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European Approaches to Adolescent Sexual Behavior and Responsibility:
Executive Summary & Call to Action [PDF]
The entire monograph is also available in [PDF]
format.
Foreword: A New Vision for Adolescent Sexual Health
Rights. Responsibility.
Respect. This trilogy of values underpins a social philosophy
of adolescent sexual and reproductive health in the Netherlands,
Germany, and France—the
countries visited by a 1998 study tour, composed of 42
U.S. experts and graduate students in adolescent sexual
health.
In these countries,
government and society view accurate information and confidential services,
not merely as needs, but as rights of adolescents. These rights, in
turn, depend upon societal openness and acceptance of adolescent sexuality.
In short, the Dutch, the Germans, and the French expend less time and
effort trying to prevent young people from having sex and
more time and effort in educating and empowering young
people to behave responsibly when they decide to have sex.
Each of these nations appears to have an unwritten social
contract which states, "We'll
respect your rights to independence and privacy; in return,
you'll take the steps you need to take to avoid pregnancy,
HIV/AIDS, and other
sexually transmitted diseases."
Is this a formula for
lax morality and promiscuity? The young people in the countries we
visited commence sexual intercourse a year or two later than
do U.S. teenagers. Further, the Netherlands, Germany, and
France boast better public health outcomes—the teenage birth rate in
the Netherlands, for example, is nearly eight times less than in the United
States. Germany's gonorrhea rate is nearly 25 times less than the U.S.
rate.
So, if Dutch, German,
and French teens have better health outcomes and delay the
onset of sexual activity longer than do U.S. youth, what's the secret?
Do we have a 'silver bullet' solution for the United States that will
reduce its three million new STD infections among teens each year,
or the 6,000 cases of HIV infection reported so far among those ages
13 to 24, or the 800,000 teen pregnancies each year?
Could the 'silver bullet'
solution for the United States be a mass media campaign
like those in Europe that boast a single, consistent message—safe sex or no
sex? Is it a public health system that makes contraception available
at little or no expense? Could it be the fact that public
health policy is based on public health research, rather
than relying on the political
or "moral" agendas of a strident minority?
Unfortunately, there
is no single, 'silver bullet' solution. The mass media
campaigns, the public health systems, and public health
policies have their part in
the Dutch, German, and French successes. Yet, success doesn't
really rest on programs and services alone. It is the societal
thinking—the
norms—that make the Dutch, German, and French successes possible. It
is the openness and the acceptance that young people will have intimate
sexual relationships without being married and that these relationships
are natural and contribute to maturing into a sexually healthy adult.
It is the refusal to brand the expression of sexuality as deviant behavior
or to cast it solely in a negative light. It is the determination to
present sexual expression as a balance—a normal part of growing up and a
responsibility to protect oneself and others. It is the respect these
societies have for adolescents, valuing them as much for who they are
as for the adults they will become.
But how relevant is
all of this to the United States? The United States is larger, more
populous, and more diverse than these European nations, and its cultural
values are different. However, size and diversity do not explain the
dramatic differences in public health indicators between the United
States and the Netherlands, Germany, and France. They do not explain
why the United States has a higher teen birth rate than the Netherlands,
France, Germany, and Morocco, Albania, Brazil, and more than
50 other developing countries. They do not explain the dramatic differences
in HIV and STD rates between the United States and the three European
nations.
We need to look deeper—not
just at contradictory and confused public policies but also at the
contradictory norms that underlie those policies. As a society, we
are uncomfortable discussing sexuality issues and, especially, teenage
sexuality. Advertising and programming in the entertainment media too
often send sexual messages that seem to say, "Just do it!" The
recent, Congressionally-mandated message to students is "Just
say no, until you're married." As a result, methods of dealing
with teenage sexuality include pretending teens do not
have sex or attempting to control and limit information
about sex and contraception.
The negative message
to teens is clear—"You shouldn't have sex, so protection is irrelevant!" No
wonder many young people in the United States are not motivated
to be sexually responsible; and when they are, they are
too often thwarted as they seek the information and services they need.
Despite U.S. adults'
general discomfort with the subject of teen sexuality,
the vast majority do not agree with "head in the sand" approaches.
Instead, the majority of adults say they want young people
to have the information
and services they need. The challenge will be to build
on these positive attitudes and to articulate the values
of honesty, openness, respect,
and responsibility that promise to underpin a new, successful
approach to adolescent sexual health in the United States.
Although the European
experience can be helpful in guiding this effort, the United
States cannot simply adapt European approaches completely.
We are different in many ways. We place a greater value on abstinence
and—given the
early age at which our teens commence sexual activity—that is a good
thing. But valuing abstinence must not override young people's
rights to accurate information that can protect and even save their
lives. At a time when 70 percent of 18-year-olds in the United States
have had sexual intercourse, we cannot afford to ignore the needs of
sexually active youth.
But we can use the experience
of the Dutch, the Germans, and the French to help us find
a more balanced approach to adolescent sexual health. Indeed,
the three 'Rs' of sexual
health—rights, responsibility, and respect—may help us overcome obstacles
and achieve social and cultural consensus on sexuality
as a normal and natural part of being a teen, of being
human, of being alive.
James Wagoner,
President, Advocates for Youth
Source/Citation:
Berne L and Huberman B. European Approaches to Adolescent Sexual Behavior & Responsibility: Executive Summary & Call to Action. Washington, DC: Advocates for Youth, 1999.
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