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LETTERS: Rachel G Pryke Parents are an untapped resource in sex education BMJ 2002; 325: 600 [Full text]

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Teenage pregnancy

Lisa Arai, E1 4NS   (14 September 2002)

Is parental participation in sex education enough?

Chan C. Y. Zenobia   (19 September 2002)

Teenage pregnancy 14 September 2002
Lisa Arai, research student Queen Mary, Mile End Road, London, E1 4NS Send response to journal: Re: Teenage pregnancy	Rachel Pryke makes two common mistakes in her letter (‘Parents are an untapped resource in sex education’, 14th September). She is mistaken in her assertion that Britain has the highest level of teenage pregnancy in Europe; it has the highest in Western Europe. Eastern European nations, such as Bulgaria and Romania, have teenage conception rates that are typically much higher (nearly twice as high in some cases.)(1) Secondly, British rates of early pregnancy are not the second highest in the world; they are the second highest in the developed world. Teenage pregnancy and motherhood is highly prevalent in developing nations. In Bangladesh, for example, over 40% of teenage girls under the age of 18 are mothers.(2) The English under 20 conception rate is currently 63 per 1000 girls, and that for under 16s, about 8 per 1000 (so that about 6 in every 100 girls aged under 20, and less than 1 in 100 under 16s become pregnant, on average).(3) Most teenage mothers are aged over 18 and the overall trend in British teenage pregnancy and fertility is downward.(1) The tendency to hyperbole on this issue is probably a consequence of the endemic pathologising of teenage pregnancy and fertility. As other commentators of teenage reproductive behaviour have pointed out, ‘The empirical magnitude of a problem need bear no relation to the amount of public outcry it evokes.’(4) (1) Singh S, Darroch J E. Adolescent pregnancy and childbearing: levels and trends in developed countries. Fam Plan Perspect 2000; 32: 14-23. (2) Alan Guttmacher Institute. Into a New World: Young Women' s Sexual and Reproductive Lives. New York, Washington: Alan Guttmacher Institute, 1998. (3) Office for National Statistics. Birth Statistics FM1 number 29 2000. London: Office for National Statistics. (4) Macintyre S, Cunningham-Burley S. Teenage pregnancy as a social problem: a perspective from the United Kingdom. In Lawson A, Rhode DL (eds). The Politics of Pregnancy: Adolescent Sexuality and Public Policy. New Haven: Yale University, 1993.
Is parental participation in sex education enough? 19 September 2002
Chan C. Y. Zenobia, RN, PhD Candidate The Chinese University of Hong Kong Send response to journal: Re: Is parental participation in sex education enough?	Rachel Pryke states that it is important to invite parents to play a pivotal role in sex education. That is an excellent point to address family resources and parent-child relationships. It is noteworthy to understand the role of gender that plays in contraception. Contraception is regarded as a power struggle between men and women. Scientific investigation of female sexuality is derived from and reproduces patriarchal knowledge and experience. Within feminist theory sexuality is identified as a site of struggle in which men exercise power over women, this can point the way to understanding women's oppression. Wherever women are culturally and economically subordinate to men, they cannot control or even readily negotiate a safer sex, including condom use and lifelong mutual fidelity (Merson, 1993). It is too embarrassing for a girl to insist on their use, because it could appear that she was promiscuous and certainly infeminine (Moore, Rosenthal, & Mitchell, 1996). Seidel (993) found that women who refused to have intercourse may be the trigger for some forms of sexual abuse. Using a condom is not a simple and practical issue but rather is a negotiation between sexes. For example, unprotected sex among young people is associated with regular sexual relations. Gay men's self-narrations of their use or nonuse of condoms should be interpreted for the communicative behavior such as their willingness, reluctance or refusal to use condoms (Middelthon, 2001). The above points about how the effects of gender affect the use of contraception that parents and professions have to consider when providing sex education to teens. References Merson, M. (1993). Slowing the spread of HIV: Agenda for the 1990s. Science, 260, 1266-1268. Middelthon, A. L. (2001). Interpretations of condoms use and nonuse among young Norwegian gay men: A qualitative study. Medical Anthropology Quarterly, 15(1), 58-77. Moore, S., Rosenthal, D., Mitchell, A. (1996). Youth, AIDS and Sexually Transmitted Disease. London: Routledge. Seidel, G. (1993). The competing discourses of HIV/AIDS in sub-Saharan Africa: Discourses of rights and empowerment vs discourses of control and exclusion, Social Science and Medicine, 36(3), 175-194.