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The Talk
December 2, 2006

We need to talk about our kids and sex. Better yet, first we need to talk to our kids about sex -- at least by the time they reach the age at which they're tempted to try it.

Written by Editorial, Fort Worth Star-Telegram

We need to talk about our kids and sex. Better yet, first we need to talk to our kids about sex -- at least by the time they reach the age at which they're tempted to try it.

They need to know that sex is a rich and rewarding experience of married adult life. They also need to know that, especially as a casual event between unmarried people, there is no such thing as truly safe sex. There are risks of unwanted pregnancy and sexually transmitted diseases associated with every practice except abstinence.

And then there's the fact of life that parents need to know: The federal Centers for Disease Control and Prevention reported recently that 52.5 percent of Texas teens have had sexual intercourse -- a number significantly higher than the 46.8 percent nationwide.

That's not an argument to stop pushing the wisdom of abstinence as children grow up. In fact, Texas public school health textbooks do exactly that, and the Department of State Health Services will spend $5.3 million this year on abstinence education programs.

But Texans simply must realize that more than half of the state's youth who have reached sexual maturity already have rejected the abstinence option at least once.

So what's a parent to do?

Talking is still the best option. To a great extent, the aphorism holds true that kids are going to do what they're going to do. But it's also true that a loving parent, armed with accurate information about the risks of teen sex, stands the best chance of influencing youthful behavior.

Medical professionals, of course, can be of great help. Teens are like other people -- they often feel that they can talk more frankly with a doctor or trained nurse than they can with a family member. Once teens have left sexual abstinence behind, parents can still hope that their kids will come to Mom or Dad to talk, but adolescents should know about other reliable sources of help.

Or there's the head-in-the-sand alternative advocated recently by the Bedford City Council.

At the urging of Councilman Charles Orean and the Northeast Tarrant County Right to Life Educational Association, the council on Nov. 14 launched an attack on Planned Parenthood and other organizations that provide counseling about sex to unwed minors.

On a 5-2 vote, the council adopted a resolution asking state Rep. Todd Smith to push passage of a state law requiring these organizations to inform parents before providing unwed minors with contraception information or devices, or referring them for abortion counseling.

Texas already requires signed and notarized parental consent before minors undergo abortions. So the more pertinent part of the Bedford resolution was its push for parental notification when an unwed minor seeks guidance on contraception. That's not currently a state requirement.

Smith said later that he would investigate the Bedford council's request. Should he do so in depth, he will find that such knowledgeable professional organizations as the Texas Medical Association, the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists and the Society of Adolescent Medicine stand firmly against required parental notification for contraception.

A 2002 study published in the Journal of the American Medical Association shows why.

Researchers surveyed girls younger than 18 who sought family planning services -- contraceptives, testing or treatment for sexually transmitted diseases and other women's health exams -- from the 33 Planned Parenthood clinics in Wisconsin. Of the 950 girls who responded, 59 percent said they "would stop using all sexual health care services, delay testing or treatment for HIV or other STDs, or discontinue use of specific (but not all) sexual health care services if their parents were informed that they were seeking prescribed contraceptives."

A secondary sample showed similar results and asked the girls whether they would continue to have sexual intercourse. Ninety-nine percent said that they would. Instead of prescription contraceptives, they'd rely on riskier methods, such as condoms (shown in other studies to have a 15 percent failure rate in preventing unwanted pregnancies, compared to 8 percent for birth control pills); having their partner withdrawal before ejaculation (a 27 percent failure rate); or unprotected sex (an 85 percent chance of pregnancy in the first year).

The 1 percent of girls who said they would discontinue sexual intercourse stated that they would engage in oral sex.

In discussing the Bedford council's request for parental notification when an unwed minor seeks information about contraceptives, Smith said he would want to know whether such a requirement would lead to fewer abortions in Texas. The JAMA study showed that girls would avoid seeking counseling, prescription contraceptives or other sexual health exams but would have high-risk sex. That's clearly a formula for more unwanted pregnancies, which most likely means more, not fewer, abortions.

Does the prospect of getting contraceptives from a place such as a Planned Parenthood clinic make teens more likely to engage in sexual activity? Janet Realini, a physician who runs a family planning service in San Antonio, addresses the question on behalf of the Texas Medical Association.

"Contraceptives are not the reason kids have sex," she said. She pointed to one study showing that, for women ages 15 to 24, the median time from their first sexual experience to their first clinic visit is 22 months.

The message is clear: Girls typically don't seek contraceptives so they can start having sex. They're having sex long before that.

Before Smith decides to act on the Bedford council's request, he should investigate current state law. He will find that, except in limited circumstances, Texas already requires parental consent -- not just notification -- for medical treatment of minors.

The most pertinent exception here is that a minor may request and receive confidential treatment if breaching that confidentiality would result in the loss of federal funds to the state. Texas receives and distributes to local clinics almost $9.8 million in federal family planning grants, and another $36.7 million in federal Medicaid family planning assistance each year. Federal law requires that all clients who seek assistance at clinics (including the Planned Parenthood site in Bedford) under those programs be treated confidentially.

If the Bedford council still wants to change the law, it should start in Washington, not Austin. But the change the council has suggested would not be wise.

If the council and the Northeast Tarrant right-to-life group seek a lower abortion count, requiring parental notification when a minor seeks help with contraception would have the opposite effect.

Parents who have a close and respectful relationship with their children are the optimum for Bedford or any other city. Strong families, in which teens seek their parents' advice about sex or other important life events, are also the best. And abstaining from sex until marriage is perfect.

None of those ideals is harmed, and other serious negatives can be avoided, by allowing teens who already are sexually active to obtain confidential medical help.

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