Archive for the ‘Youth’ Category

March 12, 2014

Teen Voices Magazine is Back, Improving the World for Girls Through Media

For 25 years, Teen Voices magazine has provided a place for journalism and other writing created by and for teenage girls. This great publication, originally based in Boston, was on the brink of shutting down last year, but Women’s eNews took it under its wing, with plans to build upon its mission of improving the world for female teens through media.

The first stories published by the new Teen Voices are now online and tackle diverse issues including recovering from anorexiawhy some women wear hijab and others don’tfeeling unworthy; and letters to celebrities as role models.

design contest for the new Teen Voices logo is currently open to 12-19 year olds; the deadline is April 3. You can also follow Teen Voices on FacebookTwitter and tumblr.

And if you’d like to support Teen Voices, there’s an IndieGoGo campaign running now through the end of March to raise funds for a “virtual newsroom,” including mentorship and paid writing assignments for teen girls.

We’re excited to see Teen Voices not only keep going, but expand the opportunities for its writers. Women’s eNews explains the need for this program and the goals:

Teen Voices at Women’s eNews will provide opportunities for education and interaction so that young women can develop and amplify their voices and contribute to issues that personally affect them.

Young women in the U.S. and around the globe often have limited knowledge of the policies, practices and rituals that influence their lives directly, giving them little opportunity to voice their approval or objection. Consider this:

  • Alongside nudity and hypersexualization in film, female teens and women between the ages of 13 and 20 are more likely than others to be referred to as “attractive” as their main attribute, according to theWomen’s Media Center’s 2012 Status of Women in the U.S. Media report.
  • Young female characters are outnumbered by boys 3-to-1 among the top-grossing G-rated family films, according to the Geena Davis Institute on Gender in the Media. This trend makes young women invisible, removes role models and results “in negative gender stereotypes imprinting over and over.”
  • Female teens surveyed by the Girl Scouts in 2011 accepted that their lives should be like that of women on reality TV shows and expected a higher level of drama, aggression and bullying in their own lives. The media is influencing young women to believe that “it’s in girls’ nature to be catty and competitive with one another.”

Teen Voices at Women’s eNews will provide honest and objective information about issues directly affecting female teens around the world, and serve as a powerful outlet for young women to express their views on issues of particular concern to them.

The project is being led by Lori Sokol, Ph.D., the new publisher of Teen Voices at Women’s eNews, theWomen’s eNews editorial, marketing and development staff and a diverse board of teenagers who will consult and advise on the issues being covered.

Don’t forget to check out the IndieGoGo campaign today!
Also! Our Bodies Ourselves has multiple back issues of the print edition of Teen Voices that we would like to give away. They are available for the cost of postage, $13 per box. If you are interested, send a check made out to “OBOS” to: Our Bodies Ourselves, 5 Upland Road #3, Cambridge, MA 02140. Be sure to include the address where the magazines should be sent. For more information, email: office AT

October 18, 2013

New Study on Youth and Sexual Violence Considers Spectrum of Rape Scenarios

In a new study published in JAMA Pediatrics, nearly 1 in 10 youths in the United States reported committing an act of sexual violence.

As part of a larger Growing Up With Media study on media consumption and exposure, the researchers surveyed 1,058 girls and boys ages 14 to 21 about their experience as perpetrators of sexual violence and their exposure to violent sexual media.

Rather than ask participants if they had ever raped or sexually assaulted anyone, the researchers asked more nuanced questions, including if they had tried to make someone have sex with them when they knew the other person didn’t want to, and if they had succeeded at doing so.

The participants were also asked if they had kissed, touched, or done anything sexual with an unwilling partner. Among the findings:

  • 9 percent of youths surveyed reported some type of sexual violence perpetration in their lifetime;
  • 8 percent kissed, touched, or made someone else do something sexual when they knew the other person did not want to (ie, forced sexual contact);
  • 3 percent got someone to give into sex when he or she knew the other person did not want to have sex (hereafter referred to as coercive sex);
  • 3 percent attempted – but were not able – to force someone to have sex (ie, attempted rape);
  • 2 percent forced someone to have sex with him or her (ie, completed rape).
  • About 3 in 4 victims were a romantic partner.

There was a good amount of overlap: 12 percent reported two different behaviors, 11 percent reported three, and 9 percent reported all four types.

When asked about the most recent time they tried to force or were able to force someone to have sex, tactics were mostly coercive. Arguing or pressuring the person (32 percent) or getting angry or making the person feel guilty (63 percent), were more commonly used than threats (5 percent) or physical force (8 percent). Alcohol was a factor in 15 percent of these situations.

It’s important to keep in mind that survey research like this — even when conducted via the internet — may underestimate true rates of actions like sexual assault, because perpetrators are motivated to avoid reporting their own crimes.

The authors note this as a limitation, adding, “Nonetheless, rates are much higher than the lifetime rate of 0.15% yielded in a national study of adults that was conducted face to face.”

Perpetrators & Victims
Women were much more likely to be the victim of an attempted or completed rape; perpetrators reported that about 80 percent of victims were female. The researchers also found that about 5 percent of victims were transgender.

White youths were more likely than nonwhite youths to report perpetrating coercive sex, and youths living in higher-income households were more likely to report attempted rape.

Perpetrators of any type of sexual violence were significantly more likely to have consumed any type of X-rated material, especially violent materials.

The authors note that while media consumption and violence could not be causally linked by their study, “it seems appropriate to suggest that frequent consumption of sexual and violent material and especially sexually violent material should be a marker for concern for adolescent health care professionals.”

Looking at the gender of assailants, researchers found that boys and young men accounted for almost all rapes and attempted rapes committed before age 18. The study notes that 98 percent of perpetrators whose first act occurred at ages 8 to 15 were male, as were 90 percent of perpetrators involved in an assault at ages 16-17.

Among 18- and 19-year-olds, women accounted for slightly more than half (52 percent) of attempted/completed rape perpetrators (seven women out of 13 total). The authors note that their broad definitions may result in finding an unexpectedly high amount of female perpetrators. They add, however, that it’s important to challenge the widespread notion that women cannot coerce men.

Some may argue that the definitions of rape and sexual assault in our investigation are too broad. Indeed, this may be why the perpetration rate among females is higher than might be posited. Rape includes acts beyond those in which the victim is physically overpowered, however. Restrictive definitions have potentially led to undercounting of sexual assault experiences.

For example, in the National Violence Against Women Survey, respondents were asked whether anyone had ever made them engage in a sexual activity “by using force or threat of force.” Psychological coercion was not clearly specified even though there are multiple coercive strategies other than physical force that can be used in a rape. To ensure that comprehensive rates of sexual assault and rape are identified as well as to begin building the research base on female perpetrators, research needs to include a fuller spectrum of rape scenarios.

Few Criminal Consequences
The findings on attitudes and punishment are chilling.

“Sixty-six percent of perpetrators reported that no one found out about the perpetration. Contact with the justice system was uncommon: 1% of perpetrators reported police contact and 1% an arrest,” note the authors.

They also found that half of perpetrators said that the victim was completely responsible for the incident. Only 1 in 3 said that they, the perpetrator, were completely responsible for the incident.

The authors recommend that more effort should be made on education that avoids victim blaming and emphasizes perpetrators taking responsibility for their own actions. They also suggest further research on factors related to taking responsibility, such as motivations behind the sexual violence and feelings of remorse or regret.

Incidents like this recent one in Maryville, Mo., in which a family moved due to harassment after the daughter was sexually assaulted, highlight the cruelty of victim-blaming and the need for prevention programs that put responsibility on the assailant.

The authors also commend bystander intervention programs, but note that most of that research has been done at the college level, and more work is needed at the high school level.

Plus: To learn more about consent, including essential rules, ways to talk about it, and examples of the enthusiastic consent model, check out Scarleteen’s Driver’s Ed for the Sexual Superhighway: Navigating Consent.

September 27, 2013

Concerned About the New “Hookup Culture?” It’s No So New, or Worrisome, After All

It seems like every so often, the media and others can’t resist a story about how college students — especially girls — are going wild with lots of meaningless sex. The implication is usually that these young women are destroying both themselves and society.

For example, a 2009 ABC news piece actually uses the word “sluts” in the headline. Almost 15 years ago, Tom Wolfe’s novel “I am Charlotte Simmons” raised some of the same criticism, often focusing specifically on the behavior of young women.

The topic was recently in the news again, thanks to a New York Times article “Sex on Campus: She Can Play That Game, Too.” Like those before it, the article largely looks at “hooking up” as something new, even though that may not be the case.

Following the trend of focusing on the “problem” of women having sex, there’s been a lot of questioning as to whether female college students are missing out on prime husband-finding time — or simply making their own choices during a period when relationships are not high on their to-do lists. Disturbingly, The New York Times story takes a detour to explore drinking and campus rape, as though non-consensual activity is somehow linked to what women enthusiastically consent to.

Given all the hand-wringing, you’d think today’s college women just discovered sex outside of long-term relationships. Yet according to research results released at a recent American Sociological Association meeting, 18- to 25-year-olds are probably not having any more sex or sexual partners than women their age 15 to 25 years ago.

The main researcher commented, “College students overestimate the degree to which their peers are hooking up. It feels like something new, but they might be surprised to know the actual frequency of sex, the number of sexual partners, etc. don’t appear to have increased from their parents’ generation.”

It may also be helpful for students to know that when Guttmacher researchers looked at rates of “premarital” sex in 2002, the percentages of women and men who had sex by age age 20 (74 percent of women, 77 percent of men) was extremely similar to the overall rates for 20-year-olds in the 1970s (72 percent), 1980s (76 percent), and 1990s (74 percent).

As Kate Harding puts it in this column on “hook-up culture’s bad rap,” none of the drama over hook-up culture — which is often based on misogyny and what people want from girls instead of for girls — is really that helpful:

If we encouraged girls and women to place real value on their own desires, then instead of hand-waving about kids these days, we could trust them to seek out what they want and need, and to end relationships, casual or serious, that are unsatisfying or damaging to them, regardless of whether they’d work for anyone else.

She later adds:

[I]f we teach all kids that there’s a wide range of potentially healthy sexual and emotional relationships, and the only real trick (granted, it’s a doozy) is finding partners who are enthusiastic about the same things you want, then there’s room for a lot more people to pursue something personally satisfying at no one else’s expense.

And that’s a fact.

Also see:
Let’s Talk About Casual Sex, Baby” by Jaclyn Friedman
Breaking News: Casual Sex Won’t Ruin Your Life!” by Jessica Wakeman
Thoughts on the ‘Hook-Up Culture,’ or What I Learned From My High School Diary” by Nona Willis Aronowitz

September 16, 2013

Headlines about the “Pullout Generation” Are Premature: Studies Show Multiple Methods of Contraception Use

A recent article in the journal Obstetrics & Gynecology has led to some catchy headlines calling today’s young, straight women “the pullout generation.”

The researchers looked at data from the 2006-2008 National Survey of Family Growth for 2,220 sexually active female respondents ages 15–24 years and found that almost 1 in 3 of those surveyed reported using withdrawal as a method of contraception during at least one month of the study. (It’s not clear how girls who were not having sex with male partners were included or excluded.)

What the study-inspired headlines don’t explain, though, is that very few of these respondents relied only the “pullout” method to prevent pregnancy – maybe even fewer than in older studies.

So it is really accurate to call today’s young women the “Pullout Generation?” Almost 9 out of 10 withdrawal users also used other methods, either simultaneously or at some other point in the study. And let’s not forget that 69 percent of those surveyed always used other methods, such as condoms and the pill.

Those who used withdrawal at any point were more likely to have unintended pregnancies, and more likely to use emergency contraception. While some coverage of the study has noted that those exclusively using withdrawal were “less likely” to get pregnant than women exclusively using other methods, the small mathematical difference isn’t considered meaningful.

When the CDC reported in 2009 on the sexual and reproductive health of young people ages 10-24 (covering the years 2002-2007), about 13 percent of unmarried, sexually active girls and women said they had used withdrawal the last time they had sex. This included those who had used withdrawal alongside another method. Thus, the reporting should have noted fewer than 13 percent were using *only* withdrawal.

In another report of contraception use by adolescents released in 2010, almost 11 percent of sexually active girls in 9th-12th grades reported using only the withdrawal method the last time they had sex. This study uses some data sources that overlap with the CDC’s report.

It’s not clear, then, that increasing use of withdrawal as a main method of contraception is actually “a thing.”

As Ann Friedman suggests in her column on the “Pullout Generation,” that doesn’t mean there isn’t legitimate interest in better and alternate birth control methods. In fact, Global Female Condom Day is today, which makes it the perfect opportunity to learn more about this woman-oriented, non-hormonal method.

For more information on withdrawal, including failure rates and things to think about, see Scarleteen and Bedsider. For more info on female condoms, read this excerpt from “Our Bodies, Ourselves” or our many blog posts on the topic.

June 26, 2013

Who (if Anyone) is Providing Teen Girls Information on Contraception and Safer Sex Practices?

The topic of sex education is often a controversial one, with much attention focused on how much (if any) education teens should receive. Implementation of abstinence-only approaches remains widespread, despite objections from health experts and evidence that comprehensive sex-ed is more effective at reducing teen pregnancy and sexually transmitted infections (STIs).

An article just published in the Journal of Adolescent Health explores the type of sex education teens report receiving, and from whom.

Most of the 2,001 teens ages 15 to 19 who took part in the national study describe themselves as white and living in the suburbs, and most of their mothers have at least some college education. The researchers only looked at teens with heterosexual experiences and make no attempt to address how their responses might differ from those of other teens from different backgrounds.

The findings, however, show some clear gaps in sex education. Among teen girls who were already sexually experienced, only about 2 in 3 had received any information on birth control from a parent (the results were about the same for STI prevention), while about 3 in 4 had received birth control information from a teacher.

Almost all girls (95 percent) reported receiving STI-prevention information from a teacher, but it’s not clear how many of those messages may have reflected abstinence-only education. About 1 in 5 girls had not received any birth control information from either parents or teachers.

Boys fared worse on this measure; more than 1 in 3 boys had never received birth control information from a parent or teacher, unless you count simply being given condoms with no additional information. Boys received STI-prevention information from parents or teachers about as often as girls did, and more of them got info from a healthcare provider when they had no other source, but the rates were still low.

Health care providers do not appear to be filling in the information gap for girls. Among the girls who had not received *any* birth control or safer sex info from parents or teachers, less than 1 in 10 got information from a health care provider. In other words, if girls aren’t getting messages about safer sex and contraception at home or school, they’re not likely to get it at all, even from their doctors and nurses.

The authors encourage improved distribution of sexual health information (SHI) in healthcare settings: “Because the majority of sexually experienced adolescents interface with the healthcare system, healthcare providers are missing many important opportunities to deliver SHI to this population.”

They do not provide any specific guidance for providers, but note that with expanded coverage for preventive and sexual health services under the Affordable Care Act, providers may have more opportunities to see teens and address this issue.

June 7, 2013

New Developments in OTC Emergency Contraception Court Case

First, a quick refresher:

A couple of months ago a judge ordered that emergency contraception pills (like Plan B) be made available over the counter (OTC) without age restrictions. The U.S. Justice Department appealed that ruling, and asked for a stay so that OTC access wouldn’t take effect during the appeals process.

Around the same time, the FDA approved Plan B One-Step emergency contraception pills for purchase without a prescription for teens ages 15 and older.

On Wednesday, the Second Circuit Court of Appeals denied the stay for two-pill types of emergency contraception. This means that two-pill regimens should become available without prescription to women and girls of all ages even before the government’s appeal is resolved. The Court allowed the stay for one-pill variants of emergency contraception (e.g. Plan B One Step), and stated that the appeal process would be expedited.

Women’s health advocates have been fighting for more than a decade to make OTC emergency contraception a reality.

Nancy Northup of the Center for Reproductive Rights called Wednesday’s order “a historic day for women’s health,” adding: “Expanding access to this safe and effective way of preventing pregnancy after failed birth control or unprotected sex is the among the very best decisions our federal government can make for women’s health.”

Marcia Greenberger of the National Women’s Law Center remarked, “The Center applauds today’s decision, which underscores the simple fact that there is no reasonable basis for restricting access to this safe and effective birth control.”

The American Academy of Pediatrics, American College of Obstetricians and Gynecologists, and Society for Adolescent Health and Medicine have collectively denounced the administration’s decision to appeal the ruling at all, and issued a strong statement rejecting limited access: “There is no scientific justification for a continued age restriction on emergency contraception. The Administration’s decision puts the health of adolescent girls at risk and is inconsistent with what we know about the safety and benefits of emergency contraception.”

It’s unclear what will happen next in the fight for more accessible emergency contraception. The Justice Department has stated only that they are reviewing the order. According to SCOTUSblog, the administration has the option of asking the Supreme Court to delay all parts of that initial order for OTC access without age restriction. NPR’s Shots explains that “some lawyers say the government might be able to appeal to the full 2nd Circuit. But more likely, if they insist on fighting, government attorneys would have to seek relief from the Supreme Court justice who oversees the 2nd Circuit — Ruth Bader Ginsburg.”

May 2, 2013

One Step Forward, Two Steps Back: The Week in Over-the-Counter Emergency Contraception

Plan B on a drugstore shelf in Canada.

Plan B on a drugstore shelf in Canada. Photo / Cory Doctorow

What a frustrating week in the ongoing battle over evidence-based health policy.

To the surprise and disappointment of women’s health advocates, the U.S. Justice Department on Wednesday filed an appeal to prevent girls under age 15 from gaining over-the-counter access to emergency contraception.

Approaching the date U.S. District Judge Edward Korman’s order making levonorgestrel-based emergency contraceptive pills (such as Plan B and Next Choice) available without restrictions would go into effect, the Obama administration also requested a stay pending appeal, meaning the judge’s order would not be implemented according to schedule.

The judge’s ruling last month was in response to the Center for Reproductive Rights’ renewed lawsuit seeking over-the-counter access to the morning-after pill.

Responding to the appeal, Nancy Northrup, CRR president and CEO, said in a statement:

Women who urgently need emergency contraception have been delayed in getting it or denied access entirely for more than a decade because of the political maneuverings of the last two presidential administrations. The federal court has made clear that these stalling tactics were based purely on politics, not science.

We are deeply disappointed that just days after President Obama proclaimed his commitment to women’s reproductive rights, his administration has decided once again to deprive women of their right to obtain emergency contraception without unjustified and burdensome restrictions.

In the appeal documents, the administration argues that the court overstepped its authority and improperly interfered with the rulemaking process; the judge should have instead sent the issue back to the FDA for further action.

“We aren’t focused in this appeal on the merits of the secretary’s decision,” a Justice Department official, who spoke on condition of anonymity, told The New York Times. “What we’re focused on is that the remedies that the judge ordered were beyond his authority.”

Ironically, overstepping is what many would argue the administration did in 2011 when HHS Secretary Kathleen Sebelius overturned a decision by FDA scientists to make the contraceptive pills available without restriction.

The administration also argues that since the actual plaintiffs in the case are all over age 15, and it’s not a class action suit, that no harm is done to the plaintiffs by granting the stay (see below). By making this argument, the administration avoids addressing the potential harm to girls who are prevented from accessing a drug both FDA scientists, and the judge, said should be available.

The administration claims that the public would suffer irreparable harm if the stay is not granted; if the ruling is allowed to go forward and later overturned, it would create confusion for women, who might “mistakenly believe that they can obtain the drug without a prescription or at certain locations where it used to be available, but is no longer.”

We’re also supposed to believe the appeal has nothing to do with politics. A Justice Department official told The New York Times: “This is a decision that the Justice Department is making in representing our client: FDA. This is not a political decision. It’s not had White House intervention or involvement. This in our judgment is the right legal step to take in this case.”

Meanwhile, FDA Approves Making Plan B Available to Teens Age 15 and Up
The decision to appeal came just one day after the FDA announced its approval of Plan B One-Step emergency contraception pills without a prescription for teens age 15 and older. The drug was previously only available without a prescription to women 17 and older.

It’s a great step forward; however, younger women, for whom access to a healthcare provider may be most difficult, are still left without prescription-free access to the drug, which must be used within a limited window.

The FDA adds to the burden by specifically requiring proof of age. From the FDA’s press release:

The product will now be labeled “not for sale to those under 15 years of age *proof of age required* not for sale where age cannot be verified.” Plan B One-Step will be packaged with a product code prompting a cashier to request and verify the customer’s age. A customer who cannot provide age verification will not be able to purchase the product. In addition, Teva has arranged to have a security tag placed on all product cartons to prevent theft.

In addition, Teva will make the product available in retail outlets with an onsite pharmacy, where it generally, will be available in the family planning or female health aisles. The product will be available for sale during the retailer’s normal operating hours whether the pharmacy is open or not.

The ID/proof of age requirement is a big hurdle for many teens. Many states set an age requirement of 16 for a driver’s license or learner’s permit. Obtaining a state ID (related to driving or not) costs money, and hours for doing so are often limited. And undocumented teenagers are unable to obtain a legal ID at any age.

“While welcomed by some as an acceptable compromise,” said Nancy Stanwood, Physicians for Reproductive Health board chair-elect, the “FDA decision to approve the sale of emergency contraceptive Plan B One-Step to those 15 years and older with government-issued identification does little to improve real access for already-vulnerable women and young teens. Plan B has a time limit, and too many women in the U.S. have gone without it because of unfair, unnecessary, and medically unjustified barriers to access.”

Writing at ThinkProgress, Tara Culp-Ressler explains other reasons why the policy shift is still problematic, noting in part that it simply isn’t based on science, and the high cost remains a barrier.

The FDA’s ruling was in response to an amended application request by Teva Women’s Health, the company that makes Plan B One-Step, to make the drug available without a prescription to women age 15 and older. The FDA in 2011 denied Teva’s application to make Plan B One-Step available for all females of reproductive age. And still the debate goes on.

April 25, 2013

How Can We Help Teen Mothers Avoid and Cope With Postpartum Depression?

Although there is a fair amount of information and research available on postpartum depression in general, very little of it seems to focus specifically on the needs or care of teen mothers.

A pilot study published in the American Journal of Obstetrics and Gynecology in March attempts to fill in this gap — and it shows some promising results.

First, the authors explain why the risks of PPD in teens are important:

PPD puts adolescent mothers and their children at risk during an already challenging time in their lives, and this hardship may be a major determinant of poor outcomes for these young mothers and their children. Untreated, depression is associated with school dropout, suicide, and substance use. Among adolescent mothers, evidence suggests that depression may prevent them from engaging in health-promoting behaviors for their infants and themselves.

The study is based on a randomized controlled trial of the REACH program (Relax, Encourage, Appreciate, Communicate, Help), which is designed to help expectant mothers develop stress management and other skills. The program was offered as structured therapy during pregnancy, followed by a postpartum “booster” session.

Participants in the therapy group used interpersonal therapy to work on effective communication skills, conflict management, improving their social support systems and building healthy relationships, and goal setting. They, as well as the control group, received a handbook of typical pregnancy and postpartum/newborn health information. A total of 106 teens age 17 or younger and without pre-existing mental health issues were randomized to the therapy or control groups.

The researchers looked for major depressive episodes within the six months after birth. Although only 12.5 percent of the REACH teens developed postpartum depression, compared with 25 percent of the control teens, the results were not statistically significant, as the study was fairly small and very few teens (19) overall developed postpartum depression. A larger study may be needed to better determine the utility of the program.

Despite a lack of clear effect, the study highlights a need for further investigation into the postpartum mental health needs of teens. As the authors explain:

Although validated treatments for adolescent depression exist and include interpersonal therapy, cognitive behavioral therapy, and antidepressant medication, teen mothers with mental health problems are mostly under treated. To date, only one published report of 2 small open-trial pilot studies addressed treatment for depression in pregnant adolescents. Despite the potentially high burden of depression to young women and their families, studies on the prevention of PPD in pregnant adolescents are virtually nonexistent.

Another lesson learned in this study was that teens preferred individual therapy sessions over the planned group sessions, so sessions were adjusted to be one-on-one. The researchers also took care to specifically design the REACH program to be culturally appropriate for a diverse group of racial and ethnic backgrounds.

April 23, 2013

Study: IUDs Offer Safe Contraception Option for Teens But Rarely Prescribed

Intrauterine devices (IUDs) are a fairly safe, long-acting form of contraception, but many myths about the devices persist. For example, it’s somewhat common to hear that women who haven’t already had a baby, and especially teenagers, are not good candidates for IUDs; neither of these is true.

For a new study published in the journal Obstetrics & Gynecology, researchers reviewed data from health insurance records of more than 90,000 women who had IUDs inserted (including both hormonal and copper IUDs). They looked specifically at how many records indicated a IUD-related complication, discontinuation, or pregnancy.

When the researchers looked at the data by age group, they found that women ages 15-19 did not discontinue using IUDs any more frequently than older women. Teens were slightly more likely than older women to experience dysmenorrhea (menstrual cramps) or absence of menstruation within one year of insertion, or failure of the IUD to prevent a normal pregnancy, but rates for both of these were very low. Only 1.8 percent of teens using a levonestrogel-releasing IUD experienced a pregnancy (3.6 percent for copper), and 2.4 percent experienced cramping (6.2 percent for copper).

Pelvic inflammatory disease occurred in less than half a percent of teens. Women of all ages using a copper IUD were much more likely to stop using it than women using the hormone-releasing IUD, and this was most true for teens, although it’s not completely clear why. Rates of removal within 30 days for any complication were estimated to be very low for teens (2.9 percent for hormone IUD, 5.2 percent for copper) as well as older women.

The researchers conclude:

Overall, these data indicate that the IUD is an appropriate contraceptive for younger women and is not likely to cause serious side effects among teenagers. Physician recommendations play an important role in their patients’ decision-making, and their recommendation of the IUD could increase the use of this cost-effective and safe method of birth control among teenagers. Thus, physicians should include information about this highly effective method when they counsel young patients on their contraceptive options to help reduce the unintended pregnancy rate among teenagers in the United States.

The authors cite evidence that teens may indeed face clinician education barriers when seeking an IUD. One survey found that “only 19% of obstetrician–gynecologists surveyed in a 2010 study stated that they would offer an IUD to an unmarried 17 year old who had never been pregnant.”

With more evidence like the current study on hand, we hope it will become easier for teens to access this long-acting, effective form of contraception.

Related: Revisiting the IUD for Contraception – Pros and Cons for Women looks at the rise in IUD use and the safety record.

April 2, 2013

Lessons in Denial: A Student Perspective on High School Health Class

by Hanna Pennington 

Hanna PenningtonNo one ever really wants to take health class; it’s a required course, something people try to get out of the way so they aren’t that about-to-graduate senior who still has to take health. And that’s because at most high schools, health class doesn’t offer much — and everyone knows it.

I spent 80 minutes every other morning in health class during the second semester of my sophomore year, and when faced with an end-of-the-year survey about the class, I realized that the time had not been “spent,” but wasted.

We had not discussed birth control; condoms were the only form of contraception mentioned, and they came up only in the context of preventing STIs. A significant number of high school students are already taking hormonal birth control, like the pill, for a variety of reasons, whether to regulate hormone imbalances that can cause acne, reduce the pain of bad menstrual cramping, or because they are having sex, but the pros and cons of the pill were never addressed.

Through reading “Our Bodies, Ourselves” and other feminist websites and books, I have learned about many types of birth control. But this is because I care about this kind of thing. Most people don’t know what they should have been taught until it’s too late.

Another way in which my health class was insufficient, and also offensive, was that LGBTQ people were only mentioned in the context of HIV/AIDS, which we learned about by watching the film “And The Band Played On.” There was no other discussion.

As a bisexual person, I felt shortchanged. I sought out resources online, much the way I did with birth control, but again, this didn’t make up for the lack of class information. The majority of high school students are straight, but it is important to provide for those who aren’t, or who might be questioning. It is important to learn about how to have safe gay sex, not only safe straight sex; that information is a lot harder to find, unless you know where to look.

Related: A “Real” Sex Ed Story: A Teenager Recalls Lessons From “Our Whole Lives”

Another issue we did not discuss is consent. People need to learn not only that it’s OK to say no, but that enthusiastic consent is the key to happy, healthy sex (in fact, there’s a petition to make consent a mandatory part of sex-ed in public schools).

Abuse, both physical and sexual, should also be discussed. And resources should be provided for everything: where to get help if you’re being abused, where to purchase prescription contraception at a discount, where to get tested for STIs, and the number for the closest Planned Parenthood, for starters.

Finally, we never discussed masturbation. It is important for students to know that instead of it being something unholy or disgusting, masturbation is a perfectly healthy and important way to explore one’s own body and sexuality.

According to research by the Sexuality Information and Education Council of the United States (SIECUS), comprehensive sex education is more effective in preventing teen pregnancy than abstinence-only education. In her 2008 New Yorker article “Rex Sex, Blue Sex,” Margaret Talbot analyzed the differences in sexual patterns of teenagers living in different parts of the country, including the prevalence of teen pregnancies and STIs and use of contraception.

In conservative red states, where abstinence-only education is the norm and religion dictates much of the discourse, teenagers have sex earlier, usually without protection. In more liberal blue states, where there is often (but not always) more comprehensive sex education, teenagers wait longer to have sex and use protection more often when they do.

Although I live in blue-state New York, my health class was not all that. It is possible to acknowledge teenagers being sexual without encouraging it, but our teachers didn’t acknowledge any part of it. It is irresponsible to teach the class assuming that everyone is and will remain abstinent until marriage.

The 2009 documentary “Let’s Talk About Sex” examines young people’s attitudes toward and knowledge of sex and sexuality, comparing America’s largely insufficient programs to those of places like the Netherlands, where parents and children talk openly about sex (and which have lower rates of teen pregnancy and STIs).

Although I was briefly tempted to move overseas, there are comprehensive sex-ed curriculums in the United States, even if they can be hard to find.

One of my friends attends Rye Country Day School in Rye, N.Y. A program there encourages underclassmen to ask upperclassmen leaders whatever they want about sex, relationships, and so on. I was really impressed when I first heard about this, as it fosters an environment that removes shame from asking questions, which is how people get the answers they need.

At Manhattan Country School, there is a sex-ed curriculum, designed by Dr. Cydelle Berlin, that involves theater arts and peer education. Trained actors answer questions while in character. There is a box in every classroom in which students can leave anonymous questions.

The Unitarian Universalist Church, instead of strictly discouraging or not discussing sex as other churches often do, teaches a K-12 sex ed curriculum called “Our Whole Lives.” As stated on the website, the program “not only provides facts about anatomy and human development, but also helps participants clarify their values, build interpersonal skills, and understand the spiritual, emotional, and social aspects of sexuality.”

This curriculum is based on SIECUS’ “Guidelines for Comprehensive Sexuality Education,” which spans the same age range and includes such important topics as body image, gender identity, masturbation, abortion, and sexuality and society.

When reading this curriculum, I was pleasantly surprised how enlightened, inclusive, and accurate it was. But this should not be surprising; accurate language should be the norm.

It is bad enough that decisions about women’s health are made mostly by male politicians, but it is even more disheartening when you realize that some of them have no idea what they’re talking about. High school students aren’t the only ones who need basic education about reproduction, but it’s a good place to start.

Hanna Pennington is a high school senior in New York whose first foray into feminist activism was at age 7, when she wrote a letter to a children’s magazine protesting the omission of Sacagawea in an article about the Lewis and Clark Expedition. 

February 14, 2013

Happy Valentine’s Day – A Safer Sex Reminder

Hey, it’s Valentine’s Day! Seems like a good time to revisit the topic of safer sex and sexually transmitted infections!

The CDC just released a new fact sheet on STIs, indicating that there are about 20 million new infections each year, and that young people (ages 15-24) account for about half of these.

In its report, CDC provided the following recommendations for women for STI screening:

  • All adults and adolescents should be tested at least once for HIV.
  • Annual chlamydia screening for all sexually active women age 25 and under, as well as older women with risk factors such as new or multiple sex partners.
  • Yearly gonorrhea screening for at-risk sexually active women (e.g., those with new or multiple sex partners, and women who live in communities with a high burden of disease).
  • Syphilis, HIV, chlamydia, and hepatitis B screening for all pregnant women, and gonorrhea screening for at-risk pregnant women at the first prenatal visit, to protect the health of mothers and their infants.
  • Trichomoniasis screening should be conducted at least annually for all HIV-infected women.

Have questions about sex, sexuality, STIs or related topics? Beloved sex-ed site Scarleteen has just launched a new live help feature, providing anonymous live chats with Scarleteen staff and volunteers. The full website, which tackles all kinds of questions about sex, is an amazing resource for young people.

December 6, 2012

Pros and Cons of Making the Birth Control Pill Available Without a Prescription

condom and the pill

Though it won’t be as accessible as condoms, health experts are proposing to make the birth control pill available without a prescription. Photo / Jenny Lee Silver

This month, the American College of Obstetricians and Gynecologists released a statement calling for oral contraceptives to be sold over-the-counter, no longer requiring a doctor’s prescription.

ACOG considered a host of issues, including the safety of birth control pills; whether pharmacists could screen for who shouldn’t get them, or if women could self-screen; adherence to taking the pill; whether women would skip other preventive care if they didn’t visit a health care provider for a prescription; and cost.

Notably, ACOG addresses frequent objections to OTC oral contraceptives by concluding that “several studies have shown that women can self-screen for contraindications,” and “cervical cancer screening or sexually transmitted infection (STI) screening is not required for initiating OC use and should not be used as barriers to access.”

As Kevin Drum points out at Mother Jones, most countries outside of North America and Europe do not require a prescription for these drugs.

ACOG notes, though, that making the pill non-prescription might increase the cost for women who have health insurance — especially since under health care reform, contraception can be purchased without a co-pay. Over-the-counter costs might end up being anything from the $4 deals many pharmacies offer to more than $100. Dr. Kent Sepkowitz also explores this concern at The Daily Beast:

Yes, your life is easier because you will be able to get the pill right this second, without calling my office. No, you don’t need to fill out forms and show insurance cards and wrangle over copay. But guess who is paying for the whole shabang? You. Yes, you.

Another concern is that if the pill were dispensed by pharmacists, we might see the more of same kinds of refusals as have happened with emergency contraception.

However, many patients may experience increased access with an OTC model. The National Latina Institute for Reproductive Health issued this response:

The recommendation that birth control be available over-the-counter supports what we know about Latinas and contraception: over-the-counter access will greatly reduce the systemic barriers, like poverty, immigration status and language, that currently prevent Latinas from regularly accessing birth control and results in higher rates of unintended pregnancy.

Pre-Prescribing Emergency Contraception to Teens
Another professional medical organization, the American Academy of Pediatrics, issued a statement recognizing high teen birth rates in the United States and barriers to access to emergency contraception for adolescents 17  and younger. The AAP strongly admonishes pediatricians who refuse to discuss or provide contraception to teens based on their own beliefs, stating:

Pediatricians have a duty to inform their patients about relevant, legally available treatment options to which they object and have a moral obligation to refer patients to other physicians who will provide and educate about those services. Failure to inform/educate about availability and access to emergency-contraception services violates this duty to their adolescent and young adult patients.

The AAP recommends that physicians provide prescriptions to emergency contraception like Plan B in advance, so teens have it ready if and when the need arises. They also urge physicians to provide accurate information to teens on this topic, and, “At the policy level, pediatricians should advocate for increased nonprescription access to emergency contraception for teenagers regardless of age and for insurance coverage of emergency contraception to reduce cost barriers.”

Nice job, AAP!

HHS Urged to Remove Restrictions on Emergency Contraception
Finally, a petition is circulating urging the U.S. Department of Health and Human Services to remove restrictions on emergency contraception and make it available to women of all ages without a prescription. To learn more, see RH Reality Check’s audio news conference and related links and commentary from Kristin Moore. Our previous posts provide background on why EC is not *already* available OTC to all women:

October 16, 2012

Study: No Link Between HPV Vaccine and Girls’ Sexual Activity

In 2006, when the FDA approved the first HPV vaccine for girls and women ages 9 to 26, one of the concerns opponents expressed was that it might make young girls think it’s OK to have sex.

That’s because the HPV vaccine protects against a virus that is contracted during sexual contact; specifically, four strains of the human papillomavirus, or HPV, which can cause cervical cancer and some vaginal, vulvar, penile and throat cancers.

In Nashville, where I live, one religious leader claimed, “What we are encouraging is abstinence and sexual purity. If they have a relationship with the Lord, they will recognize that they don’t need that vaccine.”

Others made claims along the same lines — that girls who “come from good homes” don’t need the vaccine, or that it would otherwise somehow promote promiscuity.

We’ve heard a lot less of this rhetoric lately, now that the novelty of the vaccine has worn off and the initial controversy has subsided. It always seemed like a bit of a ridiculous objection, since girls who become sexually active are probably not weighing the risk of some far-off consequence like cervical cancer. 

Heck, even the notoriously conservative Family Research Council has come around to acknowledging that either through abuse or by marrying someone who is a carrier of the virus, “it is possible that even someone practicing abstinence and fidelity could benefit” from the vaccine.

Still, opponents should be pleased with this news: The journal Pediatrics published a new study this week that shows the HPV vaccination is not associated with increased sexual activity among girls.

The researchers looked back at records for almost 500 girls who received the vaccine at ages 11 or 12 compared to about 900 girls who did not get the vaccine. Then they looked at whether the girls, over the next several years, had any record of being counseled about birth control, received contraception (specifically for birth control, not for acne or irregular periods), or had a diagnosis of pregnancy or certain STIs — all markers that imply sexual activity.

The researchers found no significant difference between girls who did and did not receive the vaccine.

Of course there are some limitations to the study, such as that some girls considered unvaccinated could have been vaccinated elsewhere, and girls could have received reproductive health care at places that weren’t counted in the study. A more conclusive set of results could come from following girls in real time over the years and collecting more detail about their health care and behavior.

However, this study provides important initial information that refutes concerns about HPV leading to increased sexual activity. Future research on concerns about the vaccine, then, might be better focused on learning more about long-term safety and effectiveness questions, rather than behavioral concerns.

Now we’ll just have to wait to see if there’s equal worry over whether boys who get the HPV vaccine are more likely to be more sexually active. I wouldn’t count on it.

December 13, 2011

Susan Wood Issues Response to Sebelius’s Overruling of Emergency Contraception Access

Last week, we wrote about a controversial decision by HHS Secretary Kathleen Sebelius, who overruled the FDA’s decision that emergency contraception should be made available over the counter to women of all ages.

On Friday, former FDA official Susan Wood issued her response to the move in the Washington Post, rejecting Sebelius’s claim that more data is needed on safety and label comprehension for the youngest of possible emergency contraception users:

…this type of age restriction, and worries about the use of medicines by teenagers, have not been applied to other products…Indeed, for no other over-the-counter medication has the FDA ever required extra data for a particular age group. (This extra data on younger teenagers was provided to the FDA in the latest application by the company.)

But somehow, the prescription requirement for Plan B — which is very safe and impossible to overdose on — remains in place for those younger teens who are in the unfortunate situation of being at risk of pregnancy and who need emergency contraception immediately.

Wood also notes that because the age restriction remains, access for older women remains restricted – emergency contraception is available without a prescription for those over 17, but is still behind a pharmacy counter.

Wood previously served as assistant FDA commissioner for women’s health and director of the Office of Women’s Health. She resigned in 2005 because of past politically motivated delays in emergency contraception approval, stating at that time:

I can no longer serve as staff when scientific and clinical evidence, fully evaluated and recommended for approval by the professional staff here, has been overruled.

Now, Wood calls out Obama for breaking his promise to the American people by allowing this overruling:

In his scientific integrity memo, the president stated: “When scientific or technological information is considered in policy decisions, the information should be subject to well-established scientific processes, including peer review where appropriate, and each agency should appropriately and accurately reflect that information in complying with and applying relevant statutory standards.”

In overturning the well-considered, scientifically based decision of the FDA, Sebelius and the Department of Health and Human Services certainly did not “appropriately and accurately reflect” the available scientific information…The president should stand by the principles of scientific integrity and restore science to its rightful place. He should support the FDA commissioner and direct the secretary to allow the agency to do its job. By doing so he will fulfill the promise of that beautiful day in March 2009 when he pledged that science would trump politics, not the other way around.

If you would like to write President Obama to object to Sebelius’s action and remind him to remember his promise about scientific integrity, you can contact the White House directly via this online form.

January 3, 2011

My Little Black Book for Sexual Health

If you have ever wished you had a little black book that answered your questions about sexual health and insurance, your wish has come true.

My Little Black Book for Sexual Health — – is available online to help you navigate the maze. This resource offers information on various topics, including how to obtain low cost insurance and rules that might govern whether birth control is covered by your insurance.

Described as “a guide for getting the health insurance you need to prevent pregnancy until you’re ready,” My Little Black Book is aimed at young people between the ages of 18 and 26; this group is most likely to be uninsured and faces a high rate of unintended pregnancy.

The interactive website is easy to use (or download the PDF version). You can flip through the virtual pages, blow the text up for easy reading, follow the tabs, or click through the table of contents. I found all sorts of helpful information — who is eligible for a school’s student health plan, how to get prescription drug coverage, and what kinds of sexual and reproductive services are covered. It is very user friendly and easy to understand.

My Little Black Book for Sexual Health was developed as part of the Reproductive Empowerment and Decision Making for Young Adults (REaDY) Initiative, a unique statewide public-private partnership led by NARAL Pro-Choice Massachusetts and Ibis Reproductive Health, to prevent unplanned pregnancy and promote sexual health for young adults in the wake of Massachusetts health care reform. A Spanish language version will be available soon.

Nekose Wills is the OBOS program assistant.