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The Source: Volume 2, Issue 3, March/April 1999

New Reports

Adolescent Pregnancy

Kids Count Special Report: When Teens Have Sex: Issues and Trends
The Annie E. Casey Foundation
This report describes the impact that teen pregnancy has on the nation and outlines a series of recommendations designed to help communities and families reduce teen pregnancy. In addition, it offers recent data on teen pregnancy, childbearing, STD rates, and detailed state-by-state data on teen sexual activity.
1998; Free; The Annie E. Casey Foundation, 701 St. Paul Street, Baltimore, MD 21202; Phone: 410/547-6600; Fax 410/547-6624.

Teenage Pregnancy: The Case for Prevention
An Analysis of Recent Trends & Federal Expenditures Associated with Teenage Pregnancy
Advocates For Youth
This document discussed the nation’s investments in primary teen pregnancy prevention programs versus its concurrent expenditures to provide services to families that began with a teen birth.
1998; $25.00; Advocates for Youth, 2000 M Street,NW Suite 750; Washington, DC 20036; Phone: 202/419-3420; Fax: 202/419-1448; Web site: http://www.advocatesforyouth.org

Reproductive Health Care

Responding to Teen Voices: A Report on the Adolescent Research Initiative
Planned Parenthood of New York City, Inc.
This report provides findings from a three-year research project called Adolescent Research Initiative (ARI) that examined barriers that prevent young people from accessing sexual and reproductive health care services.
1998; Free; Planned Parenthood of New York City, Inc., Margaret Sanger Square, 26 Bleeker Street, New York, NY 10012-2413; Phone: 212/274-7200; Fax: 212/274-7276; Web site: http://www.plannedparenthood.org

Adolescents

Goodbye to Girlhood: What’s Troubling Girls and What We Can Do About It
Barbara Dafoe Whitehead and Theodora Ooms
This publication examines the problems girls confront; how the media, schools, and other social institutions contribute to these problems; and what can be done to create a more "girl-friendly" culture. It is an authored reflection based in part on a roundtable meeting held by the National Campaign and the Family Impact seminar in late 1997.
1999; $10; The National Campaign to Prevent Teen Pregnancy, 1776 Massachusetts Ave, N.W., Suite 200, Washington, DC 20036; Phone: 202/478-8500; Fax: 202/478-8588.

Sexual Orientation

Calculated Compassion: How the Ex-Gay Movement Serves the Right’s Attack on Democracy
Surina Khan
In response to the "ex-gay" movement, this report from Political Research Associates, the Policy Institute of the National Gay and Lesbian Task Force and Equal Partners in Faith demonstrates four main points about the movement: provides political cover for a significant new phase in the Christian Right’s long-running anti-gay campaign; it is a potential tool for undermining the rationale for lesbian/gay/bisexual/transgender rights; most mainstream religious leaders and religious organizations in the United States do not share the views of the movement and the Christian Right about homosexuality; and it is part of a broader social and political movement that is authoritarian and anti-democratic.
1998; $6; Political Research Associates, 120 Beacon Street, Suite 202, Somerville, MA 02143; Phone: 617/661-9313; Fax: 617/661-0059; Web site: http://www.publiceye.org

Sexually Transmitted Diseases

Practical and Ethical Dilemmas in the Clinical Testing of Microbicides: A Report on a Symposium
Lori L. Heise, et al
This report based on a symposium sponsored by Women’s Health Advocates on Microbicides and The Population Council and produced by The Center for Health and Gender Equity, International Women’s Health Coalition and The Population Council summarizes the issues associated with the potential effects that microbicides may offer to reduce HIV transmission. It addresses ethical considerations, design of efficacy trials, appropriate standard of care, informed consent, social science research, and public policy imperatives among others.
1998; Free; International Women’s Health Coalition, 24 East 21st Street, New York, NY 10010; Phone: 212/979-8500; Fax: 212/979-9009.

Sexually Transmitted Diseases in America: How Many Cases and at What Cost?
Prepared by the American Social Health Association for the Kaiser Family Foundation.
This report assesses the incidence, prevalence, and cost of sexually transmitted diseases (STDs) in the United States today. This update is the first to use a rigorous methodology to provide new estimates on the overall number of STDs occurring in the United States. annually since the mid-1980s. It provides estimates of annual direct medical costs of STD treatment nationally as well as state-by-state.
1998; Free; The Henry J. Kaiser Family Foundation; 2400 Sand Hill Road, Menlo Park, CA 94025; Phone: 800/656-4533, request publication #1445; Fax: 650-854-4800; Web site: http://www.kff.org

New Books

Abortion Wars: A Half Century of Struggle, 1950-2000
Rickie Solinger
In this volume, a diverse group of 22 essayists—journalists, scholars, activists, physicians, philosophers—chronicle the evolution of abortion. It places key issues such as medical practice, activism, legal strategies, and the meaning of choice in the deeply complex historical context of the past 50 years.
1998; $16.95; ISBN 0-520-20952-4; California Princeton Fulfillment Services, P. O. Box 7780-4721, Philadelphia, PA 19182-4721; Phone: 800/822-6657; Fax: 800/999-1958; Web site: http://www.pup.princeton.edu

Breasts: The Women’s Perspective on an American Obsession
Carolyn Latteier
This book illustrates and investigates our societal obsession with breasts. It traces the intricate history of this erotic fascination and its affects on men’s and women’s sexuality and their relationships. It provides readers with insight into how women feel about their bodies.
1998; $14.95; ISBN 1-56023-927-1; Haworth Press, Inc., 10 Alice Street, Binghamton, NY 13904-1580; Phone: 800/429-6784; Fax: 800/895-0582; Web site: http://www.haworthpressinc.com

HIV/AIDS Internet Information Sources and Resources
Jeffrey T. Huber, Ph.D., Editor
This collection of articles is designed to highlight HIV/AIDS-specific Internet information sources and resources. Titles include "The AIDS Community-Based Service Organization and the World-Wide Web: Decisions and Experiences in Creating a Web site," "Internet Resources for HIV+ Children and Adolescents," and "HIV-Related Internet News and Discussion Groups as Professional and Social Support Tools."
1998; $19.95; ISBN 1-56023-117-3; The Haworth Press, Inc., 10 Alice Street, Binghamton, NY 13904-1580; Phone: 800/429-6784; Fax: 800/895-0582; Web site: http://www.haworthpressinc.com

Looking Queer: Body Image and Identity in Lesbian, Bisexual, Gay, and Transgender Communities
Dawn Atkins, Editor
This collection of essays explores the relationships between body form, self-reference, and sexual identity. It looks at how body form issues impact the lives lesbian, bisexual, gay, and transgender people.
1998; $32.95; ISBN 1-56023-931-X; Haworth Press, Inc., 10 Alice Street, Binghamton, NY 13904-1580; Phone: 800/429-6784; Fax: 800/895-0582; Web site: http://www.haworthpressinc.com

Liberty and Sexuality: The Right to Privacy and the Making of Roe V. Wade
David J. Garrow
This book tells three succeeding stories: "Connecticut’s Struggle for the Legalization of Birth Control," "Creating the Right to Privacy and Abortion Reformers and the Origins of Change." It tells the comprehensive story of the legacy of twentieth-century American legal history that has modified and enhanced the lives of millions of Americans.
1994; $35; ISBN 0-520-21302-5; ; California Princeton Fulfillment Services, P. O. Box 7780-4721, Philadelphia, PA 19182-4721; Phone: 800/822-6657; Fax: 800/999-1958; Web site: http://www.pup.princeton.edu

Upcoming Conferences

Book Reviews

(previously published in the SIECUS Report)

HIV/AIDS: It Can Happen To Me
American Association of Retired Persons
601 E Street, N.W.
Washington, DC 20049
28 minute video; $20.

Almost two decades into the HIV/AIDS epidemic, there are of new materials that address HIV/AIDS infection in middle and later life. It Can Happen To Me is one of these current resources.

Emphasizing that, at some point, we will all be effected or affected by the HIV/AIDS epidemic, this video portrays the older faces of HIV/AIDS. Through brief, straightforward personal accounts of adults in middle and later life, the audience learns once again that HIV/AIDS does not discriminate.

The diverse individuals that share their stories have been effected or affected—they, their spouse, their children, or their grandchildren are infected—with the HIV virus. The stories behind the faces demonstrate that "It Can Happen to You."

Mary is one woman who shares her story. She states "The person that sits there and says it’s not going to affect me, is the person that’s more at risk than anyone else."

The overall goal of this video is to heighten awareness in an age group that is not always thought to be at risk. And many middle and older adults do not think that they are at risk. One can only hope these personal narratives will make them aware of factors that would place them at risk—a blood transfusion before 1985; unprotected sexual activity; or intravenous drug use. The risk factors are mentioned in simple language, although never discussed in detail.

This video can serve the general public as a catalyst for discussion in many settings. It would be more informative if followed by a workshop on HIV/AIDS transmission. In addition, it can be used to increase awareness of older adults with HIV/AIDS among health professionals.

Incorporated into this video are a few HIV/AIDS statistics and statements that put the epidemic in perspective. One of the more powerful statements is: "The death toll attributable to AIDS among older Americans by 1998 will approach the number of Americans killed during the Vietnam War"—American Medical Association.

This reality demonstrates the need for an increase in HIV awareness, prevention, and early detection among the middle and older adults population.

Reviewed by Amy Levine, M.A., SIECUS Librarian.

What I’ve Learned About Sex: Leading Sex Educators, Therapists, and Researchers Share Their Secrets
Debra W. Haffner, M. P. H. and Pepper Schwartz, Ph.D.
Perigree Books
The Berkeley Publishing Group
New York, NY
1998, 113 pages.
$10.95

The first time that I read this lovely and lively compilation of—as the sub-title suggests—"learnings" I thought, "What fun this must have been to put together." The next thought was, "How many copies should I buy and send to my friends?" Then, "I wonder which sexologist said that?" And, every now and again, "That is a particularly interesting observation. I wish that nugget of wisdom or point of view had been expanded upon."

As you can see, this small gem of a book does indeed provoke thoughts—and how wonderful that is!

What I’ve Learned About Sex is a collection of close to a thousand observations dealing with many aspects of human sexuality. The author, well known sexology professionals, canvassed over 40 leading sexuality educators, therapists, and researchers, and asked them to write—in just one or two sentences, and without individual attribution—what they learned about sex and sexuality. These pithy statements are grouped into 20 chapters, ranging from sections on men, women, love, attraction, bodies and dating, through observations on sexually explicit materials, marital and extramarital sex, sex after 40, pleasure, peak experiences, raising sexually healthy children, and so on.

The book’s wisdom is dispensed in a "user friendly" manner and seems designed to diminish defensiveness and encourage openness to considering new ideas. Since the top of each page repeats the sentence stem "I’ve learned that…," the unmistakable message is that this is not necessarily dogma but rather just what one person has come to believe. It is offered up to the reader for consideration. Additionally, except for the five pages of resource organizations, hotlines, and Internet addresses, there are no footnotes, there is no glossary, there is no index, and vulgar and slang expressions are avoided.

Some of the "I’ve learned that …" statements are of a personal nature ("Verbal sounds are of my partner’s pleasure add immeasurably to my excitement" or "I can enjoy sexual feelings about another person and not act upon them") though most are more general ("One of the ways to kill a good sex life is to have a TV in the bedroom" and "Unless you want to break up your marriage, only have an affair with someone who has as much to lose as you do").

By universalizing experiences, books permit readers to say: "If this is included in a book, I must not be the only one to experience it! Perhaps I’m not so weird." That’s reassuring. That this area is universally compelling (perhaps only excepting the terminally disaffected) is acknowledged in one "learning" from the very first chapter: "Sex is the most commonly searched topic on the Internet."

What I Learned About Sex provides not just an opportunity for personal learning and reflection—along with some smiles and chuckles—but also can be a useful resource for encouraging communication and understanding with a spouse/partner/lover.

Indeed, this is a particularly useful and low-threat book for couples. Among the couples whom I see in therapy, I would certainly encourage one of the partners to highlight for the other a statement with which s/he agrees, differs, or questions, or which s/he wishes to discuss.

Designed for the mass market reader, this book contains a variety of thoughts with which sexologists are quite familiar, but which might be more novel and provocative to a more general public.

Just think of the wonderful individual thoughts or partner conversations which the following quotes might spark:

While many of the papers delivered at professional sexological conferences are often quite esoteric, it is worth being reminded—as this book often does—that providing information is an important educative task. And this book does it very well.

Reviewed by Dr. Robert Selverstone, a sexuality therapist and educator from Westport, CT.

Lesbian & Gay Youth: Care & Counseling
Caitlin Ryan and Donna Futterman
Columbia University Press
New York, NY
1998, 175 pages
$21.00

Lesbian & Gay Youth: Care & Counseling, a resource for adolescent health providers, arouse out of a Federal Conference on Primary Care Needs for Gay and Lesbian Adolescents held in Washington in December 1994. The authors, Caitlin Ryan and Donna Futterman, a pediatrician and social worker both well known for their professional experience with gay and lesbian adolescents, have written a comprehensive "how to" guide for caregivers, educators, program developers, and families.

This book signals the arrival of a new phase in providers understanding an adolescent minority long ignored and answers the call for them to educate themselves about gay and lesbian youth.

Medical and mental health assessment, treatment, and prevention are presented concisely enough that providers will no doubt come to rely on this small volume as a source for both professional practice and education. Individual chapters on clinical care for HIV disease and on addressing the concerns of the families of lesbian and gay youth are especially timely and informative. Additionally, the text provides numerous quick reference tables of statistics, protocols, and intervention guidelines that are both detailed and accessible.

The first part of Lesbian & Gay Youth: Care & Counseling synthesizes what is currently understood about adolescent identity development. Emphasis is placed, as it is throughout the book, on the reality of stigma and its consequences. Internalized homophobia may result in serious deficits in self esteem and in acting out behaviors while, at the same time, gay youth are at considerable risk for being victims of violence or abuse.

The discussion of stigma attempts to resolve a paradox for health care providers: how to effectively assess and treat the needs of a minority without contributing to its marginalization. The authors make a good case that gay and lesbian youth are a special need group. Early in Lesbian & Gay Youth: Care & Counseling, they argue that when isolated from the larger community, lesbian and gay adolescents appear to have more problems than heterosexual adolescents.

Stigma is subsequently identified as the key developmental variable which differentiates these young people from their heterosexual peers. How, then, does the clinician best provide for a stigmatized minority? Sadly, one youth the authors quote refers to his contacts with mental health professionals: "When they find out you’re lesbian or gay, they focus on your sexuality as the basis of your problems." Indeed, clinicians themselves may be homophobic or simply share the common worries of parents aware of the vicissitudes of life as part of a minority.

Lesbian & Gay Youth: Care & Counseling’s broader message is that all adolescents need better access to appropriate health care. Resources are still seriously deficient in most states, particularly in services for mental health. Since lesbian and gay youth are a significant part of an underserved minority, they will profit from the expansion of services for all adolescents.

Clinicians must have knowledge about this group’s particular needs and some may choose to focus on lesbian, gay, and transgendered youth. Such emphasis may be understood as a phase in our professional understanding of sexual orientation and a fair response to decades of silence from the care giving community. As a result, questions about sexual behavior may be answered and special programs, once assailed as marginalizing, developed. Evidence may be gathered to what degree depression, substance abuse, and other problems associated with gay youth differ, if at all, from the same difficulties experience by heterosexual teens.

Lesbian & Gay Youth: Care & Counseling is intelligent, well written, and instructive. It is also the work of advocates. Lesbian & Gay Youth: Care & Counseling sounds the alarm for health providers to learn more and get to work on behalf of a minority which continues to experience the painful effects of social isolation and stigma.

Reviewed by Grant Stitt, M.S.W., a psychotherapist at the Columbia Center for Gay, Lesbian, and Bisexual Mental Health.

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