Wednesday, May 26, 2010

Jill's Initial Reflection

Regarding adolescent health, and promoting sexual health, I believe that it is largely a matter of education. Once equipped with the necessary information, adolescents will have a foundation on which to base sound choices regarding their individual health. This is not to say that simply providing information will do the trick; adolescents must be engaged, they must demonstrate their ability to apply their knowledge, and they must have role models who emulate healthy beliefs and behaviors. This is very easy to say, and quite difficult to observe in the real world. What I have in mind is both formal/classroom education, and informal education; this can include through the media, peers, and through the family.

I think there is fear regarding talking about sex, there could be embarrassment, confusion, or a host of other feelings and associations. Each adolescent's situation will differ from the next. This being the case, education must be structured to overcome a variety of barriers. Potential barriers could be familial, cultural, religious, SES (as it could relate to other barriers). Where and how information is delivered could ultimately lead to overcoming barriers, or molding the curriculum to ascribe to them.

Another barrier is a potentially restricted view on what constitutes sexual health. Many may just apply the term referring to family planning and disease prevention, but I think it encompasses more, such as sexuality, sexual orientation, beliefs and related behaviors, self-esteem, and many other topics.

Given the many sources of information, and the barriers unique to each of them, there is likelihood of an adolescent receiving conflicting or confusing information at some point. I don't have a good idea of what proper resolution looks like, but hope that it includes being comfortable with asking questions, and having a trusted figure to turn to.

Susan's Initial Reflection

There are many barriers teens face to having a healthy sexuality. These factors vary from country to country and culture to culture, but common themes and difficulties appear to be present. So many things are at play when evaluating a teen’s sexuality that looking at one barrier exclusively cannot provide a comprehensive view of the health of the individual teen. Additionally, sexuality can be defined broadly or individually and therefore defining a healthy sexuality can often be difficult.
In most societies the popular media plays a large role in preventing teens from having a healthy sexuality. Media such as television, print and music all portray images of certain types of perfection which is not always obtainable for many teens. With all these different images it would appear difficult for teens to identify what is a healthy sexuality and then embody this type of sexuality themselves. Convoluted ideals and images hinder teens from creating a sexual identity for themselves which is personal and ultimately valued.
Lack of education in what a healthy sexuality may mean for a teen also serves as a barrier. If teens do not have access to the education required to lead a life including healthy sexual behaviors they are unprepared to engage in a lifestyle of being safe and sexually active. Without proper education on both how to protect oneself and how to engage in a healthy lifestyle teens do not have the mechanisms to engage in a healthy sexual life.
As stated earlier, there are many factors which contribute to achieving a healthy sexuality. The media and education play a large role in shaping a teen’s sexuality, but cultural norms and family also play a great role in sexual identity and a healthy concept of sexuality. I believe so many factors contribute to a healthy sexuality and none of them can be considered alone when trying to understand one’s own sexual identity and health. Further, I believe body image plays a role in a healthy sexuality.
Additionally, the recognition of the multitude of changes being experienced by teens at this stage in life can greatly affect their outlook and sexuality. Confidence in one’s body while fitting within social expectations can determine a teen’s ability to view their sexuality in a healthy way and promote healthy behaviors in general.

Heather's Initial Reflection

What barriers do teens face to having a healthy sexuality?

While thinking this question over, I asked a friend for his opinion and he said: how do you define a healthy sexuality? I responded it can be whatever you want it to be; whatever your opinion is. Without knowing what a healthy sexuality is though, how do we determine the barriers to achieving it, and how do we then overcome the barriers?

To me, having a healthy sexuality is being in tune with your body, knowing what sex is, and not just intercourse, but understanding all sexual activity is part of sexuality, the emotions involved with having sex, and how to do it all in a safe way, both physically and emotionally. My state of mind regarding sexuality is a lot different now, though, then when I was a teen, and I think this in itself is a barrier. I do not believe all teens are aware of everything which goes into having a healthy sexuality and the benefits and consequences of engaging in sexual activity. This awareness is hindered by a lack of adequate health education, parental attitudes and beliefs, religious views, and a lack of access to contraceptives.

Health education in the U.S. is greatly lacking. Schools are constantly dealing with funding shortfalls and with emphasis on testing standards many schools decrease their health education courses. This directly effects what adolescents learn about sexuality because there often isn’t enough time in the class period to cover every health topic or to cover it in depth. Furthermore, many parents do not believe sex education should be taught in schools or it should only focus on abstinence and not on other healthy sexual behaviors. Religious views present the same problem. The Church constantly preaches abstinence without acknowledging everyone does not abide by such strict doctrines and need to be educated on alternative ways to have safe sex. This creates a dichotomy for teens, who do not know whether it is correct to abstain or to engage and if they want to engage, they might not be equipped with the knowledge on what is safe and what isn’t. Some teens may not engage in intercourse because of the stigmas associated with it or the beliefs their parents place on them, but will engage in other sexual activities and may not do it in a safe way, jeopardizing their health. There is also a lack of easy access to contraceptives. Many pharmacies and stores keeps condoms locked, which makes it difficult for teens to access them, either due to the burden of going to the counter asking for the key and returning to get the condoms or because of the embarrassment or stigmas attached with purchasing them. Birth control is also expensive, even with insurance, which can deter teens, who may not have their own income from obtaining it.

I think it is important for people to hold a wide view of what a healthy sexuality is and to not force their opinions on others. No matter what each individual or each group believes, there will always be someone who holds a different opinion. The consequences which can come with having an unhealthy sexuality are far too great to hope adolescents will fulfill a one size fits all model.

Marisa S. Initial Reflection- Summer 2010

In your opinion, what barriers do teens face to having a healthy sexuality?

Adolescents growing up today face a multitude of barriers that inhibit them from obtaining a healthy sexuality. I think two of the biggest barriers teens face include the type of relationship that they have with their parents and the confusing and mixed messages teens receive about a healthy sexuality from media.

In my opinion even though peer groups are constantly influencing teens, parents are the true influences in their lives. A parent is the main teacher and provider a child has throughout their life. They are whom a child looks to for emotional and behavioral guidance. I think the trouble with parent-teen relationships often starts because the parents does not perceive the ‘child’ is old enough to know or talk about sex and they do not want to recognize that sexual feelings are occurring within their child. Additionally, not all parents may be comfortable themselves with their sexual identity or sexual health. If this is the case, communication between parent and teen is hindered. It is important that parents recognize the inherent curiosity of adolescents and embark on an open dialogue with their teen before sexual choices are made and health consequences happen (pregnancy, STDs etc.). If a parent is not comfortable with the topic of sex or does not feel knowledgeable in this area then they should seek help for themselves as so they can help their teen.

The second barrier I perceive as preventing teens from having a healthy sexuality is caused by the myriad of images pertaining to sexuality that come from the media. Sometimes I watch a show or movie and think to myself “no wonder there are so many teens having sex!” It is truly EVERYWHERE. And even when the media tries to make it ‘unappealing’ as with shows like The Secret Life of the American Teen or 16 and Pregnant, it is still glamorized. Additionally, the portrayal of sex in TV shows (the Real World, the OC, Greek) type-cast men and women to play roles that do not equate to healthy behavior. And teens, because they are young, naïve and want to be ‘cool’ look at these actors and actresses and think that behavior is appropriate. Even youth idols such as Miley Cyrus are becoming less and less appropriate for youth and teens to perceive as healthy role models. We need to have shows and role models that make it ok to ask questions about sex, encourage talking to parents, encourage self-confidence to ‘say no’ or ‘I’m not ready’ and to discourage the use of alcohol or drugs in sexual encounters. We also need shows that break down male and female stereotypes and show that men can be sensitive and caring in a relationship and women can be strong and independent.

Tahmina Ahmad - Initial Personal Reflection

The World Health Organization’s definition of sexual health is “the integration of somatic, emotional, intellectual and social aspects of sexuality in ways that are positively enriching and that enhance personality, communication and love.” This definition is loaded with many components that encompass and contribute to healthy sexuality; it involves not only the physical characteristics and capacities for sexual behaviors but the social and psychological attributes of sexual behavior including feelings, family/personal values, religious/cultural/social norms, safe attitudes/perceptions, open/nurturing communication, gender/sex identity and male/female roles in public/private. It is not surprising that major barriers that a teen may face to having a healthy sexuality involve a lack of a comprehensive outlook and a presence of various attitudes all during the more challenging and confounding years of their life.

1. A Lack of a Comprehensive Approach/Outlook
In understanding the various issues (mentioned above) that are known to affect sexual health in both positive and negative ways, it is easier to see how the absence or negative perspective of one or more of these factors can lead to instantaneous barriers to having a healthy sexuality in the mind of an adolescent or teen who is already dealing with a very challenging stage of life. In essence one of the biggest barriers that teens face to having a healthy sexuality is a comprehensive approach to building a level of familiarity/comforting/understanding to the various multi-faceted issues. Branches of education involved in promoting healthy sexuality among adolescents/teens may deal with these various facets but if there is a gap in resources and/or knowledge or a teen still does not feel comfortable regarding an unaddressed issue, an overall barrier to healthy sexuality still remains. It's also difficult to know what issues are important to each individual when there is a communication barrier. Obviously, the comprehensive outlook barrier exists due to many individual barriers but the fact still remains.

2. Difference or Contradiction in Attitudes
The problem of healthy sexuality is further emphasized when many different people/attitudes are taking presence in a teens life. In order to help a teen eliminate their barriers, these ‘people/attitudes’ themselves must, to some extent, have a healthy outlook on sexuality. It is no wonder that teens are confused, for example, if they may face four very different attitudes from their sex ed teacher/workshop, boyfriend/girlfriend, parent and friend. Interestingly enough, educators who may feel that they are promoting a healthy sexuality can still not understand how every individual may perceive that information. For example, emphasizing the diseases associated with unsafe sex may attach negative associations with sex in a teens mind. It is hard to avoid confusing, manipulating or maybe even offending a teen with a contradiction in attitudes or a lack of understanding in how each unique teen is processing the information relatively.

3. Challenging Years that Confound the Process
Adolescence or teenage years in and of itself serves as a challenge. There are simultaneous changes taking place in the body, thinking process (brain development), social life and etc. Furthermore, every individual may experience these changes differently. Therefore, at this stage in life, the development of healthy sexuality is confounded, influenced and affected by many other ongoing experiences unique to different teens.
After reading our assignment question, I found myself wondering what exactly is a "healthy sexuality" I came across a few definitions and thought this was the most interesting to discuss: "Healthy sex involves the conscious, positive expression of our sexual energy in ways that enhance self-esteem, physical health, and emotional relationship. It is mutually beneficial and harms no one" www.healthysex.com
The above definition says it all when it comes to barriers facing teens. I believe that the emotional consequences of sex can be just as destructive as the possible physical ones. Condoms, pills, and most contraceptives are made available free of charge to most teens in this country but when a teenager needs to speak of her sexual experience, ask for advice or even assistance then who does she turn to? probably her boyfriend who is the source of the problem or her classmates who most likely are facing her same problems and may not offer the most sound solutions. I realize that it is difficult to ask a teenager to talk about his/her feelings and accept adult advice. Never the less, I think that unless we address the emotional aspects of sex then are we being realistic when expecting teens to be sexually healthy, to use sex as means of enhancing self esteem and their emotional relationships while most adults barely manage to do so.

Tuesday, May 25, 2010

Assignment 1: Personal Reflection

Khadijah Abdallah
May 26, 2010
Pubh209.19: Adolescent Health Promotion

Assignment 1: Personal Reflection:
In your opinion; What Barriers do Teens Face to Healthy Sexuality?

The answer to this question can be broad-based or very narrow. Furthermore, it differs from region to region, country to country, and different teens face different issues all over the world. More specifically though, I think one of the issues faced by teens in the use is the need for a more mature outlook on the issue. This means that teens are constantly bombarded with ‘adult’ topics at a very young age without necessarily being taught the deeper nature of sexuality and the importance of not viewing it in a light-hearted manner. In other words, sex is glamorized, and that is a phenomenon that can be attributed to the pop culture that teens are exposed to, despite the censoring that goes on in the media these days. This is a concern in the sense that teens might not be aware of how important it is to approach the issue with seriousness before embarking on any decision; whether it be getting pregnant, becoming intimate with someone, becoming sexually active at a young age, etc. As someone mentioned the other day in class, these TV shows that idealize teen pregnancy may be a fundamental contributor to the problem. Personally, I have met high-school teenagers; smart, straight-A students who willingly became pregnant, and for various reasons such as seeing how happy their friends were, or believing that they were ready for it without understanding the physical, mental, and financial challenges that accompany such a decision. That then suggests a lack of strong role modeling for these teens in their lives, and raises the concern that one blameworthy party is the educational system, which may not be approaching the issue correctly. Otherwise, had school education on this topic been a success story, then clearly teens would not be facing any problems. Unfortunately, though, that is not the case. Thus, a balance must be reached such that students/teens become more interested in absorbing and applying what is being taught to them at schools. The manner to resolving this issue, though, is another discussion, and not one that can easily be answered.

Shelby Hickman post

Sex. Just seeing the word is enough to make timid parents shiver in discomfort and fill conservative PTA board rooms with flurried fits of rage. Amidst the shoe stomping, nose lifting, and fist flying, however, I believe an important question is forgotten. What is wrong with sex? Why the hush, the hype, the books on how to have "the talk" as though its an unnatural dreaded proccess that parents and teens will never come to terms together on without a series of literature to perpetuate a societally taboo subject.Why, when the population reached a record high was abstinence only education approved?
As teenagers begin sexual development and the realization of new bodies they are in a period that can best be described as painfully awkward and they are not embraced but pushed away. New feelings of lust, desire, romance, and mood swings are not only hushed and negatively reinforced but written off as juvenile and insignificant. At a time when the most emphasis should be paleced on these physiological and psychological changes, teens are essentially ignored because "adults" don't know how to go about dealing with them. This creates a sentiment of distrust and disconnect between teens and the more experienced influences in their lives who could be positive influences. There is little chance for education outside of TV ads, health class, and hearsay from friends, which leaves them unprepared for sexual activity at whatever age they decide to begin.

Monday, May 24, 2010

Sabrina Simms Initial Personal Reflection - Summer 2010

In my opinion, having a healthy sexuality can be a challenge to all age groups, but with teens who are coming into their own, going through puberty and other life transitions, there tend to be many fresh barriers that they have to try and overcome. Below, I list some of the barriers to teens having a healthy sexuality, which I believe, are substantial.

- Relationships with parents/caregivers: Teens are going through a period in their lives where they are unsure of themselves and are discovering new things, unsure of how their bodies are changing, and unsure of how their hormonal fluctuations are affecting their lives, to list only a few of their uncertainties during their adolescence. The relationship that a teen has with their parents/caregivers at this time in their life is important because it can determine the knowledge or access that a teen has available to them in regards to their sexual health. It can also determine their comfort level in talking about their sexual health overall and confidence level in gaining sexual health services that promote health wellness. It may not be the case in all instances, but if this relationship is not secure or even present, the teen may rely on information they receive from friends, the internet or other outlets. In many instances, the information that a teen may get from friends or other media may not be correct and can lead to the teen making some wrong sexual health decisions. However, some teens may be intuitive enough to obtain accurate information from clinics or other health care professionals.

- Cultural and religious barriers: Even though these two barriers can be discussed independently, I choose to quickly touch on them together because it is often the case that a religion and a particular culture overlap in their beliefs and values. Some cultures may not equate teens with having a sexual active lifestyle. Both religions and cultures may stress an abstinent approach to this matter or even consider it unacceptable or forbidden and may not offer sexual health outlets for teens in case they do become sexually active before it is seen as culturally appropriate. This can be a barrier to teens who do decide on being sexually active. They may be hesitant to talk with someone, such as a family member, or to visit health care clinics or doctors. These resources may be unattainable for the teens and this can have an influence on their sexuality being healthy.

- Social norms within their community/circle of friends: Often teens buckle under the peer pressure of what their friends are doing or they do what they believe will make them look more advanced or cool to their friends. Teens may not think twice about what sexual health risks they may introduce themselves to and how serious just one small mistake can be. If a new trend enters a teen’s circle of close friends, the teen will often feel pressured or feel obliged to participate in whatever that trend may be, whether it is having the highest number of sexual partners or a competition to determine the longest that someone can “last” without being protected. This is a tremendous barrier that health care professionals need to address and tackle because it takes more than just a one-session encounter to handle; it is a continual process. Teens would need to learn about making healthy independent sexual health decisions and how important it is for them to have the confidence to do so.

Sunday, May 23, 2010

Felisa Gonzales - Personal Reflection

Adolescence can be a difficult transition period. During this time period, young people are establishing their identities. A desire to be perceived as an adult may lead to experimentation with behaviors that are typically reserved for adults, such as sexual intercourse. This exploration is natural phase of development, but adolescents face many barriers to safe sexual development.

There is a strong moral contingent in the United States that fiercely argues that adolescents should abstain from sexual activity until marriage. This group is very politically active and has lobbied against comprehensive sexual education in schools based upon the incorrect belief that more information with lead to greater sexual activity. Fortunately, the current administration has eschewed abstinence-only education and is investing in more evidence-based interventions to reduce the incidence of unintended pregnancy. However, the inability for young people to receive technically accurate information in the school setting is a major barrier as it prevents informed decision-making.

Another related barrier is the fact that adolescents are frequently exposed to conflicting social norms. They likely receive strong messages from adults that they should not engage in sexual activity, but they also receive strong messages from the media and perhaps their peers that everyone, especially the popular or good-looking kids, is sexually active. This conflict may lead adolescents to engage in sexual activities for the wrong reasons.

Lack of access to contraceptives is a major barrier to healthy adolescent sexuality. Adolescents who are subject to limited information about conception or the transmission of STIs and receive conflicting messages about the appropriateness of sexual behavior may not intend to engage in sexual behavior but end up in unexpected situations which lead to unprotected intercourse. Because they have never considered the possibility of engaging in sexual intercourse, they are not prepared to engage in safe sexual intercourse if a decision is made in the moment. Similarly, students who have given a lot of thought to becoming sexually active may desire to do so safely but lack the ability to obtain the contraception they need to prevent pregnancy or STIs.

Within the field of sexual behavior, much attention is devoted to sexual intercourse and less attention is devoted to sexuality in general. Often times, adolescent sexuality is viewed from a perspective of negative risk factors rather than positive strengths or opportunities. If adolescents are not provided with information about their bodies and sexuality as a source of pride and pleasure either in school or from their parents, and lack access to contraception, they may not learn to enjoy their sexuality as an important part of their identity, something that is valuable and deserves to be cherished.

It is important to note that although the aforementioned barriers apply to all youth, LGBTQ youth face additional barriers to healthy sexuality. Their struggles to come out in a society that may not fully accept them can lead to experimentation in compromised situations, or with partners who are significantly older. The stigma of identifying as gay may be too much for young people to handle and may result in the young person having an isolated or marginalized sexual development process.

Timothy Kane: Initial Personal Reflection, Summer 2010

What barriers do teens face to having a healthy sexuality?

(1) Lack of communication and openness about sexuality leading to confusion and shame.

In the United States (US), clear and supportive communication around sexuality is lacking. Due to a variety of societal factors (cultural background of family of origin, organized religion, education, etc.), youth often receive either unclear or mixed messaging around what a healthy sexuality “looks like.” Machismo-misogyny-homophobia too often inform and define what it means to be a sexual individual, distorting the concept of a healthy sexuality. Especially during times of physical transition and exploration, youth lack non-judgmental venues which provide accurate, timely and age-appropriate information to support the development of a healthy sexuality.

In addition, a lack of communication and openness about sexuality is especially evident regarding the diversity of sexual expression and identity. Sexual diversity is often not celebrated and embraced, but rather demonized as a source of shame for both the teen and their family. Youth who exhibit and/or explore lesbian, gay, bisexual, transgender or questioning sexuality are often blamed and isolated rather than loved and nurtured.

(2) Lack of role-models for sexual health, along with an omnipresent sexualized culture.

US culture is lacking in role-models for sexual health. Individuals and couples who exhibit sexual health are not easy to identify, let alone emulate. Often, television and cinema showcase individuals and couples with dysfunctional sexual expression (dramatic, extreme and/or abusive), normalizing such expressions while also labeling them “entertainment.” Sexual stereotypes and caricatures abound since they fit “neatly” into a half hour TV drama, neglecting and complexity and diversity that is our human sexuality.

In addition, US culture is a sexualized culture filled at every turn with mixed messages regarding the value and status of a healthy sexuality. Sexual images are a staple of the advertising industry, incorporated into every aspect of visual media. Youth (and adults) are bombarded with sexual imagery and messages equating sex with power, love, acceptance and happiness. Mixed messages which blur the lines between the reality of a healthy sexuality and the fantasy of sexual acting out, make it difficult for anyone to navigate successfully the complex variables which comprise modern day sexuality.

(3) High rates of childhood sexual abuse damage youth as they seek to understand and secure a healthy sexuality. This damage often remains with individuals for a life time, requiring years of intervention (therapy, etc.) to heal. According to http://www.darkness2light.org/knowabout/statistics_2.asp:
• 1 in 4 girls is sexually abused before the age of 18.
• 1 in 6 boys is sexually abused before the age of 18.
• 1 in 5 children are solicited sexually while on the internet.
• Nearly 70% of all reported sexual assaults (including assaults on adults) occur to children ages 17 and under.
• An estimated 39 million survivors of childhood sexual abuse exist in America today.

(4) The impact of these barriers facing youth seeking a healthy sexuality is magnified for LGBTQ youth. Studies show that LGBTQ youth are four times as likely to attempt suicide than are their heterosexual peers and those LGBTQ youth rejected by their families are more than eight times as likely to attempt suicide hhttp://gaylife.about.com/od/gayteens/a/gaysuicide.htm).

Amanda Asgeirsson's Initial Personal Reflection

In your opinion, what barriers do teens face to having a healthy sexuality?

This question is so multifaceted to me. Teens have so many people and new events going on in their lives that influence their sexuality. Depending on the environment, many teens may feel pressured to have sex at a very young age. This doesn't always mean a healthy sexual life, as teens often don't have long lasting relationships, nor to they have serious relationships; they just aren't always mature enough. In addition, teens may feel uncomfortable to talk to their newly acquired partner about safe sex, and what the best method is.

Adolescents may also feel uncomfortable with sexuality because it may be discouraged by their parents, or they may not feel comfortable speaking to their parents about contraception. This is a barrier to ensuring that their sexuality is healthy.

Religion may also play a large role in a teens sexuality. Many religions promote abstinence until marriage, which for many people in this generation is a very unrealistic option. Teens may be labeled for not having sex at a younger age, and be ostracized or made fun of for not engaging in these activities.

Lastly, adolescents are still developing in the years they are starting to acquire a sexuality, and their body, brain, organs, emotions and more may get in the way. Some adolescents haven't even determined their sexuality, and they are being coerced and peer pressured into having sex at a young age.

As much as parents, teachers, administrators, and public health officials can help adolescents with their sexuality, there are limitations on how much they can acutally help. Part of being an adolescent is exploring and learning (clearly with limitations), and sometimes the only way to learn is through their mistakes.

I'm looking forward to a great class! Thanks!

Amanda Asgeirsson

Tuesday, May 18, 2010

Welcome Summer 2010 Students!

Do not think that you're in this class by accident, to just fulfill another "topics" requirement, or because it was the only class left that fit your schedule. You have landed in this class for a special reason. It is meant to be part of your journey, both as a Health Professional and as a Human (not mutually exclusive, of course!). Prof. Sara Marques and Prof. Alis Marachelian will hold your hand figuratively, and will hold the space for your to discover that purpose. No, we're not making you re-live your adolescent years, but we're going to support you in learning to create a healthy adolescence for all the teens you encounter from this day forward.

This is the space for you to track your personal reflections, anecdotes, and 'lessons learned' in the course of the summer semester.

We hope you enjoy this journey towards understanding a bit more that special stage in life called 'adolescence' -now as the adults that you are- as well as to develop and apply your skills as Health Professionals in teaching "health" to youth with the interactive, youth-focused strategies and techniques learned in and outside the classroom.

We have made this blog 'public' and we've seen all the "traffic" it's had since your predecessors started writing their reflections. Feel free to browse but not copy! The wisdom gained through your unique experiences, ideas developed, and challenges you've overcome will be a valuable asset to all those who read it. Please write knowing that the whole world will be reading!

And so, we begin our journey together...

" A candle will never lose its light by lighting another candle"