Adolescence and Sexual Health

IntroductionHuman sexuality is a complex phenomenon involving the interaction of one's biologic sex, core gender identity, and gender role behavior. Successful completion of normal stages of sexuality development is important for children and adolescents to allow for optimal life as an adult. Controversies arise for clinicians as they work with their pediatric patients regarding health care sexuality issues. It is important that clinicians help these patients in an unbiased and neutral manner. As adults, these children and adolescents will function in a number of sexuality roles, whether heterosexual, homosexual, or bisexual.Sexuality education is the knowledge that we are all sexual human beings, that our sexuality is part of our lives and can be an enhancement or enrichment of our total personality (1). Human sexuality is a complex phenomenon involving interaction between one's a) biologic sex; b) core gender identity (sense of maleness and femaleness); c) gender role behavior (nonsexual as well as sexual) (1-3). Sexuality is also a basic yet profound recognition that humans need other humans and that this human capacity to give and receive love represents a continuum from birth to death. Human sexuality involves the process of the individual at any age interacting with others and how one learns to get others to interact with oneself. As sexuality develops, the success or failure experienced by the child and teenager has much to do with eventual success or failure as an adult. Childhood sexuality is often viewed in terms of how concepts of human sexuality progress throughout stages of childhood-infancy, toddlerhood, preschool period, school age period, and adolescence. A key component to the healthy development of the teenager is how he/she proceeds with the stages of adolescent sexuality. Adolescence is the critical period of physical, psychosocial, as well as cognitive growth, leading from childhood to maturation and adult life. Puberty is the word used to describe the physical-somatic changes of adolescence. During the adolescent years, the individual must develop a healthy self-esteem and also sexual comfort-learning to deal with those in his/her "sexual" universe.Sexuality begins at birth or even at conception. At age 8-10 months, infants become aware of their genitalia (penis or vagina) and by the age of three, they usually have developed a fixed gender identify. By the time of their fourth birthday, they perceive themselves as being either boys or girls for life. The psychoanalytic view of adolescent sexual development by Freud offers health care professionals a framework for assessing adolescent sexuality. Freud contended that adults develop as sexual beings from birth through adulthood (4). Though various scholars disagree on the exact meaning of these stages, there is agreement that by the time a child enters puberty, he/she should have developed a good self-image, a sense of security, a willingness to trust others, and a conscience with a normal sense of right versus wrong. It is the parents' responsibility to first accept their children's gender, and, then, communicate to them that they are intact, beautiful, and well-formed. If this is not the case, major problems in adolescence and adulthood are likely to unfold.A review of normal childhood behavior reveals that physiologic components to sexuality are evident at an early age. During the first year of life (infancy), exploration is through mouthing and sucking while trust in the caretaker (especially the mother) develops; aggression may develop in the form of biting. Infants learn to be sexual by touching and being touched; how they are held, soothed, and nurtured impacts their emerging sexuality and sets the stage for their sexuality throughout life. Sexual exploration may involve the skin as an erotic organ and some genital touching. Male erections are noted even in utero; orgasm as a neurophysiological phenomenon can occur as early as the fourth month of life and is common in males 6 to 8 years of age. …