Beyond Abstinence and Risk: A New Paradigm for Adolescent Sexual Health

  • Amy T. Schalet
    Correspondence
    Correspondence to: Amy T. Schalet, PhD, Social and Demographic Research Institute, Machmer Hall W34A, 240 Hicks Way, University of Massachusetts—Amherst, Amherst, MA 01003-7525. Phone: 413-545-5008; fax: 413-545-3204.
    Affiliations
    Department of Sociology, University of Massachusetts, Amherst, Massachusetts
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      Two paradigms have shaped how U.S. policy makers, health professionals, and educators have approached teenage sexuality over the past several decades. The first is the abstinence-only-until-marriage paradigm, according to which sex outside of heterosexual marriage is always wrong and harmful (
      • Santelli J.
      • Ott M.A.
      • Lyon M.
      • Rogers J.
      • Summers D.
      • Schleifer R.
      Abstinence and abstinence-only education: A review of U.S. policies and programs.
      ). The second is the sex-as-risk paradigm, which defines adolescent sexuality in terms of risk and risk taking (
      • Michaud P.-A.
      Adolescents and risks: Why not change our paradigm?.
      ). The two paradigms share a near-exclusive focus on acts of teenage sexual intercourse, conceptualize such acts as dangerous, and assume that emphasizing their risks is the way to help young people become sexually healthy. Both paradigms exemplify what I call the dramatization of adolescent sexuality: They highlight internal conflicts—between impulse and cognition—and interpersonal conflicts—between boys and girls and between youth and parents (
      • Schalet A.
      Must we fear adolescent sexuality?.
      ).

      References

        • Abma J.C.
        • Martinez G.M.
        • Mosher W.D.
        • Dawson B.S.
        Teenagers in the United States: Sexual activity, contraceptive use, and childbearing, 2002. Vital Health Statistics, ser. 23, no. 24.
        National Center for Health Statistics, 2004 (Available from)
        • Albert B.
        With one voice 2004: America’s Adults and teens sound off about teen pregnancy.
        National Campaign to Prevent Teen Pregnancy, Washington, DC2004
        • de Graaf H.
        • Meijer S.
        • Poelman J.
        • Vanwesenbeeck I.
        Seks onder je 25ste: Seksuele gezondheid van jongeren in Nederland anno 2005.
        Rutgers Nisso Groep/Soa Aids Nederland, Utrecht/Amsterdam2005
        • Ferguson R.M.
        • Vanwesenbeeck I.
        • Knijn T.
        A matter of facts… and more: An exploratory analysis of the content of sexuality education in the Netherlands.
        Sex Education: Sexuality, Society and Learning. 2008; 8: 93-106
        • Horne S.
        • Zimmer-Gembeck M.J.
        The female sexual subjectivity inventory: Development and validation of a multidimensional inventory for late adolescents and emerging adults.
        Psychology of Women Quarterly. 2006; 30: 125-138
        • Houts L.
        But was it wanted? Women’s first voluntary sexual intercourse.
        Journal of Family Issues. 2005; 26: 1082-1102
        • Impett E.A.
        • Schooler D.
        • Tolman D.L.
        To be seen and not heard: Femininity ideology and adolescent girls’ sexual health.
        Archives of Sexual Behavior. 2006; 35: 131-144
        • Kost K.
        • Henshaw S.
        • Carlin L.
        U.S. teenage pregnancies, births and abortions: National and state trends and trends by race and ethnicity.
        Guttmacher Institute, Washington, DC2010
        • Manlove J.
        • Ryan S.
        • Franzetta K.
        Contraceptive use patterns across teen’s sexual relationships: The role of relationships, partners, and sexual histories.
        Demography. 2007; 44: 603-621
        • Martino S.C.
        • Elliott M.N.
        • Corona R.C.
        • Kanouse D.E.
        • Schuster M.A.
        Beyond the “big talk”: The roles of breadth and repetition in parent-adolescent communication about sexual topics.
        Pediatrics. 2008; 121: 612-618
        • Michaud P.-A.
        Adolescents and risks: Why not change our paradigm?.
        Journal of Adolescent Health. 2006; 38: 481-483
        • Pearson J.
        Personal control, self-efficacy in sexual negotiation, and contraceptive risk among adolescents: The role of gender.
        Sex Roles. 2006; 54: 615-625
        • Pleck J.H.
        • Sonenstein F.L.
        • Ku L.C.
        Masculinity ideology: Its impact on adolescent males’ heterosexual relationships.
        Journal of Social Issues. 1993; 49: 11-29
        • Santelli J.
        • Ott M.A.
        • Lyon M.
        • Rogers J.
        • Summers D.
        • Schleifer R.
        Abstinence and abstinence-only education: A review of U.S. policies and programs.
        Journal of Adolescent Health. 2006; 38: 72-81
        • Schalet A.
        Must we fear adolescent sexuality?.
        Medscape General Medicine. 2004; 6
      1. Schalet, A.T. (In press). Not Under My Roof: Parents, Teens and the Culture of Sex. Chicago: University of Chicago Press.

        • Stone N.
        • Ingham R.
        Factors affecting British teenagers’ contraceptive use at first intercourse: The importance of partner communication.
        Perspectives on Sexual and Reproductive Health. 2002; 34: 191-197
        • Tolman D.L.
        Dilemmas of desire: Teenage girls talk about sexuality.
        Harvard University Press, Cambridge, MA2002
        • van Lee L.
        • van der Vlucht I.
        • Wijsen C.
        • Cadée F.
        Fact sheet 2009: Tienerzwangerschappen, abortus en tienermoeders in Nederland: Feiten en cijfers.
        Rutgers Nisso, Utrecht2009
        • Whitaker D.J.
        • Miller K.S.
        • May D.C.
        • Levin M.L.
        Teenage partners’ communication about sexual risk and condom use: The importance of parent-teenager discussions.
        Family Planning Perspectives. 1999; 31: 117-121
        • Widman L.
        • Welsh D.P.
        • McNulty J.K.
        • Little K.C.
        Sexual communication and contraceptive use in adolescent dating couples.
        Journal of Adolescent Health. 2006; 39: 893-899

      Biography

      Amy T. Schalet is an Assistant Professor of Sociology. Her book, Not Under My Roof: Parents, Teens, and the Culture of Sex, will be published later this year by the University of Chicago Press.