17 World Health Organization, “Approach to adolescents,” http://www.un.org.in/Jinit/who.pdf.
18 Robert E. Rector and Kirk A. Johnson, Ph.D., “Teenage Sexual Abstinence and Academic Achievement”; available online at: http://www.heritage.org/Research/Welfare/upload/84576_1.pdf.
19 Robert E. Rector, Kirk A. Johnson, Ph.D., Lauren R. Noyes, and Shannan Martin, “The Harmful Effects of Early Sexual Activity and Multiple Sexual Partners Among Women: A Book of Charts”; available online at: http://www.heritage.org/Research/Family/upload/44695_2.pdf.
20 In adult women using hormonal contraceptives, the probability of failure in the first 12 months is 7 percent (injectable) and 9 percent (oral). (Kathryn Kost et al, “Estimates of contraceptive failure from the 2002 National Survey of Family Growth,” Contraception 77 (2008): 10–21); typical use by adult women of oral contraceptives results in pregnancy in 8 percent of them within the first year (www.guttmacher.org/in-the-know/prevention.html).
21 Planned Parenthood, “About Us,” http://www.plannedparenthood.org/about-us/about-us-90.htm.
22 Planned Parenthood, “Who We Are,” http://www.plannedparenthood.org/about-us/who-we-are-4648.htm.
23 Elise DeVore and Kenneth R. Ginsburg, “The protective effects of good parenting on adolescents,” Current Opinion in Pediatrics 17, no.4 (August 2005): 460–65.
24 Most of this material is from DeVore and Ginsburg, 2005.
25 If the girl is out of control and nothing adults do has any impact, the answer is still not birth control; it’s crisis intervention by a team of mental health professionals.
26 Laurence Steinberg, Susie D. Lamborn, Sanford M. Dornbusch, and Nancy Darling, “Impact of Parenting Practices on Adolescent Achievement: Authoritative Parenting, School Involvement, and Encouragement to Succeed,” Child Development 63 (1992):1266–81; Laurence Steinberg, “We Know Some Things: Parent-Adolescent Relationships in Retrospect and Prospect,” Journal of Research on Adolescence 11, no.1 (2001): 1–19.
27 While this is unlikely to be the case for this girl, the information may be relevant for siblings. This is general information that every parent should have.
28 Under the age of 17.
29 Before she turned 5. Bruce J. Ellis, John E. Bates, Kenneth A. Dodge, David M. Fergusson, L. John Horwood, Gregory S. Pettit, and Lianne Woodward, “Does Father Absence Place Daughters at Special Risk for Early Sexual Activity and Teenage Pregnancy?” Child Development 74, no.3 (May/June 2003): 801–821.
30 “Having an unrelated male in the home is also associated with earlier puberty.” In Bruce J. Ellis, “Timing of Pubertal Maturation in Girls: An Integrated Life History Approach,” Psychological Bulletin 130, no.6 (November 2004): 920–58; Bruce J. Ellis and Judy Garber, “Psychosocial antecedents of variation in girls’ pubertal timing: Maternal depression, stepfather presence, and marital and family stress,” Child Development 71, no.2 (March/April 2000): 485–501; Terry E. Moffitt, Avshalom Caspi, Jay Belsky, and Phil A. Silva, “Childhood Experience and the Onset of Menarche: A Test of a Sociobiological Model,” Child Development 63, no.1 (February 1992): 47–58; Bruce J. Ellis, John E. Bates, Kenneth A. Dodge, David M. Fergusson, L. John Horwood, Gregory S. Pettit, and Lianne Woodward, “Does Father Absence Place Daughters at Special Risk for Early Sexual Activity and Teenage Pregnancy?” Child Development 74, no.3 (May/June 2003): 801–21. Regarding the increased risk to early-maturing girls, see Laurence Steinberg and Amanda S. Morris, “Adolescent Development,” Annual Review of Psychology 1, no.52 (February 2001): 83–110; also see Ronald Rohner and Robert Veneziano, “The Importance of Father Love: History and Contemporary Evidence,” Review of General Psychology 5, no.4 (2001): 382–405; Mark D. Regnerus and Laura B. Luchies, “The Parent-Child Relationship and Opportunities for Adolescents’ First Sex,” Journal of Family Issues 27, no.2 (2006): 159–83.
31 P. Donovan, “Mother’s Attitudes Toward Adolescent Sex, Family’s Dating Rules Influence Teenagers’ Sexual Behavior,” Family Planning Perspectives 27, no.4 (1995): 177–78; Renee Sieving, Clea S. McNeely, and Robert Wm. Blum, “Maternal Expectations, Mother-Child Connectedness, and Adolescent Sexual Debut,” Archives of Pediatrics and Adolescent Medicine 154 (2000): 809–16; Melina Bersamin, Michael Todd, Deborah A. Fisher, Douglas L. Hill, Joel W. Grube, and Samantha Walker, “Parenting Practices and Adolescent Sexual Behavior: A Longitudinal Study,” Journal of Marriage and the Family 70, no.1 (February 2008): 97–112.
32 Michael Ungar, “The importance of parents and other caregivers to the resilience of high-risk adolescents,” Family Process 43, no.1 (February 2004): 23–41; M. Resnick, P. Bearman, R. W. Blum, et al, “Protecting Adolescents from Harm: Findings from the National Longitudinal Study on Adolescent Health,” JAMA 278 (1997): 823–32; Renee Sieving, et al, “Maternal Expectations.”
33 Allowing a teen to make health decisions in a closed room with her provider undermines and weakens the parent-child relationship. Planned Parenthood does that with this approach.
34 C. Lammers, M. Ireland, and M. Resnick, “Influences on adolescents’ decision to postpone onset of sexual intercourse: a survival analysis of virginity among youths aged 13 to 18 years,” Journal of Adolescent Health 26, no.1 (January 2000): 42–48; M. Resnick, et al, “Protecting Adolescents from Harm.”
35 Between the ages of 15 and 18.
36 Laura Fingerson, “Do Mothers’ Opinions Matter in Teens’ Sexual Activity?” Journal of Family Issues 26, no.7 (2005): 947.
37 Kimberly K. Usher-Seriki , Mia Smith Bynum, and Tamora A. Callands, “Mother–Daughter Communication About Sex and Sexual Intercourse Among Middle- to Upper-Class African American Girls,” Journal of Family Issues 29, no.7 (2008): 901–17; P. J. Dittus and J. Jaccard, “Adolescents’ perceptions of maternal disapproval of sex: relationship to sexual outcomes,” Journal of Adolescent Health 26, no.4 (April 2000): 268–78.
38 One study of Asian and Pacific Islander teens concludes, “[This] highlights how powerful and simple an intervention can be between mothers and adolescents.” ( Hyeouk Hahm et al, “Longitudinal Effects of Perceived Maternal Approval on Sexual Behaviors of Asian and Pacific Islander (API) Young Adults,” Journal Youth Adolescence 37 (2008): 74–84.)
39 V. Minichiello, S. Paxton, and V. Cowling, “Religiosity, sexual behavior and safe sex practices: Further evidence,” Australian and New Zealand Journal of Public Health 20, no.3 (June 1996):321–22; M. Resnick, et al, “Protecting Adolescents from Harm”; Michael J. Donahue and Peter L. Benson, “Religion and the Well-Being of Adolescents,” Journal of Social Issues 51, no. 2 (Summer 1995): 145–60.
40 Laura Fingerson, “Do Mothers’ Opinions Matter in Teens’ Sexual Activity?” Journal of Family Issues 26, no. 7 (2005): 947–74.
41 X. Li, S. Feigelman, and B. Stanton, “Perceived parental monitoring and health risk behaviors among urban low-income African-American children and adolescents,” Journal of Adolescent Health 27 (2000): 43–48; A.A. Rai, B. Stanton, Y. Wu, et al, “Relative influences of perceived parental monitoring and perceived peer involvement on adolescent risk behaviors: an analysis of six cross-sectional data sets,” Journal of Adolescent Health 33 (2003):108–18.
42 Richard A. Crosby, Ph.D.; Ralph J. DiClemente, Ph.D.; Gina M. Wingood, ScD, MPH; Delia L. Lang, MPH, Ph.D.; and Kathy Harrington, MPH, MAEd, “Infrequent Parental Monitoring Predicts Sexually Transmitted Infections Among Low-Income African American Female Adolescents,” Archives of Pediatrics & Adolescent Medicine 157 (2003):169–73.
43 Cohen D. A., Farley T. A., Taylor S. N., et al, “When and where do youths have sex? The potential role of adult supervision,” Pediatrics 110 (2002): 66; Elaine A. Borawski et al, “Parental Monitoring: Negotiated Unsupervised Time, and Parental Trust: The Role of Perceived Parenting Practices in Adolescent Health Risk Behaviors,” Journal of Adolescent Health 33 (2003): 60–70; Colleen DiIorio et al, “Sexual Possibility Situations and Sexual Behaviors Among Young Adolescents: The Moderating Role of Protective Factors Journal of Adolesce
nt Health 35 (2004):528.e11- 528.e20.
44 Ibid.
45 Debra W. Haffner, Beyond the Big Talk: Every Parent’s Guide to Raising Sexually Healthy teens—from middle school to high school and beyond (New York: Newmarket Press, 2001).
46 Ibid., 113.
47 See “Sex and the Anticultural Teenager” in Kay S. Hymowitz, Ready or Not: Why Treating Children as Small Adults Endangers Their Future—and Ours (New York: Free Press, 1999).
48 New York Academy of Sciences, Sept 18-20, 2003
49 B. J. Casey, Jay N. Giedd, and Kathleen M. Thomas, “Structural and functional brain development and its relation to cognitive development,” Biological Psychiatry 54 (2000): 241–57.
50 Rhoshel K. Lenroot and Jay N. Giedd, “Brain development in children and adolescents: Insights from anatomical magnetic resonance imaging,” Neuroscience and Biobehavioral Reviews 30 (2006): 718–29.
51 Claudia Wallis, “What Makes Teens Tick?” TIME Magazine, May 10, 2004; available online at: http://www.time.com/time/magazine/article/0,9171,994126,00.html?internalid=ACA.
52 Roshel K. Lenroot and Jay N. Giedd, “Brain development in children and adolescents.”
53 Linda Patia Spear, “The psychobiology of adolescence,” in Kathleen Kovner Kline, Authoritative Communities: The Scientific Case for Nurturing the Whole Child (New York: Springer-Verlag, 2007).
54 Daniel Weinberger, “Brain Development, Culpability and the Death Penalty: The International Justice Project”; available online at: www.scribd.com/doc/2169002.
55 Claudia Wallis, “What Makes Teens Tick?” Time, September 26, 2008.
56 “Growth and Development, Ages 13 to 17—What Parents Need to Know,” http://www.advocatesforyouth.org/index.php?option=com_content&task=view&id=156&Itemid=206
57 Daniel Weinberger, “Brain Development, Culpability and the Death Penalty: The International Justice Project”; available online at: www.scribd.com/doc/2169002.
58 Greg Muirhead, “Early Puberty Tied to Risky Behavior,” Clinical Psychiatry News 36, no. 4 (2008): 3.
59 Of course there are wide variations among individual adolescents, and not everything here will apply to every teen.
60 Monique Ernst and Martin P. Paulus, “Neurobiology of Decision Making: A Selective Review from a Neurocognitive and Clinical Perspective,” Biological Psychiatry 58 (2005): 597–604.
61 Ibid.
62 Adriana Galvan et al, “Earlier Development of the Accumbens Relative to Orbitofrontal Cortex Might Underlie Risk-Taking Behavior in Adolescents,” Journal of Neuroscience 26, no.25 (2006): 6885–92.
63 Laurence Steinberg, “Cognitive and affective development in adolescence,” Trends in Cognitive Sciences 9, no. 2 (February 2005).
64 Of course, alcohol increases the likelihood of risky behavior. But even while sober, teens are susceptible to lapses in judgment.
65 Ibid.; K. Kersting, “Brain research advances help elucidate teen behavior,” Monitor on Psychology (July/August 2004): 80; John Merriman, “Linking Risk-Taking Behavior and Peer Influence in Adolescents,” NeuroPsychiatry Reviews 9, no.1 (2008).
66 Ronald E. Dahl, “Adolescent Brain Development; A Period of Vulnerabilities and Opportunities,” Annals of the New York Academy of Sciences 1021 (2004).
67 Yurgelin-Todd, www.sosparents.org/flash10.html
68 Laurence Steinberg, “Cognitive and affective development in adolescence.”
69 Ibid.
70 Linda Patia Spear, “The psychobiology of adolescence,” 272.
71 Ronald E. Dahl, “Adolescent Brain Development”; Professor of Psychiatry and Pediatrics at the University of Pittsburgh and organizer of the 2003 conference on adolescent brain development.
72 Linda Patia Spear, “The Adolescent Brain and Age-related Behavioral Manifestations,” Neuroscience and Biobehavioral Reviews 24 (2000): 424–25.
73 Laurence Steinberg, “Risk Taking in Adolescence: What Changes, and Why?” Annals New York Academy of Sciences 1021 (June 2004): 54–57.
74 Claudia Wallis, “What Makes Teens Tick?”
75 Richard L. Wiener and Monica K. Miller, “Determining the death penalty for juveniles,” Monitor on Psychology 35, no. 1 (January 2004).
76 Planned Parenthood of the Southern Finger Lakes newsletter, “SEX: Talk About It,” Fall 2005, 1; available online at: http://www.plannedparenthood.org/ppsfl/newsletter-sex-talk-about-it-2486.htm.
77 Stats for 2007: Chlamydia: 324, 548 cases in females under twenty, higher than any other age group and almost 5 times the reported cases in males (http://www.cdc.gov/std/stats07/tables/10.htm).HPV: this infection does not need to be reported; estimated prevalence for 03-04 among sexually active females was approximately 40 percent in those aged 14–19 years and 50 percent in those aged 20–24 years (http://www.cdc.gov/nchs/about/major/nhanes/nhanes2003-2004/nhanes03_04.htm).
78 “Sexually Transmitted Disease Surveillance 2007 Supplement,” Department of Health and Human Services, Centers for Disease Control and Prevention, http://www.cdc.gov/std/Chlamydia2007/CTSurvSupp2007Short.pdf; and “Quick Stats: Prevalence of HPV Infection Among Sexually Active Females, Aged 14–59 Years, by Age Group,” National Health and Nutrition Examination Survey, United States, 2003–2004, http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5633a5.htm?s_cid=mm5633a5_e
79 Amanda Dempsey, Sharon Humiston, and Anna-Barbara Moscicki, “Panel Discussion: Practical Pediatrics: Effective Communication Strategies for Cervical Cancer Prevention” (part of symposium held October 8, 2006, called Pediatricians at the Forefront of Preventing Cervical Cancer: What You Need to Know About HPV), http://www.medscape.com/viewprogram/6281.
80 The size of the T-zone can be affected by other factors besides age.
81 There is wide individual variation in the size of transformation zones.
82 To be more accurate, it moves up through the uterine os, or opening, toward the uterus. But for the purposes of this discussion, it’s fair to describe this as “shrinking,” because the area available for infection gets smaller.
83 Franck Remoue et al, “High intraepithelial expression of estrogen and progesterone receptors in the transformation zone of the uterine cervix,” American Journal of Obstetrics and Gynecology 189 (2003): 1660–5.
84 I.e., the immune system.
85 Sun Kuie Tay and Albert Singer, “The effects of oral contraceptive steroids, menopause and hormone replacement therapy on the cervical epithelium,” in Jordan, Singer, Jones, and Shafi, eds.S, The Cervix, 2nd edition (Black-well Publishing, 2006), 132.
86 I.e., a lymph node.
87 Margaret A. Stanley, “Immunochemistry and Immunology of the Cervix,” in Jordan, Singer, Jones, and Shafi, eds., The Cervix, 57.
88 Smoking can also inhibit these cells functioning.
89 Sandra L. Giannini et al, “Influence of the Mucosal Epithelium Microenvironment on Langerhans Cells: Implications for the Development of Squamous Intraepithelial Lesions of the Cervix,” International Journal of Cancer, 97 (2002): 654–59.
90 Szarewski (2001); also see Cervix, 57
91 Franck Remoue et al, “High intraepithelial expression of estrogen and progesterone receptors in the transformation zone of the uterine cervix.”
92 Sun Kuie Tay and Albert Singer, “The effects of oral contraceptive steroids, menopause and hormone replacement therapy on the cervical epithelium,” 135.
93 From discussion with Anna-Barbara Moscicki, MD, October 2007; and Jordan, Singer, Jones, and Shafi, eds., The Cervix, 135. With the average age of sexual debut at age fifteen, and the postponement of childbearing for ten years or more, this is something to keep in mind.
94 Anna-Barbara Moscicki et al,”Cervical Ectopy in Adolescent Girls with and without Human Immunodeficiency Virus Infection,” Journal of Infectious Diseases 183 (March 15, 2001).
95 Jordan, Singer, Jones, and Shafi, eds., The Cervix, 91.
96 R. L. Winer, “Risk of female human papillomavirus acquisition associated with first male sex partner,” Journal of Infectious Dise
ase 197, no.2 (January 15, 2008): 279–82.
97 Anna-Barbara Moscicki et al, “Differences in biologic maturation, sexual behavior, and sexually transmitted disease between adolescents with and without cervical intraepithelial neoplasia,” Journal of Pediatrics 115 (1989): 487–93.
98 I found the immature cervix mentioned by Alice one time, in her explanation of why it’s important for sexually active young women to go for regular gynecologic check-ups.
99 For example, see: “Ready or Not? The Scarleteen Sex Readiness Checklist,” http://www.scarleteen.com/article/boyfriend/ready_or_not_the_scarleteen_sex_readiness_checklist; “Trying to decide when to have first intercourse,” http://www.goaskalice.columbia.edu/1970.html; and Robie H. Harris, It’s Perfectly Normal: Changing Bodies, Growing Up, Sex & Sexual Health (Cam-bridge, MA: Candlewick Press, 2004).
100 K. Kersting, “Brain research advances help elucidate teen behavior,” Monitor on Psychology (July/August 2004): 80; Claudia Wallis, “What Makes Teens Tick?”
101 Ronald E. Dahl, “Adolescent Brain Development,” referring to the work of Ann Masten, Ph.D., op cit.
102 Dr. Mary S. Calderone, Dr. James Ramey, Talking with your Child About Sex, Ballantine Books (1982).
Chapter 4
1 They are in conflict over other issues too, but my focus is risky sexual behaviors.
2 The video had been developed by MCPS staff.
3 James Trussell, “Contraceptive failure in the US,” Contraception 70, no.2 (August 2004): 89–96.
4 Citizens for Community Values, “Workshop Summary: Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention” (12–13 June 2000), http://www.ccv.org/downloads/pdf/CDC_Condom_Study.pdf.
5 King K. Holmes, Ruth Levine, and Marcia Weaver, “Effectiveness of condoms in preventing sexually transmitted infections,” Bulletin of the World Health Organization 82, no.6 (June 2004): 454–61.
6 This was an analysis of many studies. The range of risk reduction was 35–94 percent.
7 Susan Weller and Karen Davis, “Condom effectiveness in reducing heterosexual HIV transmission,” Family Planning Perspectives 31, no.6 (November–December, 1999): 272–79.
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