Table of Contents
To the love of my life, my husband, Walt
And to the joys in my life, Mary,
Charlotte, Laura, and Walter
Introduction to the 2007 Edition
I have a very peculiar job. I am a pediatrician who talks to a lot of kids about an enormous problem many parents and professionals dont want to seelet alone discuss openly. I talk about the explosive epidemic of sexually transmitted infections threatening kids. Some compare my profession to that of a veterinarianone who diagnoses illnesses in patients who cant (or wont) talk. Others, after they have listened to my lectures, think that I am an obstetrician/gynecologist. I have even gotten letters from folks who think that I am a psychiatrist. I am none of these things. I am a pediatrician and a mother who has seen too much pain in too many kids. Please let this sink in for a moment: I am a pediatrician talking about sexually transmitted infections. That alone is a sobering reality.
In the mid-1980s, I completed my pediatric residency training in a large inner-city pediatric hospital. I cared for babies of teens and for the teens themselves. I cried a lot during those years because I saw enormous pain in the eyes of these child mothers. But I took comfort in the thought that perhaps the bulk of the pain was isolated in the inner city, in kids who awoke every day to a single mom who drank too much or to a filthy, overcrowded apartment.
After six years of treating kids with sexually transmitted infections, I told my husband that it was time to move on. I wanted to treat plump, full-term babies whose mothers read child-care books and researched the safest toys.
I wanted to leave behind my clinical portion of the 19 million new sexually transmitted diseases that occur in Americans every year. Burn that number19 millioninto your mind. Thats new cases, every year. I wanted no part of them any longer. I was tired.
We moved to the suburbs and I cared for my friends kids and my kids friends. I was relieved that the mess was far away, locked in pockets of troubled, high-risk kids who needed quality medical care from a fresh crew of physicians.
What occurred in my medical practice over the following ten-plus years shook me to the core. Slowly, meticulously, those wretched infections surfaced in the bodies of my new crop of patients. I was angry and sad. These kids were not high-risk according to the medical literature. They had stable homes, clean clothes, and attended excellent schools. Chlamydia and herpes werent supposed to be here.
In my optimism, I hoped that my experience was unusual. So I turned to the medical literature to find out what was happening around the country. What I found rattled me. On my (and your) watch, an epidemic had exploded among our kids. From 1960 to 2000 the number of sexually transmitted diseases in our children skyrocketed. I asked my colleagues in internal medicine, pediatrics, and family practice if they were aware of the numbers I showed them. They shook their heads. Sure, they believed the numbers, they said. But they just didnt have the time or the energy to speak out about them.
I called gynecologists around the country and asked them. Absolutely, they knew, but again, they were weary and felt helpless to succeed at anything beyond damage control (code words for pleading with kids to use condoms).
I called high school counselors. Did they know about this epidemic? No, they said, but they believed the numbers. Life for many of these kids just feels out of control, many of them lamented.
So I wrote this book to bring to parents and educators the information we must have to help our own kids negotiate a very toxic sexual culture. When the first edition of this book was printed in 2002, 15.3 million Americans contracted a sexually transmitted disease each year, and two-thirds of those infections occurred in teens. We werent immunizing young girls against HPV, and many in the general public had never heard of human papilloma virus or the vaccine for cervical cancer. Since 2002, the number of cases of new sexually transmitted diseases has jumped by four millionand more than half (approximately 10 million) of these infections occur in teens. In 2006 the pharmaceutical company Merck introduced a vaccine against HPV, and in short order, pediatricians across the country began immunizing girls as young as nine against this sexually transmitted disease. HPV became a household word and even kids have learned that cervical cancer is caused not by a common virus, but by a sexually transmitted one.
What you will read is meant to sober you and to help us as parents understand that todays sexual culture is not that of the 1970s or even the 1980s. The sexual landscape is changing fast, and sexual education programs have difficulty keeping up with the rate of infections. These infections are real, and they are broader, I believe, than any of us realize. Our kids are confused and they need honest answers, facts, and help. We owe this to them. We, the generation who birthed the sexual revolution and the feminist movement, owe our kids our best efforts to keep them from the harm that many of us unleashed on them.
Much of this information will frighten you, and you wont want to believe it. So dont take my word for itlook up the data referenced in the notes section. We are not to live fearfully, but wisely, with our eyes open and our ears ready to listen and our opinions ready to be heard. This epidemic can be reversed. It will be reversed because our kids get whats going on and they are backing away from sex. In 1991, 54 percent of kids were sexually active before high school graduation. That number has now dropped to 46 percent. Why? Because kids know that trouble is all around them. They realize (while we adults dont) that the sexual climate is very dangerous, and they are opting to postpone sex until they are older. Good for them.
We must educate ourselves so we can help them. Helping kids avoid sex when they are young is no longer a moral or religious issue; it is a medical one. If I didnt believe that we can be effective in helping our kids delay their sexual debut, I would stay silent. But we can help. You can help. Who you are and what you say to the teen in your life can save his life.
This book is for you. Take what you learn and change the life of one teen you know. Here are seven crucial ways to protect your kids from the deadly epidemic that has claimed far too many young lives already.
1. Know the data
Teens today face greater threats than we did, with the twin (and related) epidemics of sexually transmitted infections and depression. Know the facts to prevent your teen from becoming a victim.
2. Get to know your teens friends
The best way to find out what your teen is involved in is to ask what his friends are up to. You can bet that whatever your kids friends are doing, your own children are doing as well.
3. Dont just talklisten
If you really want to get closer to your kids and get them to open up, just gently ask questions and then listen without responding or interrupting. You must wait (sometimes days) to give your opinionif you want it to make an impression on your teen.
4. Engage, dont bail
Teens needand wantparental involvement more than even toddlers do, even though theyll likely deny it. (An angry 16-year-old with a set of car keys is far more dangerous to himself than a 2-year-old running toward the street.) Stay connected and stay present.
