For and against: Doctors should advise adolescents to abstain from sex
Against a background of high rates of teenage conceptions and an increasing level of sexually transmitted infections, a debate in this week's BMJ considers whether advising abstinence is an effective response to declining teenage sexual health.
Abstinence makes sense and is effective, argues Trevor Stammers, a tutor in general practice and an author and broadcaster on sexual health. Research shows that early intercourse carries greater risks and often leads to subsequent regret. Sexually active teenagers are also more likely to be emotionally hurt and have an increased risk of depression and suicide. Abstinence programmes from the US also show "a sharp reduction in the number of pregnancies."
Easier availability of contraception and more explicit sex education at an earlier age are tired and inadequate responses to declining teenage sexual health, says the author. Doctors should encourage adolescents to avoid early sexual intercourse so that they can enjoy better long term sexual health, he concludes.
Roger Ingham, a researcher on sexual conduct and sex education, believes that the answer lies in promoting greater openness about young people's sexuality. A policy of advising young people not to have sex will not encourage them to deal with issues such as peer group pressure. It also runs the risk that they will become even more alienated from adults and that they will be less likely to use the services available, argues the author. Indeed, countries such as Norway, Sweden and the Netherlands - where teenage conception rates are considerably lower than in the UK - have an earlier and more open approach to sexual issues in schools and families.
Although poor sexual health among young people is a complex issue, many people in the UK are making efforts to improve the sexual health of young people by teaching about responsibility and good personal relationships, he concludes.
Contacts:
Trevor Stammers, Church Lane Practice, London, UK
Email: stammtg@globalnet.co.uk
Roger Ingham, Centre for Sexual Health Research, University of Southampton, UK
Email: ri@soton.ac.uk