Youth are more able to make sexual decisions that are right for them when:
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They are provided with objective, factual and up to date information.
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They have the opportunity to develop values and practice skills.
Sexual decision making and the outcomes of those decisions are impacted by substance use and life circumstances.
KAI’S STORY…
I guess lately I’ve been drinking a bit more…maybe too much. I usually have a drink or two to loosen up at parties, especially if I don’t have any weed around. Sometimes I get a bit out of control when I drink. I’m so shy around girls and booze helps me make people laugh. Last week I blacked out though. I’ve never done that before, and when I woke up, I was with a girl I’d been drinking with. I know she sleeps around, but I don’t know for sure if we had sex. I have no idea if she’s on birth control. This feels really gross. I kinda think she took advantage of me. Does that count as a sexual assault? What if she’s pregnant? Do you think I caught something?
ALEX’S STORY…
I’m getting pretty stressed cuz I think Taylor is going to break up with me. Taylor says we’ve been together long enough. I think Taylor is sick of waiting for me to have sex. What bothers me the most is being reminded that I did it with Jae so why not with Taylor too? I guess that’s a fair point. But that was a long time ago and I didn’t really like it. Everyone keeps telling me that if Taylor really loved me, they’d wait. But what if time’s up and Taylor does break up with me? Maybe I should just do it and get it over with. Besides, I’m older now and should probably like it, right? I don’t know why I’m waiting anyway.
SUBSTANCE USE AND SEXUALITY
In adolescence, the pleasure center of the brain develops before the judgment center resulting in teen risk taking. Risk taking involving substance use is common in youth. Substance use can lead to more dangerous risks such as having risky sex.
According to the 2012 Canadian Alcohol and Drug Use Monitoring Survey (Health Canada, 2014):
70%
youth ages 15-24
drank alcohol in the past year
50%
youth ages 15-24
drank alcohol in the past 30 days
20%
youth ages 15-24
used marijuana in the past year
22%
youth ages 15-24
used an illicit drug other than marijuana in the past year
Substance use is even more common among street-involved youth. In a 2010 Edmonton study of street-involved youth ages 15-24:
86%
street-involved youth
reported alcohol use in the past 3 months
15%
street-involved youth
reported alcohol use every day
97%
street-involved youth
reported use of non-injection drugs at least one time
14%
street-involved youth
reported use of injection drugs at least once
Good
to
know:
In an Ottawa study of street-involved youth, 69% of participants reported they were under the influence of drugs or alcohol while having sex in the last three months (Ottawa Public Health, 2011).
TIP:
Some youth believe marijuana is not harmful because of the legalization of medical marijuana in Canada and the decriminalization of marijuana in some states in the USA. Presenting research based information about marijuana can support youth who might be feeling unsure about use to challenge their assumptions and consider change.
IMPACT OF SUBSTANCE USE ON SEXUAL HEALTH
Because substances affect youth differently than adults, youth may experience more serious, longer lasting or even permanent effects from use.
Substance use may result in:
- Reduced communication skills which impacts the ability to set and understand sexual boundaries.
- Decreased fine motor skills and coordination which may impact correct condom use.
- Poor memory which may impact the ability to take the birth control pill at the right time.
- Sex at an early age and/or unprotected sex.
- Multiple sexual partners.
Good
to
know:
Alcohol and street drugs do not change how hormonal birth control works, but clients who use substances may find it difficult to use those products correctly. For example, for birth control pills to work properly, they need to be taken about the same time every day. This is not always realistic for some users.
Long term or heavy use of street drugs and alcohol can also result in:
- Increased sexual desire but problems with arousal, lubrication, erection, ejaculation and orgasm.
- Lower sexual desire (McKay, 2005).
- Reproduction problems such as changes in ovulation, irregular menstrual cycles and early menopause.
- Impotence (inability to have or maintain an erection), atrophy (shrinking) of the testicles, decreased sperm count and enlarged breasts in males (Alberta Health Services, 2010).
- Painful sex (McKay, 2005).
For information on Substance Use during Pregnancy, click here.
Good
to
know:
Despite what some youth believe, Viagra and similar products do not increase the sex drive. When taken by a person that was not prescribed the medication, or when taken by a person in a way other than prescribed, these medications can cause serious injury or even death (Pfizer, 2015).
SEXUAL DECISION MAKING
For street involved and other high risk youth, the decision to have sex may be made because of life circumstances. For example, some youth have sex:
- Because they had sex with that person before and believe that they have to.
- To feel safe.
- To avoid conflict.
- To keep a relationship.
- For money, drugs or a place to sleep.
Youth may need support recognizing that sex is about choice. People have the right to choose to:
- Have sex or not.
- Set personal boundaries and limits.
- Make sexual decisions sober.
- Talk to a partner about limits and safety.
- Protect each other with a condom and safer sex practices.
Good
to
know:
Although people have the right to choose sex, some people have that right taken away. Some youth are not able to choose abstinence because someone else has taken away that choice. Youth who are in an abusive relationships may be involved in a situation where setting a sexual limit, suggesting condoms or using birth control could put their safety at risk. For more information on relationships, click here
Supporting Youth to know if they are ready for Sex
Being “ready for sex” is more than about feeling sexually aroused and having a person to have sex with. Sexual readiness is about physical, emotional and relationship readiness.
To help youth make their own healthy decisions, service providers can:
- Provide up to date and factual information.
- Provide opportunities to build and practice skills and consider values.
- Offer resources.
- Ask questions.
- Avoid implying what youth “should” do.
- Recognize that having sex may be a healthy choice for some clients.
Here are some questions that service providers can ask youth, which can help them to think about if having sex is the right choice (Government of Alberta, 1995-2015).
Questions about the body:
- Are you healthy enough to have sex?
- Do you have an STI? Does your partner? Have you been tested?
- Have you talked about and accessed STI protection?
- If pregnancy is a concern, have you talked about and accessed contraception?
- Are you sober? Are they?
- Can your body handle an STI or pregnancy?
Questions about emotions and values:
- Do you really want to have sex?
- Do you have a positive self-image and good self-esteem?
- Are you feeling pressured by your partner? Someone else? Yourself?
- Are you trying to fix a strained relationship?
- How would this activity fit in with your personal, religious or family values?
- How will you feel the next day?
- Do you know your limits and boundaries? Do you know how to communicate them? Will they be respected?
- Can you respect other’s communicated boundaries?
Questions about relationships:
- Do you care for this person? Does that matter? Do they care about you?
- Have you communicated your limits, values, safer sex plan and goals for sex?
- Do you trust this person?
- Is there mutual respect in this relationship?
- Do you want the same thing from sex?
- Will this bring you closer together emotionally as well as physically?
- How will this affect your relationship with this person? Will this affect your other relationships?
- Is this activity legal?
TIP:
It is important to teach youth how to analyze and interpret the media and how to fact check so that they can understand the influence on their decisions. Tips for providing this education can be found here.
SOCIAL MEDIA, PORNOGRAPHY AND SEXTING
Social media, sexting and pornography influence the sexual decision making of youth.
Social media is any online, digital or mobile communication platform where users communicate with other users.
According to American research, 92% of all teens access the internet daily with 24% on “almost constantly,” 89% of teens use at least one social media site, and teens send an average of 67 texts/day (Lenhart, 2015).
According to a British Columbia study of street involved youth, 95% accessed the internet (Smith et al., 2015).
Sexting is when people send or receive sexual pictures, messages or videos by cell phone or mobile device.
About 24% of Canadian teens in grades 7-11 have received a sext (defined as sexy, nude or partly nude photos). Around 30% of grade 11 students report to have seen a sext intended for someone else (Steeves, 2014).
Pornography is sexually explicit media showing genitals or sexual activity with the purpose of sexually arousing the viewer.
Around 23% of Canadian students in grades 7-11 have accessed pornography at some time, with males (40%) being more likely to access than females (7%) (Steeves, 2014).
Pornography may be linked to:
- Lower self-image.
- Increase in risky sexual behaviors.
- Seeing females as sex objects and males as sexual aggressors.
- Unrealistic or unhealthy attitudes and expectations about sex, relationships, bodies and gender roles.
- Negative impacts on adolescent brain development (Owens et al., 2012).
Good
to
know:
Social media, sexting and pornography may have legal considerations such as:
- When people under 18 take or send nude pictures of themselves, it can be considered creating and/or distributing child pornography.
- If the person they send it to is also under the age of 18, it can be considered as providing pornography to children.
- Police may lay charges for cyberbullying.
CONSENT
Sexual activity without consent is sexual assault.
Consent is:
- Needed for every sexual activity, every time.
- Understanding what is being consented to.
- Asking partners if they understand what they are saying yes to.
- Checking in with the partner and accepting that either partner can change their mind at any time.
People cannot give consent if they are:
- High or drunk.
- Forced, threatened, bribed, intimidated or offered rewards to do something sexual.
TIP:
It is important to use gender neutral language when discussing consent and sexual assault because people of any gender can be sexually assaulted and people of any gender can be perpetrators of sexual assault.
The age of consent is the age at which a person is considered to be able to legally consent to sex. In Canada, it is 16 years old, except if the:
- Other person is in a position of authority (e.g., teacher, coach, or employer).
- Sexual activity is exploitative (e.g., pornography, prostitution, or trading sex for safety).
There are “close in age” exceptions to this law.
- 14 and 15 year olds may consent to sex if the partner is less than 5 years older.
- 12 and 13 year olds may consent to sex if the partner is less than 2 years older.
- Children younger than 12 cannot consent to any type of sexual activity. Having sex with a child younger than 12 is against the law.
Other important things to know about consent:
- People cannot legally consent to sexual activity if they are drunk or high.
- One person cannot give consent on behalf of another person.
- Just because someone did the activity before doesn’t mean they consent to do it again.
- People who are married, common-law or are in other long term committed relationships still need to have consent before sex.
- Consent cannot be implied by body language, appearance or flirty/sexual behavior.
- Consent can be withdrawn at any time during the activity.
TIP:
When discussing sexual consent with youth, they may come up with many “what if” scenarios trying to find a loophole in consent laws. To see an entertaining but informative video that addresses many of these “what ifs,” click here.
Good
to
know:
People under 18 can access many medical services including contraception, STI testing and treatment and abortions, without parent permission if they are a mature minor. This means they are able to understand the:
- Treatment.
- Consequences of treatment.
- Consequences of not having the treatment.
COMMUNICATION
Healthy communication in relationships is about being able to safely express and respect needs, goals and limits.
There are four basic styles of communication:
- Aggressive communication: loud volume, angry tone, name-calling, “you” statements and profanity, threatening gestures and glaring eye contact are used to intimidate the other person. Some aggressive communicators use stillness and low volume to intimidate or threaten. This may lead the other person to feel unsafe and often results in escalating conflict.
- Passive communication: quiet volume, weak tone, saying “I’m sorry,” shrinking body language and minimal eye contact is used to avoid or escape the conflict. This often happens if the person is feeling unsafe but may escalate conflict.
- Passive-aggressive communication: sarcastic tone, exaggerated gestures and facial expressions and saying one thing (such as an apology) and clearly meaning another are used to manipulate the other person. This is often used when the person is frustrated or angry but doesn’t know how to express it and often escalates conflict.
- Assertive communication: volume is even, calm tone may reveal underlying emotions consistent with discussion, “I” statements are spoken, confident body language and even eye contact are used to describe the situation and state feelings and needs, expectations or limits.
When youth are presented with a situation that is unsafe or uncomfortable, ideally, they would use assertive communication to REFUSE that situation. However they can also DELAY or NEGOTIATE to avoid participating in an activity that is not right for them.
Delaying gives the person time to think about other ways to respond to the situation (e.g., “I see my brother over there. He’s my ride, so I’ll let you know later”).
Negotiating is when alternatives are provided to change the situation for the better (e.g., “How about we go to laser tag instead, my treat”).
Refusing is when assertive communication is used to clearly set boundaries (e.g., “You are asking me to do something that I feel is not safe. I am not going to do that today”).
(Centre for Addiction and Mental Health, 2015)
TIP:
When community service providers communicate their own boundaries, they are modelling the skills youth need to learn to set and communicate their boundaries and needs.
RESOURCES
For more information on substance use, please visit:
http://www.ccsa.ca/Pages/default.aspx
For more information about sexual decision making, see:
https://www.optionsforsexualhealth.org/sexual-health/sexuality/talking-about-sex
For more information on consent and support, see:
http://sexualityandu.ca/uploads/files/CTR_AgeOfConsent.pdf
http://www.sexualityandu.ca/sexual-health/sexual_assault_the_law
REFERENCES
Alberta Health Services. (2010). Beyond the ABCs information for professionals: Alcohol. Retrieved from http://www.albertahealthservices.ca/assets/healthinfo/AddictionsSubstanceAbuse/hi-asa-beyond-abcs-alcohol.pdf
Alberta Health Services, Sexual & Reproductive Health. (2015). Sexting, Social media & pornography: Impacts on youth health. Calgary, Alberta, Canada.
Centre for Addiction and Mental Health. (2015). Grade 9 physical and health education. Retrieved from https://youthrelationships.org/gr9_skillsparti
Government of Alberta. (1995-2015). Am I ready for sex? Retrieved from, http://www.health.alberta.ca/health-info/sex-am-I-ready.html
Health Canada. (2014). Canadian alcohol and drug use monitoring survey. Retrieved from http://www.hc-sc.gc.ca/hc-ps/drugs-drogues/stat/_2012/summary-sommaire-eng.php
Lenhart, A. (2015). Teens, social media & technology: Overview 2015. Retrieved from http://www.pewinternet.org/2015/04/09/teens-social-media-technology-2015/
Ottawa Public Health. (2011). Enhanced street youth surveillance in Ottawa 2011. Retrieved from http://canadianharmreduction.com/node/2017
McKay, A. (2005). Sexuality and substance use: The impact of tobacco, alcohol and selected recreational drugs on sexual function. The Canadian Journal of Human Sexuality 14(1/2), 47.
Mediasmarts.ca. (2013). Impacts on Young People. Retrieved from http://mediasmarts.ca/digital-media-literacy/digital-issues/pornography/impacts-young-people
Owens, E. W., Behun, R. J., Manning, J. C., & Reid, R. C. (2012). The impact of internet pornography on adolescents: a review of the research. Sexual Addiction & Compulsivity, 19(1-2), 99-122.
Pfizer. (2015). How does Viagra work? Retrieved from https://www.viagra.com/learning/how-does-viagra-work
Smith, A., Stewart, D., Poon, C., Peled, M., Saewyc, E., and McCreary Centre Society. (2015). Our communities, our youth: The health of homeless and street-involved youth in BC. Vancouver, BC: McCreary Centre Society.
Steeves, V. (2014). Young Canadians in a wired world, Phase III: Sexuality and romantic relationships in the digital age. Ottawa: MediaSmarts.