Authors: Jane Fonda
When Is Talking to a Professional Confidential?
If you think you cannot discuss these issues with your parents, some states allow teens to discuss contraception, adoption, or abortion with a doctor confidentially. Your health information is generally considered “privileged” and “protected,” based on federal law.
Still, it is important for you to understand what doctors and mental health professionals cannot keep private.
When Is It Not Confidential?
First of all, professionals can never keep it a secret if a person under eighteen is being abused in any way. If the pregnancy is the result of statutory rape or incest, the physician must report it to the authorities because the law has been violated. Statutory rape is when an older boy or man has sex with a young woman who is not legally able to give consent. The age at which you can give consent varies from one state to another.
Whether you are old enough to see a doctor by yourself depends on the laws in your state. Many states allow minors to consent to their own medical care as it relates to reproductive health and birth control. In most states, if you are seeking birth control, you are considered an “emancipated minor” and allowed to give consent for your own care. Your own doctor should be able to provide this care for you, but some doctors refer teenagers to family planning clinics, like Planned Parenthood, for their reproductive health care. However, your ability to independently fill prescriptions or get medical procedures (including abortions) varies from state to state. If you are not sure about what medical care you need, and talking to your parents about it is not an option, you can call a doctor’s office without giving your name and ask about options for someone your age. You could also call the hotline at Planned Parenthood (1–800–230–PLAN) for advice.
Planned Parenthood has clinics all over the country for males and females. Their services are low-cost and sometimes free.
Resources
• Planned Parenthood: 434 West 33rd Street, New York, NY 10001 1–800–230–PLAN
www.plannedparenthood.org
• Go Ask Alice!: A question-and-answer website affiliated with Columbia University
www.goaskalice.columbia.edu
• National Council for Adoption: 225 N. Washington Street, Arington, VA 22314; 1–703–299–6633
www.adoptioncouncil.org
• National Adoption Information Clearinghouse: P.O. Box 1182, Washington, D.C. 20013; 1–703–352–3488 or 1–888–251–0075
www.adoption.org
• Adoption Institute
www.adoptioninstitute.org/research/domesticadoption.php
• Sex in the States, from Sex, Etc.: This website for teens provides state-by-state information about rights to sex education, birth control, access to abortion, and more.
www.sexetc.org/state
14.
Sexually Transmitted Infections
How Do You Get an STI?
Any act of sex (oral, anal, vaginal) can lead to a sexually transmitted infection (STI or STD) for either partner.
How are you going to keep each other safe? Using condoms every time is the most effective way to prevent STIs. As I have said before, if you or your partner have been sexually active already, you will need to get tested. Do not accept anyone’s word that he or she is free of an STI.
Some STIs are inconvenient and curable; others are painful and permanent. By choosing to have sex, you and your partner are linking yourselves together. You are linking together your health. People in caring relationships make certain that they keep their partners safe and healthy.
Some Basic Facts About STIs
• STIs vary. Some are serious diseases that can cause infertility in adults and birth defects in babies. Some STIs can lead to chronic health problems.
• Some STIs are curable, but others aren’t.
• You can get the same STIs over and over again.
• Some STIs can be passed from a pregnant female to her baby during birth or afterward through her breast milk.
• Sometimes STIs don’t cause symptoms, or one STI can cause the same symptoms as another one, or they can be mistaken for flu symptoms. A doctor’s test can find out for sure.
• You can get or give STIs through oral, anal, and vaginal sex.
• You can get STIs not only from sexual contact with an infected person, but also by touching his or her sores, blisters, bumps, warts, mucous membranes, or skin.
• People also pass on some STIs by sharing infected drug needles or syringes, tattoo needles, body-piercing needles or jewelry, razors, manicure or pedicure instruments—any type of instrument that can cut, scrape, or enter the body.
What If You Contract an STI?
Most STIs don’t cause symptoms, meaning that anyone can have them and not know. This also means that people with STIs look just the same as people without STIs. If you are having a symptom (pain, fever, genital sores or bumps, vaginal discharge, penile discharge, or pain with peeing), see a doctor and take your partner with you. If you have an STD, it is your job to make sure your partner is safe, too.
You should be tested once a year, or any time you begin a relationship with a new partner. Testing for the most common STIs is as simple as giving a urine specimen in a cup.
The Most Common STIs
STIs can be caused by bacteria or viruses. In general, bacterial infections can be treated and cured with antibiotics, while viral infections cannot be and can turn into chronic conditions that require ongoing care.
Bacterial Infections
Chlamydia:
Chlamydia is by far the most common and occurs in high rates in teenagers. You may have no symptoms at all or it may cause vaginal bleeding when you do not have a period, increased vaginal discharge, pain or burning with urination, or a discharge from the penis in boys or men. Repeated infections with chlamydia can affect your fertility in the future.
It is curable with antibiotics. After treatment most doctors will have you come back for “test of cure” to be sure you are free of chlamydia. It is important that your partner is treated at the same time, or you will become re-infected. As with all STIs the best way to prevent chlamydia is to use condoms.
Gonorrhea:
Gonorrhea may cause a green or brown discharge, vaginal bleeding, pain deep in the pelvis, or no symptoms at all. It can infect other parts of the body through the bloodstream, like your joints. Oral sex with a partner infected with gonorrhea can cause a throat infection with gonorrhea. Gonorrhea can be passed on to an infant during the birth process, so all pregnant women are screened for gonorrhea during pregnancy. It is treatable with antibiotics. You and your partner should be treated at the same time. Antibiotics such as penicillin G, ceftriaxone, and doxycycline are preferred treatments.
Syphilis:
Syphilis is the most serious and dangerous of the bacterial STIs. Early symptoms, lasting six to ten weeks, can include severe pain, a painless sore called a
chancre
1
and enlarged lymph nodes close to the chancre. The illness can then have a latent period, where no symptoms are observed. During the second phase of the infection, symptoms include a rash. In the last phase of the illness, the infection attacks the nervous system and other organs. Although rare, this can lead to incurable mental illness, paralysis, and severe pain.
Syphilis is curable with antibiotics such as penicillin. Safe-sex practices are helpful for reducing the odds of transmission, but the disease can still be passed through mucous membranes or chancres during touching and foreplay.
Viral Infections
Although they can be treated to help relieve the symptoms, viral STIs are not curable.
Human Papillomavirus (HPV)
(also called genital warts):
Causes very contagious warts outside or inside the genitals and in the throat. The warts are most dangerous on a female’s cervix because they can cause cervical cancer. A vaccine to prevent HPV, approved in 2006, is now widely available for both boys and girls. It requires three shots over the course of about six months, and is extremely effective in preventing genital warts.
Hepatitis:
The viral types of hepatitis, A, B, and C, can be passed on through sexual contact, are very contagious, and can cause liver cancer and death. You can get hepatitis A also from food and water, and types B and C from syringes and needles. Types A and B can be prevented by vaccination, but there’s no vaccine for type C. You have most likely received a vaccine against hepatitis B, which has been given to all infants in the United States for over twenty years.
Hepatitis B is transmitted most commonly through sexual contact. It is more contagious than HIV/AIDS because it can be passed along in saliva through kissing or sharing
toothbrushes. It can result in a yellowing of the skin and eyes, accompanied by fever and/or nausea. Often there are no observable symptoms.
Herpes Simplex Virus (HSV):
HSV is very common because in most people it causes mild or no symptoms, so they don’t know that they have it and can pass it on. In other people, herpes causes repeated outbreaks of tiny, painful blisters at times of physical and emotional stress. These break open and release fluid that’s very contagious when touched. Herpes blisters can appear on the face (even in the eyes or mouth) or anywhere else on the body, including on or inside the genitals. The sores can be treated with medicine to make the virus retreat inside the body so that they heal faster, but there’s no cure, and the virus can become active again. Typically, cold sores around the mouth are associated with HSV-1 and genital outbreaks are associated with HSV-2.
If you become pregnant, it is very important to let your medical provider know if you have been infected with HSV, because the risk to a newborn is very serious. If a woman has active blisters at the time of delivery, the baby will be delivered by cesarean section to prevent infection in the baby.
Human Immunodeficiency Virus (HIV):
The fastest growing group of people infected with HIV, the virus that causes AIDS, are young people aged fifteen to twenty-four.
Human immunodeficiency virus (HIV) causes
acquired immunodeficiency syndrome
(AIDS). People can be
HIV-positive
—infected with the virus—for more than ten years
before any symptoms appear and they learn that they can give it to others. By taking special combinations of medicines, people can maintain a healthy life without it developing into AIDS.
If you are HIV positive, you will need to have a long-term relationship with a doctor who specializes in HIV. You will take daily medicines and have your blood checked periodically. Many HIV-positive people now live very long lives, with the virus not even detectable in their blood as long as they take their medicines.
AIDS:
AIDS is the most dangerous STI because it destroys the body’s ability to protect itself against infections. This is why AIDS causes so many different symptoms as the people who have it become extremely sick and die.
Because AIDS is deadly, people worry about whether they can get it just from being around HIV-positive people or from touching them or something that they touched. But HIV is not passed along by casual contact. HIV is transmitted
only
through infected body fluids and instruments that have become contaminated with them.
This is how you can contract HIV:
• from infected semen or vaginal fluid that enters your body during unprotected vaginal, oral, or anal intercourse. The fragile membranes in the vagina, mouth, and rectum can absorb the virus and do so more quickly if irritated or torn during intercourse.
• from infected blood that gets into your bloodstream through a skin opening, your mucous
membranes, or your eyes, or on an instrument that can pierce or cut the skin
• from breast milk from an HIV-positive female
• HIV can also be passed from a pregnant female to her baby during birth, unless she takes medicines to prevent it. For this reason all pregnant women are screened for HIV during pregnancy and are treated with medicine if they are positive.
Scientists first became aware of AIDS in the 1980s, when many gay men began developing the illness. This caused AIDS to become associated with homosexuality even though anybody can contract HIV.
1
chancre (
shan
-ker)
15.
Sexual Abuse
Experiencing sexual abuse of any kind affects your self-esteem, your ability to trust and to have successful relationships, your behavior, and how you feel about your body. It can affect your very identity!
It’s important for you to understand what sexual abuse is and, if you have been a victim or know someone who has been a victim, what you can do about it. Both boys and girls can experience sexual abuse and unwanted sexual touching. One in four girls and one in six boys are victims. And 90 percent are victimized by someone the family knows and trusts.
What Is Sexual Abuse?
Sexual abuse is forcing you into any kind of unwanted sexual activity. This includes someone touching you sexually, showing you his or her genitals, showing you sexual pictures, or doing anything else sexual. Sexual abuse is against the law, and nobody—
nobody
—has the right ever to do it.
You can be sexually abused in all kinds of ways, all of which are illegal, even if it happens one time.
If You Are Sexually Abused
If you yourself have been a victim of sexual abuse, you probably know how hard it is to talk about what happened. But it is really important to talk about it, especially with an adult who is compassionate, understanding, and will believe you. There are people specially trained to help you if you’re being or have been abused. Breaking the wall of silence and telling someone is the first step to healing … provided they believe you.