Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, April 9, 1995 TAG: 9504200019
SECTION: EDITORIAL PAGE: G-3 EDITION: METRO
SOURCE: ARTHUR R. SLAUGHTER, M.D.
DATELINE: LENGTH: Long
All teens are at risk for unhealthy behaviors. There are not two distinct populations at risk, but rather a gradation from low to high risk, depending on many factors: social, economic, religious, educational, family support, access to services, self-esteem and individual responsibility.
Teens are in a state of tremendous hormonal, physical and emotional transition. They are under pressure from others to perform, conform, be, become, shoulder responsibility and comprehend at a time when self-fulfillment, personal identity, delight, tenderness, understanding, structure and freedom compete for their allegiance. Meanwhile, the media blare forth an unrealistically fast, sexy image of success.
Can we adults not remember our teen years?
Our community can consider many mutually compatible options. Several volunteer activities have been detailed recently in this newspaper. Additionally, the Roanoke Adolescent Health Partnership provides better access to care through school-based health centers and a community teen-health center at Hurt Park. The centers provide counseling and treatment for most health issues of adolescence, including sexuality.
Some options worth further elaboration derive from the personal responsibilities and opportunities that belong to our children, and that are inherent in our roles as parents, teachers and other professionals.
Parents and guardians have a responsibility to discuss and counsel their children regarding the realities of sexuality. The skill is not automatic. It can be tough to begin such discussions when one has not tried. But parents must begin these talks early, so that children recognize that sex is a natural and necessary part of life that deserves open communication at home, at school, at worship and in the doctor's office.
If we imply to our children that sex is a topic best left for when they are older, they will seek the information elsewhere, getting a barrage of distortions from the media and misinformation from the playground. To balance external input, we must begin and continue to educate at home.
But the need to begin at home in no way diminishes the need to foster learning at school. Public and private education must affect the lives of children positively regarding sexuality. Neither home, school, houses of worship nor health care should pass the buck to the other. Each has its own contribution to a matrix of understanding that our children form.
Family-life education in the schools must be given as much emphasis as the three R's. Should not a child master her ABC's before asking for AFDC? Is it not better that we help them calculate the personal costs of unwed pregnancy and provide solid reasons to avoid, postpone or decrease sexual activity through open and honest discussions?
Teachers of math, history, science, the arts and language should welcome legitimate discussions of sexuality, including its rewards and consequences. A child with the openness, courage and honesty to discuss condoms in school should be encouraged and then challenged to debate opposing viewpoints. We educate to prepare our children for their tomorrow. Our adolescents will reach their own conclusions and act accordingly. Understanding and controlling their own sexuality will determine to a large degree the opportunities in their future.
Our schools can help assess how the children in our community approach risky behaviors and whether our efforts lead to change. The Centers for Disease Control has a valid, self-reporting instrument, the Youth Risk Behavior Survey. Our schools should use this confidential survey to help measure trends in risky behaviors.
School is the most practical forum to assess large populations of children. Yet our schools shy away from such measures for fear that the results may reflect badly on the schools' performance or that their use might be controversial. Does our educational system have more concern for appearance than for substance?
Other institutions are expected to strengthen moral fiber. Do we ask that our houses of worship be the sole bastions of morality? These institutions can enhance personal choice in sexuality decisions, giving depth to spirituality and sharpening tools of morality. These skills must be exercised and recognized as important at home, at work, at school and by health-care providers.
Spiritual leaders can stress that while our behaviors can be forgiven by God, we must accept personal responsibility for our choices. Our places of worship can influence the choices of our children more by spiritual and behavioral guidance than by condemnatory judgement.
Religious programs to encourage sexual abstinence among peers can help provide the skills of restraint. Youth who make other choices, however, should not be disenfranchised from spiritual support.
Parents and health-care providers can enhance moral and spiritual choices without being experts in theology. We can encourage and offer the opportunity for spiritual discussion and experience, even if public-school teachers are not allowed to do so.
Health-care services must shoulder a very important role. Doctors, nurses and counselors should seek opportunities to engage teens in discussions of sexuality and risky behaviors. Many kids go through late grammar school and most of their teen years with little medical supervision. Some of the more common health visits at this time are for colds, sprains and sports examinations.
We may pass a child for volleyball, but do we find out how comfortable he is discussing sex with his parents? Do we ask whether he really understands how to prevent HIV, sexually transmitted disease and unwanted pregnancy; whether he rides with someone who drinks alcohol; whether he wants to talk more about his current or intended activities; whether he has considered the positive rewards of abstinence or delayed sexual involvement?
If not, then we may send another child to the volleyball court without enhanced skills, with an attitude unchanged since we first said hello, and with little chance to have influenced his potential outcome. Whether he or she is an orthopedist, dermatologist, emergency or urgent-care doctor, pediatrician or family doctor, a few open-ended questions to a teenager in a physician's care can signal a permission to talk frankly and can possibly lead to less risky behaviors.
Engagement in such discussions can be effective if nonjudgmental, honest and individualized for each person. Silence can be a loud statement of our lack of concern. The ankle will heal, but a broken heart and spirit may cripple.
Children must learn, without mixed messages, and accept the responsibility that sex, like driving fast, can be fun but very dangerous. Spiritual, educational and experiential restraints offer a better margin of safety. The less teens know about how and when to drive the organs and spirits they possess, the more likely they are to wreck the lives that touch them.
Arthur R. Slaughter is a Roanoke physician.
by CNB