus is on risks: abortion, pregnancy, and sexually transmitted infections (STIs).
And while these issues are serious, some experts believe there is another, potentially more dangerous risk frequently left off the agenda: abusive relationships.
"If you are in an emotionally destructive relationship it can become a lifelong spiral downward," says Kim Martyn, sexual health educator with the Toronto Public Health Department. "These situations can be hard to find your way out of and they set up negative patterns for future relationships."
Martyn says that while parents become upset over the possibility of their teenage daughter becoming pregnant, in her opinion, it is not as serious as being in an emotionally destructive relationship. "Why? Because with the right living situation, you can still get on with your life even if you are a teen mum. It's a challenge and I wouldn't wish it on anyone but you can still be positive - particularly if you have support." Not so with destructive relationships, she says, which often have lasting and sometimes permanent effects.
Martyn holds similar views on abortion. "If someone is emotionally healthy and she feels it's her own choice, apart from some feelings of sadness for what could have been, women tend to move on and they are just fine." Something which is much more difficult to do once in an emotionally destructive relationship.
One of the unfortunate ironies is that many parents focus on the risks of sex itself and emotionally destructive relationships may progress for some time without intercourse. This may lead parents into thinking that things are okay when big trouble is brewing. Trouble that can lessen the chances that their daughter will lead a happy, productive life as an adult.
Characteristics of destructive relationships
Parents should watch for the danger signs: a boyfriend who is demanding to know where she is at all times, calling constantly, checking on her - which may seem appealing at first," says Barbara Neilson, a social worker at The Hospital for Sick Children (SickKids) in Toronto. Neilson says a teenager who slowly cuts off contact with other friends and only spends time with the boyfriend is another worrying sign.
For the most part, those at risk are girls and, in many cases, the boyfriend in question is somewhat older. Since an older man may seem more sophisticated and have access to material things not normally available, such as a car, disposable income, and an apartment, teen girls are often 'swept away'. Sometimes, girls may be impressed simply because their new boyfriend is not an immature teenage boy. At the same time, an abusive boyfriend need not be older nor be the possessor of material things. A controlling nature and a vulnerable girl are all that is required.
"[The abusive boyfriend] starts to break down the person's sense of self and confidence," says Martyn, adding what often happens next is the boyfriend will "introduce them to potentially more destructive activities such as skipping school, alcohol and drug use, and unsafe sexual activity." Perhaps encouraging a teen to go through with an unplanned pregnancy as a means to gain and hold on to control of the teen.
Both Martyn and Neilson agree that the most vulnerable are teen girls with low self-esteem from families with poor communication skills.
Positive, realistic representations of teen sex and relationships: non-existent
"You wouldn't want to learn about sex and relationships from TV, video, and pop culture," says Martyn, offering one explanation as to why teens can make catastrophic decisions when it comes to these matters. "The bodies are not real: breast and penis size, skin is perfect," she says about media depictions of sexuality. "The relationships are fabricated as well. There isn't any intimacy and tenderness, and though there may be a nod to it, safe sex is not discussed." Martyn says since teen sexual relationships tend to include intimacy and responsibility when it comes to safety issues, many teens know these media do not depict reality. However, not all understand this or have the strength to resist the media's seductive message.
A recent study published in the journal Pediatrics concluded that the media in general shows "frequent and compelling portraits of sex as fun and risk-free" and that the higher the exposure to sexual content in movies, TV, music and magazines, the more likely teens were to have intercourse.
So while some but not all of the risks are addressed in some venues, the competing and louder message is that there are no risks and those who partake are having a great and care-free time being perfect sexual athletes.
Two strategies: preventing sex or preventing the risks?
Drawing on data from 30 developed nations, a 2001 Guttmacher Institute report on teen sexuality addressed how different countries cope with these conflicting messages and the issue of teen sexuality in general. Comparing societal attitudes and rates of abortion and pregnancy, the study came to what many might consider a controversial conclusion:
"Societal acceptance of sexual activity among young people, combined with comprehensive and balanced information about sexuality and clear expectations about commitment and prevention of childbearing and STIs within teenage relationships, are hallmarks of countries with low levels of adolescent pregnancy, childbearing, and STIs."
In other words, if you educate kids about all the risks, set clear guidelines about expectations and responsibilities, and let them know sex is okay under these circumstances, the rates of abortion, teenage motherhood, and STIs go down.
Many parents and some governments do not agree with this position.
"We have some groups in our country who would like to prevent unintended pregnancy and sexually transmitted diseases, and some groups that would like to prevent people from having sex," Jonathan Klein, chairman of the American Academy of Pediatrics Committee on Adolescents, told the Washington Post in May 2006, adding that both groups are willing to distort research to support their position.
Without a doubt, just as not getting involved in relationships is the best way to prevent an abusive one, abstinence is the best way to prevent pregnancy, abortion, and STIs. The problem is many teens refuse to be abstinent.
Attitude, knowledge, and skills
"If we look at any activity in life, it's about attitude, knowledge and skills. Attitude comes from the family mostly," says Martyn. "You can ask them to wait until marriage but unless they have embraced the family's values or religion, it's unrealistic." In terms of knowledge, Martyn says promoting critical awareness is key and it is not enough to let the schools provide the right amount of accurate information.
"Skills are the most neglected part because parents, schools, and churches are uncomfortable with acknowledging that there are skills that people need as they grow to navigate adulthood. It's still the old thinking: if we address it, we are encouraging them to do it."
So, abstinence is unrealistic for many teens but at the same time, parents don't want their teens running around getting into trouble in relationships, whether they be sexual or not.
"Everything is being aware of what's going on - not in a snoopy way but knowing the friends at school and meeting boyfriends or girlfriends," says Neilson. "Continue to convey what the family values are in conversation with this person who is growing up."
Neilson says that open communication is the key. Unfortunately, teens can be as notoriously bad at communication as, well, parents. The way to overcome this is to begin early, do not stop, and be realistic.
"As adolescents get older, pick and choose the times to talk with them. Rides in the car work because you are not looking at each other's faces. There is less intensity." Neilson suggests that teens should be taught about healthy relationships and parents should "appeal to where they are headed as opposed to where they have been. You have to teach them to think."
In addition to not having a dialogue about sex and relationships, some parents make the mistake of panicking when they discover their teen is sexually active. Panic is often expressed as lecturing or punishing. "You need to have limits that ease up at each age but you have to recognize that you can't control them."
Attempts to assert complete control over sexual and other relationships tend to fail. "If undue control is exercised, teens often feel resentment and may flip into depression because they feel they don't have control," says Martyn. "In many of these cases I've watched them choose a time to rebel and react first chance they get. They also take off. Kids will not tolerate it - especially in Canada,- a country where youths can get contraceptives more or less for free and parents have no right to their teens' medical records, including those concerning reproductive health."
Neilson suggests arming teens with all the information they need, encouraging a strong sense of self, and demanding that they take responsibility for their actions. To do this, parents need commitment and follow through. There is a pay-off: "Kids with good self-esteem are going to have a healthy sexual life."
More sex advice for parents and teens
- Build close, caring relationships with your children early in childhood.
- Talk early and often with your children about sex.
- Let teens know how you feel about what they are going through and what you expect.
- Try to compare your youth experience to your teens'.
- When you hit resistance, try not to take it personally.
- Be clear about your own sexual values and attitudes.
- Invite boyfriends and girlfriends over to the house for family dinners.
Jonathan Link
Medical Writer
AboutKidsHealth