Healthy Living: A Teen Perspective

In 2006 the Girl Scout Research Institute published "The New Normal Report" in collaboration with the Michael Cohen Group, from data collected from 2,060 girls, 461 boys, and 599 mothers. The goal of the research was to collect information about

• the general attitudes and perceptions of girls about a variety of health-related issues;
• the influence of adult role models in determining girls' health-related attitudes and behaviors;
• the impact of demographics and culture on attitudes toward health, body image, and health-related behaviors; and
• the current level of awareness among girls concerning health-related information.

What the girls in this study said, was that they wanted to be "normal"- find that safe middle ground where they will not be teased, and will fit in with their peers. The major findings include these:

• About 30% of the girls had a distorted perception of their own weight - perceiving themselves as heavy when they were not, or perceiving their weight as normal when they were heavy, and the older the girls, the greater the degree of distortion;
• 26% of the girls had some dissatisfaction with her weight, compared to 19% of the boys;
• More than 60% of teenage girls skip breakfast at least once a week and nearly 20% skip it every day;
• The more physically active girls were, the greater their self-esteem and the more satisfied they were with their weight, regardless of their weight, although 40% of the 11- 17 year old girls said they do not play sports because they do not feel skilled or competent and 23% do not think their bodies look good during sports;
• Girls worried more than boys about everything (e.g., weight, peers, college, exercise, family, & school; and
• 89% of girls reported that their mothers made positive comments about how they look.

Another important finding of this report was that moms were the most frequently cited source of health information and were clearly role models for their daughters. The girls with the broadest range of female role models, including women who were more full-bodied, were more satisfied with their own shapes.

Girls in this study defined health as the absence of illness or unhealthy activities or symptoms. Being free of drugs, alcohol, and tobacco was cited by the greatest number (87%) of girls as "healthy." When talking about health, these girls were not worried about the fact that only 19% of those over the age of 16 did something physical every day, or that 15% reported watching more than 3 hours of TV every day; or that 40% of the teens said they watch TV during dinner 3+ times a week.

One of the most important take home messages from this report was that although teens demonstrate basic knowledge about healthy foods, exercise, and eating, they often do not put that knowledge into practice, and it is "normal" for many teens to make poor choices with respect to diet and exercise. Factors contributing to this gap between health-related knowledge and behaviors include:

• Not understanding the future consequences of current behavior;
• A lack of healthy food options and positive role models;
• Competing concerns, such as fitting in, that are more important at the time of the decisions; and
• Not wanting to look "extreme," too healthy, or weird to friends.

It is clear from this report that efforts to improve the health of our teens must also be directed at adults, who can make a difference. If we want teens to make better choices about diet and exercise, we need to help them understand two important things. First, that diet and exercise patterns are linked to emotional health, self-esteem, and body image. We have to emphasize the importance of physical activity, in spite of increasing demands of homework, socializing, and extracurricular activities. We also need to provide more opportunities for girls to participate in informal, less competitive physical activities in safe environments where they do not feel self-conscious about their looks or ability, and where they can be active. Second, we have to demonstrate positive, long-term outcomes that result from health behaviors. The habits they form in their teen years will have long term results and be harder to break as adults.

Resources:
AdiosBarbie.com
Soy Unica! Soy Latina!
We Insist of Natural Shapes (WINS)
CDC's Youth media Campaign: VERB

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Labels: Body Image

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What Motivates Teens to Have Sex

A recent article in Perspectives on Sexual and Reproductive Health (2006) by Ott, Millstein, Ofner, & Halpern-Felsher, explored relationship goals and positive expectations about sex with 637 ninth graders. These researchers concluded that the youth valued intimacy the most, then social status, and finally, sexual pleasure.

With all the focus on the risk of sexually transmitted infection including HIV associated with sexual behavior, there has been plenty of research about adolescent perception of the negative consequences of sex, but little about what motivates teens to engage in sexual behavior in the first place. If the sexuality education teens are receiving focuses only on the risks, ignoring the reasons they engage in sex, I would expect that the education is destined to fail.

Sexual behavior can be motivated by perceived benefits including, the desire for excitement or pleasure, intimacy, or peer approval or respect (social status). The teens in this study expected sexual behavior to bring intimacy, pleasure and increased social status, but there were gender differences as well as differences based on sexual experience.

Not surprisingly these researchers found that girls in their sample valued intimacy significantly more and sexual pleasure less than males. Sexually inexperienced females thought that having sex would bring them more social status than did sexually experienced girls. Males reported higher mean expectations that sex would result in pleasure and social status than did females. Females and sexually inexperienced youth reported lower expectations that sex would meet their goals than did males and sexually experienced youth.

It would seem to me that if male and female teens are looking for intimacy and social status, we, the adults in their lives, need to help them identify non-sexual ways to achieve those goals. Especially in the case of girls, who seem to understand that becoming sexual may be a social liability, adults need to provide more discussion about how their expectations may differ from reality. The results in this article also would suggest that our stereotypes about males being motivated by pleasure may be inaccurate.

As parents, educators, and clinicians, it is important to be aware of the expectations teens have for sexual involvement and provide frank discussions and skills to help teens achieve intimacy, social status and even sexual pleasure, without sexual risk. It makes perfect sense to me that teens are looking for connection and closeness in our culture, I think we all are.

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Labels: Sexuality

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Teens and Single Sex Education: Is it Good for Their Health?

Why does the concept of single-sex education continue to be considered? There are many people on both sides of the argument about whether single-sex education is beneficial for children and teens, and you can find research to support both perspectives.

On one hand, advocates say that students in same-sex schools are less distracted by the opposite sex, girls demonstrate more interest in math than their co-educated peers do, and students in same-sex schools score significantly better on cognitive tests. This would suggest that individuals focus on schoolwork more or have a broader range of interests available to them and that the academic options are less gendered-limited.

The other side of the argument includes concerns that if teaching patterns are altered to "fit" one gender, stereotypes will be reinforced and the differences between the genders will be enhanced, ignoring individual difference. This perspective is related to the fear that in a same sex educational setting each gender will reinforce the cultural expectations they perceive - girls becoming solely concerned with their looks and boys becoming solely concerned with their strength.

We do know that any education must be well-implemented, take into account individual differences, and "engage" students at many levels. Whether that education is public or private, same sex or coed, seem to be less important than how motivated students are to participate in the education provided. There are poor schools everywhere.

Having two daughters in a single sex school I have to admit I have a pretty strong bias, but I also see a tremendous amount of difference between the coeducational elementary school education they received and the single-sex middle and high school educations they are currently receiving. Walking around campus after school the difference is particularly striking. There are groups of girls preparing for, or competing in, sports, there are practices in progress for plays, orchestra, and academic competitions, as well as clubs meeting, community service activities, and grabbing an occasional nap. The clubs include subjects that are definitely not gender-determined. The include subjects as diverse as robotics, manga/anime, knitting, trivia, and garage bands. The girls excel at many different things, none limited by their sex.

This same sex environment encourages these girls to try everything and not be afraid to fail at anything. Just that ability to try something new promotes health and wellness in many ways. Physically, kids who do not fit the social "norm" of attractiveness are less focused on their appearance then they might be in a coeducational setting, and much more likely to participate in sports. Academic kids are able to excel as well, finding they are less concerned by being called "nerds." Kids in same sex schools also tend to be more comfortable with their bodies, as well, allowing more open discussion about the changes associated with puberty and growing into adults.

Nothing fixes everything, but I suspect that same sex schools support student health a little bit more than coed schools, particularly if classes are smaller and there are counseling and support services available.

You can find more information about same sex education at:
The National Association for Single Sex Public Education (NASSPE)
A recent article by Meghan O'Rourke, in Slate.

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Labels: Sexuality

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Teen Health and Holidays

I want to take a moment and wish everyone a happy holiday season. No matter which holidays your family embraces, the winter months bring opportunities to spend time together, as well as to reflect on our lives, choices, and futures. I send blessings to all the readers of this blog and hope that your lives are joyful, thankful and healthy.

In addition, remember that the natural tendency to retreat from the cold and dark, spend time at home, and be thoughtful, can bring comfort, but also sadness in people not happy with their circumstances. Especially during the busy holiday season, it is easy to let teens pull away from family gatherings, traditions, and rituals as they struggle to find their place in our families, deciding whether they belong with the adults or the children. Teens also may have lost some of the magic associated with the holidays, and depending on your family, may not have started to assume some of the responsibility for the activities of the holidays, which in the doing, also bring joy.

When preparing for this holiday season, remember your teen has many talents and plenty of energy to share, and s/he may need extra help getting into the spirit and feeling like they are a part of the holidays. I encourage you to include them in the planning and to find activities they enjoy and can be responsible for - creating the family newsletter, preparing and addressing cards, planning and preparing for parties, planning and cooking meals, baking, decorating, making gifts for teachers, shopping, wrapping, mailing, even cleaning. I realize not everyone thinks of these activities as fun, but consciously choosing the activities you will complete, remembering what is important about them, and doing them with your teens can provide you both with some quality time, as well as providing your teen with an understanding of how the holidays come about, the energy and love that go into the preparations, and an opportunity to make a contribution she or he can be proud of.

Slowing down and thinking through your priorities, the activities you will participate in, and remembering to find the joy of the holidays will not only help your teens, it may help you find a little extra joy, too! During the holidays - be well, laugh often, love well, and play well!

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HIV Infection and Teens

In September, Lori Wiener, PhD, DCSW and Emilie Steffen-Smith wrote an article for FOCUS: A Guide to AIDS Research and Counseling for the AIDS Health Project entitled "Facing Adult Life with HIV" that really brought home what it would mean for children or teens to be infected with HIV.

UNICEF estimates that 1,800 children are infected with HIV each day worldwide, and half of all new HIV infections occur among youth. Young Black youth, and youth living in the South and Northeast are at the highest risk. Almost all young women were infected through heterosexual sexual contact, and the risk factors continue to include early sexual behavior, high numbers of sexual partners, and sexually transmitted infections, which increase the likelihood of contracting HIV.

Parents and professionals acknowledge that adolescence includes experimentation along with developing skills needed to be adults, but when most parents were teens an error in judgment did not mean a lifetime of illness and sexuality did not bring issues of disclosure and transmission of HIV. HIV-positive youth confront the same challenges as other teens and young adults, but they do it in the context of a life-altering and highly stigmatized disease. This context compounds a young person's difficulty making decisions about life goals, intimate relationships, and sexual activities, and medical care, and in particular their career choices and future planning.

There is considerable evidence that adolescents with HIV who already have to manage the physical and medical consequences of HIV also experience more emotional and behavioral disorders, and psychiatric illness when compared to young people without HIV. Compared to the general population, HIV positive children 4 to 17 years old have higher rates of anxiety, depression, and attention deficit hyperactivity disorder. The higher rates of depression are of concern in part, because depressed people are more likely to be non-adherent with their HIV antiviral treatment.

If children were infected with HIV as children, the disease may change as children enter adolescence. It is common that new physical symptoms present, medications may become less effective, and teens can be less than consistent in receiving the care they need. In addition, given their body image is already changing, the impact of the disease may be harder on them. Teens with HIV may be smaller than their peers, struggle with recurrent thrush, medication side effects, abdominal distress, muscular swelling, headaches, and other physical problems, which may lead to feared rejection from peers or social isolation.

It is important that adults who care for these teens be alert to physical and neurological effects of the disease as well as an adolescent's emotional response to these effects. In particular, a personal crisis such as a family fight, a breakup with a friend, problems in school, and the HIV-related body changes may trigger unusually strong emotional reactions in these teens, undermining their well-being and medication adherence. Loss and bereavement are important issues that may repeat if a teen is also dealing with the infection or loss of a parent. Teens may experience anxiety, depression, guilt, quit performing well in school, or just feel "lost."

As part of the support provided to teens, disclosure decisions may need to be revisited as well. Research suggests that that adolescents who disclose their HIV status to friends and professionals tend to have fewer symptoms of post traumatic stress disorder (PTSD), perceive themselves as more competent, and have higher rates of disclosure to sexual and romantic partners.

Sexuality and dating can bring about a crisis as well. HIV+ teens have similar rates of sexual behavior and substance abuse as HIV- teens, but they experience more stress associated with the transition to sexual behavior. They are also likely to have the same lack of knowledge about their bodies and HIV transmission as other teens, requiring clinicians with whom they share a trusting relationship to provide additional sexuality education. Growing up is hard enough, but doing it with a stigmatizing disease, makes these teens fragile and needing additional support.

Resources for HIV+ teens: Camp Heartland

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Labels: HIV

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Getting Teens Hooked Into Preventive Health Care

A recent issue of the Journal of Adolescent Health (October 2006) included an article entitled "Vaccination: An Opportunity to Enhance Early Adolescent Preventive Services," by Rupp, Rosenthal, & Middleman. This aricle provided some great suggestions for how clinicians can use the new vaccines (HPV and meningitis) as opportunities to provide preventive services to a population that traditionally has received little preventive care.

There are many reasons why teens do not seem to get the preventive care they need during adolescence. Some lack insurance or transportation, and others just do not come in for annual exams, electing only for acute care or required physicals for sports or summer camp.

Any chance to screen a teen for health risks should be taken by clinicians, but some clinicians do not feel they have the time, are uncomfortable bringing up health issues with teens, or are not prepared to talk with parents about the need for preventive screening and time alone with the teen to ask the more "sensitive" questions about alcohol or drug use and sexual involvement.

It is clear that teens need more effective preventive services given that the major morbidities/mortalities of adolescence are psychosocial in nature, and thus, likely to be preventable. Unintentional injuries (including sports), violence and suicide are the major causes of death among this age group. Substance use, sexual behaviors, and dieting are behaviors with which adolescents being to experiment and can be associated with significant morbidity and mortality.

The 2003 Youth Risk Behavior Surveillance Survey conducted by the Centers for Disease Control and Prevention (CDC) reported that:

• more than 25% of teens report binge drinking;
• 22% report marijuana use;
• 10% of teens had taken some sort of diet pill, powder or liquid;
• and 6% had used vomiting or laxatives to control their weight.

The new immunization recommendations will hopefully motivate parents to get teens in to see their provider and motivate clinicians to screen teens for risky behavior, discuss confidentiality as well as physical, emotional, and cognitive changes associated with adolescence, and encourage teens to come in every year to discuss any health concerns they may have.

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Labels: Health Care, HPV

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Child Internet Safety

I know that there is a lot of information out there on Internet Safety, however, no amount of coverage is overkill if we prevent one child or teen from being exploited on the Internet. As parents and professionals from a different generation, we really do not understand the ease in which our children have access to strangers via the Internet, the vulnerability of youth, and the number of predators there are in cyberspace, just waiting to find a young person who can be manipulated or exploited.

I want to use this post today to send every parent and professional to an important web site and resource. I had the pleasure of attending a presentation by Officer Steve DeWarns this week, who provides internet safety classes for parents, a program called "Kid Safety on the Internet" for 5th - 6th grade students, as well as information about online child exploitation at www.internetchildsafety.net. He can be reached at (707) 480-0327.

On his site you can find video clips, news articles, samples of acceptable use policies for schools and Internet agreements for families, safety pledges for students of different ages, instructions for setting MySpace.com accounts to private, and links to places to learn about and purchase parental control software, as well as resources for parents whose children have been exploited on the Internet. His web site also includes some of the Media Safety Guide from Senator Hillary Rodham Clinton, and a link to one of my favorite sites Common Sense Media which includes tons of helpful information as well as great reviews of the movies currently in theaters - from both parents and youth.

One of my favorite handouts on this site is a six-page Online lingo guide including the these three frequently used abbreviations:

121 one to one
AFK away from keyboard
ASL age, sex, location

Please review Internet Safety rules with your kids, ask them to take you on a tour of MySpace, a chat room, and if you do not understand how much they are using the Internet, learn how to check the computer's history. Talk to your kids, take a class, do whatever you can to keep them safe!

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Labels: Online/Internet Safety

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Grand Rounds 3.8: Thank You

I would like to thank Topher from the rumors were true for hosting this week's Grand Rounds and including my post on Consensual Sex or Rape.


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Teen Hearing and Music

I remember hating it when my parents yelled "turn that music down," and yet, here I am, saying to both my teenage daughters, when they have their earbuds tucked into their ears, "I can hear that" - which is code for "turn that music down."

According to a 2005 article in Pediatrics, 12.5% of kids between the ages of 6 and 19 suffer from loss of hearing as a result of high volume used with ear phones. A major contributor to this significant statistic is the introduction of earbuds (small speakers that fit inside your ear) that deliver the sound directly into the ear canal, eliminating other sounds.

Another contributing factor to the potential for hearing damage is the amount of time spent "plugged in." With iPods and other MP3s, the number of storable songs is in the thousands, resulting in a longer hours of use.

So how do you know if you have damaged your ears with your music? One surefire way to tell your music is too loud is if others who are not wearing the earbuds, can hear the music playing in your ears. To avoid damage, experts recommend not listening to a music player for more than an hour a day. This may seem unreasonable to many teens who listen while they do homework, on the bus, on an airplane, waiting in line, working out, or just walking around. Often people resort to earbuds to try to cover up the already loud noise around them, but this causes even more damage because they have to turn the volume up even higher.

The two problems that arise from this loud volume for long durations of time are called tinnitus and noise-induced hearing loss. These both occur when the tiny, sensitive nerve endings in your ear suffer trauma from high noise levels.

To protect yourself, or your teens, keep the volume and amount of time spent listening down!

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Labels: Media

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Teens and HIV Vaccine Trials

Young americans are challenged to "be the generation" that ends the AIDS epidemic.

The National Institute of Allergy and Infectious Diseases (NIAID), one of the National Institutes of Health, recently announced the launch of the "Be The Generation" public awareness campaign, challenging young Americans to be the generation that ends AIDS through the discovery of a safe and effective preventive HIV vaccine.

Using multi-generational pairs of individuals, the awareness ads compare major social issues such as civil rights with the search to end the AIDS epidemic. The campaign challenges this generation to become involved in changing the world as the generations before them did. The first step is to make a concerted effort to overcome a general lack of knowledge about HIV vaccine research in order to recruit diverse populations into clinical trials that will determine whether vaccine candidates in development might benefit this and future generations.

The campaign was launched with a television commercial airing in 14 U.S. cities where HIV vaccine research is taking place (including Atlanta, Baltimore, Birmingham, Boston, Chicago, Nashville, New York, Philadelphia, Providence, Rochester, San Francisco, Seattle, St. Louis and Washington, D.C.). The ad, aimed at educating Americans about preventive HIV vaccine research, will run for six weeks in these target markets and began in October. The ads also can be viewed on the affiliated Web site, be the generation. The TV and Web outreach will be supplemented by a community toolkit, and partnerships between the campaign, community-based organizations and HIV vaccine research institutions.

Research conducted over the past five years shows that public awareness and understanding of HIV vaccine research is very low. For instance, only 25 percent of Americans surveyed were aware that HIV vaccines being tested cannot cause HIV infection. In addition, misperceptions and fear related to clinical research and the use of an HIV vaccine are widespread, particularly among African Americans, the population most heavily affected by HIV/AIDS in the United States. Left unchecked, these misperceptions can make trial recruitment more difficult, delay clinical research and undermine education efforts and eventual use of a preventive vaccine. You can take a quiz on the new site and test your knowledge about preventive HIV vaccine research.

Through this focused public education campaign, the hope is to engage communities to help pave the way to a preventive HIV vaccine by raising awareness, expanding understanding of HIV vaccine clinical trials and, ultimately, increasing trial participation.

The "Be The Generation" campaign materials include posters, brochures, detailed fact sheets and mini fact sheets. The materials are tailored to the four U.S. audiences most affected by the HIV/AIDS epidemic: African Americans, Hispanics/Latinos, women, and men who have sex with men.

Resources:
Centers for Disease Control and Prevention HIV Research
NIAID Fact Sheet on Clinical Research on HIV Vaccines

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Labels: HIV

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Religion and Teen Sexual Behavior

The Journal of Adolescent Health included a recent article entitled "The role of parent religiosity in teens' transitions to sex and contraception" exploring the associations of parent and family religiosity with the timing of sexual initiation or use of contraception at first sex.

The researchers analyzed a sample of sexually inexperienced adolescents aged 12–14 years in the 1997 National Longitudinal Survey of Youth (NLSY97) to test the association between multiple dimensions of parent and family religiosity and the transition to first sexual experience and contraceptive use at first sex during the teen years. They assessed the association between parent and family religiosity and the timing of adolescent sexual experience and examined contraceptive use separately by gender and race/ethnicity.

Among all sub-populations except African American adolescents, more frequent parental religious attendance was found to be associated with delayed first sex. An important predictor of delayed sexual initiation among teens was engaging in religious activities on a daily basis. Unfortunately, strong religious beliefs and more frequent participation in family religious activities was associated with males being LESS likely to use contraception at first sex.

The authors concluded that more frequent parental religious attendance and family religious activities are related to a delay in sexual initiation, however, stronger family religiosity does not translate into improved contraceptive use.

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Labels: Sexuality

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Is it Consensual Sex or Rape?

The Washington Post recently published a story that disturbed me deeply. The story "Court Says Consensual Sex Can't Become Rape" by Ernesto Londono reported about a Court of Special Appeals in Maryland that overturned a rape conviction based on a legal view that "a woman cannot be raped after she has agreed to have sex."

According to this story, the issue was that at some point during a sexual encounter the female asked the male to stop, and he did not. His defense is "she had started to have sex," so it was consensual. Her perspective is that she did not feel she could say no and when she experienced pain during intercourse, she told him to stop, and he did not. The legal issue at hand is the difference between rape and sexual assault.

As a parent, I want to be able to teach my children that "no means no" and that they can stop any behavior, at any time, and have the right to expect the person they are with to respect their decision and choice. As a health educator, we are teaching sexuality education classes that include the message that if a sexual partner refuses to use a reliable method of birth control or a barrier method to prevent HIV, or if there is a perceived sexually transmitted infection, or the intercourse is rough or includes violence or coercion, a person can say "stop." Do we need to add the caveat, "unless you already consented?"

But what is "consent to have sex?" According to RAINN (Rape, Abuse, & Incest National Network) consent must be explicit. A prior or current relationship or previous acts of intimacy are insufficient indicators of consent and verbal consent must be obtained both in each instance of sexual intimacy and as the level of sexual intimacy increases (e.g., moving from kissing to petting, from petting to oral sex, from oral sex to intercourse, etc...). Wouldn't that suggest that at any point in a sexually intimate encounter, a person can withdraw their consent, and the other person would be expected to stop?

As a community, including the courts, medical professionals and parents, we need to be clear - rape is sexual contact that occurs against a person's will by means of force, violence, duress, or fear of bodily injury. How hard is that to understand?

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Labels: Sexuality

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Grand Rounds 3.07: Thank You

I would like to thank Rita Schwab from the MSSP Nexus Blog for hosting this week's Grand Rounds and including my post on Teens and the Web World.

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Lesbian, gay, bisexual, transgender, queer & questioning youth

Lesbian, gay, bisexual, transgender, queer & questioning youth have specific health needs and need safe places in the community where they can explore their feelings, socialize, and get support during adolescence and/or the coming out process. Many of these youth face discrimination and bullying, and need the support of parents,teachers, clinicians, and community members. Below is a resource list with links and brief descriptions for the San Francisco Bay Area.

The Outlet Program, Mountain View – Outlet supports and empowers lesbian, gay, bisexual, transgender, queer and questioning youth ages 13-20 living on the Peninsula and South Bay. Through a range of support services, leadership training, community education and advocacy, Outlet successfully increases youth confidence, builds personal assets, and creates healthier communities.

The Billy Defrank Center, San Jose - Youth programs provide a safe space for youth to develop their sexual and gender identities and empower them to realize their potential as valuable members of the community.

Lyric, San Francisco - Lavender Youth Recreation and Information Center (LYRIC) is a community center for lesbian, gay, bisexual, transgender, queer and questioning youth 23 and younger. LYRIC’s mission is to build community and inspire positive social change through education enhancement, career training, health promotion, and leadership development with lesbian, gay, bisexual, transgender, queer, and questioning youth, their families, and allies of all races, classes, genders, and abilities.

The Pacific Center - Berkeley - The Pacific Center is a Lesbian, Gay, Bisexual, and Transgender (LGBT) community center serving the East Bay and Greater Bay Area that offers a broad array of human and health services for LGBT people of all ages and backgrounds.

The Lambda Youth Project, Hayward - The Lambda Youth Project serves needs of LGBTQQ youth as well as their friends and families. It provides a safe place for young people to explore feeling and connect with other young people, and creates drug/alcohol free activities and events.

SMAAC, Oakland - SMAAC Youth Center provides a safe space for youth who would otherwise have no such space in their lives. In additional to safe, supervised recreational activities, the Center provides one-on-one mentoring, health education, computer training and access, employment assistance, leadership and facilitation training, counseling and support to these often overlooked youth.

STRANGE, Santa Cruz - STRANGE is a nonprofit youth organization that serves and empowers the multi-racial, intersex, transgender, queer, bisexual, lesbian, gay, and questioning youth of Santa Cruz County and their straight and adult allies. They create safe spaces, which provide opportunities for support, socializing, and activist work to end the social isolation often experienced by these youth and to build a strong community.

The Diversity Center, Santa Cruz - The Diversity Center is a community center dedicated to advancing the causes and priorities of lesbian, gay, bisexual, transgender, intersex and questioning (LGBTIQ) individuals and their allies in Santa Cruz County.

Positive Images, Sonoma County - Positive Images provides a safe space for teens and young adults and provides community educational services for high schools, businesses, community-based organizations, colleges, hospitals, social service departments, and other organizations interested in learning more about the issues facing GLBTQQI youth and young adults.

Spectrum, Marin County - Spectrum hosts and collaborates with a variety of programs, groups and activities for the LGBT community, including Rainbow's End, a facilitated social and support group for lesbian, gay, bisexual, transgender, and questioning youth ages 14-19 that meets weekly for fun, discussion, and support.

The GSA Network, based in San Francisco, serves all of California - Gay-Straight Alliance Network is a youth-led organization that connects school-based Gay-Straight Alliances (GSAs) to each other and community resources. Through peer support, leadership development, and training, GSA Network supports young people in starting, strengthening, and sustaining GSAs and builds the capacity of GSAs to:

• create safe environments in schools for students to support each other and learn about homophobia and other oppressions
• educate the school community about homophobia, gender identity, and sexual orientation issues
• fight discrimination, harassment, and violence in schools

Resources for queer parents and parents with queer children (adult and teen children)
Colage - Exists to engage, connect, and empower people to make the world a better place for children of lesbian, gay, bisexual, and/or transgender parents and families.

PFLAG San Jose Chapter - Parents, Families and Friends of Lesbians and Gays (PFLAG) promotes the health and well-being of gay, lesbian, bisexual and transgendered persons, their families and friends through: support, to cope with an adverse society; education, to enlighten an ill-informed public; and advocacy, to end discrimination and to secure equal civil rights. Parents, Families and Friends of Lesbians and Gays provides opportunity for dialogue about sexual orientation and gender identity, and acts to create a society that is healthy and respectful of human diversity.

Transgender specific organizations, local and national
The word "transgender" is an umbrella term that includes female and male cross dressers, transvestites, drag queens and kings, female and male impersonators, intersexed individuals, pre-operative, post-operative and non-operative transsexuals, masculine females, feminine males, all persons whose perceived gender or anatomical sex may be incongruent with their gender expression, and all persons exhibiting gender characteristics and identities which are perceived to be androgynous.

Transgender Law Center, San Francisco - The Transgender Law Center (TLC) is a civil rights organization advocating for transgender communities. They connect transgender people and their families to technically sound and culturally competent legal services, increase acceptance and enforcement of laws and policies that support California's transgender communities, and work to change laws and systems that fail to incorporate the needs and experiences of transgender people.

Transgender San Francisco - TransGender San Francisco is a non-profit corporation dedicated to serving the educational, social, and recreational needs of the transgendered community. TGSF is also dedicated to educating the general public about transgenderism and promoting a positive image of transgendered persons among the general public. The transgendered community includes all transgendered persons, their family and friends, and anyone with a sincere interest in the transgendered.

Youth TIES, SF Bay Area - Youth Trans & Intersex Education Services (Youth TIES) is a youth-led organization advocating for trans, gender-variant, intersex and questioning (TGIQ) youth. They address the challenges facing TGIQ youth in the San Francisco Bay Area by educating the service providers who work with them, and providing TGIQ youth with information and referrals.

Gender.ORG - Gender Education and Advocacy (GEA) is a national organization focused on the needs, issues and concerns of gender variant people in human society. They seek to educate and advocate for all human beings who suffer from gender-based oppression in all of its many forms.

And for parents with gender variant children
The Gender Development Program (GDP) provides outpatient psychosocial evaluations and therapeutic services for children, adolescents and their families. The program focuses on gender variant behaviors and gender or sexual identity development. The GDP also assists children with these issues and co-occurring mental health disorders, as well as provides psychosocial consultation for children with medical genital conditions.

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Labels: GLBT

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Teen Smoking

According to the Health Behavior News Service, Health Psychology recently published a meta-analysis of 48 articles published about teen smoking cessation programs and quit rates. The adolescents who enrolled in these studies smoked an average of 10 cigarettes a day, were white, and about half were female. They also wanted to quit, which mirrors a report from the CDC saying that 61% of teen smokers wanted to quit.

The quit rates of teens who participated in smoking cessation programs was 9.1% compared to a 6.2% quit rate for teen smokers not in cessation programs. Not all cessation programs were effective though. The best cessation programs included:

• Cognitive-behavioral techniques or strategies to enhance motivation;
• Social influence content to counter tobacco industry promotions, peer pressure, and media images;
• Programming within schools;
• At least five sessions; and
• Longer follow-up periods.

This research suggests that teens who smoke should sign up for the cessation programs now provided by most HMOs and school-based clinics.

Photo credit: benkay

Labels: Substance Abuse

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Teens and the Web World

Yuki Noguchi's article in the Washington Post on October 29, 2006 entitled "In Teens' Web World, My Space Is So Last Year," was really interesting. However, I was less interested in what sites kids think are "in" as social spaces on the Internet, than I was about the facts about these sites. Did you know that Google struck a $900 million deal with NewsCorp primarily to advertise on MySpace? That may be because MySpace has amassed 124 million profiles during the last 2.5 years and with teens spending 1 - 4 hours a month decorating and posting notes and pictures on their profiles, or their friend's profiles, they are being exposed to a lot of advertising.

Here are some average times spent on social networking sites in the past few years:

• In October 2002 the typical Xanga user spent an average of 1 hour 39 minutes a month on the site.
• In October 2003, Friendster users spent an average of 1 hour and 51 minutes on the site which increased to 3 hours and 3 minutes in February 2006.
• In October 2005 MySpace users averaged 2 hours 25 minutes.
• In September 2006 Facebook users spent an average of 1 hour and 9 minutes on the site.

These teens are fickle though - these are free sites and teens reportedly change sites frequently, in mass, with their friends, looking for better services, new ways to communicate and share content they find or create, escaping a creepy predator, or to avoid the peeping of their parents or teachers.

What are teens doing on these sites? They are posting on blogs (like their parent's diary), looking for their friend's profiles, looking at photos, leaving comments, and finding friendship and romance. There is a whole new type of peer drama associated with these social spaces. Friends are hurt by what is said, being excluded, or just not being "cool" enough to rank as top friends.

Apart from the drama and social chaos caused by the communication on these sites, teens are also victimized by predators pretending to be peers and raking in personal information posted by teens for their friends. Add these social threats to the inactivity associated with hours spent online, and the prognosis is not good. I hate to sound like an old fogey, but we need to make sure our preteens are well-versed in web safety, get our teens off these sites unless they can block strangers, and get them interacting with people in the community and making friends the old-fashoned way. Their health and safety may be at risk!

Photo credit: lorri37

Labels: Media

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