On Teens and Sex: Where's the Love?

Helping our kids develop into smart, tender, sexual beings is vital to their future happiness and as challenging as parenting gets. The perplexity of sex is that it's so compelling, such a power for good—and yet so dangerous for young people if they set off on the wrong track. Sex education in schools is beset with endless debate about abstinence only versus safe sex. What's missing and sorely needed is a focus on love and ennobling sexual intimacy as immutable currents in human life. Both as doctor and mother, I can't help but believe that our anything-goes society, in which impulses are immediately satisfied and sex is divorced from love and bonding, is simply not healthy physically, emotionally, or spiritually.

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If we look at what today's teens are doing, it is enough to make parents weep and safe-sex educators recognize a need greater than condoms. The Guttmacher Institute reported recently that more than 75 percent of teens have had sex by the time they are 19 years old. And sophisticated sex at that: Some 25 percent of virgins over 15 have had oral sex; of those who've had intercourse, almost all have also engaged in oral sex and 11 percent in anal sex. Of kids under 15, about 14 percent have had sexual intercourse, and a quarter of teenagers have had at least one sexually transmitted disease. In fact, young people account for half of the 19 million new STD cases each year. Safe-sex slip-ups occur even if kids know the drill, and teens are simply clueless about condom use during nonvaginal sex.

Gravitas. While the risks of disease are towering, we can't ignore emotional dangers—and the need to reintroduce the gravitas that comes with sex connected to mature, abiding love. (Granted, this can be tough in a teen media culture brimming with physical encounters that are casual and crudely comic.) How hard it must be to form meaningful connections when casual hookups squeeze out good old dating, and "friends with benefits" becomes a new species of social relationship. The love that moves mountains and makes the world go round is something quite different, based on respecting and cherishing if not adoring another human being for his or her worth, in the sparkle of romance and affection. And I'll go out on a limb and say that this is what most young people still dream of, girls and boys alike.

One message for those intimate parent-child conversations is that early sex is a threat, and it remains a greater threat to girls than to boys. Teen pregnancy occurs in about 750,000 girls each year. Compared with adults, a teen, with an immature cervix, is more likely to catch an STD, triggering problems like smoldering pelvic inflammatory disease that can silently take away fertility, tubal pregnancies, cervical and even throat cancer, and transmission of disease to offspring at birth. That doesn't mean boys are invulnerable; they just suffer fewer and milder consequences.

However much our daughters should take equality with men for granted, they must know that sex is distinctly sexist. An old saying goes that men give love to get sex while women have sex to get love. There's something there. The brains of teen boys are raging with the libido hormone testosterone, while girls have some increase in testosterone but at far lower levels. In contrast, girls have more oxytocin, the cuddle hormone, and seem to be more sensitive to it than boys. Also, teenage emotions are responding to basic instincts from the lower brain, which awakens the body to its generative capacities. Such impulses searching for instant gratification can easily overwhelm the higher frontal lobes—which impose thoughtful, rational, and conscience-driven restraints on behavior—because, by some quirk of nature, those distinctly human higher cognitive centers don't fully mature until the early 20s. Parents, like it or not, have no choice but to be their kids' frontal lobes for a time, and that's a source of vintage teen turbulence.