"Adolescent Boys Avoid Pediatric Care" (AAP News October 1995) includes the quote, "Adolescent boys are a very tough population to educate about safe sex." Although it was not the main point of the article, the issues of sexuality are a big part of what sends adolescents away from the pediatrician, so let me comment.

Education about safe sex is basically instruction on how to avoid producing babies or getting diseases from other human beings you find attractive and whose bodies you would like to temporarily use for the purpose of personal pleasure without any need for long term commitment. Does anybody notice a problem here?

Maybe it is the truly caring and nurturing part of the pediatrician, the one who has also seen a child from infancy, that rebels at such a cynical approach to the rest of his or her life. This makes it difficult to adopt the "animal model" of adolescence currently in vogue, the one that says, "of course they will be doing it, just try to blunt the epidemics."

Of course, condoms do not protect the heart and the wrenching breakup, inevitable when a relationship starts with sex, leave two populations -- the wounded and the calloused. It was not supposed to end up this way, what with all those authoritative endorsements.

I find it incredible that the AAP has taken so many trendy but destructive stands in this area. I ask individuals to look hard at the motivations of their own hearts. Do not justify your own past or present behavior by calling down certain doom on the next generation. In fact, folks, it may already be too late for the masses.

In my own practice, however, I take a different stand and ask young teens to swim against the tide even if the tide keeps coming. If anyone is interested, I would gladly correspond.

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