E. James Lieberman M.D. - Like It Is: A Teen Sex Guide

Pictured on cover: Zach Lawless and Ashley Wagoner
(photograph by Barry Greene).

Drawings by Jennifer M. Leong.

LIBRARY OF CONGRESS CATALOGUING-IN-PUBLICATION DATA

Lieberman, E. James, 1934
Like it is : a teen sex guide / by E. James Lieberman and Karen Lieberman Troccoli.
p. cm.
Includes bibliographical references and index.
Summary : Provides information about sex, relationships, and birth control, with an emphasis on informed consent and mutual respect, and discusses such options as parenthood, adoption, and abortion.

ISBN 978-0-7864-0526-8

1. Sex instruction for teenagers. [1. Sex instruction for youth.] I. Troccoli, Karen Lieberman. II. Title.
HQ35.L543 1998
613.9'07dc21 98-27176
AC

British Library cataloguing data are available

1998 E. James Lieberman and Karen Lieberman Troccoli. All rights reserved

No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying or recording, or by any information storage and retrieval system, without permission in writing from the publisher.

McFarland & Company, Inc., Publishers
Box 611, Jefferson, North Carolina 28640
www.mcfarlandpub.com

This book is an expression of faith
in the readiness of young people
to govern their futures wisely.
We dedicate it to them,
and to their parents, teachers and counselors.

Our experiences with peers and patients, teachers and students, family and friends, form the basis of this book. We owe special thanks to Lisa Kaeser of the Alan Guttmacher Institute, and Debra Hauser and Jane Norman of Advocates for Youth, who reviewed the final draft. Many teens helped formally and informally by sharing their experiences, ideas, insights and questions with us. Jennifer M. Leong provided the illustrations. To Dr. Robert A. Hatcher at Emory University we express admiration and gratitude for his longstanding leadership in family planning education and service. We are heavily indebted to his Contraceptive Technology and his work on emergency contraception.

While we take responsibility for any omissions or errors in this book, we remind readers that a book, no matter how accurate, cannot substitute for a visit to the doctor or family planning clinic.

We thank our families, Carol Lieberman and Kenneth and Nicholas Troccoli, for their loving support and always helpful opinions and suggestions along the way.

Every year millions of young Americans discover something new about life from their own bodies. They find out that no matter how much they thought they knew about sex, they have a lot to learn. Unfortunately many learn the hard way, from painful and costly mistakes. We hope that this book will help prevent some of those unhappy experiences.

Parents mean well in their efforts to teach their children about sex, but they often meet a wall of privacy or embarrassment that is quite normal in families at this stage. Teachers may be well prepared, but often they are forbidden to teach certain topics by principals or school boards.

Few teens get advice on sex and contraception from a doctor or nurse. Too often, young women first get family planning information after a pregnancy scare or unplanned pregnancy. The media are full of sexual drama but rarely offer help with sexual realities. Despite its apparent openness, American society leaves young people to fend for themselves in a sexually overheated environment where the cost of mistakes is terribly high. The facts, as of 1995:

About half of all teenagers55 percent of men and 50 percent of womenhave intercourse before the age of 20.

One million adolescent women become pregnant each year.

Four-fifths (82 percent) of teen pregnancies are unintended.

Almost halfover 300,000of these unintended pregnancies end in abortion.

Teen mothers are less likely to finish high school.

One out of four sexually experienced teens contracts a sexually transmitted disease each year; HIV infection is often contracted before age 20.

Most teens believe the average young person does not have enough accurate information about sex and reproduction.

Sex can be like a roller-coaster ride or like boating on a gentle current. Roller coasters and boats can be quite safe or dangerous, depending on their quality and the circumstances. You would not want to ride a roller coaster that failed inspection by qualified engineers, and you shouldnt go out on a boat without a life preserver. Many lives have been harmed by the pursuit of pleasure without care. Our purpose in this book is to prevent harm by providing guidance to young people who have thoughts and feelings about sex, who will be making decisions affecting their whole lives.

Experts in sex therapythe treatment of sexual problemssay that the sexual organs are located between the ears, meaning that the mind, the personality, and ones knowledge and attitudes are more important than the physical equipment located below the neck. Young adults, and older ones too, confront emotional, intellectual, and moral questions about sex that have more to do with the mental than the physical side of life. When is a person mature enough to have sex? Is premarital sex ever okay? Is the main purpose of sex to make babies? To have fun? To express love? How can I resist pressure to have sex? What makes sex safe or unsafe? Why do some of my friends take so many chances, as though nothing bad could happen to them, while others are totally afraid?

These kinds of questions have many answers. Sometimes there is only one right answer, but more often there are several. A right answer for one person may be wrong for another. By the same token, answers lead to many different consequences. We wrote this book to help you think about sexual truths and consequences. Where the facts are known, we state them as clearly as possible. Even so, the implications of plain facts are as different as people themselvesdepending, for example, on their moral and spiritual values.

These values are being formed at the same time decisions about sexuality have to be made. Religion, morals, relationships, emotions, hormones, and psychology all characterize the complicated stage we call adolescence. Each person tries to weave these themes into a stable, sensible way of being, a personal philosophy or tapestry of personality.

This book is a tool for young adults coming to terms with sexuality. It provides a straightforward discussion of the issues while leaving room for readers to decide what is best for themselves. The information is presented with authority, the attitudes with humility. Rarely will everyone have the same judgment in an area as diverse, dynamic and personal as sexual behavior. We speak out on a few matters on which we feel strongly, we give several answers on most issues, and we leave some things entirely to the reader. Our values will be at odds with those of some people. Our goal is to help you be successful in your commitment to the values you cherish.

The stories about young people in this book come from many sources. Sometimes we combine cases to make a point clear. We always change names and identifying details so as not to violate anyones privacy.

We are concerned with three sexual consequences to be avoided: unintended pregnancy, sexually transmitted disease, and emotional harm resulting from premature intimacy or abusive relationships. Thats why this book addresses pregnancy, protection against sexually transmitted diseases, and building sound, healthy relationships.

Because the field is changing rapidly, readers must check with a health professional regarding any personal medical questions, diagnosis or treatment. For updates on general topics and advances see the Resources section. Current information is always available through libraries, reputable organizations, and the Internet, as we indicate.