Mother and adolescent knowledge of sexual development: the effects of gender, age, and sexual experience

Adolescence, Spring, 1996 by Marilyn Hockenberry-Eaton, Mary Jane Richman, Colleen Dilorio, Teresa Rivero, Edward Maibach

According to recent statistics from the Guttmacher Institute, over one million teenage girls become pregnant each year (Henshaw, 1994). Of equal concern is the fact that 25-30% of all gonorrhea cases are among adolescents 15-19 years of age and 10-12% of syphilis cases are among this same age group (Centers for Disease Control and Prevention, 1993). Armed with these sobering statistics, educators have renewed their efforts to incorporate sex instruction into the public school curricula. In 1992, 94% of states recommended and 34% mandated some form of sex education in the public schools, often beginning as early as the elementary grades (Haffner, 1992). The content of most programs includes factual information about sexuality, reproduction, pregnancy prevention, sexually transmitted diseases, and acquired immune deficiency syndrome (AIDS). The primary objective of presenting such information is to prepare students to make informed decisions regarding sex-related issues in their own personal lives.

Recent surveys reveal that adolescents' understanding of sexual issues may be inadequate, indicating either that students never acquired basic information about sexual development or that the information was not retained outside the classroom setting. These findings raise concerns that the current format of sex education programs may be ineffective in providing basic sexual information to adolescents. However, before changes can be made in the programs, more information is needed about what students do not know.

The purpose of the present study was to determine the extent to which adolescents could define a series of basic sexual development terms and whether the adequacy of their definitions varied by age, gender, or level of sexual experience. Since concern has been expressed about parents' understanding of sexual development, a second purpose was to determine the extent to which mothers of adolescents could define the same terms and to compare the responses of mothers to those of adolescents.

REVIEW OF THE LITERATURE

Despite the prevalence of sex and AIDS education programs in the public school systems and health care settings, studies reveal that adolescents lack adequate information about human sexuality, reproduction, and STD and pregnancy prevention (Ammerman, Perelli, Adler, & Irwin, 1992; Carver, Kittleson, & Lacey, 1990; Freeman, Rickels, Huggins, Mudd, Garcia, & Dickens, 1980; Leland & Barth, 1992). In an early study, Freeman et al. (1980) found that 57% of a combined sample of high school adolescents and never-pregnant teenage girls at a family planning clinic were uncertain about when a female is most fertile, and 58% believed that the pill could harm a teenage girl's body. Males were more likely than females to believe that women can tell when their "safe time" is, that birth control does not need to be used if sex is only occasional, and that pregnancy cannot occur after unprotected first-time intercourse.

In the decade since the Freeman et al. study, sex-related issues have received more attention from the media due primarily to the AIDS epidemic. Yet studies reveal that adolescents continue to be poorly prepared regarding sexual development. In a recent study, Carver et al. (1990) found that 10th to 12th grade students were able to answer only an average of 12 items correctly on a 30-item true/false test of sexual knowledge. Girls answered an average of 14 items correctly, whereas boys answered an average of 11 items correctly. Leland and Barth (1992) assessed the sexual knowledge of 1,033 high school students on the west coast. They found that students correctly answered an average of 11 items on a 20-item test of general sexual knowledge. No differences were found in the total mean scores for males and females. However, on a subset of 8 items related to STD prevention, males answered more items correctly. Males were more likely than females to know that a space must be left at the tip of a condom to catch sperm, that latex condoms are more effective than animal-skin condoms, and that condoms are effective in preventing the spread of STDs.

Ammerman et al. (1992) surveyed 160 girls regarding their understanding of reproductive anatomy and body functions. The participants were asked to label and define body parts on both male and female figures. Participants were more likely to label and define correctly the vagina, testicles, penis, and anus and less likely to label structures such as vas deferns, urethra, and clitoris correctly. Further, most participants understood only nontechnical and slang terms - not medical terms. There were no differences among the respondents based on age, sexual activity, or history of sex education.

Several investigators have focused their studies on the assessment of contraceptive knowledge. The findings indicate that adolescents are confused about the effectiveness of various types of contraception, have misunderstandings concerning the conditions under which one might become pregnant, and lack adequate information about birth control methods (Kellinger, 1985; Padilla & Baird, 1991; Panzarine & Gould, 1988; Reichelt & Werley, 1975; Scott, Shifman, Orr, Owen, & Fawcett, 1988; Smith, Chacko, & Bermudez, 1989). Of particular note was the study by Scott et al. (1988) in which they asked adolescents to name the things that one can do to keep from getting pregnant and how those things work. The findings revealed that the respondents were generally familiar with the pill but less familiar with other contraceptive methods. Overall, the method named most frequently was the pill, although the condom was named by a majority of males. Males also listed withdrawal with greater frequency than did females, whereas females listed the intrauterine device (IUD) more often than did males. The findings also revealed that the adolescents had misunderstandings about how birth control works. For example, some respondents stated that the pill works by killing eggs and an "IUD closes off the opening for the sperm to get through" (p. 676).