Monday, Jun. 08, 2009 03:53AM EDT
"Unfriendly” waiting rooms, fear of judgment and a general apathy toward the anatomical focus of their sex ed classes mean many sexually active teens aren't bothering to visit doctors or clinics to discuss their sexual health, a new survey from Planned Parenthood Toronto reveals.
Teens want to learn about healthy relationships and sexual pleasure, but their education has focused largely on sexually transmitted infections, pregnancy and birth control.
The study's authors argue that this disconnect and confidentiality concerns have contributed to a worrisome statistic: 83 per cent of the 1,216 teens surveyed had never accessed sexual heath care from a doctor or a clinic, even though most had already engaged in vaginal, oral or anal sex.
The teens, aged 13 to 18, were surveyed in workshops conducted between December, 2006, and August, 2007, in a joint project between Planned Parenthood Toronto, York University, the University of Toronto, Wilfrid Laurier University and Toronto Public Health.
Twenty-four per cent of the teens had not engaged in any sexual activity; 69 per cent had kissed a partner; 27 per cent had experienced vaginal intercourse; 25 per cent had given or received oral sex; seven per cent reported having anal sex and seven per cent had been involved in a pregnancy.
Young women were more likely to access sexual health services than men, and they did so mostly for birth control, pap smears and pregnancy tests. Young men mostly went for free condoms, information about safer sex and HIV or STI testing.
The authors found that “fear of judgment” was the greatest barrier preventing youth from going to a clinic. Many of the respondents did not feel that the clinic staff were positive toward them, and many also complained that the waiting rooms weren't “youth friendly.”
Some teens complained that traditional sex ed topics weren't resonating. The authors factored this into the disconnect with professionals. Fewer than 30 per cent of respondents reported learning about healthy relationships, and no group included sexual pleasure in their list of top three topics learned.
Adolescents want “information about being a partner, rather than only [about] the health of the genitals,” said Dr. Peggy Kleinplatz, of the faculty of medicine at the University of Ottawa.
“As fascinated as we all are with spermatogenesis and how egg meets sperm, what's more interesting to everybody, including adolescents, is what do you do with sexual desire, how do you know when to act upon it, what kind of relationship is fulfilling and what should you be looking for to make sure your relationship is healthy and satisfying rather than one that's unhappy, dysfunctional and disappointing,” Dr. Kleinplatz said.
She added that the survey will give Canadian sex educators a “mandate to give adolescents what they want and need.”
The study results are “a very important message” for educators who hope to foster better safe-sex practices among youth, said Alex McKay, research co-ordinator at the Sex Information and Education Council of Canada. “You cannot look at the need for sexually transmitted disease prevention in isolation of the dynamics of real life relationships that people inhabit,” Mr. McKay said.
Learning about healthy relationships in school ties directly into better safe-sex practices because adolescents who know how to communicate with their partners are more likely to succeed in negotiating condom use, said Sarah Flicker, one of the study authors and an assistant professor of environmental studies at York University.
Aside from sexual pleasure and good relationships, the survey respondents also expressed a desire for more detailed information on HIV/AIDS. Dr. Kleinplatz was concerned they weren't also asking for information about more common infections such as chlamydia, herpes and HPV.
Planned Parenthood Toronto also held focus groups with 80 service providers, who reported that a lack of funding, training and referral networks were hindering their ability to deliver quality services to youth.
Mr. McKay said part of the problem is that sex education is typically wedged into physical education classes, which leaves educators little time for much beyond biology.
“Added to that is the sense among some educators that they are treading on sensitive territory. It's often safest for them to confine themselves to the transmission of cold, hard facts,” said Mr. McKay, citing Bill 44, the human-rights legislation that now allows Alberta parents to pull their children out of classes dealing with sex, religion or sexual orientation.
“One of the things that's needed is a better supportive environment for educators.”