We are now three days into 2021. What does this new century hold in store for the world at large, especially for those living in countries with fast aging populations and a rapidly growing young population, like Sri Lanka? Will it allow young people especially, adolescents on the threshold of adulthood, to face the future more positively? Or will the invasion of new technology add to their personal problems? Will stiffer demands for competitive academic performance, the rise in shattered families and broken homes due to divorce, alcoholism and drugs, compound the problems they face as they struggle to cope with hormonal changes that are part of their growing up? How will these negative factors affect their reproductive health and well being? Evidence shows that due to few options left to them, as parents shy away from their duty as the first communicators of sex education to their children, many young adolescents are now turning to the internet seeking information on how to deal with sexual problems.
The Sunday Observer spoke to Senior Lecturer, Department of Psychiatry, University of Sri Jayewardenepura and Consultant Child and Adolescent Psychiatrist, Colombo South Teaching Hospital Dr Yasodha Rohanachandra to get a better perspective on why online sex is now a popular tool for accessing information on sex among adolescents and what adverse impacts this could have on their overall health and well being.
Excerpts …
Q. The Health Ministry this year has decided to give priority to a long neglected health issue, the sexual and reproductive health of adolescents, adopting a more holistic approach to solve the problems of young people. What is meant by a holistic approach and how different is it to the previous approach?
A. According to the World Health organization, Comprehensive Sexuality Education (CSE) involves teaching and learning about the cognitive, emotional, physical and social aspects of sexuality. It aims to equip children and adolescents to develop respectful social and sexual relationships; consider how their choices affect their own well-being and that of others; and understand and ensure the protection of their rights throughout their lives. Such education should encompass self-awareness and knowledge about the body (including anatomical, physiological and emotional aspects) and sexual health and well-being, including information about body changes and maturation processes.
All children and adolescents, including that not in school, should have access to such information and education, which should be free, confidential, adolescent-responsive and non-discriminatory. Ideally, this information should be available both online and in person, and it should be age-appropriate, based on scientific evidence and comprehensive and inclusive in content.
Q. In recent years we have seen increasing reports of youth engaging in free sex. According to reports and surveys a large percentage of adolescents now rely on online sex information rather than obtaining such information from a qualified professional. Why has the internet become so popular among young people for accessing sex education?
A. The internet allows a wide range of sexual behaviours (i.e. viewing pornography, sexting, cybersex, etc.) available at low cost, that can be accessed through many devices including Smartphones and allows anonymity.
This variety of experiences available, ease of access and anonymity make online sexual activities popular among adolescents. The danger is that all the information available in the internet is not accurate or culturally appropriate. Due to their developmental stage, adolescents are not capable of differentiating which information is reliable and which is not. Therefore, getting information online may lead to the development of myths about sexuality and sexual behaviours.
Q. How do you define an adolescent? What are the special problems they face during this period?
A. The World Health Organization defines ‘Adolescents’ as individuals between 10-19 years. The period of life between 10 - 14 years is considered early adolescence, 15-17 is mid adolescence and 17-19 is late adolescence. Adolescence is a period where many physical, psychological and social changes take place. Physically, there is emergence of puberty and accompanying changes in the sex hormones. Psychologically, these hormonal changes lead to attraction towards the opposite sex and curiosity towards sexual activities. However, the areas of the brain responsible for impulse control, planning and judgement are not yet fully developed. Therefore, they are likely to act on their sexual impulses, engage in risky behaviour and seek information through the internet. Also, the hormonal and developmental changes in the brain can make adolescents moody and have volatile and unpredictable emotions.
Q. Does this affect their relationship with parents?
A. Yes. This is the time when peers and fitting in with a social group becomes more important than the relationship with the parents. Therefore, adolescents are more likely to be influenced by their peers and give into peer pressure at this age. They also become distant from their parents and this may lead to conflicts between parents and children.
This is the period when the adolescent starts to develop their own identity or a sense of understanding of themselves in terms of gender identity, sexual identity, vocational direction, and ideological view. Therefore, during this period they may be confused about who they are and what they want from life and are likely to experiment with different things to find what suits them. However, the majority go through adolescence without developing significant social, emotional, or behavioural difficulties and many of the problems resolve by the beginning of adulthood.
Q. What is the adolescent population percentage in Sri Lanka? How many of them are sexually active while still in school? Has the numbers increased in recent years?
A. According to the Department of Census and Statistics, the adolescent population between 10-19-years was approximately 16.2% in 2012. The results of the child activity survey conducted in 2016 showed that 98.4% of the 12-14 age group and 60.3% of the 15-17 age group were attending school.
The “National Survey on Emerging Issues among Adolescents in Sri Lanka” (2004) revealed that 6% of 14-19 year-olds in schools and 22% of out of school adolescents have had sexual experiences with heterosexual partners while 10% in school and 9% out of school adolescents have had homosexual relationships. The National Youth Health Survey 2012/2013 has shown that among the 15-19 age group 34.3% of males and 18.1% of females have engaged in sexual activity within the preceding year, with 5.3% of them engaged in penetrative sexual intercourse. This data suggests that the proportion of adolescents engaging in sexual activities has increased over the years.
Q. Does the low level of knowledge among adolescents, especially about transmission of HIV and STI make young people more vulnerable to Reproductive Health (RH) problems.?
A. According to the National Youth Health Survey, less than 50% of adolescents aged 15-19 were aware that it is possible to become pregnant during the first sexual intercourse and only around 50% were aware that it is possible to acquire HIV following a single sexual intercourse. The rise in the sexual experiences in adolescents coupled with the lack of knowledge on its consequences poses adolescents at a high risk of unwanted pregnancies and sexually transmitted diseases.
Q. With the increasing move towards new technology, increasing divorce rates, fears of unemployment, and the emergence of new infectious diseases such as Covid-19 in this new year, what do you consider as the most significant problems that adolescents would face?
A. In Sri Lanka academic expectations is a major stressor faced by adolescents. Problematic internet use is also becoming commoner among them. We now see a higher number of adolescents with sexual abuse and teenage pregnancies. Self-harm and suicide are also major problems. Parental substance use, marital disharmony, domestic violence and financial difficulties add significant stress to this age group.
Q. Is it true that young people exposed to online risks and online sexual harm from a young age consider the frequency and regularity of exposure to sexual solicitation as being a ‘normal part’ of their online experience?
A. In my day to day practice, I have found that many adolescents are exposed to sexual material online in Sri Lanka and this appears to have worsened in the past few months as children are given more access to Smartphones and computers to engage in online teaching. Due to the online teaching during the Covid-19 period, parents often had to leave their children unsupervised with the Smartphone/laptop while they are at work. Many adolescents have used this opportunity to access sexual materials and for online gaming.
Q. Health-wise what are the impacts of online sex information on young people?
A. The use of the internet can lead to inappropriate relationships, cyber bullying and isolation, for young people. Excessive use of the internet may lead to sleep disturbances, low mood, and attention problems. Some adolescents may go on to develop internet addiction. Therefore, the key is using the internet in moderation under parental guidance and supervision.
Q. What about sexual themes that are now increasingly being given prominence in the media, print advertisements, television, and even video games and other child-friendly mediums.
A. There is some evidence that exposure to sexual material and pornography can lead to early first-time sexual experience, particularly, for adolescents who frequently watch such material. The use of pornography by adolescents has also been shown to be associated with stronger permissive sexual attitudes such as premarital sex and casual sex.
Q. New changes in our education system are unfolding. What is your view on sex education friendly classrooms for older students and school leavers?
A. Sex education programs in schools have been shown to delay initiation of sexual intercourse, lead to fewer sexual partners, fewer experiences of unprotected sex and increase the use of protection. Therefore, incorporating sex education in the curriculum is of great benefit. Such programs should aim at enabling students to communicate with family, peers, and teachers about issues that affect sexual health, make informed and thoughtful decisions about their sexuality, and enable students to take responsibility for their sexual health.
Q. What is the role of parents in imparting correct sex education to their children?
A. Parents are the best people to provide sex education to children. In day to day conversations, parents encounter many opportunities to discuss sexual health and behaviour with their children.
It may be an instance where the child questions the parent about something they have heard or seen or an instance where the child tells the parent about intimate relationships of their friends. Instead of shutting them up, the parents need to turn these instances into opportunities for sexual education. As parents, it is important to have an open line of communication with the children. It is the parents’ responsibility to be aware of the dangers that exist online and to provide a supervised environment where the child could use the internet under guidance. Certain Apps may also help in filtering out websites that contain harmful content.
Q. Your message to all young persons?
A. The internet has a lot of advantages if you use it the right way and for the right purposes. But it can also lead to a great deal of problems if used inappropriately and excessive use does more harm than good. Therefore, it is important to be mindful about your pattern of use and to recognise any negative impacts and get help of your parents or elders before it becomes a problem.