TEEN HEALTH:

Prom, Intercourse, of Course?

by Dr. Ann L. Engelland

(April 17, 2008) Just in case you are a prom-goer or the parent of one, let’s think about how to approach the ever tricky subject of teen sex. After you think and talk about a date, a dress, whether to wear a cummerbund, which friends to share a limo with, which after-party to attend, and what to do about alcohol, remember to think and talk about sex, too.

I recently read that 1 in 5 seventeen-year olds plans to have sex for the first time on prom night. Hmmm. Stated another way, twenty percent of prom-goers will lose their virginity on prom night. If we consider that half of US teens do not use condoms at the time of their first intercourse, we are looking at a lot of unprotected intercourse. Might as well slip the “morning after pill into the OJ at the after-prom breakfast. Just kidding.

Combine this information with another piece of news (recently published but based on ten-year-old data. I offer it because I am not sure it has changed too much in the last decade): Only half of teens report discussing contraception or sexually transmitted diseases (STDs) with a partner prior to having sexual intercourse for the first time.

Most of us know that sex education at home takes place over many years and in many different conversations. But maybe prom deserves another chat. What are the important messages to share during this conversation?

“Loss of virginity” should be a “planned” thing. Not a spontaneous, swept-up-in-the-moment sort of event. Planning prevents regret, disease, embarrassment, and unwanted commitments, like pregnancy.

Virginity is not a gift to give away. Nor is it a reward for being asked to the prom. You never “owe” anyone sex or sexual favors. A conversation ahead of time, in the calm of a cool sober moment can set the boundaries before there is a misunderstanding.

What is virginity anyway? It is not an anatomic reality; it is a concept. Teens experiment plenty with fondling, touching, hooking up, playing the bases, or whatever you want to call it before they have intercourse. They incur plenty of risk of herpes, HPV, other STDs and even pregnancy from these activities alone. The physical reality of intercourse is on a continuum with all these other ways of being sexual. Nevertheless, few would argue that intercourse ratchets up the risk - emotional, physical, and psychological.

How do you know if you’re ready anyway? In her 2005 book, The Real Truth about Teens and Sex, Sabrina Weill, a former Seventeen editor, numerates five questions to ask to test readiness.

1. Are you ready to talk honestly and openly with your partner about birth control and STD prevention?

2. Are you ready to go to the doctor to be tested periodically for STDs, to have a gyn exam, and to talk about your sexuality?

3. What are your plans to prevent STDs and pregnancy? Do you know beyond the shadow of a doubt how to use a condom?

4. Are you interested in sex because you are ready or because other people want you to?

5. Are you most interested in sex when alcohol is around? Do you need to lose your inhibitions in order to have the courage or spontaneity to think of having sex?

If you decide that prom night is the night, and you are confident that the person you have chosen is someone you can trust, then ask yourself one other question: How can I make this experience the best it can be, one that I will not regret for as long as I live?

1. Buy condoms, whether it’s for you or for your partner.

2. For girls: buy or ask your doctor for a prescription for Plan B. (Plan B is the morning after pill, available over the counter for anyone over 18 with ID. Most doctors will call in a prescription for anyone younger. It is safe and effective and once you decide to have sex, you should keep some in your top drawer.) If the condom “malfunctions” this is imperative as back-up.

3. Drinking is illegal, of course. If you choose to drink anyway, do not consume more than one drink per hour. Intoxication will take away from the experience in ways you won’t even realize. Make the first time a good time, and one to remember.

4. Take your time with your lover. Don’t rush. Enjoy the touch, the pleasure, the joy of sex and being sexual with someone who matters to you. Being a good lover takes practice. Don’t be too tough on yourselves if it doesn’t seem to go like the movies.

If you choose abstinence, have you thought through how you will do that? Abstinence may take more advanced planning than sex! What will I say and when? What if he/she/I get carried away? Will “No” mean “No”? Can I withstand the pressure? What if I lose my relationship for refusing? What if someone forces me?

Even if you have had intercourse already, it is perfectly fine to decide that on this particular occasion, you will be abstinent. Or that you will be abstinent for a long time to come. The choices are yours and belong to no-one else.

To reinforce your choice about sex, you should choose not to drink alcohol. Alcohol will lower your inhibitions, putting you at risk of changing your mind, getting swept up in the craziness or making regrettable decisions.

There are other options to consider. If you cannot have “the” conversation with your potential date, then consider going with a friend or a group rather than a “date”. This is more “acceptable” in some communities than others. However, once the partying starts, lines blur, and large groups of kids who are not looking for sex can have great fun being together.

Let your parents know where you will be and when. Be sure you have an escape plan if things are dangerous or dangerously dull.

Remember to put your own feelings first when it comes to sex. Be proud of whatever decision you have made and trust your judgment.

Dr. Engelland has a practice in Mamaroneck devoted to Adolescent Primary Care. She now accepts Aetna and Hudson Health Plan. Dr. Engelland can be reached at 698-5544 or AnnEngellandMD.com