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relationships with boys while the data reflects trends to support this theory it is inconclusive 24 the freedom to communicate with adolescent boys was restricted for girls regardless of whether they lived in an urban or rural setting and regardless of whether they went to school or not more urban girls than rural girls discussed sex with their friends those who did not may have felt the subject of sexuality in itself is considered an adult issue and a taboo or it may be that some respondents were wary of revealing such personal information 25 contraceptive use among indian girls goyal claims that misconceptions about sex sexuality and sexual health were large however adolescents having sex relationships were somewhat better informed about the sources of spread of stds and hiv aids 24 while 40 of sexually active girls were aware that condoms could help prevent the spread of hiv aids and reduce the likelihood of pregnancy only 10 5 used a condom during the last time they had intercourse 24 in the netherlands edit according to advocates for youth the united states teen pregnancy rate is over four times as much as it is in the netherlands 26 in comparison in the documentary let s talk about sex a photographer named james houston travels from los angeles to d c and to the netherlands 27 in the netherlands he contrasts european and american attitudes about sex from the hiv rates to the contemplations of teen parenthood in america houston depicts a society in which america and the netherlands differ most dutch parents practice vigilant leniency 28 in which they have a strong familial bond and are open to letting their children make their own decisions gezelligheid is a term used by many dutch adolescents to describe their relationship with their family the atmosphere is open and there is little that is not discussed between parents and children amy schalet author of not under my roof parents teens and the culture of sex discusses in her book how the practices of dutch parents strengthen their bonds with their children teenagers feel more comfortable about their sexuality and engage in discussion with their parents about it a majority of dutch parents feel comfortable allowing their teenagers to have their significant other spend the night 29 same sex attractions among adolescents edit adolescents who are attracted to others of the same sex are strongly affected by their surroundings in that adolescents often decide to express their sexualities or keep them secret depending on certain factors in their societies these factors affect girls and boys differently if girls schools and religions are against same sex attractions they pose the greatest obstacles to girls who experience same sex attractions these factors were not listed as affecting boys as much researchers suggest that maybe this is because not only are some religions against same sex attraction but they also encourage traditional roles for women and do not believe that women can carry out these roles as lesbians schools may affect girls more than boys because strong emphasis is placed on girls to date boys and many school activities place high importance on heterosexuality such as cheerleading 30 additionally the idea of not conforming to typical male gender roles inhibited many boys from openly expressing their same sex attraction the worry of conforming to gender roles did not inhibit girls from expressing their same gender preferences as much because society is generally more flexible about their gender expression 30 researchers such as lisa diamond are interested in how some adolescents depart from the socially constructed norms of gender and sexuality she found that some girls when faced with the option of choosing heterosexual same sex attracted or bisexual preferred not to choose a label because their feelings do not fit into any of those categories 31 sexually transmitted infections edit adolescents have the highest rates of sexually transmitted infections stis when compared to older groups sexually active adolescents are more likely to believe that they will not contract a sexually transmitted infection than adults adolescents are more likely to have an infected partner and less likely to receive health care when an sti is suspected they are also less likely to comply with the treatment for an sti coinfection is common among adolescents 5 an sti can have a large negative physiological and psychological effect on an adolescent the goal of the pediatrician is for early diagnosis and treatment early treatment is important for preventing medical complications and infertility prevention of stis should be a priority for all health care providers for adolescents diagnosis of an sti begins the evaluation of concomitant stis and the notification and treatment of sexual partners some states in the us require the reporting of stis to the state s health department 5 media influence edit modern media contains more sexual messages than was true in the past and the effects on teen sexual behavior remain relatively unknown 32 only 9 of the sex scenes on 1 300 of cable network programming discusses and deals with the potentially negative consequences of sexual behavior 33 the internet may further provide adolescents with poor information on health issues sexuality and sexual violence 34 a study on examining sexual messages in popular tv shows found that 2 out of 3 programs contained sexually related actions 1 out of 15 shows included scenes of sexual intercourse itself shows featured a variety of sexual messages including characters talking about when they wanted to have sex and how to use sex to keep a relationship alive some researchers believe that adolescents can use these messages as well as the sexual actions they see on tv in their own sexual lives 35 the results of a study by deborah tolman and her colleagues indicated that adolescent exposure to sexuality on television in general does not directly affect their sexual behaviors rather it is the type of message they view that has the most impact 36 gender stereotypes enacted in sexual scenes on tv were seen to have a large effect on adolescents girls felt they had less control over their sexuality when they saw men objectifying women and not valuing commitment the study discussed the risk of women internalizing this message and spreading the idea that it is okay to be weak and answer to men all the time however girls who saw women on tv who refuted men s sexual advances usually felt more comfortable talking about their own sexual needs in their sexual experiences as well as standing up for themselves they were comfortable setting sexual limits and therefore held more control over their sexuality findings for boys were less clear those who saw dominant and aggressive men actually had fewer sexual experiences 36 however some scholars have argued that such claims of media effects have been premature 37 furthermore according to us government health statistics teens have delayed the onset of sexual intercourse in recent years despite increasing amounts of sexual media 38 a 2008 study wanted to find out if there was any correlation between sexual content shown in the media and teenage pregnancy research showed that teens who viewed high levels of sexual content were twice as likely to get pregnant within three years compared to those teens who were not exposed to as much sexual content the study concluded that the way media portrays sex has a huge effect on adolescent sexuality 39 teenage pregnancy edit main article teenage pregnancy adolescent girls become fertile following the menarche first menstrual period which normally occurs between age 11 to 12 after menarche sexual intercourse especially without contraception can lead to pregnancy the pregnant teenager may then miscarry have an abortion or carry the child to full term pregnant teenagers face many of the same issues of childbirth as women in their 20s and 30s however there are additional medical concerns for younger mothers particularly those under 15 and those living in developing countries for example obstetric fistula is a particular issue for very young mothers in poorer regions 40 for mothers between 15 and 19 risks are associated more with socioeconomic factors than with the biological effects of age 41 however research has shown that the risk of low birth weight is connected to the biological age itself as it was observed in teen births even after controlling for other risk factors such as utilisation of antenatal care etc 42 43 worldwide rates of teenage births range widely for example sub saharan africa has a high proportion of teenage mothers whereas industrialized asian countries such as south korea and japan have very low rates 44 teenage pregnancy in developed countries is usually outside of marriage and carries a social stigma teenage mothers and their children in developed countries show lower educational levels higher rates of poverty and other poorer life outcomes compared with older mothers and their children 45 in the developing world teenage pregnancy is usually within marriage and does not carry such a stigma 46 legal issues edit main articles age of consent and statutory rape see also marriageable age and teen marriage age of consent for heterosexual sex outside of marriage by country or territory age varies by state in australia mexico and the united states in china hong kong is an exception where the age of consent is 16 not 14 wrong in the map puberty only nayarit 12 13 14 15 16 17 18 21 only bahrain must be married sexual conduct between adults adolescents and adolescents younger than the local age of consent is generally illegal aside from close in age exemptions or in jurisdictions where only sex between married couples is legal 47 such as those in some islamic countries in many jurisdictions sexual intercourse between adolescents with a close age difference is not prohibited around the world the average age of consent is 16 48 but this varies from being age 13 in sudan age 16 in spain and canada and age 16 18 in the united states in some jurisdictions the age of consent for homosexual acts may be different from that for heterosexual acts the age of consent in a particular jurisdiction is typically the same as the age of majority or several years younger the age at which one can legally marry is also sometimes different from the legal age of consent sexual relations with a person under the age of consent are generally a criminal offense in the jurisdiction in which the act was committed with punishments ranging from token fines to life imprisonment many different terms exist for the charges laid and include statutory rape illegal carnal knowledge or corruption of a minor in some jurisdictions sexual activity with someone above the legal age of consent but beneath the age of majority can be punishable under laws against contributing to the delinquency of a minor 49 in some countries marrying a person under the age of consent may make sex with that person legal regardless of the age of consent 50 51 52 53 societal influence edit social constructionist perspective edit the social constructionist perspective see social constructionism for a general definition on adolescent sexuality examines how power culture meaning and gender interact to affect the sexualities of adolescents 54 this perspective is closely tied to feminism and queer theory those who believe in the social constructionist perspective state that the current meanings most people in our society tie to female and male sexuality are actually a social construction to keep heterosexual and privileged people in power 55 researchers interested in exploring adolescent sexuality using this perspective typically investigates how gender race culture socioeconomic status and sexual orientation affect how adolescent understand their own sexuality 56 an example of how gender affects sexuality is when young adolescent girls state that they believe sex is a method used to maintain relationships when boys are emotionally unavailable because they are girls they believe they ought to engage in sexual behavior in order to please their boyfriends 57 developmental feminist perspective edit the developmental feminist perspective is closely tied to the social constructionist perspective it is specifically interested in how society s gender norms affect adolescent development especially for girls for example some researchers on the topic hold the view that adolescent girls are still strongly affected by gender roles imposed on them by society and that this in turn affects their sexuality and sexual behavior deborah tolman is an advocate for this viewpoint and states that societal pressures to be good cause girls to pay more attention to what they think others expect of them than looking within themselves to understand their own sexuality tolman states that young girls learn to objectify their own bodies and end up thinking of themselves as objects of desire this causes them to often see their own bodies as others see it which causes them to feel a sense of detachment from their bodies and their sexualities tolman calls this a process of disembodiment this process leaves young girls unassertive about their own sexual desires and needs because they focus so much on what other people expect of them rather than on what they feel inside 14 another way gender roles affect adolescent sexuality is through the sexual double standard this double standard occurs when others judge women for engaging in premarital sex and for embracing their sexualities while men are rewarded for the same behavior 58 it is a double standard because the genders are behaving similarly but are being judged differently for their actions because of their gender an example of this can be seen in tolman s research when she interviews girls about their experiences with their sexualities in tolman s interviews girls who sought sex because they desired it felt like they had to cover it up in order for example they blamed their sexual behavior on drinking not to be judged by others in their school they were afraid of being viewed negatively for enjoying their sexuality many girls were thus trying to make their own solutions like blaming their sexual behavior on something else or silencing their own desires and choosing not to engage in sexual behavior to a problem that is actually caused by power imbalances between the genders within our societies 14 other research showed that girls were tired of being judged for their sexual behavior because of their gender however even these girls were strongly affected by societal gender roles and rarely talked about their own desires and instead talked about how being ready rather than experiencing desire would determine their sexual encounters 58 o sullivan and her colleagues assessed 180 girls between the ages of 12 and 14 on their perceptions on what their first sexual 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