It is not many moons ago that women were put in lunatic asylums (as mental health hospitals were called), and spent their adult lives confined and locked away for moral reasons. Their only crime was having sex out of wedlock and becoming pregnant. When I began my psychiatric career 40 years ago, that practice had fortunately stopped, but at that time, a few of these women could still be found in the long term institutions, their lives wasted and ruined by their behaviour.
Now the pendulum has swung to the other extreme, where ‘anything goes’. I do not take any moral ‘high ground’. I simply express grave concerns based on my knowledge and experience of being a doctor for almost 50 years. People’s morals are none of my business, as everyone old enough to know what they do, must also take responsibility for any consequences.
In one area of the country, England ( but I understand elsewhere), there are 13 year old girls who have the contraceptive hormone implant without the knowledge or consent of their parents. In my view a 13 year old girl has insufficient knowledge to make that decision for herself nor should she be asked to do so. The girls know that they have sex and need to be protected from pregnancy, but this is not a decision based on knowledge of the necessary developments during the teenage years in the continuum of life’s journey.
What has happened, that the precious teenage years of gradual sexual development, rather than sexual behaviour, emotional growth, learning the values of responsibility and control, and being guided along new paths have now been abandoned by so many teenagers and their parents. Sex is not just a physical act with temporary pleasure, it has, or used to have, a much deeper meaning and can have long term consequences. It used to mean commitment and love, and was not given or taken without due thought and care. For many, those values have long since disappeared, and if parents have not these values and understandings, then guidance of their teenagers is absent or without meaning.
Maybe I am too old, but, from my knowledge and experience, I feel sorry for what these girls are actually missing, or what they are going to miss in the future, just as I felt sorry for those incarcerated so wrongly. There is so much to do as a teenager, without sexual behaviour being part of the equation, so, why are they missing out and behaving and having to be treated like adults?
As a young married doctor, fifty years ago, I worked for the FPA (Family Planning Association) for several years. I was totally appalled that abortions were still happening in very dangerous conditions ‘in the back streets’ without proper sterile conditions or anaesthetics, and, in fact, that abortions had to happen at all. So, for several years, I worked to help married women avoid unwanted pregnancies. At that time, we could not even advertise our clinics publically, in the libraries, etc.
At that time, the atmosphere was beginning to change, and I was asked to open one of the first clinics for students. These were all 18 years and over and many who attended were unmarried, though in long term relationships. This was a break from tradition, for the FPA. I don’t think any of us thought that the pendulum would swing as far as it has in the present day. At that time, the oral contraceptive had just been developed and so I was among the first to prescribe this for patients when it was introduced into the clinics.
However, we did so with much caution. We took cervical smears yearly. We measured the blood pressures and monitored all the patients on the oral ‘pill’ every three months. We used to advocate (at that time) a break for several months about every 2 years, to let the body regulate itself again, and offered an alternative form of contraceptive during that time. We observed the psychological effects of the hormones, in particular the incidence of depression. There was much medical interest in the possible side effects, in particular the possible increase or decrease in the risk of breast or uterine cancer, increased risk of clotting of the blood or migraine attacks. Over the years conflicting results were found. But, whatever, the use of hormones as contraceptives is an interference of normal function, but these concerns appear to have vanished.
I am well aware that changes in the hormones given have taken place over the past years, but these are still hormones which produce changes to the natural events of the body.
All 13 year olds’ bodies should be adapting to natural changes. These are the years when a 13 year old should be growing, physically, emotionally and mentally, not just being free to satisfy every whim, desire or pressure, to the possible detriment of their future health. It should not be considered ‘normal’ to have sex at this young age. What follows next if the tide of change is not stopped?
In all my years working as a doctor, and for the past 35 years as a psychiatrist, I can honestly say that I never prescribed any treatment for any condition that I wouldn’t take or have myself if I was in the same condition or suffered the same illness.
My one exception was the ‘pill’ as there were other methods, even if not so aesthically acceptable, that served the same purpose and did not have the same possible health risk factors.
I am very concerned on many levels about 13 years old girls having the implant, though I concede that, given the present behaviours of many of these youngsters, such action will prevent unwanted pregnancies and hence be necessary. It is reliable and lasts for several years.
But, in all cases, I believe that the parents should be part of that decision. A 13 year old may be old enough to engage in sex, but is not old enough to have the responsibility of that kind of choice. Putting an implant into a 13 yrs old without parental knowledge or agreement is wrong. It is taking away parental responsibility. For what reason? I do not understand how such decisions have come about. If a 13 year old is indulging in sexual activity, either boy or girl, then the parents should be aware of this behaviour, as much as knowing what their child is drinking, eating, smoking etc. They should know where they are, who they are with and what they are doing at this tender age. Quite truthfully, I see this as neglect and parents reneging on their responsibilities.
But, what about the possibility of these young teenagers contracting sexually transmitted diseases. AIDS is still around, even if it appears to have lost its newsworthiness over time, but is not the only serious sexually transmitted disease with long lasting effects. Being unable to conceive in later life is just one result possible.
It seems as though all caution, sensible behaviour, control and responsibility by their parents has been abandoned in these girls’ lives and the reality of danger forgotten or ignored. Consequences follow behaviour and the ‘it won’t happen to me/her’ philosophy is ostrich-like in the extreme.
Teenagers, girls and boys, need to learn that a person can’t have everything in life that he or she wants and must learn control. They must learn to value themselves as a person, not as a sex object or be in some peer performance-rating.
The law can prosecute anyone who has sex with a girl under 16 years and regards the under 13 years girls as not being old enough to give ‘consent’ even if they agree to the sexual act being performed. However, it appears that teenage boys are exempt from this law in relation to their actions with their teenage girlfriends. I think the only way to prevent these young girls from this behaviour is to make it a criminal offence for any boy, of any age, to have sex with an under 16 year old girl. This might sound draconian, but these 13 years old girls are sex objects by acceptance or default.
In my opinion, girls of 13 years are too young for these implants and this action is not only encouraging sexual behaviour, it is saying ‘it is fine, just carry on’. I would term it a form of abuse. However, it is better, in the present culture, than a pregnancy at 13 years, but should be with parental knowledge. The parents of these girls have much work to do.
But, just consider that boys were held responsible – after all, consenting heterosexual activity requires two people. There would be a universal outcry if boys having sex with 13 year old girls were the ones to take precautions via being given chemical castration without their parent’s knowledge. But what is different? Both are equally responsible. The female, yet again, has to take the consequences, not the male. Why? Why are the girls being made sterile for a few years rather than the boys? Hormone implants are not innocuous.
One girl, reported by the newspaper, said she had the implant inserted, as she wanted to have sex when she felt like it with her boyfriend. Her mother wrote that, once she had found out that her daughter had the implant, ‘she was proud of her daughter taking that responsibility’.
What hope have teenagers when their parents not only condone such behaviour but are proud of such dubious ‘responsibility’? What have these girls learned to expect from and contribute to life? Is sex the best they can be offered or expect? Of course, young teenagers should not be having children, as they are not yet adult themselves.
The long term answer is about altering the culture that has developed over recent years. The pendulum has swung much too far.
This trend is being encouraged on all sides, by TV (a programme about the joy of teenage sex), by advertising, girls magazines, and by a reneging of parental responsibility and control.
As someone who understands the value of love and commitment and who has studied the health and illnesses of both body and mind for over half a century, I find the trend of these adolescents unbelievably sad.
Many would say ‘old woman, get real, this is the 21st century’! I have spent a career in medical and psychiatric study and work, and I know what I know. I am very ‘real’. The teenage years should not be wasted or destroyed, difficult as they may often be. But damage can occur, more so in the present climate of behaviours, that may not be able to be healed.
The focus for living life is in the brain not the genitals or stomach, but it seems that both these areas are becoming increasingly dominant in present day culture. At the centre, responsible for their teenagers’ growth, well being, development and behaviour, are the parents. Many still spend much time with their teenagers, giving guidance and gentle but firm control, but sadly, many seem to have forgotten or reneged on that duty of care, either from neglect, ignorance, busyness or simply believing that ‘what the teenagers want, the teenagers can have’.
Society has moved from the asylum to anything goes.
Many still find a middle, sensible and healthy road but, increasingly, many don’t. The task of society is to find that road for all.
Teenage years can never be regained.