Many authorities on adolescent sexuality agree that educational efforts designed to increase teenagers’ awareness of contraception and other aspects of sexuality would be much more effective if they treated sexuality as a positive aspect of our humanity rather than something that is wrong or shameful. In many Western European countries, where teenage birthrates are dramatically lower than in the United States even though levels of

Sexuality During Childhood and Adolescence

adolescent sexual activity are equal to or greater than those in America, sex is viewed as natural and healthy, and teenage sexual activity is widely accepted. This stands in sharp contrast to the United States, where sex is often romanticized and flaunted but also frequently portrayed as something sinful or dirty that should be hidden.

We offer a list of suggestions for reducing teenage pregnancy rates in the United States. These suggestions were gleaned from a large body of research on adolescent sexuality.

1. The American family planning clinic system and school-based health clinics need to be upgraded and expanded to provide free or low-cost contraceptive services to all adolescents who want them. Of equal importance is the need to publicize that clinics maintain the confidentiality of their clients.

2. The United States should follow the lead of several European nations in estab­lishing a compulsory national sex education curriculum that is extended to all grade levels. Safe expression of adolescent sexuality should be treated as a health issue rather than as a political or religious issue. Research indicates that teenag­ers who have been exposed to comprehensive sex education are considerably less likely to become pregnant than those who have had no such education, especially if exposure to sex education occurs before the young people become sexually ac­tive (Masters et al., 2008; Zimmerman et al., 2008).

3. Adolescent boys must share responsibility for birth control measures. Efforts to educate teenagers to prevent unwanted pregnancies must recognize that male at­titudes are important for the practice and effectiveness of birth control. Adolescent boys often consider birth control to be their partners’ responsibility. Sex education programs should stress that responsibility for contraception is shared.

4. Condoms should be made readily available in middle schools and high schools. The results of several studies confirm that distributing condoms in schools is not associated with an increase in sexual frequency or younger age of sexual debut (Vamos et al., 2008). This research indicates that school-based condom availability can reduce teenage pregnancy and lower the risk of contracting STIs, including HIV/AIDS. Educational efforts should be directed toward en­couraging teens to use condoms correctly during every intercourse experience. This is especially important because even when teens do use condoms, they often use them incorrectly (for example, starting intercourse without a condom; Barclay, 2010).

5. Adolescent-parent communication about sex must be increased. A nationwide survey found that almost half (47%) of American youths ages 12-14 reported that their parents exerted more influence than others on their decisions about sexual activity (Albert, 2004). A huge majority (87%) of these participants indicated that they would be better prepared to postpone sexual activity and avoid unplanned pregnancies if they could talk more freely and openly with their parents about sex, especially the use of contraception to prevent pregnancy. Unfortunately "many teens do not talk with their parents about ways to prevent pregnancy" (Centers for Disease Control, 2011g, p. 419). This finding, together with comparable results of other studies, strongly indicates that a key strategy for reducing teen pregnancy is the development and implementation of programs designed to enhance adolescent-parent communication about sex. One such program, introduced as an after-school educational activity at middle schools in southeast Texas, demonstrated that parents who are willing to openly discuss sex with their children may be especially effective agents in efforts to reduce the rate of teenage pregnancies (Lederman et al., 2008).