Contraception: Ladies’ Choice?

Couple Vision About The Future

The pill.

The implant.

The IUD.

The patch.

The diaphragm.

The shot.

The ring.

Plan B.

Tubal ligation.

What do they have in common??

All are forms of “girl” contraception. Some use hormones, some act as a barrier, some make the sperm-journey to the fallopian tubes a trip from hell, but they all work in preventing pregnancy. And they all require either a vagina, cervix, or uterus in order to function properly.

Quick! Name a form of “guy” contraception! Did you say vasectomy!? You got it!           One. Simple. Answer.

However, there is a method of contraception that is shared: condoms. Those amazing, inexpensive little tubes of synthetic material also prevent STI’s. Score one for condoms!

Does something seem a little off-balance to you? Like….maybe….the females have to carry the burden of unintended pregnancy prevention? Well, you would be correct.

But, what if the situation were reversed? Check out this hysterical Buzz Feed Video called What if Buying Condoms Was Like Buying Birth Control? 

 

Yes, we can laugh – I totally cracked up – but watch it again and imagine if it were a young woman approaching her parent. It becomes a serious issue, doesn’t it? We don’t realize just how unbalanced this situation is until we understand how our societal norms dictate to women that they are solely responsible for their reproductive health, yet society also makes it difficult for women to follow through with those choices. Women need to have final say in the method they use – it is their body, and they are the ones who become pregnant – not much we can do about that biological fact. But the fact remains that there are barriers for women when it comes to actually obtaining birth control.

For example….

  • Feeling shamed. If a young woman carries condoms in her purse or is on the pill, whispers of the woman’s questionable morality might become apparent. Instead, the focus should be on her sense of responsibility.
  • Difficult to obtain. In order to receive a hormonal method of birth control, a young woman must visit their healthcare provider, undergo a physical exam, receive a prescription, then go to the pharmacy for pick-up. How long does that process take? An entire day? What if there are no health centers near her residence? What if she does not drive?
  • Corporations dictating what their insurance policies will cover. There is active debate simmering about who can determine the reproductive health choices of a woman; the woman? Businesses? Bosses? I don’t know about you, but I just as soon make my own health choices, thank you very much.
  • Cost. For individuals who are struggling financially, obtaining hormonal birth control can be a huge problem.

That, my friend, is a reality many young women have to endure to be responsible, safe, and healthy.

An example of the ridiculousness women sometimes have to go through to get protection is an anecdote shared in a recent conversation with a fellow educator. He relayed an experience in which a young woman tried to purchase condoms at a pharmacy but was refused. Why? Well, she’s a woman, of course. Why does she need a (male) condom?

She walked away empty-handed, putting herself and her partner at risk for an STI and/or unintended pregnancy.

That. Story. Blew. My. Mind.

How fortunate that MOST places are happy to sell preventive sexual health products to consumers who care for their bodies. Thankfully this story illustrates a rare event, however it is eye-opening to realize what some women go through to keep themselves and their partners healthy.

So, what can we do?

As parents we can help raise a new generation of responsible, safe, and healthy young people by being available for conversation about reproductive health for both males and females and every gender in between.

Someday there will be a way for men to prevent pregnancy with options other than condoms or vasectomy (You want to cut WHERE????). In the meantime, teach your sons to be proactive in their partner’s reproductive health. How?? What about these suggestions…

  • Do a little research on contraception and be informed about different options.
  • Discuss various methods of birth control with their partner.
  • Accompanying their partner to the clinic.
  • Help pay for the birth control.
  • Remind their partner to take the pill or whichever method is chosen.
  • Be responsible for the STI component – the barrier method (i.e.condoms).
  • Respect their partner’s choice of contraception.

Just because the ovary-owners have to worry about carrying a baby for nine months, doesn’t mean the testes-owners are not accountable as well.

And if your child is in a same-sex relationship, this conversation should still take place. Pregnancy may not be an issue, however STI’s are. The responsibility of reproductive health should be shared.

Remember the Seinfeld episode when Elaine was in a panic because sponges were no longer sold?

Seinfeld: Are You Sponge-worthy? (Facebook Link)

Check out the differences in how George and Elaine handled their birth control options. George said no to condoms regardless how his partner felt (see how important education and instruction are?). However, Elaine painstakingly evaluated her potential partner in which both individuals were in agreement with the method.

Someone I’m very fond of (my husband…) commented after watching this Seinfeld episode, “See! It’s hard for men, too! We have to open the package!” Um, yeah. Maybe there IS a reason women are primarily responsible for contraception…….

Bottom line. Even though women are ultimately responsible for contraception, that is no excuse for it to be a woman’s issue. All genders have a vested interest in contraception and should be part of the conversation.

“Mom, we’re pregnant”…..Moving forward when your world is rocked.

IMG_3699

I was fortunate enough to sit next to a very interesting and inspiring woman on the plane the other day. Her most recent work involves caring for and counseling people who have HIV/AIDS. Naturally, our conversations revolved around “how to change the world”. But since neither of us has any political aspirations, we agreed that we can change our little corners of the world by having conversations with others that may impact their lives in a positive way. And what can I say? I like to talk about sex!

As our flight was descending, she requested I address one discussion in particular: The importance of parents in supporting their children when life hits them hard.

Imagine this scenario….

……It is a lovely autumn afternoon. You are relaxing while reading the latest sexy romance novel tucked inside a recent National Geographic (no worries, I won’t tell), when your son approaches you with a very serious look on his face. So many things go through your mind; he crashed the car, he flunked a test, he flunked out of school (!), he doesn’t want to go to Grandma’s tonight…. Whatever it is, it can’t be THAT bad. Whatever it is, it will be resolved as soon as he spills…..

But wait. What was that? What did he say? You don’t think you heard this correctly. His girlfriend is what? Pregnant? What??!! Since when??!! They are only 16 years old! They CAN’T be sexually active yet……can they?

 

Happy surprised woman screaming with open hands

Your response is…

A. Start screaming and yelling “What were you thinking????”
B. Start sobbing uncontrollably.
C. Look at him and say, “Okay, joke’s up.”
D. Don’t say anything you will regret, get your thoughts together, give him a hug, and tell him you need a minute. Walk away and grab the wine and someone to talk to.

Well, we all know the obvious answer is D (with or without the wine, however). But if you reflexively chose A, B, or C, I won’t judge. I understand it is shocking, scary, and maybe dream-shattering – at least in that moment.

So, how do you move forward??

A friend once told me: Don’t Admire the Problem, Work Towards the Solution.

We have all made mistakes. Some mistakes are quite trivial, and others rather shocking, scary, and dream-shattering. And if you haven’t, Ms or Mr. Perfect, I’m sure you know someone who has. Think about how you or someone you know (wink) has worked through seemingly insurmountable problems. I’m betting they gained wisdom and courage to help them grapple with future distressing predicaments. That’s how life works.

You have to make a choice. You can dwell on the problem (“Why me? What will the neighbors think? How could they have done this? I’m so embarrassed. Their life is overrrrrrr!”) Or, you can be a part of the solution by continuing to move forward with the situation at hand.

“In any moment of decision, the best thing you can do is the right thing. The worst thing you can do is nothing.” Theodore Roosevelt

Just Move Forward.

After you’ve calmed yourself down, take your son by the hand. Tell him you love him. Tell him you will get through this together. This sounds pretty fairy-tale. I get it. I also know that there will be “discussions” of “disappointment”. However, keep it in check – be kind and acknowledge this probably was not on his immediate bucket list either. Put yourself in his (shaking) shoes.

Let me help you reframe your thoughts…

Let’s back away from the idea that certain life situations are “problems” and appreciate that they are, well….”certain life situations”.

In the past I’ve written about helping your child make good choices based on their values and purpose in life. I suggested asking them a few questions, two of which are:

  •  Where do you see yourself in 5 (or 10) years?
  •  How do you see yourself achieving this goal/dream?

Well, now I want you to ask yourself these questions:

  • What kind of relationship do you hope to have with your child 5 (or 10) years from now?
  • How do you see yourself building that relationship?

So, you tell me. With those four choices up there, which one makes the most sense? Freaking out? Or working together to come up with a plan?

Yeah. I thought so.

 

Arm-ing our young women with protection

human hands showing thumbs up

Photo courtesy DPC

A couple of weeks ago, amidst the disturbing reports of violence in the Middle East and the eye-opening spread of Ebola, a little news blurb caught my attention – on both the local and national news. I have a peculiar radar for certain topics, and anything to do with adolescents or sexuality health related topics always grabs my attention.

What was this report?

The American Academy of Pediatrics (AAP) released a report written by Dr. Mary Ott and Dr. Gina Sucato and the COMMITTEE ON ADOLESCENCE indicating intrauterine devices (IUD’s) and implants are the best method of birth control for adolescent women. I was already familiar with this concept; I’d attended a conference a year or so ago in which school-based health center clinicians touted this as the best option for sexually-active young women. At that time, I remember thinking…what’s wrong with the pill??? But I’ll get back to this in a minute.

Of course the BEST and ONLY way to prevent STI’s and pregnancy is abstinence. However, about half of all high school students have had sex by the time they graduate, so it is important to address topics such as contraception.

In fact, conversations about sexuality health should begin when kids are little. No, they don’t need to know about intercourse at age 4. Rather, conversations about healthy relationships, learning to assert themselves, and respecting themselves and others can be woven into everyday conversation. And remember, whether you are a parent, family member, teacher…whomever…they are watching you, so model what you preach.

But I digress…

So, let’s assume you’ve had “the talk” (about relationships, I mean) and feel confident she has been taught well. But now you have been informed she would like to visit the doctor for birth control. If you start to sweat, shake, stutter, and your eyeballs fall out, explain to her that you would like to have this conversation when you have a minute to sit and chat with her. After sipping (okay, gulping) a little wine and feel a little more relaxed and ready to LISTEN, it is time to have an intelligent conversation with her.

Understanding the basics of birth control options for young women is the first step in engaging in this type of conversation. If you don’t know what options are available, it will be difficult to sound intelligent…and we don’t want them to think we don’t know what we are talking about, do we???

Back to my earlier comment: So, what’s wrong with the pill???

Well, nothing really. At least not when it is used correctly and consistently. And that, my friend, is the problem. With perfect use, the pill is about 99% effective. However, it is rare that the pill is used perfectly. Therefore, with typical use (yes, that’s a term), the pill is about 91% effective. Not bad – unless you are the nine in 100 who become pregnant.

You are probably wondering how a pill can be used incorrectly or inconsistently. Well, here are some glitches:

  • It is not taken at the exact same time every day. (Setting an alarm can help.)
  • Forgetting a pill here and there. (The pill must be taken 7 consecutive days to be effective. If you miss more than one, you must use a back-up method)
  • Taking a medication which may lessen the effectiveness of the pill, therefore a back-up method should be used. (Tell your healthcare provider about all medications being taken.)
  • Not refilling the prescription on time each month.

According to Dr. Ott and colleagues, the oral contraceptive pill is the most commonly used method of hormonal contraception among adolescents. The pill is also an effective way to treat other reproductive health ailments, not just for prevention of pregnancy.

(Planned Parenthood)

But this is where the other options trump the pill.

Both the IUD and the implant (which are referred to as long-acting reversible contraception – LARC), are placed into the body for between 3-12 years, depending on the device, with nary a thought!

Wait?! What? WHERE in the body, you ask…

Implants:

The progestin implant (Implanon and Nexplanon are two commonly used) is surgically inserted into the inside of the upper arm by a specially-trained healthcare provider. It’s a quick procedure – about five minutes. It can be left in for up to three years.

(Planned Parenthood)

The IUD

IUD’s are used commonly used world-wide; we are finally catching on to this effective method in the U.S. One type of IUD contains copper which prevents pregnancy by stopping sperm in its tracks. (They don’t like copper.) This IUD can stay in the uterus about 10-12 years.

The other type of IUD contains levonorgestrel (a hormone) and also prevents sperm from making a “run for it” by causing the cervical mucus to become really thick and sticky. This type of IUD can stay in place up to 5 years, depending on the particular IUD selected.

(Planned Parenthood)

Here’s a comparison chart with information gathered by Dr. Mary Ott and Dr. Gina Sucato, CNN, and Planned Parenthood. (Okay, there are a few stray comments interjected by yours truly…)

These stats reflect the odds of pregnancy when using the specified method for one year.

IUD:Implant chart

CNN

Don’t get me wrong…..

There IS a risk for every type of contraception. This is where a CONVERSATION WITH YOUR HEALTHCARE PROVIDER is mandatory. Information you read here, online, in books, or discussed with friends is always helpful, but we don’t know YOU or your CHILD. Your physician will offer personalized care that cannot be provided anywhere else. Information given on this site (and others) is merely to inform and get the conversation started. Keep in mind that by denying a sexually-active adolescent access to birth control, an unplanned pregnancy may become a reality.

One last word…

Having said all this, it is important to understand that hormonal methods of contraception DO NOT protect against STI’s. This is where conversation with penis-owners and vagina-owners becomes imperative. Even with the use of hormonal contraception, no matter which method works for your family member, a condom must be used in tandem to prevent the spread of STI’s and HIV. In other words, sexual health responsibility does NOT lie solely with the young woman, it is a dual responsibility. After all, it does take two to tangle, does it not? Both parties should be taught to be equally responsible for the health and well-being of not only themselves, but of their partner (that’s that “respect” topic mentioned earlier). And in the case of same-sex relationships where pregnancy is not an issue, a barrier method of birth control is recommended – not to control birth, but to help both partners stay healthy.

A special thank you to Dreyer Medical Group Obstetrician and Gynecologist                                                                             Dr. Caroline Mills, MD  for reviewing this post. You rock!

Resources:

American Academy of Pediatrics

WebMD: IUD for Birth Control

Implanon

 

 

National Coming Out Day

 

I told my mom I was a lesbian when I was 16. My mom told me "as long as you are happy, who am I to tell you who to love?" My mother and I became closer and are still close 8 years later.

(Photo Courtesy of Whisper and Huff Post – see link below)

My hope as an educator and ally is if you know a young person (or an old person!) in your world who identifies as LGBT or Q, you respect and appreciate them for the person they are.

For information about National Coming Out Day, and to see more cool quotes, click on this link:  National Coming Out Day 2014: LGBT Whisper Users On Acknowledging Their Sexuality In The Open by Curtis Wong.

Also, check out this link to the Human Rights CampaignIt explains why today is important and also features a pretty cool (short!) video.

Coming Out Day -

It matters.

Let’s change the channel.

 

Photo courtesy of StopBully.gov

Photo courtesy of StopBullying.gov

Bullying….something we hope our children don’t experience – or instigate. Even if they do not experience bullying directly, 56% of students have been bystanders and witnessed bullying in the school setting. (The Family Place Be Project.org) Odds are, your child or their friends will indeed be effected by bullying. With the school year just beginning, now is a good time to be armed with strategies to assist the young person in your life when faced with this issue.

Bullying occurs when a person or persons repeatedly harms or threatens another person either verbally, physically, emotionally, or socially. This can be done directly (hitting, teasing, threatening) or indirectly (starting rumors, leaving someone out on purpose).

I won’t waste our time going through all the effects bullying can have on a person. We all know it can increase anxiety and depression. It can decrease self-esteem. The child may not want to attend school, and is likely to skip PE. (Guess where a lot of bullying takes place while in school?)

……………And the effects can last a lifetime.

So what do we do?

1. Labeling people as “bullies” and “victims” is not a great idea. Labeling a person implies this is who they are and who they will always be, and we don’t want these young people to carry that label into adulthood – we want them to grow into confident, compassionate humans.

2. Model empathy and kindness. Avoid disparaging remarks about others, especially those who identify as a minority within your community; someone who is “different” than you as far as race, religion, culture, sexual orientation, or economic status. Typically these individuals become the targets of those that bully.

3. Understand the social messages that inundate our society.  Reality shows frequently model belittling between individuals. I just don’t find that entertaining; in fact, I find it hurtful and painful to watch. The message we send to people, regardless of age, is that by insulting others, people can appear more confident and powerful. The truth is, the person doing the belittling is probably dealing with their own feelings of insecurity, or have experienced bullying themselves. They haven’t learned social skills that enable them to communicate effectively without using hurtful messages. We also hear controlling messages in music, and experience less-than-friendly rivalry with certain sporting events, such as wrestling. (Bullying statistics.org) Start a conversation with your young person about these messages.

4. Focus on positive behavior. When you see a young person being kind to someone, remark on it. However focus on what the child did and what the outcome was, not how you feel about what the child just did. For example, “I noticed you help Richard get away from Tom when he was teased. He looked relieved.” (Guidelines for Effective Discussions About Bullying.) That can inspire the child to be kind because it makes HIM feel good about his actions, not because it makes YOU feel good or proud.

5. Talk about bullying. Explain bullying is never okay, and that it is important to tell an adult if it happens to them or a peer. According to stopbullying.gov, give them strategies such as telling the person doing the bullying to stop – but do not confront – then walk away. Or disarm him with humor, then walk away. Or just walk away. (Get the pattern here?) An adult should be informed – or tell friends – so s/he won’t feel so alone. Walk in groups of friends or stick by adults, since it isn’t is likely to happen if there are adults around.

6. Look for tell-tale signs that your child may be having problems. Classic signs include increased anxiety and depression, falling grades, or feeling “too sick” to go to school. Locker room bullying before and after PE class, as well as during class, is common. Playground bullying as well as during intramural sports are other typical bully opportunities. If your child or student refuses to dress for PE, attend PE class, or decides they no longer want to play on a team or go out for recess, red flags should be going up.*

7. Be there for your child. Ask them open-ended questions about their day. Ask who they hang with, eat with, talk to. Show them you are there for them.

8. Many kids are bystanders, that is, they witness the bullying, but don’t know what to do. I totally get that. There is a fear of becoming a victim themselves. But when that happens, the person who bullies has an audience, which they like, and they also take the silence as approval and encouragement. So let’s have them try these strategies offered by Stan Davis of StopBullyingNow.org and StopBullying.gov.

  • Help the person being bullied escape by telling him he is needed elsewhere and then walking out with him.
  • If someone is sharing a rumor, change the subject.
  • Do not spread rumors, and tell friends to not share rumors as well.
  • Spend time with or become friends with the person who is being bullied so they don’t feel alone.
  • Tell a trusted adult.

9. One other interesting tidbit to keep in mind. According to Bullying Prevention of the State of Maine and Stan Davis, encouraging a student to talk with the person who bullied  them to explain how they feel is a big no-no. By telling that person they feel hurt, sad, mad…whatever… s/he has gained power over their target that they were seeking – their bullying worked! It won’t stop the behavior, in fact it may make the problem worse. Remember, this isn’t a squabble between two friends.

In summary, the only way to stop bullying is to make it socially unacceptable.

This goes beyond “it’s not nice” to bully. How can we change our social constructs so that good deeds demand more of our focus than negativity? TV, music, movies, sports, news, daily conversation…..be aware of the subtle messages our youth are receiving. We can’t change what is on TV, but we can change the channel.

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*Roman, C., & Taylor, C. (2013). A Multilevel Assessment of School Climate, Bullying Victimization, and Physical Activity. Journal of School Health, 83(6), 400-407.

Sorry Mom

Originally posted on TeenWorldConfidential:

Construction Zone! 

I am revamping my website and have not had time to write much! Please enjoy this post – it is one of my first posts on TeenWorldConfidential. 

——————————————————————————-

Sorry Mom

Sorry Mom

So, my youngest daughter is studying abroad in Australia. What a great experience, right? For spring break, she asked if we would mind if she went on an adventure trip with some of her friends. “Sure!” I said….”just no scuba diving, bungee-jumping, or skydiving.” (Did I mention this was an ADVENTURE tour?). She agreed. Kind of. I think what she said was, “Oh, Mom. You don’t need to worry about me!”  About two weeks later she sends me this photo. If you look carefully, her hands read, “SORRY MOM”. (You can click on the photo to enlarge it.)

Yup. As parents we want the best for our children. We want them to be healthy, productive members of society…

View original 423 more words

Let’s Talk: Sexually Assaulted Males.

Males who are sexually assaulted may feel distressed, confused, and isolated.

Males who are sexually assaulted may feel distressed, confused, and isolated.

Society tends to place a greater eye on female victimization when it comes to rape and sexual assault. I get that. It’s pretty scary to think about the physical strength of a male vs. the strength of a female and the odds of defending herself. There’s a bit of testosterone involved.

However……

Females are not the only victims of rape, and we are doing society a disservice by neglecting this important reality.

As we know, instances of sexual assault and rape are markedly underreported for many reasons. According to the National Institute of Justice, these are some of the more common reasons that men and women do not report sexual abuse:

  • shame
  • embarrassment
  • lack of support by authorities
  • humiliation
  • distrust of legal system
  • guilt
  • privacy
  • fear of retribution
  • afraid of what others will think

Consider this: what if a male is physically or psychologically forced into having sex, either by a man or woman? There is an untruth that all guys “want it”, so males cannot be raped. Another fallacy is if a man is raped, he must identify as gay. Imagine how difficult it would be to report the assault when the societal assumptions about male sexuality are so skewed.

According to Sally Strosahl, M.A., LCPC, this situation is more common than we realize, and the psychological effects on the male victim can be devastating, just as it is for other sexes (female and intersex*). She relayed the following story about a high school male with whom she had the privilege to counsel.

“Mike (not his real name) began to close himself off from friends and family. He often retreated to his bedroom after dinner rather than engage with the family as he usually had in the past. His appetite decreased as well and he began to lose weight.
Mike, who is typically upbeat and easygoing, suddenly became surly and easily irritated. As his personality continued down a negative path, his parents recognized this as an indicator of depression and sought out my therapeutic services.
After the first couple of sessions, he began sharing personal details about his relationship with his girlfriend. She was a bit older; a senior in contrast to his sophomore status.
Mike wasn’t quite ready for a sexual relationship, though he did enjoy time spent together. However, his girlfriend had different ideas and wanted to engage in sexual activity with this young man. Using psychological coercion, she forced him into a physically intimate relationship despite his preference to wait until he was ready.
Using threats such as, “ If you don’t have sex with me, I’ll tell everyone you have a small penis” or derogatory statements such as, “I don’t know why I bother going out with you. You have no idea how lucky you are to have me.” She was psychologically abusive by taking advantage of his vulnerability. Mentally beating Mike down, his “girlfriend” coerced him to have sex – otherwise knows as rape. However, this young woman soon grew bored with him and broke it off, possibly going on to her next sexual conquest.
After several sessions of therapeutic work, he slowly came to understand that he was a victim of rape, sexual abuse, and emotional abuse. Eventually he met a new girl – his age – and has a healthy relationship thanks to the hard work this young man went through with counseling and with the support of his parents.

I want to emphasize that as awful as rape and sexual assault is for a victim, not getting the appropriate psychological help to recover can make the situation infinitely worse. I encourage all victims of abuse – sexual or other – to seek help. It is not your fault – no matter if you are male or female. Get help.”

Sexual assault of men is real. Because of the social stigma attached to it, reporting is incredibly low. According to the Sexual Assault Response Services of Southern Maine,  61% of all rapes are not reported. Male-only statistics are harder to come by because of the lack of reporting. Being aware that this actually occurs is the first step in advocating for these individuals.

Here are some telling statistics according to The Campus Sexual Assault Study researched by RTI International.

Since entering a college campus…

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We are all familiar with the media accounts of men in power who have sexually assaulted and abused young boys and men. Religious leaders, teachers, a university football coach … all using their authority to coerce males for their sexual pleasure and/or to demonstrate their dominance. But women can do the same.

I happened upon this interesting article When Men Are Raped by Hanna Rosin as I was finishing up this blog post. For further investigation about men who are sexually assaulted, I recommend this article.

Would you like more information or support? Please go to these links. You are NOT alone.

RAINN

Pandora’s Project

1 In 6

Men Can Stop Rape

Band Back Together

Universities also offer support and counseling. Please, go talk to someone. It’s not your fault.

With counseling, sexual assault victims will find their path blooming with hope.

With counseling, sexual assault victims will find their path blooming with hope.

(*Intersex: A person is born with ambiguous male and female anatomy – external as well as internal. Sometimes it is obvious at birth, other times it isn’t noticed until puberty, and sometimes a person never knows! There are several medical conditions associated with being intersex, including Turner Syndrome and Klinefelter Syndrome. This has nothing to do with sexual orientation. See my blog for more information about different types of identities. Facebook You Have Set A Great Example.)