Sexual Decision Making
According to the Sexuality Information and Education Council of the United States (SIECUS), a sexually healthy teen will show or have the following characteristics within their relationships with themselves, parents and family members, peers and romantic partners.
Relationship with Self
- Appreciates their own body
- understands changes that happen during puberty, and views them as normal
- practices health-promoting behaviors, such as abstinence from alcohol and other drugs and getting regular check-ups
- Takes responsibility for their own behaviours
- identifies own values and acts on those values
- understands the consequences of their actions
- understands that media messages can create unrealistic expectations related to sexuality and intimate relationships
- is able to tell the difference between personal desires from that of their peer group
- understands how alcohol and drugs can affect decision-making
- Is knowledgeable about sexual health issues
- understands the consequences of sexual behaviors
- makes personal decisions about masturbation consistent with personal values
- makes personal decisions about sexual behaviors with a partner that line up with personal values
- understands their own gender identity and sexual orientation
- understands the effect of gender role stereotypes and makes choices about appropriate roles for oneself
- understands peer and cultural pressure to become sexually involved
- accepts people with different values and experiences
Relationships with Parents and Family Members
- Communicates effectively with family members about issues, including sexuality
- maintains appropriate balance between family roles and responsibilities and growing need for independence
- is able to negotiate with family on boundaries and tries to understand parents point of view
- respects rights of others and demonstrates respect for adults
- understands and seeks information about parents’ and family’s values and considers them when developing their own values
- asks parents and other trusted adults questions about sexual health issues and accepts their guidance
Relationships with Peers
- Interacts with all people (including those with different sexual orientation and gender identity different from their own) in appropriate and respectful ways
- communicates effectively with friends
- is able to show empathy in relationships
- is able to identify and avoid relationships that may exploit themselves or others
- understands and rejects sexual harassing behaviours
- respects others’ right to privacy and does not share personal information that others have shared with them
- Acts on one’s own values and beliefs when they conflict with peers
- understands pressures to be popular and accepted and makes decisions consistent with their own values
Relationships with Romantic Partners
- Expresses love and intimacy in developmentally appropriate ways
- believes that everyone has equal rights and responsibilities for love and sexual relationships
- is able to communicate not wanting to engage in sexual behaviour and accepts when others don’t want as well
- tries to understand and empathize with partner
- Has the skills to evaluate how ready they are for mature sexual relationships
- talks with a partner about sexual behaviors before they happen
- is able to communicate and negotiate sexual behaviors
- if they choose to have sex, protects self and partner from unintended pregnancy and STIs through effective use of contraception, condoms, and other safer sex practices
Safer Sex Practices
Talk to your teen about sexual decision making and the emotional maturity involved in sexual activity.
Ask your teen:
- Are they feeling pressured to have sex? And where that pressure is coming from?
- Why do they want to have sex? Why does their partner want to have sex?
- Do they feel comfortable talking to their partner about STIs, birth control and/or condoms?
- If birth control fails how will your teen and their partner handle an unintended pregnancy?
Any type of sexual contact or activity involves some risk. These risks could be physical, social or emotional. Practicing safer sex can reduce the chance of getting an STI or pregnancy. Talking to your teen about safer sex practices will help them make healthy decisions and avoid sexual activity that may put them at risk. Only abstinence – completely avoiding sexual contact, including intercourse or oral sex—is the only certain way to prevent an infection.
To make sexual activity as safe as possible, ensure your teen knows to plan ahead by:
- making sure that they discuss and understand each other’s limits in regards to sexual activity
- getting and giving consent for every sexual activity
- using condoms and dental dams (a thin square of latex that can be used to prevent the spread of STIs during oral sex) correctly to prevent pregnancy, STIs and HIV
- using a condom to prevent STIs and as a backup form of birth control
- getting tested and treated for STIs and HIV
- talking to their partner about their past sexual relationships and their history of STI testing and treatment
- reducing the chance of getting an STI by limiting the number of sexual partners
- understanding how drugs and alcohol make a person less inhibited, and negatively affects their ability to make decisions or consent to sexual activity.
- People who have sex while using alcohol or drugs are less likely to use condoms and forget to use their birth control method or not use it correctly (e.g., forget to take their birth control pill).
It’s important that your child has the information they need to know at the right stage of their development. Things your child needs to know about birth control:
- using more than one birth control method (dual protection) —such as hormonal birth control and condoms — gives the best protection against pregnancy and STIs
- there are many types of birth control options — including abstinence. They will need to choose what is best for them.
- some birth control methods are harder to use or take more getting used to (e.g. diaphragm, sponge)
- birth control needs to be used properly and needs to be used every time they have sexual intercourse to be effective at preventing pregnancy and STIs
- where to go for birth control. They can talk to a doctor or visit a local sexual and reproductive health clinic.
Types of Birth Control
When it comes to birth control, there are several options to consider. Some will be more suited to your teen and their life than others. Understanding what each type is and how they work will help you to pass on the relevant knowledge to your child, and help them make their own decision about what will work best for them.
Abstaining from sexual activity that involves exchange of bodily fluids, and/or genital to genital, or skin to genital contact, is the only way to be completely avoid the risk of pregnancy or STIs. Abstinence means different things to different people. Some people make the decision not to do these types of sexual activities. Abstinence to prevent STIs or pregnancy means that you don’t:
- directly touch your partner’s genitals
- have vaginal sex (penis to vagina)
- have anal sex (penis to anus)
- have oral sex (mouth to penis or mouth to vagina)
If a person chooses not to partake in any of the sexual activity listed above, it means they don’t need to use other forms of birth control and, that they’re protected from STIs and HIV. To learn more, click here.
A male condom is a thin covering that fits over a hard (erect) penis. It decreases the risk of pregnancy by stopping sperm from getting to and entering the egg. It also decreases the risk of STIs and HIV by stopping semen, vaginal fluid or blood from being passed between partners. Use a condom every time you have sex (oral, anal, vaginal) to prevent STIs and as a backup form of birth control. Most condoms are latex, but there are non-latex ones. All condoms sold in Canada must meet government standards. To learn more about condoms and how to properly use them, click here.
A vaginal condom is a soft, plastic (non-latex) sleeve with 2 flexible rings, one on each end. The closed inner ring goes inside the vagina to cover the opening of the uterus. The outer ring stays outside the vagina to cover the genitals. It decreases the risk of pregnancy by stopping the sperm from getting to or entering the egg. It reduces the risk of STIs by stopping semen, vaginal fluid or blood from being passed between sexual partners. To learn more, click here.
Intrauterine device (IUD)
An intrauterine device (IUD) is a small, soft, T-shaped device with a nylon string attached to it. A health care provider has to put it in. There are 2 types of IUDs (copper and hormonal). Hormonal IUDs are sometimes called intrauterine systems (IUS). They work in different ways. Depending on the type of IUD, it can help prevent pregnancy for 3 to 10 years. New research suggests that long-acting methods of birth control such as IUDs work the best for preventing pregnancy over time. To learn more, click here.
Birth Control Pill (‘The Pill’)
The pill is taken every day to prevent pregnancy. It contains hormones (estrogen and progestin) that are like the hormones females produce. They stop the ovaries from releasing an egg. To learn more, click here.
Birth Control Patch (‘The Patch’)
The birth control patch is a thin, light brown patch that you wear on your skin. It has to be changed once a week. The sticky part contains hormones (estrogen and progestin) that are like the hormones females produce. These hormones are absorbed through the skin. They stop the ovaries from releasing an egg. To learn more, click here.
Vaginal Contraceptive Ring (NuvaRing®)
The vaginal contraceptive ring is a soft, 5.5 cm (2 inch), clear, plastic (non-latex) ring that a female puts in their vagina once a month. It contains hormones (estrogen and progestin) that are like the hormones females produce. They stop the ovaries from releasing an egg. To learn more, click here.
Hormonal Birth Control – Extended and Continuous Use
Extended use is when a person takes a birth control product for 2 or more cycles without stopping, then take a planned, hormone-free break. During this break, their period will come. Females who use this method will have fewer periods.
Continuous use is when a person takes their birth control product without stopping (without taking planned hormone-free breaks). This means they will have no periods. Talk to your health care provider for more information. You can also read Hormonal Birth Control for more information.
Progestin-Only Pill (POP)
Progestin-Only Pill (POP), also called the mini-pill, is a pill a female takes every day to prevent pregnancy. POP contains one hormone (progestin). It doesn’t contain estrogen. POP comes as a 28-day pack (there are hormones in all 28 pills). There are no hormone-free pills. POP prevents pregnancy by:
- decreasing the cervical mucous and making it thicker
- making the lining of the uterus thin
- slowing down the egg in the fallopian tube
- sometimes stopping an egg from being released
To learn more, click here.
Birth Control Injection (Depo-Provera® or ‘the Shot’)
The shot contains a hormone (progestin) like the hormone females produce. It doesn’t contain estrogen. The hormone stops your body from releasing an egg, makes the lining of the uterus thin and makes cervical mucous thick. You need a prescription for the injection. It needs to be given every 10 to 12 weeks. To learn more, click here.
Vaginal spermicides are put in the vagina before sex to help prevent pregnancy. They contain an ingredient (nonoxynol 9) that kills sperm. When sperm comes in contact with a spermicide, the sperm dies and a female can’t become pregnant. Spermicides come as film, foam, gel, cream or suppositories. Some types of spermicides can be hard to find in Canada. To learn more about spermicides and how to use them, click here.
A diaphragm is disc-shaped, made of latex or silicone, and has a flexible rim. It’s inserted into the vagina before sex. It covers the cervix and stops sperm from entering the uterus. A diaphragm must be used with a special type of gel that kills sperm (spermicidal gel). To learn more, click here.
The sponge is a disposable piece of soft foam filled with a chemical that kills sperm (spermicide). It is inserted into the vagina to cover the cervix and helps prevent sperm from entering the uterus. To learn more, click here.
Fertility Awareness-Based (FAB) Methods
Fertility Awareness-Based (FAB) methods, sometimes called natural family planning, identifies the days of the month when the egg’s ready to be fertilized and becoming pregnant is most likely (fertile time). This can be used to:
- prevent pregnancy—don’t have vaginal intercourse or use another method of birth control during a woman’s fertile time
- become pregnant—have vaginal intercourse during a woman’s fertile time
To learn more, click here.
Lactation Amenorrhea Method (LAM) (used after the birth of a baby)
Lactation Amenorrhea Method (LAM) is a temporary method of birth control that can be used up to 6 months after the birth of a baby. Lactation means your body is making breastmilk and amenorrhea means you aren’t having a monthly period. It must be used correctly to work.
Exclusive breastfeeding (this means not feeding your baby anything other than your breastmilk) helps prevent an egg from being released each month. You can’t become pregnant if your body doesn’t release an egg. To learn more about how LAM is used when you are breastfeeding, click here.
A tubal ligation is a permanent method of birth control. Surgery is done to close the fallopian tubes (the tubes that the egg travels through). This stops the egg and sperm from meeting. If the sperm can’t reach and enter the egg, you can’t become pregnant. To learn more, click here.
A vasectomy is a permanent form of birth control. The tubes (vas deferens) that carry the sperm from the testicles into the semen are cut and sealed. This means there’s no sperm in the semen, so no sperm to reach and enter the egg. To learn more, click here.
Withdrawal (Pulling Out)
Withdrawal is used during vaginal intercourse to reduce the risk of pregnancy. Withdrawal is when the penis is pulled out of the vagina before ejaculation. Ejaculation shouldn’t happen near the partner’s vagina. If semen is near the opening of the vagina, sperm can reach and enter the egg. To learn more, click here.
Emergency Contraception (EC)
A female can use emergency contraception (EC) if they aren’t sure if they’re protected from pregnancy (e.g., condom breaks, forgot birth control), or if they had unprotected sex. EC doesn’t protect against STIs and HIV. It needs to be used right away, but can be used up to 5 days (120 hours) after unprotected sex. The 2 methods of EC are emergency contraception pills (ECPs) and the copper intrauterine device (IUD).
The 2 types of ECP’s are Levonorgesterol ECP (e.g. Plan B®, NorLevo®, Next Choice®, Option 2®) or Ulipristal Acetate ECP (e.g. Ella®). The copper intrauterine device (IUD) requires a prescription and it is put in by your health care provider. To learn more, click here.
Sexually Transmitted Infections (STI)
An STI is an infection that’s passed on by sexual contact. The rates of STIs in Alberta continue to rise. The rates of both chlamydia and gonorrhea are highest in the 15-24 year old age group.
Here’s what your child needs to know about STIs:
- STIs are infections that are passed on by sexual contact. This includes vaginal, anal or oral sex or intimate skin-to-skin contact without penetration.
- any type of sexual contact or activity involves some risk
- although most STIs can be cured, some cannot, including HIV, genital herpes and HPV
- STIs affect both men and women
- abstinence—completely avoiding sexual contact, including intercourse or oral sex—is the only certain way to prevent an infection
- they can protect themselves from STIs by practicing safer sex
- using a condom every time they have sex, will protect them from STIs
- getting tested is an important way to protect their health and their partner’s health
- STIs can negatively affect a person’s sexual and reproductive health
- an infection can also be spread from a pregnant woman to her baby before or during delivery
- it is both their right and their responsibility to protect themselves
There are many types of STIs—some your child may not have even heard about. Below is information on the different types of STIs, how they are passed between people, and if they are treatable, how they are treated.
Chlamydia is caused by bacteria. While most people don’t have symptoms, it can cause symptoms such as pain when a person urinates (pees), pain during sex or anal discharge. Chlamydia is treated with antibiotics. To learn more, see Chlamydia.
Genital herpes is caused by the herpes simplex virus (HSV). It may cause blisters in the genitals, rectum or mouth. Because it’s caused by a virus, genital herpes can’t be cured. There is medicine that can help control it so that the outbreaks aren’t as serious or as often. To learn more, see Herpes.
Genital Warts or Genital Human Papillomavirus (HPV)
Genital warts are caused by the human papillomavirus (HPV). It causes skin growths on or around the genitals or anus. The symptoms can vary greatly. Some people have only a few warts or other people have many warts. The warts may also continue to grow and spread or go away on their own. They often come back after treatment. HPV can be prevented by getting immunized. To learn more, see HPV.
Gonorrhea is caused by bacteria. While most people don’t have symptoms, it can cause discharge from the penis, vagina or anus, or cause pain during sex or in the lower abdomen. Gonorrhea can also infect the throat, anus, pelvic organs and eyes. If not treated, gonorrhea can lead to pelvic inflammatory disease, testicle infections and infertility. Gonorrhea is treated with antibiotics. To learn more, see Gonorrhea.
Hepatitis B is a virus that causes liver infection. The virus can be passed on through sexual contact, sharing needles or contact with blood. Some people with hepatitis B have no symptoms, while others may be very tired, have a mild fever or muscle aches. While most people recover, some develop chronic infections. It can lead to serious liver disease, liver cancer and death. Hepatitis B can be prevented by getting immunized. To learn more, see Hepatitis B.
Syphilis is caused by bacteria. If the person is going to have symptoms, the average time between infection and symptoms is 21 days. Early symptoms may include painless sores in the genitals, mouth and rectum, or a painless rash on the palms of the hands, soles of the feet or the whole body. If syphilis isn’t treated early, it can lead to serious health problems like blindness, or problems with the nervous system or the heart. Syphilis is treated with antibiotics. To learn more, see Syphilis.
Trichomoniasis (also called ‘trich’) is caused by a parasite. Not everyone has symptoms. The symptoms can include pain when urinating (peeing), discharge from the penis or vagina, itching in the penis or vagina and pain during sex. Trichomoniasis is treated with antibiotics. To learn more, see Trichomoniasis.
HIV is caused by a virus. HIV can be passed on through sexual contact, sharing needles or contact with body fluids. HIV attacks the immune system (the body’s defence system against illness and infection). Without a strong immune system, the body can’t fight infection or disease. If it’s not treated, someone with HIV can develop acquired immune deficiency syndrome (AIDS). While there’s no cure, treatments are getting better and people living with HIV can live long and healthy lives. To learn more, see HIV.
If you or your teen, want more information about getting tested for an STI, click here.