Education And Debate For and against

Doctors should advise adolescents to abstain from sexForAgainst

BMJ 2000; 321 doi: http://dx.doi.org/10.1136/bmj.321.7275.1520 (Published 16 December 2000) Cite this as: BMJ 2000;321:1520

Against a background of high rates of teenage pregnancy and an increasing prevalence of sexually transmitted infections, the sexual conduct of young people is vigorously debated. Many teenagers later say that they had sexual intercourse “too early”—but should doctors be advising young people to abstain from sex? Trevor Stammers, who is a tutor in general practice and an author and broadcaster on sexual health, and Roger Ingham, who has done research on sexual conduct and sex education in Britain and other countries, consider whether advising abstinence is an effective response to declining teenage sexual health.

For

  1. Trevor Stammers, tutor (stammtg@globalnet.co.uk)
  1. Department of General Practice, St George's Hospital Medical School, London SW17 0RE
  2. Centre for Sexual Health Research, Faculty of Social Sciences, University of Southampton, Southampton SO17 1BJ
  1. Correspondence to: T Stammers, Church Lane Practice, London SW19 3NY

    Recent trends in adolescent sexual health in the United Kingdom are cause for concern. In England alone, almost 90 000 teenagers became pregnant in 1997. Slightly fewer than 7700 of these girls were less than 16 years old, and about half had abortions.1 In 1995-7, the rate of increase in gonorrhoea among 16-19 year olds was 45%—the highest increase seen in any age group. During the same period and in the same age group, the incidence of chlamydia rose by 53% and that of genital warts by 25%.1 Early intercourse often leads to subsequent regret: only two fifths of respondents in a recent study indicated that first intercourse occurred “at about the right time”; 45% of girls and 32% of boys indicated that it had happened too early or should never have happened at all.2 Sexually active teenagers are more likely to be emotionally hurt (figure) and have an increased risk of depression and suicide.3

    Contraception in not enough

    These indices reflect the outcome of years of unprecedented availability of contraception among young people and increasing sex education in schools. Contraception as the cornerstone of sexual health promotion for adolescents has manifestly failed. In almost 15 years of general practice I have never seen a …

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