Vol. XXVI, No. 8 March 2004

March 2004

Happy International Women’s Month!

Oral Sex and Youth – what’s going on?

Lyba Spring, Sexual Health Educator

Toronto Public Health

The media have been full of articles looking at the “trend” amongst adolescents, especially for girls in grade 7 & 8, of performing oral sex on young males. Sexual Health Educators have been interviewed in droves by print, radio and television media in an attempt to both clarify and do a reality check on some of the more sensational stories.

Kim Martyn, works for Toronto Public Health and is also the author of “All the Way – Sex for the First Time” published by Sumach Press. She recently wrote to her colleagues:

“Contrary to the impression generated by the recent media reports, not all girls 12 to 14 years old are performing oral sex in school washrooms and at parties. To begin with, the available statistics on oral sex do not specify whether they have engaged in this activity within the context of a relationship. Here is what we know according to the Canada Youth, Sexual Health and HIV/AIDS Study, published in 2003. Although the researchers did not ask grade seven students if they had had oral sex, they gave them the option of adding “other” sexual activities. Oral sex was then self-reported at 1%. By grade 9 the percentage (of oral sex at least once) for girls was 28%, and 32% for boys. It is safe to assume that for students in grades 7 and 8, the rates would be somewhere between 1% and 30%.”

It was an article in the Globe and Mail (February 7, 2004), which touched off the media frenzy. Martyn says, “Much of the current media hype is based on US media and incidents. The Globe article was almost totally based on girls’ private school students, a very specific population.”

For people working in the sexual health field, there is general agreement that within relationships, over the past 20 years, oral sex has become more a part of people’s sexual repertoire. The extent of this sexual activity in young teenagers’ “casual” relationships is not known. According to Martyn, “the examples cited on talk shows and in news articles should not be generalised to the whole population”.

That said, anecdotal information inevitably comes our way.

Recently, a colleague told me that her son was greeted on the first day of high school by a girl who offered him oral sex by way of introduction.

Even as I was typing this article, a parent called me with the following story. Her 13 year old was recently on a trip with the family. The girl and her friend hooked up with some 17 year olds. They ended having oral sex; i.e., fellatio. When the mother found out, she pursued a number of avenues. One was legal. Given the age difference and the fact that the boys had given them alcohol, the police are now involved. The second avenue was to talk with her daughter about the concept of servicing boys in this way. She asked if she had enjoyed it and how she felt about it. Quite a progressive parent. She knew that her daughter had only kissed a boy once before: this was a quantum leap. The daughter reported that oral sex is “common” amongst her friends. Moreover, it is considered a kind of notch in one’s belt. The girls who “do” are the queens of the school.

So the mother’s third avenue was to call me to see if I could do some programming in the school and raise the gender issue. We don’t even know, although we assume it to be true, that oral sex is referring only to fellatio. We can only speculate for this age group about the gender dynamics involved.

Are girls and young women getting tit for tat? Do girls feel pressure to give their boyfriends oral sex? Do they really get points from their peers – both male and female – of they do it? Usually, when grade eight students are asked if there is a gender difference when it comes to sexual activity, they say the girls who are known to be party girls are sluts and the boys are players. The latter is considered to be the more positive designation.

I suggested to the 13 year old’s mother that the school Parent Council might want to have someone come and talk with them as I had recently done in a local high school. That principal subsequently invited me to speak with the teaching staff to see how we might collaborate in the future on sexuality education. Many students drop physical education after grade nine and then have no formal sexuality education during those crucial decision-making years.

One of the oral sex articles included a discussion of the role of sex education in schools. Martyn expressed annoyance at the assumption that when students ask about something it means they are involved in it. “Some of the recent articles cite students in grades 5 to 7 asking specific questions about oral sex. This is nothing new; nor is it surprising, given the frequency with which ‘going down’ is mentioned in pop media these days, “ Martyn says.

I recently participated in a panel discussion for TVO called Vox Talk, a program for adolescents. The subject was sexual health education. The panel included three teenagers. There was also a small audience, who were asked for their comments. Two young teens offered the following example of the way some sexual activities are trivialized. One was wearing a set of bracelets. Each colour represented a different sex act. Her friend explained that if a boy rips one off her wrist, she “has to” perform that act. There is a sense of competition – “Oh, you haven’t done such-and-so yet.”) One assumes that, as with other cases of coercion, girls with a lower self-esteem may be more vulnerable to this type of pressure.

Kim comments, “because we do not entirely understand the gender dynamics, we can only assume that there may be pressure – either within the context of a relationship, or from peers”.

The attitude amongst young people which seems to be driving the current media interest seems to be that they don’t consider oral sex to be sex. Well, neither do most adults (ex-US President, Bill Clinton being a case in point). The Journal of Human Sexuality, in their article “What is Sex? Students’ definitions of having sex, sexual partner, and unfaithful sexual behaviour” (Volume 12, No. 2, 2003) studied 164 heterosexual Canadian University students. They asked them about their definitions of the terms “having sex”, “sexual partner” and “unfaithful”. They were given a list from which to choose. Interestingly, while less than 24% considered oral genital behaviour to be “having sex”, more than 60% thought that the giver or receiver of oral sex was a “sexual partner”. More than 97% considered a partner who had oral sex with someone else to have been “unfaithful” - hardly a casual activity, then - at least for students in university. In their conclusion, the authors advise educators and counsellors to clean up their language:

“…the response to the question ‘How many different people have you had sex with?’ might be different than to the question ‘How many sexual partner have you had?’ or ‘How often have you been unfaithful to your partner?’”

They go on to caution health care professionals and those promoting safer sex to “be specific with respect to the terms and phrases they use when inquiring about individuals’ sexual histories and assessing their potentially at-risk sexual behaviours.”

However, there seem to be some young teenagers who do not see oral sex as a significant sexual activity; others simply do not consider it to be as intimate as other sexual activities. For sexual health educators, one reason to pay attention to naming this activity is the issue of protection. If they don’t see it as sex, they don’t need to think about Sexually Transmitted Diseases/Infections (STDs/STIs).

In fact, the most likely risk is the transmission of HSV 1 to the genitals. When comparing unprotected oral sex to unprotected vaginal or anal intercourse, in terms of potential damage, it is a lower risk activity. While the risk is lowest between young peers, the mind-set regarding this as “no risk” can obviously be dangerous, especially with the increase of age/exposure.

A case in point is the recent resurgence of syphilis. Men having sex with men (MSM) are at high risk through unprotected oral sex. If young high school males who are just coming out to themselves experiment with older gay men, they are at risk for syphilis and HIV. It is easier to get HIV if one has untreated syphilis; HIV speeds up the damage to a person with syphilis. Many MSM who get syphilis are co-infected with HIV.

Martyn recommends that educators continue to work with parents wherever possible to increase their comfort and skills in dealing with their children’s sexuality from a very early age. She would also like to see more discussion of gender dynamics in teaching this age group. She reminds all adults, especially health professionals to be clearer and more specific in their use of language when referring to sexual activities. It is certainly time to delete the term, “sexually active”.

Remember the old joke? “Are you sexually active?” “No, I just lie there.” Let’s replace that vague term with the name of the specific activity when discussing risk, protection and the need for testing.

Probably the most important form of oral sex is just that – talking about sex in the most open, frank and informed way we possibly can. As Sue Johanson used to say, “sex is easy to do, but hard to talk about.”

Received

From the Women’s Health Clinic, Manitoba

“A Friend Indeed”, - a specialized publication for women in menopause and midlife, celebrates its 20th year anniversary with its March/ April 2004 issue.

Janine O'Leary Cobb, a Canadian mother of five, who taught sociology and humanities at a college in Montreal, conceived of A Friend Indeed (AFI) in 1983, when she experienced symptoms of menopause, but could find almost no helpful information. “A Friend Indeed” is now published under the umbrella of the Women’s Health Clinic in Winnipeg, a community health center run by and for women. AFI, published six times a year, provides timely, well-researched and balanced information about a wide range of health issues that matter to midlife women. For a complimentary sample issue and further information, go to: http://www.afriendindeed.ca or contact Heather Patrick: Phone: (204) 989-8028; e-mail: afi@afriendindeed.ca

From Women’s Health Matters

In their News section:
* WHI estrogen-alone study stopped early
* Women leave doctors in the dark when it comes to drugs
* Stress affects survival patterns of women with breast cancer
* Same-sex couples plan differently for retirement
To read these and other news stories, please go to the Women’s Health Matters News page:
http://www.womenshealthmatters.ca/news/index.cfm

Strategies to Control Stress
Women, who are often the caregivers in the home, are particularly vulnerable to stress because they rarely take enough time out for themselves:
http://www.womenshealthmatters.ca/facts/quick_show_d.cfm?number=489

March Highlight on Smoking and Respiratory Health
More women are smoking than ever before - and more are trying stop. But if you have ever tried to quit smoking, then you know firsthand how difficult it can be. Smoking and Respiratory Health are the March Resource Picks of the Month:
http://www.womenshealthmatters.ca/resources2/march04picks.html

Answers to Readers’ Questions on Sexual Assault
Read February’s guest expert, Deidre Bainbridge’s answers to readers’ questions about Sexual Assault: http://www.womenshealthmatters.ca/le_club/expert/q&a.cfm

Story of the Month: “Cancer is Harder Than Quitting”
How one woman’s inability to quit smoking led her on a painful journey of illness, loss and a renewed commitment to her health:
http://www.womenshealthmatters.ca/le_club/stories/index.cfm

New Enhancements to Women’s Health Matters Resource Database
Recent Additions – resources added in the past 30 days. This is a live feature that changes every time a new record is added to the database. Go to:
http://www.womenshealthmatters.ca/resources/l_search.cfm

Featured Searches – their most frequently requested topics. Click on the link below, and then select your topic of choice:
http://www.womenshealthmatters.ca/resources/f_search.cfm

The Resource Database was launched in September 2003 and now contains almost 1200 descriptions of books and periodicals, audiovisual and multimedia materials and web-sites.

From DES Action (US) The Voice with:

the transcript of a teleconference on DES sons

the summary of another teleconference on animal research findings re: future DES health effects

an article on the relationship between DES and DDT

From A Friend Indeed the newsletter with:

a lead article on smoking and midlife women

a reminder about the Endometriosis Association (endo@endometriosisassn.org or www.endometriosisassn.org)

more information on the WHI study on HRT regarding negative results shown for breast cancer, heart disease and Alzheimers

Go to: www.afriendindeed.ca

From the Lesbians and Breast Cancer Project

Community Launch of the report - and celebration on April 2^nd at Buddies in Bad Times Theatre in Toronto. Women who participated will discuss “what’s lesbian” about lesbians having breast and gynecological cancer. Buddies is wheelchair accessible, and American sign language interpretation will be available upon request. Contact Pam Grassau for further information, or to book an interpreter - pamela.grassau@sw.ca or call (416) 351 3800 extension 2127 or TTY (416) 778-4082.

From the Canadian Women’s Health Network

Improving primary health care was a core recommendation of the Romanow report. Currently a variety of demonstration projects and new funding models are underway - most designed and developed without the consideration of gender. To this end, National Coordinating Group on Health Care Reform and Women, has released a discussion paper and is seeking input: http://www.cwhn.ca/hot/call/default.html#primary-care

The Gender and Peacebuilding Working Group (GPWG) of the Canadian Peacebuilding Coordinating Committee (CPCC) seeks your support to commemorate International Women’s Day, March 8, 2004. This year the GPWG is organizing a cross Canada Women, Peace and Security postcard campaign. http://www.cwhn.ca/hot/call/default.html#wps

The Canadian compassionate care program leaves too many caregivers out in the cold. While this is a long overdue step in the right direction - Sweden, Germany, Austria, Norway, Portugal, Spain and Greece, to name just a few countries, already have systems in place for paid caregiving for relatives - it is not enough: http://www.cwhn.ca/resources/kickers/homecare.html

News flash!

New Democrat MP Judy Wasylycia-Leis is introducing a Private Member’s Bill to establish a national breast implant registry.

The Canadian Health Network has bi-monthly up dates on what’s new: http://www.canadian-health-network.ca/

From the Planned Parenthood Federation of Canada (PPFC)

Are you pro-choice and concerned about the erosion of women’s health rights, including reduced access to abortion services in Canada? Are you alarmed at the attack on women’s rights in the U.S. and the potential ripple impact of the neo-conservative agenda on Canadians? Then join the “Pro-Choice Canada Coalition” and help raise awareness through a national “Day of Action for Choice in Canada” on April 25, 2004.

The national office of the PPFC and Pro-Choice Action Network (Pro-CAN) are collaborating to build an ad hoc coalition for this one-time day of action and they want your involvement. Agree to be part of the coalition; promote and participate, in your community and with your constituents, this national day of activity. PPFC and Pro-CAN will provide you with fact sheets, promotional mini-posters, tips for organizing events in your communities and a national link to other like-minded organizations. No voice will mean no choice.

Activities in Canada on April 25th will coincide with events organized by the Planned Parenthood Federation of America (PPFA) and other national pro-choice groups in the U.S. In addition to raising awareness of choice and access issues, the “Pro-Choice Canada Coalition” will take this opportunity to publicly honour Dr. Henry Morgentaler in Ottawa with a Lifetime Achievement Award.

Contact them so that they can put you in touch with others in your community also interested in building this coalition. They are looking for organizations in each province and each urban centre to take the lead in building awareness and spreading the word about this day of action. A “tool kit” of tips, promotion resources and a “Day of Action for Choice in Canada” events listing will soon be available at www.ppfc.ca

[There is a movement afoot in the Registered Nurses Association of Ontario (RNAO) to ask the government to cut funding to PPC. Internal opposition has mobilized –ed]

From the AIDS Committee of Toronto (ACT)

A call for submissions for: www.womenlovinwomen.com a new web-site for women who love women, featuring STI/HIV information, research and articles and more. They are looking for articles, stories and poetry from lesbian, bisexual and trans women of all ages, about health, STIs, identity, sexual health, relationships, spirituality, love, life, sex…. They need responses by Friday, April 2^nd, 2004. Please send to Tania Smith Women’s Community Development Coordinator: tsmith@actoronto.org. They have specific guidelines. Please contact Tania for more information.

Also from ACT
The AIDS Committee of Toronto is currently looking for youth between the ages of 15 and 26 to join them in the planning, development and delivery of the Peer Outreach Project (POP). POP aims to decrease HIV infection and promote healthy sexualities among Lesbian, Gay, Bisexual,Trans and Queer/questioning youth. They will provide training and opportunities to gain valuable experience and new skills. The ability to speak a second language is a plus. For more information contact: Humberto Carolo, Youth Community Development Coordinator, AIDS Committee of Toronto. Call:
416-340-8484 ext. 254 or write: hcarolo@actoronto.org or go to: www.actoronto.org/youth

From the Ontario Breast Cancer Information Exchange Partnership (OBCIEP) www.obciep.on.ca their newsletter with:

an update on the lesbian and breast cancer study

information about a new study on women of colour living with breast cancer (Contact Jennifer Nelson at the University of Toronto: jennifer.nelson@sw.ca)

an update on women over 70 and cancer

information on the low-income study (contact: judy.gould@sw.ca)

a new web-site for young women with cancer: www.cbcn.ca/youngwomen

From the Latin American and Caribbean Women’s Health Network www.reddesalud.org the Women’s Health Journal with:

a 20 page insert reporting on chemicals in the environment and women’s health

an update on the Network’s campaigns against violence

information on the 2004 Calls for Action on May 28, the International Day of Action for Women’s Health

a report on the Latin American and Caribbean Day for the Decriminalization of Abortion

a section on campaigns against the marketing of tobacco to women

publications and conferences

From the December 6 Fund brochures on interest-free loans for women leaving violent homes. The brochures are in six languages: Russian, Farsi, Somali, Korean, Spanish, Chinese and English. The pamphlet outlines the criteria of the loans program. The December 6 Fund is a registered charity, which formed a year after the 1989 Montreal Massacre. Their mission is to work with women to assist them in making the transition from abusive situations to greater safety and self-reliance. To order these brochures, call 416-392-9126 or visit: www.dec6fund.ca

Conferences/Workshops

“The Young and the Breastless”

A special networking event for young women with breast cancer sponsored by the Patient and Family Counselling, BC Cancer Agency. May 14-15, 2004 in Vancouver. Register on or before April 1, 2004 for the early bird fee of $60; regular price $75.00. Details on the Canadian Breast Cancer Network web-site at http://cbcn.ca. For more information you can also e-mail: young_and_breastless@shaw.ca.

First Stage Trauma Treatment for Women

Sponsored by the Centre for Addiction and Mental Health, this two-day seminar will explore information on post traumatic stress responses, the biological, psychological and social contexts of trauma and its treatment as well as the essential components of first stage trauma treatment. To register, call 416-595-6020 or visit: www.camh.net/ets.

Feeling Good About Being Bisexual: A Workshop for Women
Tuesday, April 20, 7:00-9:00 PM. This workshop will provide a safe and supportive environment for women to talk about the unique issues, experiences and challenges of being bisexual. Facilitator: Cheryl Dobinson. Location: North York Women’s Centre, 201 Caribou Road (two blocks south of Lawrence, east off Bathurst). The workshop is free, but pre-registration is required. For more information, call: 416-781-0479 or e-mail: info@nywc.org or go to: http://www.nywc.org/about/findus.html