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To Teens, Oral Sex Really Isn't 'Sex'

Belief puts youths at risk for sexual diseases

MONDAY, May 28, 2001 (HealthDayNews) -- When is sex not sex?

Apparently when it's oral sex.

At least that's what many adolescents and young adults believe. Surveys show that as many as 60 percent of American youths don't consider engaging in oral sex as "having sex."

That's bad news, say health professionals, because it may lull teens into the mistaken belief that they can't catch a sexually transmitted disease through oral sex.

"Some adolescents may be well-educated about sexually transmitted diseases they can acquire from intercourse, but they may not realize they can get the same diseases from oral sex," says Bruce Ambuel, associate professor of family and community medicine at the Medical College of Wisconsin in Milwaukee.

"There is a significant disease risk," Ambuel says. "This is a big concern."

Oral sex can put teens and adolescents at risk of catching HIV, the virus that causes AIDS, Ambuel says. Herpes, gonorrhea and syphilis are among the other diseases that can be transmitted through oral sex.

The view of oral sex as harmless fun may have gotten a boost from the widely publicized actions of former President Clinton, who engaged in oral sex with White House intern Monica Lewinsky.

"It's suddenly being viewed by young people as very casual," says Tamara Kreinin, president of the Sexuality Information and Education Council of the United States. "I think there is some cause for concern that we are hearing so much anecdotally about oral sex among teens and adolescents."

Statistics on oral sex among teens are scarce. But about half of all high school students in the United States are sexually active, meaning they have had sexual intercourse.

By ninth grade, about 33 percent of all girls and 45 percent of all boys have had sexual intercourse at least once, according to a national survey by the U.S. Centers for Disease Control and Prevention (CDC). By the senior year of high school, the numbers rise to 66 percent of girls and 64 percent of boys.

Although the survey did not include results for oral sex, experts say it seems logical to assume that kids who have gone all the way probably have experimented with oral sex.

Oral sex 'quite common' among teens

In fact, Ambuel says, "We can say from a few small studies that oral sex seems to be quite a bit more common among adolescents who have had sexual intercourse."

Some psychologists and psychiatrists who work with young people say that sexual experimentation is a normal part of growing up, and adults shouldn't be overly concerned if teens engage in oral sex or mutual masturbation -- activities that earlier generations called "heavy petting."

At the same time, teens need to be made aware of the health risks inherent in oral sex, these experts say.

"For me, for 16-year-olds to engage in all kinds of sexual practices which stop short of intercourse is normal, and probably was ever thus," says Dr. Elizabeth Berger, a Philadelphia-area child psychiatrist and author of Raising Children With Character.

"Youngsters, if they are psychologically healthy, and they meet someone and they're in love, are passionate and motivated to have some kind of sexual experience, up to and including orgasm," Berger says.

"This is good preparation," she says, "for the technical loss of virginity that happens with fully mature, and hopefully married, sexuality."

Berger, who says young people must be educated about sexually transmitted diseases, says she believes they shouldn't engage in sexual intercourse until marriage.

And, she says she favors sexual expression only within a committed relationship.

"Let us distinguish between things that happen in drunken stupors at frat houses and things that happen between two 16-year-olds who are madly in love," Berger says.

Society's impact on teens

Like many things teens do, the sex lives of teens often reflect what's happening in the broader society, says Dr. Charles Huffine, an adolescent psychiatrist in Seattle and assistant medical director of King County Mental Health, Chemical Abuse and Dependency Services.

"My sense is that our society is highly ambivalent about sex, and teens are ambivalent about sex," Huffine says. "Oral sex has that 'tweener' quality."

Teen sex, oral or otherwise, is an inescapable part of the process by which adolescents learn to make choices in preparation for adult life, he says.

"Negotiating sexuality is one of the absolute core aspects of what all adolescents have to do," he says. "And the question is, what is the right way? How does someone get from being the protected little child to this mature individual who is going to make a choice that affects the rest of your life?"

"Unless we are going to return to a time when people get married as soon as they reach puberty to someone their family chooses for them, this will be something adolescents have to do on their own," Huffine says. "This is the context around which that question about oral sex exists."

That's not to say that adults can't offer advice, he adds.

But others say adults can and should declare their opposition to teen sex.

"I personally think we ought to be sending a strong message to our adolescents not to rush into sexual experimentation," says Ambuel. "There's plenty of time to do that as they get older."

"It's important for parents to tell their children they don't want them to have sex or be involved in oral sex, either," he says.

Kreinin, of the sexuality information council, says parents and significant adults in a child's life need to talk to children about sex from an early age.

"They need to have parents and caretakers have a conversation over time that is not just about the mechanics of sex, but about love and emotions and relationships," she says.

"We're finding out more and more that teens want to learn from their parents and from significant adults in their lives," Kreinin says. "Kids want to talk to adults about sex. They want information, and they want viewpoints."

What To Do

For information on making decisions about sex, written specifically for teens, check out the American Academy of Family Physicians.

To find out more on the transmission of AIDS and other diseases through oral sex, visit the CDC online.

Or, you might want to read previous HealthScout articles on teens and sex.

SOURCES: Interviews with Bruce Ambuel, Ph.D., associate professor of family and community medicine, Medical College of Wisconsin, Milwaukee; Elizabeth Berger, M.D., child psychiatrist, Philadelphia; Charles Huffine, M.D., assistant medical director for child and adolescent programs, King County Mental Health, Chemical Abuse and Dependency Services, Seattle; and Tamara Kreinin, president, Sexuality Information and Education Council of the United States, New York City
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