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Sexual Health

10/16/2017

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I recognize that I've neglected your page for awhile but I wanted to make sure I found the best sites I could for this topic so you can come to this entry at any time and find links to reliable sources. I'm certain that I am providing you with links to sites that will be able to answer any questions you can imagine related to sex.
Picture
Sexual health is an incredibly important topic and one some adults avoid discussing. I'm going to share trusted links ​to try to help you navigate this topic in case you are a teen being given little, inappropriate, or inaccurate information. I'm very aware that different families and cultures have their views on when you should become sexually active. I'm not here to insert my values. Understand that I have taught teens long enough to know that lacking information can lead to unhealthy risk-taking. Relying on peers or older students often lends to taking on misinformation as fact. My goal is that you are informed and you decide when the time is right for you based on your values. When the time is right, I want you to stay healthy: physically, intellectually, emotionally, and socially. I want you to respect that not everyone shares your values and what works for you might not feel right for someone else. So, let's get started.
​The World Health Organization (2016) defines sexual health as
 "a state of physical, mental and social well-being in relation to sexuality. It requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence."
I love this poster from ACT Youth. Before you even think you are ready for a sexual relationship, can you say that you have what it takes to be sexually healthy?

​Act responsibly according to values

​Values are your judgment of what is important in life. Have you given much thought to what your values are? You will find that once you have a clear idea of your core values (use the sort cards activity below as a starting point), choosing to make decisions with your values in mind means you will tend to feel much better about the decisions. 
One struggle you might face is when you find that your values do not fully align with the values of others. For instance, someone might comment that the LGBTQ community are all sinners and you are quite open to the LGBTQ community or one group of friends values waiting until marriage for sex and another group is open to having different sexual experiences before marriage. Obviously your parents and other role models are trying to instill values in you that they find important. If your parents are not particularly fond of someone you are dating, give some thought to how that person's values align with your parents' values. Be clear on your values and understand that values are not set in stone. Your values might adjust with your life experiences. Take time to try this quick activity to determine which values are most important to you. 

​Value sort cards - The Good Project

​Forming and maintaining healthy relationships

​In the last blog, I shared about the importance of being able to have healthy friendships. Before you consider dating or sex, you should feel confident about yourself and you should have healthy friendship groups. You might want to quickly review the information I shared.
Most of us learn how to be in relationships from our parents and other couples close to our family or from what we see in the media. Here are some links you can look at to help you decide if the relationships around you are healthy. Take the lists they provide and look at some music videos, TV shows and movies. Evaluate these couples and those you have in your close family circle.

Building confidence and self-esteem - Psychology Today
Steps to improve self-esteem - Reach Out
​​Lists of healthy and unhealthy behaviors - Teen Health
5 components of healthy relationships - Planned Parenthood
Quiz to determine if relationship is healthy - Love Is Respect
Quiz to determine if you are a good partner - Love Is Respect
​Healthy relationships quiz - Mensline
If you are concerned about being in an unhealthy relationship or have a friend in one, find a trusted adult to talk to about the situation.

Able to set appropriate boundaries

When you are in a healthy relationship, you should be able to communicate your boundaries clearly without the fear of the other person reacting negatively. For those of you who are just starting to hang out with someone you like, talk about whether or not you are comfortable with:
  • remaining friends or "going out"/ "dating"
  • hanging out in a small group or as a pair at school
  • meeting outside of school in public spaces in a small group or as a pair
  • posting your relationship on social networking for all friends to see, a select few, or none
  • flirting with each other, holding hands, peck on the cheek, quick kiss on the lips, french kissing, none of these
  • communicating your feelings openly with each other.
I would suggest that you also lay out the boundaries for how much time you will spend together in school, online, and outside of school and how much time you want to have with family and friends. Controlling people demand non-stop attention. A healthy relationship means a balance of time together and time apart. If your relationship progresses, revisit your boundaries.
If you have reached a level of maturity where you are mutually and respectfully wanting to take your relationship to the next level of being physically intimate, refer to this sex readiness checklist to determine if you truly are ready.

4 signs you are about to have sex for the wrong reason - Stay Teen
If you decide you are ready, that means you should be willing to use and discuss one of the following checklists to help you determine your boundaries for sexual activity:
teenhealthsource sexual inventory checklist
Yes, no, maybe checklist - very detailed for mature couples - Scarlateen
Have these discussions before you find yourself in the heat of a moment and be sure to re-visit your boundaries regularly. If you look at the inventories and do not understand the terms, the sites have vocabulary sections and/or search options.
Here are a few quick reads that might add to your understanding of setting boundaries:

sex,etc
loveisrespect

Understanding consent

Please make sure you understand the meaning of consent, which is actively agreeing to be sexual with someone. Under no circumstances should you assume what someone wants to do, nor should you assume because you've tried something once with a partner that you can do the same thing again. Be clear about asking for consent as a way of showing your maturity and mutual respect for your partner. Always remember that different people have different values and comfort levels.
Sexual consent - Planned Parenthood
Saying no is no problem - Stay Teen
Intimate ways to ask a partner about sex - Go Ask Alice
Why consent matters - MTV: It's Your (Sex) Life

Comfortable with and knowledgeable about my body 

Take time to learn about your body. You learn about the reproductive system of males and females at school but you should also learn about sexual anatomy. When the time is right for you to be sexually active, you want to enjoy the experience, right? 
​Basics of female reproductive system - as taught to 11-13 year olds - Teen Health
Basics of male reproductive system - as taught to 11-13 year olds - Teen Health
​Male and female reproductive anatomy worksheets - labeled and unlabeled by Manitoba Education and Training
Once you understand the reproductive system, it's helpful to understand anatomy related to sexual pleasure.
Sexual and reproductive anatomy - Planned Parenthood
For those who are ready to have a detailed explanation of sexual anatomy - Scarleteen
Sexual response cycle - Medicinenet
In every sex ed course I've taught, teens have asked about masturbation. These links provide basic information and some common myths. Masturbation is one way that people can learn about their bodies.
Information on masturbation - Teen Health Source
Masturbation and myths - Sex,etc
What exactly is sexual intercourse? What does it mean when people say anal or oral sex? What does (insert slang sexual term) mean?
Sex terms from a-z, including slang - Sex,etc
Sex terms from a-z, including slang - Teen Health Source
​What is sex? - Scarlateen
There are a lot of myths about how pregnancy occurs.
Can a girl get pregnant if..? - Stay Teen
Other common questions are what are orgasms and do women have orgasms? 
What are orgasms? - Sex,etc
For those with a variety of questions about orgasms - Go Ask Alice of Columbia University
Are male and female orgasms different? - Go Ask Alice
The science of women's pleasure - OMGYes

Understand about sexuality

What is sexuality?
Sexuality - Options for Sexual Health
Detailed explanation of sexuality - Scarleteen
Sex, gender, and orientation - Bedsider

Recognize risks involved and ways to reduce them

Abstinence is the only way to prevent pregnancy and STIs 100%. If you choose to have sex and are not interested in pregnancy or an STI, you need to make sure you are very clear on how to do your best to prevent both.
What are STIs?

What is an STI - New Zealand Family Planning
STI prevention - Healthy Children
STI symptoms - Mayo Clinic
Video on preventing STIs - Planned Parenthood
What types of birth control are available?
Birth control options - Stay Teen
Birth control methods - Bedsider
Birth control explorer - Stay Teen
Relative birth control effectiveness - Options for Sexual Health
​Possibility of pregnancy or STI? - Scarleteen - shows levels of risk
Sexual behaviors and risks - Act For Youth

Know how to access and use health care services 

 Please ensure that you are talking openly with your family doctor, gynecologist, school nurse, or health clinic professionals about your sexual well-being. There is nothing that you can discuss with these individuals that they have not heard or read about during their training or practice. Trust me!
Screening tests by Options for Sexual Health
Want birth control but scared of visiting doctor - Go Ask Alice
What happens at an appointment (male and female) - Teen Health Source
First visit to gynecologist - Scarlateen
Dealing with doctors: Taking care of your healthcare destiny - Scarlateen

Resources I chose 


There are endless resources on the topics I've shared in this entry. I have selected a few that I wanted you to revisit a few times so you could get a feel for those that appeal to you. I'm going to list them separately here so you can quickly visit each and determine which are most appropriate for you.
actforyouth.net 
optionsforsexualhealth.org 
plannedparenthood.org
stayteen.org
goaskalice.columbia.edu
​MTVitsyoursexlife.com
​​sexetc.org
loveisrespect.org
teenhealthsource.com
kidshealth.org/en/teens

​More mature readers:
bedsider.org
scarlateen.com
OMGYes.com
Additional Resources for parents and teachers:
Parent info on teens and dating by Raising Children
Research paper for parents on Puberty and Adolescent Sexuality by Fortenberry,MD,MS
Information for parents about masturbation by Healthy Children
LGBTQ by Healthy Children
Links to Sexual Orientation and Gender Identity by American Psychological Association
Research on teen pregnancies, abortions, HIV/STIs, and contraception use by Guttmacher
Article on the Dutch approach to sex ed by PBS
Information for men on relationships and well-being by Mensline in Australia
Tips for talking to teens about dating and relationships by Good Therapy
How to make healthy decisions about sex for teens by Healthy Children
Any question you could possibly think of about sexual and reproductive health by Go Ask Alice of Columbia University
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Sexual Education - Relationships

5/26/2016

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Daily I see young adults in schools trying to figure out how to have healthy friendships and relationships. For some these relationships seems to come easily and for others there is a genuine struggle.I'd like to steer you in the direction of making all types of relationships easier for you so I'm going to share what I see in the teen relationships that are healthy. I will also be pointing out red flags I see that tell me a person is in an unhealthy situation which can often mean there is emotional or physical abuse. 

Friendships

First, it's helpful to know that there are a few types of friendships.
4 types of friendships:
  • Acquaintances - Peers you see often but do not necessarily share personal information with
  • Casual - Share some information but very cautiously 
  • Agenic - Develop strong bonds and share common goals, like winning games or pulling off a theatrical performance
  • True - Express real emotions, trust and relate openly with each other, are supportive and empathic, forgive, are reliable, and want the best for each other (O'Grady)
In school you will likely have each type of friendship mentioned above. Learning to collaborate with casual friends and acquaintances is important preparation for the real world. Don't underestimate the importance of agenic friends who are with you and encouraging you through tough challenges. All are important but clearly there is nothing like finding a true friend or two. 
Picture(Gibbons)
Establishing healthy friendships is key when you are trying to navigate challenges of school, family life, extracurricular activities, and more. You might notice that the people you have as friends changes as you mature, but what should you experience in your friendships to reassure you that the friendship is a genuine and balanced one? How do you go about making friends, especially if you are shy? One thing I would suggest is that you closely observe and mimic the peers who have close friendships (notice I did not emphasize peers who are most popular). What you will notice is that true friends tend to behave in certain ways with one another. True friends:
  • ask questions like, "How was your weekend?" or "Did you enjoy the movie you went to see last night?" Not only do they ask questions showing interest, they genuinely care to hear the answers.
  • smile and laugh when they are around each other. True friends do not cause unnecessary stress and drama, nor do they drain a friend's batteries with their negativity. 
  • appreciate having other friend groups. Possessiveness can be a sign of an abusive relationship. 
  • give each other space. Sure, they might prefer being around each other but when they are not, they do not incessantly text, call, and check up on each other. They do not try to make others feel guilty.
  • notice a struggling friend and help find the right support. Friends know when the support needed is beyond their capabilities.
  • share interests and encourage each other to try healthy, new activities. If the new activity doesn't go well, they are the first to congratulate a friend for taking a risk. True friends do not pressure each other to take unhealthy risks.
  • don't seek information so they can share the information with others. People who gossip are lacking maturity and trust me, this maturity to keep information confidential does not necessarily come with age. When someone gossips a great deal, they are proving incapable of keeping people's private information confidential. If someone gossips about others incessantly, don't think they will treat you differently.
  • are aware when a friend is not balanced. "Hey, you look like you haven't slept in three days, do you need to talk? I'm worried about you?"
  • allow each other to express their uniqueness. Better yet, they encourage each other to show their true colors.
  • pick each other up during tough times. 
  • treat other friend groups with respect. They don't bully others because they are secure with their self and in their own group.
  • understand that people make mistakes, learn from them, apologize, and move on.
What else do you notice about true friends? How can you learn from them? Is there a safe group of true or agenic friends for you to approach if you are struggling to make friends? 

Problem Zone

At times you might find that a friendship has taken a turn and maybe your other friends or your family suggest that you need to re-evaluate the relationship. Something in your gut probably tells you they are right but it's not always easy to end a friendship. The video by Watchwellcast gives pointers for how you can spot and end a toxic friendship.

Dating

Picture(Tomak)
 Okay, here is a trickier topic because giving advice on this topic can really vary based on cultural backgrounds. I will start by saying that your parents have likely laid out values for you and have determined when or if you are allowed to date. What does dating even mean at the various ages? Again, this can vary greatly from family to family or culture to culture. 
Before considering dating, I would start by saying that I think you should check that you are:
  • able to manage strong friendships.
  • confident and assertive.
  • involved in many activities you enjoy.
  • able to communicate clearly and effectively.
  • clear in what you want in a dating relationship.
When you have a person in mind you would like to date, check that they tick the points above, as well. Why is this important? If a person you like doesn't have their own activities, you could easily become the focus of all of this person's attention. That might sound appealing but in a short time it might feel very overwhelming, as you might find this person insisting on your full attention at all times. If you are not assertive or able to communicate clearly, you could have difficulty setting boundaries and sticking to them. If the other person doesn't have solid friend groups, you might find this person not liking you hanging out with your friends. Think about an unhealthy relationship you've seen, I guarantee you that you will be able to notice  some of the strengths above are lacking.

Keep it simple

If you do decide to start dating, keep it simple. Meet each other in mixed sex groups of friends who are and are not dating. When you hang out in this arrangement, you can have fun and there isn't a constant pressure of what you should be doing. One of the things I truly like about international schools is that there seems to be far less pressure to date and more appreciation for hanging out in friend groups. Sure, some of the people from upper grades in the group might be dating but they're interacting with everyone in the group, not smothering each other nor isolating themselves. Group members seem to raise red flags of concern if a couple is being too clingy with one another. Typically this type of arrangement lets everyone in the group grow into their own person and develop their own sense of self worth and identity. I see far fewer abusive relationships with students who hang out in groups.
If you do decide as an older student to get more serious, I like to look at Sternberg Triangles as means of teaching you to figure out what you want in a loving relationship and how to set boundaries.

Sternberg Triangles

Picture
(Sternberg Triangle Theory of Love)
Picture(Zoe)
Think about relationships you see in your every day life, including those you see in movies or on TV. Try to determine which type of relationship the couples have based on the triangles above. First, let's explain the three components of relationships:
Intimacy - feeling of closeness, affection, warmth, familiarity, close attachment
Passion - powerful feeling of sexual attraction, intense desire
Commitment- dedicated, devoted, loyal
If we look at consumate love, you can see this type of couple would have intimacy, commitment, and passion; whereas, couples with infatuation only have passion. Spend some time looking at each type of relationship. Do you recognize each type of couple in the people you know?
The clip below is one that many of us adore. Ellie and Carl started out as good friends and their relationship grew into consumate love. Notice, though, that when they hit hard times, often the passion was likely missing but the commitment and intimacy never wavered. At those times, they had companionate love. 
The idea here is not to judge relationships but more to help you understand that at different points of people's lives, different relationships might be more appealing. Maybe someone who was married ten years and is getting a divorce does not want a commitment but wants passion and intimacy. You might hear a university aged student say she doesn't want commitment or intimacy but wants passion. Again, some cultures would see the value in each type of relationship while others would not. Some insist on nonlove until marriage; you know your values.
In a relationship, it's important to set clear boundaries with the person you like. Here is where communication and assertiveness come into play. For example, "We're in 8th grade so I want you to know that I'm happy to hang out in groups and hold your hand but that's as far as this is going to go." An older student might say, "I'm very clear in where I want to go in my future so I need you to understand that at this point I'm not interested in a sexual relationship." Or, "I know you want to take the next step but I need time to think about that. Please don't pressure me about this until I have time to make a good decision for me." Perhaps another example, "I can't believe you asked me to send you a sext. I find that very disrespectful so don't ask me again." Something tells me this fifth grader, Zoe, has the assertive communication piece in place. 

(Pixar)
In the next blog, I'll talk about sex. Take time between now and then to learn about the different types of relationships and start having discussions with your parents about their hopes for you in terms of relationships. Remember that you have a lot of time for serious relationships. Your teen years should be about having fun with friends and building your interests and confidence. Any serious relationships should also be friendships that do not hold you back.

Resources you, your  parents, and teachers should explore

Check where your dating relationship falls on the spectrum
Quizzes on healthy relationships, being a good partner, knowing if abusers can change, and helping the abused
John Hopkins - The Teen Years Explained (excellent guide for young adults, parents, and teachers)
Educator toolkits for helping middle school and high school teens establish healthy relationships
Parent tips for when teens should date
Relationships 101 - basics for dating relationships
Helping a child with a toxic friendships
Social media and teen relationships by Pew Research Center - US based data but good info
5th Grader Relationship Rules and Regulations. Zoe tells Noah how it is. Daily Mail, 21 Sept. 2016, http://www.dailymail.co.uk/femail/article-3799486/Sassy-fifth-grader-s-note-boy-class-goes-viral.html. Accessed 2 Nov. 2016.
Leitch, Heather, and Monica 9. “Teens & the Relationship ABCs.” Sutter Health, 2015, http://www.pamf.org/teen/abc/types/friends.html. Accessed 11 Sept. 2016.
O’Grady PhD, Patty. “Friendship: The Key to Happiness.” Psychology Today, Psychology Today, 1991, https://www.psychologytoday.com/blog/positive-psychology-in-the-classroom/201210/friendship-the-key-happiness. Accessed 11 Sept. 2016.
Sternberg Triangle Theory of Love. Looking at intimacy, passion, and commitment in relationships. 3 Jan. 2009, http://www.drgaramoni.com/blog_living_your_whole_life_well_files/triangle.gif. Accessed 28 Oct. 2016.
watchwellcast. “Toxic People: How to End a Bad Relationship.” YouTube, 4 May 2013, https://www.youtube.com/watch?v=wPwck0EQkgs. Accessed 11 Sept. 2016.
xXJEashXx, pixar. “Favorite Pixar’s up Scene Ever - Ellie and Carl’s Relationship Through Time, Sad Scene.”YouTube, 22 Mar. 2010, https://www.youtube.com/watch?v=F2bk_9T482g. Accessed 30 Oct. 2016.
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Sexual Education - Puberty

5/23/2016

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Puberty is a word that can make you feel awkward and excited at the same time. You and your peers are going through changes and you might find that you are not discussing these changes very openly with one another. There is no need to be secretive about a subject everyone experiences. As you are about to learn, the changes are quite amazing. Don't be afraid to talk about puberty with your parents, teachers, or classmates. Remember, if you have a question, there is a very good chance that it's something other peers are curious about as well.
​I'm going to share with you about the changes both boys and girls go through on this same page. Last I looked, we don't live in same sex colonies. You need to have a clear understanding of what all of your peers are going through.

Changes in
​girls only

  • usually starts between 9-13 years old
  • reach full height by 18
  • ​breasts develop (different rates)
  • ​nipples enlarge and can change color
  • wider hips​
  • ​body fat shifts to breasts, pelvis, upper back
  • vaginal discharge happens - white or yellow stains in underwear (keeps vagina clean and moist)
  • menstruation/period starts about 2 - 2 1/2 years after puberty starts

​
Once breast development starts, you might want to talk to your mom or a trusted adult about taking you shopping for bras. You should try to be active in sports throughout puberty. There are special bras for doing sports, which offer more support.

Changes in both
​boys and girls​

  • Brain triggers sex hormones
  • Body hair -armpits, legs, pubic region
  • acne/zits- 85-90% of people get them (often worse for boys)
  • bone growth causes increase in height
  • skin more oily
  • sweat more
  • sex drive stimulated
  • might masturbate in private
  • emotions seem harder to control
  • organs increase in size
  • extra hormones may cause bad breath
  • improved abstract thinking, planning, and goal setting​
  • have to be careful of reckless behavior

Changes in
​boys only

  • usually begins between 10-14 years old
  • Swelling in chest during first year
  • increase in testicle size
  • growth of penis and scrotum
  • semen can be released during erections
  • chest and facial hair
  • shoulders broaden
  • reach full height by early 20s
  • vocal cords get thicker and longer and larynx gets bigger = deeper voice
  • muscles get bigger
  • body fat increases
  • produce sperm (increases as puberty progresses)
  • appetite increases dramatically
When you start participating in contact sports, you need to invest in a cup/box to protect your genitalia. Talk to your dad or coach about where to purchase and how to wear a cup.

Hygiene

During puberty everyone starts to get oilier skin, sweats more, and even experiences bad breath. Suddenly, you might find your parents nagging you more about getting a shower or a bath. Peers at school might  joke about each other smelling and teachers sometimes feel like they are going to pass out in a room full of teens right after recess ends. You need to be aware of the fact that no one enjoys being around someone that doesn't smell pleasant.
What can you do? 
- Shower daily, especially after you do sports
- Avoid any special products for washing your genital area - soap and water is all you need
- Use deodorant with antiperspirant (using body sprays or perfumes just add another scent to your odor)
- Brush several times a day, floss, and get regular dental check-ups

Why do I feel like an emotional mess?

You might reach a point where you feel like you don't have much control of your emotions. A common phrase you might hear adults say is "He's going through puberty so his hormones are out of control. He's an emotional wreck; angry one minute and laughing uncontrollably the next." Hormones play a part in why you feel like you suddenly have mood swings but there are other factors, as well.
​Factors that can affect your mood:
  • Lack of sleep - need at least 8-10 hours but have the urge to stay up late
  • Brain not fully developed until early 20s -tend to be impulsive without thinking about consequences
  • Lack ability to label own emotions and accurately read adults' emotions
  • Want to be independent but still need parental support
  • Empathy is developing so peers are not always caring
  • Relationship issues 
  • Trying to figure out your identity - Who am I?
  • Facing struggles in academics or activities
  • Not knowing how to approach someone you like
  • ​Puberty challenges
  • Mental health issues 
  • Hungry or thirsty
It's important for you to learn to express your feelings and to ask others what they are actually feeling, since you will not always be able to judge accurately. This page has several charts of emotion words and ideas for how to practice labeling your emotions. 
Link to blank faces coloring page
There is a great deal to learn while studying puberty. Below I'm including links to reliable resources that you can revisit at any time.

Resources for you to check out

KidsHealth puberty
​Puberty for boys
Puberty for girls
​Puberty, menstruation, and hygiene
WebMD boys puberty quiz
WebMD girls puberty quiz
WebMD puberty directory
Female anatomy
​Male anatomy
​​​Dealing with acne
Periods
Tampons, pads, cups
Parent sex ed center
Teacher's guide on puberty for boys with puzzles and worksheets to check your knowledge
Teacher's guide on puberty for girls with puzzles and worksheets to check your knowledge
Activities you can try to learn about your emotions 
Interactive bodies that show changes for males and females
All resources used to create this blog are linked.
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    I like to share brief, researched tips to help young people lead a balanced life. Typically I send tips via emails to expat teachers or students where I work.  I've decided to share to a larger audience. While some parts of my blogs will clearly be geared toward expat young adults, many shared ideas will be generic tips that apply to anyone.

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