Advancing Sexual and Reproductive Health and Rights
Perspectives on Sexual and Reproductive Health
Volume 34, Number 4, July/August 2002


When we talk about "healthy" sexual activity, especially as regards young people, the focus tends to be on whether and how individuals go about preventing pregnancy and disease. Much less attention goes to examining whether and how they go about protecting their sexual rights: their right to say no to behaviors or demands that are unacceptable to them, as well as to initiate activities that they consider safe and pleasurable. But it is critical that youth who are beginning their sexual lives--not to mention those who are not yet ready to do so--recognize that they have a say in all aspects of their sexuality. It is equally critical that when they need to, they are able to just say no.

Vaughn I. Rickert and colleagues have studied adolescent and young adult women's sexual assertiveness by asking a sample of family planning clinic clients how frequently they believe they have each of 13 sexual rights; the somewhat troubling results are reported in the lead article of this issue of Perspectives on Sexual and Reproductive Health (see article). In no case did all women believe that they have the right to express a given desire or engage in a given behavior. Roughly 10-20% felt that they never are entitled to refuse to have intercourse or to make other decisions about sexual activity or contraceptive use, regardless of their partner's preferences; to tell their partner what kind of sexual behavior they are willing, or unwilling, to engage in; or to ask a partner if he has been tested for sexually transmitted diseases. At best, about 50-80% considered themselves always to have such rights.

Rickert and his coauthors' further contribution is an exploration of the factors that distinguish young women who lack sexual assertiveness. They find that poor academic performance, sexual inexperience, inconsistent contraceptive use and membership in a minority ethnic group can double or even triple the odds that women believe themselves never to have certain sexual rights. As the researchers discuss, these findings have implications for a wide variety of sexual health programs, both in schools and in other settings.

In the larger scheme of things, what are we to make of the findings of Rickert and his team: Why do so many young women lack sexual assertiveness? Where does sexual assertiveness come from? As Patricia East and Joyce Adams see it (see article), power is fundamental to sexual assertiveness, and individuals who feel disempowered--because of their age, race, socioeconomic status or any other characteristic--may be unable to protect their sexual rights. Furthermore, East and Adams observe that many young people "do not even know that they have sexual rights, let alone know how to assert them"--but the authors find this unsurprising, given the current policy climate, and the Bush administration's unwillingness to acknowledge young people's basic right to comprehensive sexuality education. For East and Adams, the keys to sexual assertiveness are promoting awareness of rights and providing education about all of the options, skills and behaviors young people need to protect their autonomy and their health.

Also in This Issue

•Using data from the 1988 and 1990-1991 National Surveys of Adolescent Males, Renata Forste and David W. Haas show that teenage men who expect to initiate intercourse soon engage in more risky behaviors and more precoital sexual activity, and are less involved with religious institutions, than their peers who plan to delay first intercourse (page 184). Youth who anticipate initiating intercourse most commonly attribute their sexual inexperience to a lack of opportunity, whereas those who plan to delay most often cite a desire to wait until marriage. Given these findings, the researchers stress the importance of studying the social, psychological and behavioral context of adolescent sexual activity, rather than simply the question of whether young people are sexually experienced.

• Nicole Stone and Roger Ingham help deepen our understanding of teenage sexual and contraceptive behavior in the United Kingdom by analyzing the predictors of contraceptive use at first intercourse among a sample of British youth (see article). They find that while different factors are important for males and females, discussion of contraceptive use before first sex is significant for both. Such discussion, in turn, is most likely if youngsters have parents who are open, available and comfortable discussing sexual issues.

• Sanders Korenman and coauthors extend the study of the consequences of unintended pregnancy on infants' health by examining both parents' intentions, as reported by young mothers in the 1979-1992 National Longitudinal Survey of Youth (see article). The analysts find a higher risk of poor outcomes among children whose conception was unintended by at least one parent than among those whose parents had both wanted a pregnancy: The former group are more likely than the latter to have a mother who delayed prenatal care, did not breastfeed and, possibly, smoked heavily while pregnant.

• In a research note based on analyses of 1995 National Survey of Family Growth data, LeaVonne Pulley and coauthors challenge the notion that pregnancy mistiming is a unitary construct (see article). The analysts conclude that the extent to which a pregnancy is mistimed varies according to women's socioeconomic and demographic characteristics. Moreover, they observe, maternal happiness and behavior vary with the degree to which a woman intended her pregnancy. The authors urge other researchers to consider alternatives to conventional definitions of intendedness.

--The Editors