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Healthy Adolescent Sexual Development October 2010 Richard E. Kreipe, MD, FAAP Division of Adolescent Medicine Golisano Children’s Hospital University.

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Presentation on theme: "Healthy Adolescent Sexual Development October 2010 Richard E. Kreipe, MD, FAAP Division of Adolescent Medicine Golisano Children’s Hospital University."— Presentation transcript:

1 Healthy Adolescent Sexual Development October 2010 Richard E. Kreipe, MD, FAAP Division of Adolescent Medicine Golisano Children’s Hospital University of Rochester Medical Center ACT for Youth Center of Excellence Cornell University Family Life Development Center Cornell University Cooperative Extension of New York City New York State Center for School Safety University of Rochester Medical Center Div. of Adolescent Medicine Text Copyright © 2010 by ACT for Youth Center of Excellence

2 Outline  Define terms and concepts  Key biological, psychological and social features of normal adolescent sexual development  Markers of healthy—and unhealthy—behaviors and relationships in adolescent development  Resources

3  Adolescent 1 : phase between childhood and adulthood; physical changes of puberty  Sexual Health 2 : “state of physical, emotional, mental and social well-being in relation to sexuality…not merely the absence of disease, dysfunction or infirmity…requires a positive and respectful approach to sexuality and sexual of coercion, discrimination, and violence…sexual rights of all persons must be respected protected, and fulfilled”  Development: change over time; ecological view Healthy Adolescent Sexual Development 1.Steinberg L. Adolescence 9 th ed, 2010 2.Nat’l Strategy to Improve Sexual Health. JAMA 2010;304(9):1006-6

4 Adolescent Sexual Development: Biology  Puberty  Girl→Woman; Boy→Man  Reproduction  Internal and external changes  Central parts of the brain  Gonads make sex hormones  Ovaries: estrogen  Testicles: testosterone  Hormones cause changes of puberty

5 Adolescent Sexual Development: Biology  Estrogen: breast development; height; widening of the hips; body fat; menstrual cycles (balance of estrogen and progesterone).  Testosterone: growth of the penis, height, widening of the shoulders, deepening of the voice and facial hair.

6 Adolescent Sexual Development: Biology AAAAAAAAQH8/wUTsJIeYx1Q/s400/armpit+hair.jpg images/body-odor-blocker.jpg

7 Adolescent Sexual Development: Biology  Normal puberty  Begins: breast age 7-13; testicles age 11-15  Ends: girls age 12-16; boys age 14-20s  Females  Menstruation: 11-13 years of age  Irregular periods normal  Ovulation ► Pregnancy possible  Males  Nocturnal emissions (“wet dreams”)  Ejaculation ► Release of sperm

8 Adolescent Sexual Development: Psychological  Thinking: rational decision making, abstractions, consequences of behavior  Brain maturation 1  Disconnect between capacity and behavior  Alcohol and substances may further impair  Behavior Risk/Benefit Analysis 2  Potential risk may be overestimated  Potential benefits may be overestimated even more, especially in peer relationships  Social situations: realize influence of brain maturation and analyze benefits more closely 1.Steinberg L. Adolescent Brain Development….IOM/NAS 2.Reyna V. Psych Science Pub Int 2006;7:1-44

9 Adolescent Sexual Development: Psychological  Identity: sense of self, role in society to prepare for adult intimacy; experimentation and role play 1  Gender identity  Male or Female  Transgender: “trapped in the wrong body”  Sexual orientation (not a “preference”)  Heterosexual  Gay/Lesbian  Bisexual  Questioning  LGBTQ 1.McNeely and Blanchard. The Teen Years Explained. Johns Hopkins Center for Adolescent Health, 2010 “Sexual minority”

10 Adolescent Sexual Development: Socio-Cultural  Family, peers, social networks  Traditions  Neighborhood/neighbors  School  Faith Community  Youth-serving agencies

11 Adolescent Intimate/Romantic Relationships  Much time, emotional energy devoted to intimacy, romantic relationships; preparing for adulthood  10-14 year olds: preoccupied with romantic issues; mixed-gender groups  15-19 year olds: romantic relationships central to social life; vast majority have had at least one relationship, half “serious”; spend more time with partner than with family and friends  Open communication, high levels of trust, partner relatively close in age, emotional support  Sexual minority youth 1.McNeely and Blanchard. The Teen Years Explained. Johns Hopkins Center for Adolescent Health, 2010

12 Adolescent Sexual Development: Adult Communication  Parent-Adolescent: What, How, When, How Often ALL matter 1, 2 ; verbal and non-verbal  “Actions speak louder than words”  “Do as I say, not as I do”  Sexuality normal part of development  Openness, authenticity, mutual respect, trust and emotional support in context of human relationships (with self and with others) 1.Parent-Adolescent Communication about Sex in Latino Families: A Guide for Practitioners. ( 2.The Teen Years Explained. Johns Hopkins Center for Adolescent Health 2010

13 Adolescent Sexual Development: Common Behaviors  Masturbation 1  Alone in privacy, or in group (“circle jerk”)  Early same-sex exploratory behavior  Does not predict sexual orientation  “Practice…to see what it’s like…”  Genital touching 1  Sexual intercourse  Vaginal: onset delayed and more condom use 1, earlier more like to be forced 2  Oral, Anal: avoid pregnancy, maintain “virgin status” 1 1.Short MB, et al. Adolescent Sexual Development. In Textbook of Adolescent Health Care, American Academy of Pediatrics 2011

14 Average Age of Initiation of Sexual Intercourse in U.S. Facts on American Teens' Sexual and Reproductive Health January 2010

15 Healthy Adolescent Sexual Development 1. Ferber T & Pittman K. State Youth Policy: Helping All Youth to Grow Up Fully Prepared and Fully Engaged. (  Biological (puberty, reproduction)  Psychological (thinking and identity)  Socio-Cultural (multiple influences)  Positive Youth Development 1  Problem-free is not fully-prepared.  Shift the focus away from helping individual children and youth “beat the odds” toward a full-fledged commitment to change those odds.  Thinking differently is hard, acting differently is harder, acting together is harder still.  Strategy of risk reduction and promotion of protective factors

16 Advocates for Youth: Rights, Respect, Responsibility® Campaign  Youth have the right to accurate and complete sexual health information, confidential reproductive and sexual health services, and a secure stake in the future.  Youth deserve respect.  Society has the responsibility to provide young people with the tools they need to safeguard their sexual health…  Young people have the responsibility to protect their own emotional and physical health as well as that of their partners. Advocates for Youth. The Vision: Rights. Respect. Responsibility.

17 Resources 1 of 4  Sexuality Information and Education Council of the United States (SIECUS )  SexEd Library:  Advocates for Youth :  American Academy of Pediatrics, Promoting Healthy Sexual Development : -Promoting-Healthy-Sexual-Development.pdf -Promoting-Healthy-Sexual-Development.pdf

18 Resources 2 of 4  The Teen Years Explained  Webinar: JHU%20Webinar%20April%202010.wmv JHU%20Webinar%20April%202010.wmv  A Guide to Healthy Adolescent Development. Johns Hopkins University Press 2010 : Interactive%20Guide.pdf Interactive%20Guide.pdf  Global Lessons on Healthy Adolescent Sexual Development (2009 ):

19 Resources 3 of 4 Presentations ACT for Youth On-Line Training: Adolescent Identity Development: Adolescent Ethnic and Racial Identity Development: Family Planning 101: Five Promises: Addressing School Completion and Teen Pregnancy:

20 Resources 4 of 4 Publications ACT for Youth Publications New Vision for Adolescent Sexual and Reproductive Health Growing Up Transgender: Research and Theory Growing Up Transgender: Safety and Resilience

21 Was this presentation useful? Please give us your feedback: The ACT for Youth Center of Excellence connects positive youth development resources and research to practice in New York State and beyond. The Center provides:  Technical support, training, and evaluation for youth-serving programs funded by the NYS Department of Health.  Youth Development resources:, publications, training and events, and the e-letter ACT for Youth Update. Email to  A home base for the ACT Youth Network. Visit the network at 607-255-7736 http://www.actforyouth.net ACT for Youth Center of Excellence

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