Sexuality is an important aspect of development during adolescence. The ability to identify and communicate with adolescent who may be at high risk of premature activity is important since sexual intercourse at an early age can have serious short and long-term consequences. An emphasis of confidentiality and an honest appraisal of implications of early sexual activity will enhance discussions about sexual issues with adolescents. Some parents are ill prepared for discussions about sexuality. Having conversations with their adolescent on sexuality may be difficult for them. Many adolescents claim both experience and confidence about sexual issues, they are often uncomfortable about discussing sexuality, both with adults and their peers. Pressure from peers may leave them wondering whether they are normal, and unhealthy. It becomes crucial that their family creates opportunities for conversations about sexuality with adolescents.

Persons aged twelve to nineteen or twelve percent make up the United States population. Approximately fifty to sixty percent of adolescent girls and seventy to seventy-five percent of adolescent boys have had sexual intercourse by the time they graduate from high school (Cutrona & Troutman 1997). There are also a growing number of adolescents having sexual intercourse before the age of thirteen (Comerci & MacDonald1996). One study conducted in a Mid-western town found that fifty-three percent of adolescents under the age of fourteen were having sexual intercourse.

The consequences of early sexual intercourse can not be avoided by society. Physical, emotional, and social consequences have a short and long-term impact on the development of adolescents. Forty-percent of all adolescent females will become pregnant before they graduate from high school (Comerci & MacDonald 1996). Almost fifty-percent of the 1.1 million teenage pregnancies each year will end in abortion or miscarriage. The 500,00 births occurring in adolescent girls, 31,000 occur in girls under fifteen (Shafer & Sweet 1995).

Sexually transmitted diseases have both short and long term consequences. In recent study fifteen to nineteen year olds accounted for twenty-four percent of all reported cases of gonorrhea (Orr, Wilbrant, & Brack 1998). The incidence of chalmydia of infertility is reported to be five to thirty percent in sexually active teenagers (Orr, Wilbrandt & Brack 1998). A DNA study shows human paillomavirus (HPV) or genital warts is present in eighteen to thirty-three percent in sexually active females aged fourteen to twenty-four (Orr, Wilbrandt & Brandt 1998). Racial and socioeconomic differences put some populations at an even higher risk for sexually transmitted diseases. Sexually active African American women are at twice the risk of developing pelvic inflammatory disease than Caucasian women. Persons aged thirteen to twenty-one represent one percent of all cases of acquired immuno-deficiecny syndrome (Comerci & MacDonald 1996). Because of the long period between exposure to human immunodefciency virus (HIV), and the people who are seropostive, the number of adolescents who are presumed to be HIV positive is higher than the number living with AIDS. Adolescents with AIDS live predominately in urban areas, and the percentages of youth with AIDS are minorities. There used to be an early belief that HIV transmission was primarily limited to homosexual populations, but in present days heterosexual contact is the mode of transmission in many cases of HIV among adolescents.

Seldom addressed are the psychological and social risks of early sexual intercourse in adolescents. Adolescents who have intercourse at an early age do for several reasons including peer pressure, anger at parents, and sometimes curiosity. They are poorly prepared in these situations to work out healthy patterns of sexual intimacy that allow for open discussions about their needs about contraception and about questions related to normal sexual functioning. Early unsatisfactory sexual experiences, particularly among females, often setup patterns for repeated unsatisfying relationships that continue into adulthood. The cost to self-esteem can be great when sexual favors are traded for dates, affection, and reassurance about physical appearance or peer approval.

There are many social costs of early sexual involvement. Graduation rates from high school are decreased for both males and females that are involved in teenage pregnancy. Only forty percent of girls who leave high school because of pregnancy will graduate from high school. Only two percent of those who give birth before age nineteen will graduate from college by twenty-nine (McCarthy 1995). The decreased family stability for adolescents involved in teenage pregnancies is also a social cost. The developmental tasks when adolescents are confronted with adult problems of parenthood and relationship difficulties have a long lasting influence on the individuals, their families and society as a whole.

A discussion of adolescent sexuality must take place in the context of the psychological development stages of adolescence. The changes of adolescence occur along a continuum, divided into three stages: early, middle, and late adolescence. Most of the sexual concerns and behavior that occur in adolescence are directly related to these specific development stages and tasks. Physical development is usually complete by the end of the middle stage. A common mistake of adults is that physically mature adolescents will think and reason as adults, when they are still emotionally and cognitively immature.

Early adolescent is characterized by concern about physical changes over issues of independence and protection and by the beginning struggles of separation and individual identity. Issues that may appear small to adults can reach crisis proportions in young adults. Common concerns in early adolescence include fears that physical development is either too fast or too slow, concern about genital and breast appearance in both boys and girls and concern and curiosity about the bodies.

The most common sexual activity of young adolescents is self-stimulation or masturbation. These behaviors are considered normal and not harmful, although periodically parents or adolescents may need reassurance about the normalcy of masturbation. When sexual intercourse or other genital sexual activity with a partner occurs in early adolescence. It is often out of a need to enhance self-esteem. Almost all of the time these relationships are expliotive, usually with an older partner. When a young adolescent is found to be involved in a sexual relationship, it is important to understand the history in order to determine whether there has been sexual abuse, since sexual abuse is not uncommon in young sexually active adolescents.

Most often, a young adolescent involved in sexual intercourse faces significant family dysfunction. The adolescent may become involve in premature sexual activity out of battles in family or out of an attempt to get the adults in his/her environment to be more concerned and involved. Sexual activity in early adolescence may reflect an imitation of adult models of sexual promiscuity. Adolescents in these situations need the opportunity to talk about their sexual behavior and need options for building self-esteem.

The most common issue that affects sexual behavior in middle adolescence is concern with peer approval. Both in sexual behaviors and in other health related area, are common at this stage and usually a rise out of the development task of defining oneself socially. Adolescent may view sexual intercourse as a way to get peer acceptance or as something that can be justifiable postponed. When adolescents in this period perceive that the majority of their significant peer group is sexually active. The media portrays sexual intercourse as a rite of passage to adulthood may conflict with advice from adults to postpone sexual intercourse. Studies show that adolescents who watch more sexually explicit television programs are more apt to have intercourse at an earlier age.

The struggle for independence is the other task that may complicate sexual decision making in middle adolescence. When parents are having particular difficulties with transitions from rules for children to rules for teenagers. Adolescents often prove their parents' lack of control by initiating behaviors that are forbidden, including sexual intercourse. Adolescents who have sexual intercourse at this stage often do so out of needs to prove to themselves that they are lovable and acceptable, although sometimes intercourse occurs of curiosity. Issues of contraception, commitment and preferences about sexual pleasuring may be discussed prior to sexual involvement.

Sexual maturity is characteristic of late adolescent, this is a stage when the adolescent becomes more cognitive mature. Issues of peer acceptance become somewhat less important as motivating factors for behavior, and conflicts over independence with family members. Sexual concerns in this development group often focus on long term relationship and commitment or decisions about parenthood precipitated by unplanned pregnancy or on the risk of venereal disease from current or previous relationship. 

Families and our schools must play a role in helping adolescents understand their feelings and make responsible decisions about sexual activity. To be effective in this role they need to understand the developmental stages and tasks of adolescence. The ability to communicate openly with adolescent patients is the key to successful intervention. Confidentiality, nonjudgmental listening and the provision of clear information are the cornerstones of a successful relationship.

Bibliography:

Comerci GD, MacDonald DI. Prevention of substance abuse in children and adolescents. Adolesc Med: 1996.

Cutrona CE, Troutman BR. Psychological outcomes of adolescent pregnancy, maternal and child effects. Semin Adolesc Med: 1997.

McCarthy J. The educational and vocational futures of adolescent families. McAnarney: 1995.

Orr DP, Wilbrandt ML, Brack CJ, Reported sexual behaviors and self-esteem among young adolescents. Mosby: 1998.

Shafer MA, SweetRL. Pelvic inflammatory diseases in adolescents. Guilford: 1995.

Zabin LS, Hardy JB, Smith EA, Hirsch MB. Substance use and its relation to sexual activity among adolescents. J Adolesc Health Care: 1994.

Keywords : Term Paper, Psychology, Adolescent Sexuality

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