RATIONALE
 Updated February 2, 2008

“We parents must repeat the message of preventing pregnancy and sexually transmitted infections to our children multiple times during the course of a month and year. Just having one ‘birds and bee’s talk’ is not enough. Our job is to impress the risks of early and unprotected sex upon our daughters’ psyches. So that when they are tempted to have sex—as they most likely will be—they hear our voices saying ‘no.’ -Linda Bradley, MD

Parents: research shows that teens are less likely to engage in sexual activity, abuse drugs, and have emotional problems when they feel deeply loved and connected to you and their families and believe they can talk to you, without judgment, about pressing issues like sexuality.¹ And when the parents of children of color don’t ignore the realities of racism and discrimination, but rather, openly discuss these injustices within their families, their children tend to develop the inner strength to challenge obstacles, overcome them, and achieve.²

Parents, educators, mentors, counselors, and health professionals: from 1991 to 2005 teen births in the United States dropped to the lowest rate they had ever reached during the entire 65 years since the consistent documentation of these rates began.³, ⁴  Studies show that 86% of the decline in teen pregnancies was due to 18 to 19 year-olds using contraceptives correctly more often than before, and 14% resulted from 15 to 17 year-olds choosing abstinence more often than before.⁵  

[Aside: From 1990 to 2006 birth rates for both adolescent and adult females declined most significantly among the married population.^6,7,8,9  For more information about this phenomenon, read this rationale's side bar, “Across Age Groups, Unmarried Births Are Up, Married Births Down. Why?” here].

However, we still have a long way to go to protect our young from the potentially damaging consequences of premature, uninformed, or misinformed sexual activity. In fact, even with our recent decline in teen pregnancies, among the world’s developed nations, the U.S. has the highest number of teens becoming pregnant and acquiring sexually transmitted infections.^10,11

And, alarmingly, preliminary data reveal a 3% increase in teen pregnancies in the U.S. from 2005 to 2006 (up from 40.5 births per 1,000 females ages 15-19 in 2005 to 41.9 births per 1,000 in 2006).¹² This is the first such increase in 14 years.¹² The increase in teen births for non-Hispanic blacks ages 15 to 19 was even higher—5%—rising from a rate of 60.9 percent in 2005 to 63.7 percent in 2006.^13,14 For this age group, this rate was higher than that of any other racial or ethnic group of young women in the U.S.^13,14  

The reported recent rise in teen pregnancies is not surprising considering that the latest analysis of available data shows that the number of U.S. teens who received formal instruction about birth control methods plummeted from 87% (females) and 81% (males) in 1995 to 70% and 66% in 2002.^15,16

Compared to white teens, blacks youths received even less formal instruction about birth control methods. In 2002, fewer than half of all black teen girls surveyed and only 1 in 3 black teen males had received instruction about birth control methods when they really needed it—before they started having sex.^15,16

According to research, in the U.S., effective sex education programs for middle-school-age teens share certain characteristics including using the latest science-based evidence to create youth curriculum that really work.¹⁷ Such programs provide:¹⁷ 

• Consistent and repeated communication about the physical and emotional health benefits of abstinence

• Instruction on realistic strategies to delay and refuse sex

• Clear explanations of the importance of condoms and other contraceptives in preventing pregnancy and sexually transmitted infections including HIV/AIDS

• Accurate instruction on the correct use of condoms and other contraceptives.

But between 1995 to 2002, while fewer teens received instruction in sex education programs modeled after ones that actually prevent teen girls from becoming pregnant, the number of teens who only received instruction about abstinence more than doubled to 1 in 5.¹⁸ This occurrence is despite the fact that teens around the world have been having sex throughout the ages—and never stopped.¹⁹  The difference between now and the past is that, previously, teens were typically encouraged to wed, and did.¹⁹ Therefore, they had sex in the context of marriage.¹⁹  But today, in developed countries like the U.S., we encourage our teens to delay marriage until they are well into their twenties or beyond.¹⁹ 

Today, at a time in history when the leading cause of death of African-American young women is HIV/AIDS (as reported for 2004),²⁰ we adults are the caretakers of the youths to whom the future belongs. Given the fact that teen sexuality is a timeless phenomenon,¹⁹ for us to instruct our adolescents as though all of them will postpone sexual activity for a decade or more is irresponsible and even cruel. If this assessment sounds harsh, consider these findings about teens, sex, pregnancy, and sexually transmitted infections in the U.S. from Chapters 10 and 24 of TEEN SISTERS' HEALTH (Books 2 and 3):  

Regarding pregnancy* and 15 to 19 year old girls, in 2002…

• Girls who started having sex before they were 15 years old were almost twice as likely to get pregnant as those who waited until they were older (46% more likely compared to 25%).²¹

• More than 1 out of 3 girls (31%) who had sex got pregnant.²¹

• Girls who used birth control the first time they had sex were much less likely to have a baby by the time they were 20 years old than girls who didn’t use birth control the first time they had sex (43% less likely compared to 27%).^21,22 

• 4 out of every 7 teen girls who got pregnant had their babies; 2 out of 7 got abortions; and 1 out of seven had a miscarriage.²³

In 2006…

• Preliminary data indicates that teen girls ages 15 to 19 had 435,427 babies.¹⁰
  And of these infants, almost one fourth—103,692—were born to non-Hispanic Black mothers.<sup>24
  
  [Aside: We have refrained from using the term "teen pregnancy" because, for the very youngest mothers, "teen pregnancy" may be a gross misnomer given that these girls may have been impregnated by men, not teenage boys.25, 26 For more information on this topic, read this rationale's sidebar, "Adult Male Impregnation:6, A common Cause of Very Young Teen Motherhood," here.]</sup>

Regarding sexually transmitted infections (STIs)…

• Over 65 million people may have an incurable STI.²⁷,²⁸

• Every year, 1 out of every 4 teens catches an STI.^27,29

• 1 out of every 2 sexually active young people will catch an STI by the time she or he is 25 years-old.^27,30

• Even though only about 1 out of 4 sexually active people are teens or young adults, about 2 out of 4 people who got STIs in 2000 were 15 to 24 years-old.³¹

And from Chapter 18’s “Doctor’s Visit”…

“Today, my heart broke into pieces. I had to tell a nineteen year-old, a young woman whose entire life is ahead of her, that she has HIV.

“I know many people live long and productive lives with this virus. But I prayed that my daughter will never have to hear the news I gave my patient.” –Dr. Linda

Although teenage sexuality and avoiding the pitfalls of premature sexual exploration are, by necessity, pivotal topics in TEEN SISTERS' HEALTH, they aren’t the only ones. In this book, we explore issues relevant to a to a young woman of color’s whole being—her body, her mind, and her spirit. From embracing her heritage to rejecting societal stereotypes; from fitness to nutrition, from higher education to wealth-building, from community involvement to environmental stewardship, and much more. Coming from two distinct faith traditions ourselves—Christian and Buddhist—in this book, we endeavored to respect the backgrounds and beliefs of every girl.

We set out to write TEEN SISTERS' HEALTH in a reader-friendly style based on scientific findings and human experiences like the ones presented in this rationale. Our goal in creating this book was simple but not easy: to help each young woman who reads these pages cultivate a fulfilling life of no regrets.

Girls can rely on TEEN SISTERS' HEALTH to empower them with the knowledge they need to make educated decisions and smart choices. We offer it in support of your efforts to maintain caring, honest, and open lines of communication with your daughters, students, mentees, clients, and every young woman in your life.  

Linda Bradley, MD  
M. LaVora Perry                              References

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