1. Changing Our Paradigm for Understanding Adolescent Sexuality Amy Schalet, Ph.D. Ibis Social Science Postdoctoral Fellow June 6 th, 2006

2. Age of First Sex Median Age U.S.Netherlands Girls1717 Boys1818 Sources: Graaf et al., 2005; United Nations, 2003

3. Age of First Marriage Median Age U.S.Netherlands Women2529 Men2731 Sources:Abma et al., 2004; United Nations, 2003 Sources: Abma et al., 2004; United Nations, 2003

4. Percentage of Women Who Have Sexual Intercourse Before Age 20 Sources: Darroch et al., 2001; Graaf et al., 2005; Mosher et al., 2005

5. Public Health Source: Schalet, 2004

7. Source: Advocates for Youth, 2001

8. Contraceptive Use at First Intercourse HormonalContraceptionCondom Hormonal + Condom Dutch Females 647546 American Females 266717 Source: Abma et al., 2004;Graaf et al., 2005 Source: Abma et al., 2004; Graaf et al., 2005

9. Percentage of Children Living in Low-, Middle- and High-Income Households Low Income (<50% Median) Middle Income (50%-150 Median) High Income (>150% Median) United States 22%62%16% Netherlands10%82%8% Economic Resources Source: Luxembourg Income Study: Key Figures

10. Sexual Experience Dutch Adolescents Sexual Experience Dutch Adolescents Felt in Control of Timing of First Sexual Experiences Enjoyed First Sexual Experiences Experienced First Intercourse as Mutually Desired and Decided Engages in Current Sexual Activity within Steady Relationship Feels in Love with Current Sexual Partner

11. Sexual Experience American Adolescents Sexual Experience American Adolescents Control: ? Enjoyment: ? Mutuality:? Relationship: ? In Love: ?

12. USBoysUSGirlsNLGirls/Boys Wished Had Waited Longer to Have Sex* 63%69% 8% 8% Experienced First Sex as Really Wanted* 59%33%88% Subjective Experience of Adolescent Sexuality * See Notes Sources: Abma et al., 2004;Albert, 2004; Graaf et al., 2005 Sources: Abma et al., 2004; Albert, 2004; Graaf et al., 2005

13. Data Collection Data Collection Interview Period: 1991-2000 Interviewees: White, Secular and Moderately Religious Middle Class Interview Type: Semi-structured In-depth Interviews 72 Interviews with Boys and Girls, Ages 15-17 58 Parent Interviews (Mothers and Fathers) Interview Content: Variety of Topics Interviews: 1-2 hours, Taped, Transcribed, and Analyzed with N5

14. Raging Hormones Out of Control DRAMATIZATION Battle of the Sexes “Not Under My Roof” Adolescent Sexuality in the United States

15. Readiness and (Self) Regulation NORMALIZATION Relationship Between the Sexes Normal and Non- Secretive Sexuality Adolescent Sexuality in the Netherlands

16. Sex as Risk-Taking Dramatization Love as Extraordinary Sex as Secret Teenagers in the United States

17. Sex as Preparation Normalization Love as Normal Sex as Negotiation Teenagers in the Netherlands

18. Percentage of Women Who Have Sexual Intercourse Before Age 20 Sources: Darroch et al., 2001; Graaf et al., 2005; Mosher et al., 2005

19. Dramatization of Adolescent Sexuality ParentsTeenagers Raging Hormones Out of Control Sex as Risk The Battle Between the Sexes Love as Extraordinary “Not Under My Roof” “Not Under My Roof” Sex as Secret

20. Adolescent Sexual Health (Sexual) Agency (Sexual) Agency Control over and Ownership of Sexual Decision Making Process Control over and Ownership of Sexual Decision Making Process Recognition and Communication of Wishes and Boundaries Recognition and Communication of Wishes and Boundaries Anticipation of and Preparation for Sexual Activity Anticipation of and Preparation for Sexual Activity Pleasure and Enjoyment Pleasure and Enjoyment Mutuality in Romantic Relationships Mutuality in Romantic Relationships Relationships Relationships Emotions Emotions Interactions Interactions Connection Between Parents and Teenagers Connection Between Parents and Teenagers

21. Cultural Change in the Netherlands, 1968-1981 Sexual ATTITUDES change Sexual ATTITUDES change 1968: < 25% of the adults believed it is right for a 1968: < 25% of the adults believed it is right for a girl to have sex with a boy that she loves girl to have sex with a boy that she loves 1981: > 60% of the adults believed it is right for a 1981: > 60% of the adults believed it is right for a girl to have sex with a boy that she loves girl to have sex with a boy that she loves Source: Kooy, 1983

22. Public Opinion United States 65% of respondents say that sex under the age of 18 is never justified 65% of respondents say that sex under the age of 18 is never justified The Netherlands The Netherlands 25% of respondents say that sex under the age of 18 is never justified 25% of respondents say that sex under the age of 18 is never justified Source: Halman, 1991

23. Sources: Abma, J.C., G.M. Martinez, W.D. Mosher, and B.S. Dawson. "Teenagers in the United States: Sexual Activity, Contraceptive Use, and Childbearing, 2002." National Center for Health Statistics. Vital and Health Statistics 23 (24). Hyattsville, MD: Centers for Disease Control and Prevention, 2004. Abma, J.C., G.M. Martinez, W.D. Mosher, and B.S. Dawson. "Teenagers in the United States: Sexual Activity, Contraceptive Use, and Childbearing, 2002." National Center for Health Statistics. Vital and Health Statistics 23 (24). Hyattsville, MD: Centers for Disease Control and Prevention, 2004. Advocates for Youth. “Adolescent Sexual Health in Europe and the U.S.-Why the Difference?” 2nd Edition. Washington, DC, 2001. Advocates for Youth. “Adolescent Sexual Health in Europe and the U.S.-Why the Difference?” 2nd Edition. Washington, DC, 2001. Albert, Bill. "With One Voice: America's Adults and Teens Sound Off About Teen Pregnancy." Washington, DC: National Campaign to Prevent Teen Pregnancy, 2004. Albert, Bill. "With One Voice: America's Adults and Teens Sound Off About Teen Pregnancy." Washington, DC: National Campaign to Prevent Teen Pregnancy, 2004. Darroch, Jacqueline E., Susheela Singh, and Jennifer J. Frost. "Differences in Teenage Pregnancy Rates among Five Developed Countries: The Roles of Sexual Activity and Contraceptive Use." Family Planning Perspectives 33, no. 6 (2001): 244-50 & 81. Darroch, Jacqueline E., Susheela Singh, and Jennifer J. Frost. "Differences in Teenage Pregnancy Rates among Five Developed Countries: The Roles of Sexual Activity and Contraceptive Use." Family Planning Perspectives 33, no. 6 (2001): 244-50 & 81. Graaf, Hanneke de, Suzanne Meijer, Jos Poelman, and Ine Vanwesenbeeck. "Seks Onder Je 25ste." Utrecht/Amsterdam: Rutgers Nisso Group/Soa Aids Nederland, 2005. Graaf, Hanneke de, Suzanne Meijer, Jos Poelman, and Ine Vanwesenbeeck. "Seks Onder Je 25ste." Utrecht/Amsterdam: Rutgers Nisso Group/Soa Aids Nederland, 2005. Halman, Lodewijk C.J.M. Waarden in De Westerse Wereld: Een Internationale Exploratie Van De Waarden in De Westerse Samenleving. Tilburg: Tilburg University Press, 1991. Halman, Lodewijk C.J.M. Waarden in De Westerse Wereld: Een Internationale Exploratie Van De Waarden in De Westerse Samenleving. Tilburg: Tilburg University Press, 1991. Kooy, G.A. Sex in Nederland: Het Meest Recente Onderzoek Naar Houding En Gedrag Van De Nederlandse Bevolking. 1e druk ed. Utrecht: Uitgeverij Het Spectrum, 1983. Kooy, G.A. Sex in Nederland: Het Meest Recente Onderzoek Naar Houding En Gedrag Van De Nederlandse Bevolking. 1e druk ed. Utrecht: Uitgeverij Het Spectrum, 1983. Luxemburg Income Study Key Figures (http://www.lisproject.org/keyfigures.htm) Luxemburg Income Study Key Figures (http://www.lisproject.org/keyfigures.htm) Mosher, W.D., A. Chandra, and J. Jones. "Sexual Behavior and Selected Health Measures: Men and Women 15- 44 Years of Age, United States, 2002." In Advance Data from Vital and Health Statistics; no 362. Hyattsville, MD: National Center for Health Statistics, 2005. Mosher, W.D., A. Chandra, and J. Jones. "Sexual Behavior and Selected Health Measures: Men and Women 15- 44 Years of Age, United States, 2002." In Advance Data from Vital and Health Statistics; no 362. Hyattsville, MD: National Center for Health Statistics, 2005. Schalet, Amy. "Must We Fear Adolescent Sexuality?" Medscape General Medicine 6, no. 4 (2004). Schalet, Amy. "Must We Fear Adolescent Sexuality?" Medscape General Medicine 6, no. 4 (2004). United Nations. Trends in Europe and North America: The Statistical Yearbook of the Economic Commission for Europe. New York, 2003. United Nations. Trends in Europe and North America: The Statistical Yearbook of the Economic Commission for Europe. New York, 2003.

24. My contact info: Amy Schalet, PhD schaleta@obgyn.ucsf.edu Find Schalet, 2004 “Must We Fear Adolescent Sexuality” at: “Must We Fear Adolescent Sexuality” at:www.medscape.com/viewarticle/494933