What’s real sex? Kids narrow definition, put themselves at risk
St. Louis Post-Dispatch, and Carol M. Ostrom
The Seattle Times Nov. 6, 2002

  It's a taboo topic, but one that parents, educators and healthcare providers have been discussing quietly for the past couple of years and with a greater degree of urgency.
  Many teenagers - and even children as young as middle school - are having oral sex. Some of them don't think of it as real sex. And many are unaware that it can be dangerous.
  Health-care professionals and educators say frank discussion and useful information concerning oral sex should be shared in classrooms, at community forums, and, to be sure, at home. But not everyone sees it that way.
  Sex talk has long been difficult in a family setting, and at school, where some parents feel it doesn't belong. With that mindset, teachers and administrators often tread lightly when it comes to sex-education classes; in terms of oral sex, they’ll answer questions students might have but not necessarily introduce the topic themselves.
  But oral sex has magnified in other venues. The Bill Clinton-Monica Lewinsky scandal put the topic on the front pages of the nation’s newspapers and on television. Since then, stories about teens and oral sex have surfaced in teen magazines and television shows. Recent surveys indicate that a significant number of youths engage in oral sex. In doing so, they risk contracting sexually transmitted diseases such as the herpes virus and HIV, the virus that can cause AIDS.
  Less obvious, but potentially devastating as well, can be the psychological effects. In many instances, it's the girl who is providing oral sex to the boy as a way of starting or maintaining a relationship. Many boys speak of oral sex as a way of having fun while avoiding intimacy. Health professionals say those attitudes do not auger well for meaningful relationships later in life.

'Light' sex
  No one can say with certainty whether today's teens are engaging in oral sex more than previous generations. But studies have established that a lot of it is going on.
  In a survey of teens conducted last year by the Henry J. Kaiser Family Foundation with Seventeen magazine, 23 percent of students questioned in seventh through 12th grade said they had had oral sex. In 11th and 12th grade the number increased to 42 percent. The survey also found that 38 percent of teens did not think oral sex was as big a deal as sexual intercourse. And 30 per cent didn't know that a boy or girl could become infected with HIV by having oral sex.
  Some of those findings are consistent with interviews the St Louis Post-Dispatch has conducted over the past year with teens parents, teachers and health-care professionals. The teenagers were promised anonymity and false names in exchange for open discussion.
  Just a few teens acknowledged that they've had oral sex. But most say they have friends who have talked about doing it and that the practice is common. Estimates from the teens range from a quarter to a third of students at their schools.
  Even so, some teens wonder why all the fuss.
  Scott, 15, said he hasn't had oral sex, but, "Me and my friends don't think of it as a really big deal," he said. "It's really quick and less serious (than intercourse). And you don't really have to like a girl."
  Julie, 16, a sophomore, has had oral sex and says it's "not fun." But she says, "It seems like when you are in a relationship, it's just what they want."
  Interviews with teens in Seattle reveal similarities in attitudes, including the pressure girls say they feel from boys. (Local teens' names were also changed.)
  "It's 'You like me, so why don't you give me oral sex? '" said Amy, 14, a ninth-grader at a Seattle high school. "You want guys to like you, so you think maybe if you do it, they'll like you."
  But Amy says she's "not into that."
  "Girls I know who have done that, their reputation changes," she said. "If a guy does it, they don't say anything about it. But if a girl does it, that's when they start saying she's nasty and stuff.”
  Daniel, 17, a Seattle senior, said his friends think oral sex is "pretty cool, pretty trendy." Technically, he said, he believes a person could be a virgin and be engaging in oral sex. But he believes it's "disrespect toward both sexes," especially since "the boy is Just using (the girl) for his pleasure."
  Richard, 14 a Seattle freshman, says one friend insists he's had it over 30 times." Does he believe him? "No," Richard said. But he hedges his bet: "I say, 'Watch, you’re going to get AIDS.'"
  Unlike some of his peers, Richard is clear that "oral sex is sex, period. I know that clear and He talks with his mom and dad about sex, he said, and with his older brothers, most often with the one closest to him in age. We talk about (oral sex) all the time." he said. "He tells me not to do it. Because he doesn't want me to get AIDS or anything."
  Richard said his friends "think I'm corny because I don't do it. ... They laugh at me,"
  Parents get their information filtered mostly through their children. There was the story of seventh-graders caught having oral sex in a school bathroom; of a group of ninth-graders caught after school at the home of parents who are away during the day.
  For some, that leads to conversations that are troubling - like the one Gail Dabler had with her daughter about her friends' experiences.
  "Some of my daughter’s friends felt really used," said Dabler, a St. Louis area school nurse. "They felt really uncomfortable, but they did it to feel popular and accepted. The boys were trying to convince them that it wasn't going- all the way, that this was ‘light’ sex."

Emotional and physical toll
  Helen Power, a senior lecturer on women's studies at Washington University, says the emotional fallout of having oral sex can be devastating to teenage girls.
  "If they're doing it to get boys and keep boys and not doing it for their own sexual satisfaction, seems quite sick," she said. "It's a sense of domination and reaffirmation of the whole heterosexual ideal that you'll do anything to have a boy or man in your life."
  And then there are the physic repercussions, like the ones D Beth Gearhart discovered. Gearhart, a Missouri gynecologist, found herpes simplex virus type 1 lesions in the genitalia of about a dozen teenage girls over a two month span a couple of years ago. Herpes simplex 1 is normally found in or around the mouth.
  She recalls the first of those patients - a 17-year-old who considered herself a virgin. When Gearhart discovered the lesions, her conversation with that patient went like this:
  Gearhart: "You said you haven't been sexually active. Are you sure?"
  Patient: "Yeah."
  "Have you had oral sex?"
  "Well ... yeah."
  Surprised at the attitude, she began calling school districts to see if they were aware of such a trend. The answer was yes.
  When Gearhart offered to visit schools to talk about the risks, she got a mixed reaction. Administrators told her that parents didn't want the topic raised directly with their children.

Dilemma for schools
  Parents have long been divided over how best to address sex education in the schools.
  One in three schools nationwide teaches an abstinence-only curriculum that forbids discussion of oral sex or safe sex.
  But a Kaiser Foundation study found that 80 percent of parents surveyed wanted their teenagers to be taught how to use different forms of birth control in junior and senior high school. Ninety-four percent said they wanted teachers to discuss with students the pressure to have sex and the emotional consequences of becoming sexually active.
  The Kaiser survey didn't specifically address oral sex, said Tina Hoff, vice president for public health information at the foundation. But based on the strength of opinion, she believes parents are looking for more, not less, to be covered in the classroom.
  Health educators in Puget Sound say they're torn: Without good definitions, kids form their own. But when talk gets too graphic, parents can become alarmed.
  "Our teachers have to be careful," said Lloy Schaaf, director of curriculum and instruction for the Mukilteo School District, which will soon update its HIV--AIDIS unit curriculum. "They have to stick closely to what the district has adopted, because that’s their safety net. It's tough - you walk a real fine line as educator."
  In Seattle Public Schools, specific discussion of oral sex is not mandated by the curriculum. And the health-risks survey the district, conducted in 1999 did not ask about it separately, or make it clear whether oral sex was included in the question about "sexual intercourse."
  The survey, which included questions from the Centers for Disease Control and Prevention used to track risk behaviors over time, shows the percentage of kids who say they've had sexual intercourse dropped between 1995 and 1999. At Nathan Hale High School, for example, in 1995, 45 percent of students said they'd had sexual intercourse; by 1999, that percentage dropped to 31 percent.
  However, the drop could reflect a trend toward oral sex if teens didn't consider it to be “sexual intercourse,” conceded Pamela Hillard, manager for health education for Seattle Public Schools.

'You have to be really clear'
  Even though the curriculum doesn't make it mandatory, in the classroom Seattle schools' health educators are trying hard to make it clear oral sex is included in the continuum of risky behaviors, said Hillard. "We want to be certain our children understand this is a form of sex, and a behavior that is risky to their health and development."
  Tamara Brewer, a health educator at Ingraham High School, presents clear definitions for her ninth-grade health class in a presentation called, "At what point am I having sex.
  "In the adolescent world, being subtle or talking around a subject does not get the results you want – you have to be really clear,” said Brewer, who said she’s been addressing oral sex seriously for the past five or six years.
   "I worked in a clinic, and I was getting kids saying they were virgins, presenting with STDs, having oral and anal intercourse," Brewer recalled. "This whole confused area is causing kids to think they are protected, and they are not. . . . I truly believe, if we want kids to practice abstinence, we need to talk about this."
  At Nathan Hale, Nickie McDonald says she also takes the straightforward approach in her ninth-grade health class. While she's blunt with her definitions, "I don't give them a lesson how to do it."
  But being blunt is necessary, she said. "Some kids don't know what it is. I assume that most of them don't know. . . . I hope most of them don't know."

Things every teen - and parent - should know
* While the risk of contracting most sexually transmitted diseases through oral sex is significantly less than with intercourse, experts say it can't be considered totally "safe" sex. "The risk isn't zero," says Dr. Hunter Handsfield, a nationally known leader in STD prevention who works with the University of Washington and Public Health - Seattle & King County.

* Herpes simplex virus type 1, which is normally found in or around the mouth in the form of a cold sore, is causing an increasing proportion of genital herpes cases, probably because of the increasing frequency of oral sex among young people, says Handsfield. Likewise, STDs normally found in the genital tract can be transmitted to the mouth and throat during oral sex.

* Teens are more susceptible to sexually transmitted diseases because of a lack of immunity, says Dr. Bradley Stoner, an infectious-disease specialist at Washington University. "It's thought that the first exposures to a pathogen may cause the most harm because your body hasn't seen it before."

* People infected with STDs, such as herpes, may not detect symptoms for some time and could unknowingly pass them, on to others through oral sex.

* Some STDs, such as herpes and HIV, are incurable. Symptoms can be controlled with medications, but those infected will always have the disease and will have to tell future partners about the disease in order to prevent its spread.

- St. Louis Post-Dispatch and The Seattle Times