Raising Sexually Healthy Children and Adolescents: General Overview and Look at 'Normal Development'

Raising sexually healthy children and adolescents does not result from one single conversation about the how's and what's of sexuality.  Raising sexually healthy children and adolescents follows a long and thoughtful process of communicating through words and behaviors, attitudes, feelings, and information about sexuality and, even more importantly, about the child himself or herself.  Specifically how parents touch their baby, change their diaper, or respond to finding a toddler masturbating provide experiences which strongly influence children's feelings, attitudes, and beliefs about both themselves as individuals and their sexuality.

Many parents today are quite concerned about:

• The possibility of their children being sexually abused
• What they can do to raise sexually healthy children
• Reducing the risk of their children being victimized;
• Not burdening their children with undue fears about sexuality
• Understanding ‘what's normal and what's not’ in terms of specific sexual behaviors.

These concerns are well-warranted, since some one in four or five children are being victimized by sexual abuse at some time during their childhood.  Still, there is much that parents can do to reduce the risk and increase the likelihood that their children will disclose to them should they be abused.

Right from the Start guidelines (SEICUS, 1995) provide a solid foundation upon which parents can raise children and adolescents to become sexually healthy adults.  I suggest that parents routinely ask themselves if what they are doing supports the following as they engage in all areas of their children’s lives:

• Sexuality is a natural and healthy part of living that begins at birth and continues throughout life.
• All children should be loved and cared for and should feel safe and protected.
• All children should feel respected and valued as unique individuals.
• Children should experience their sexuality as a natural part of their development.
• Children begin to learn about sexuality as soon as they are born and continue to learn throughout their lives.
• Parents are their children's most important sexuality educators. School and preschool teachers, day care workers, and health professionals can also provide a positive influence in children's development toward sexual health.
• Children learn from how people touch them, talk with them, and through expectations others have of them. The messages that children receive affect their future attitudes, values, and behaviors.
• Children are naturally curious about how their bodies look and work; how male and female bodies differ; and where babies come from.
• Children's understanding of sexuality is influenced by their parents, other family members, friends, and neighbors, community and school, as well as the media and other factors.
• Children should have experiences which clearly communicate to them that sexuality should never be coercive or exploitative.
• Information about sex-related health risks and abusers should be presented to children within the context of positive information aimed at healthy personal and sexual development such as human development and relationships, personal skills, and health.
• In a pluralistic society, which the United States is, educators should respect the diversity of values and beliefs about sexuality that may exist in a community and among families.

To be frank there has been very little empirical research done to look fully into normal sexual development. Still there is some general understanding about what typically occurs and what parents can do to support healthy sexual development. The next section covers this information.

Infancy

Most importantly infants are learning through their relationships with caregivers to relax and trust others. Babies who feel loved and secure through their relationships with primary caregivers are in the process of developing the capacity for caring interpersonal relationships, which are the cornerstone of healthy sexuality in adult life (www.sexualityandu.com).

Parents and caregivers should be observant of their infants’ temperament and thoughtful about the way which they approach babies as they care for them. Talk to the baby as you prepare to change diapers or feed him/her. Consider how parents and caregivers should be helping infants feel good about their bodies. Let that intention determine the way that you care for infants.

Infants are focused on their senses and may routinely touch their genitals. Boys regularly experience erections. This is normal and not a response to erotic stimulation, but a natural response to touch, friction, or the need to urinate. Infants often prefer nudity. This is not  erotically sexual in nature, but is simply the result of their natural inclination to seek sensory experiences.

Toddler and Preschool Years

Toddlers and preschoolers are developing language at a staggering rate. Parents and caregivers can use this time to teach their children the names of their body parts, making sure to include the genitals. It is also an opportune time to teach, through behaviors, a healthy respect for the toddler's or preschooler's body and ownership. Specifically parents and caregivers can take care not to 'force' kisses or hugs that are not 'okay' with the very young child, and to model the same between adults or child and adult. For example, the case might be:

• That's not okay to touch me there
• It is my body
• You can give Auntie Audrey a hug if you want or not
• It is your body and your choice.

These experiences will promote the toddler's and preschooler's growing sense of autonomy and ownership of their body, which are key factors in the development of sexual health.

Toddlers and preschoolers will often masturbate and/or explore their peers during play interactions. This is normal. Parents and caregivers can use these moments to teach healthy sexuality:

• Touching yourself feels good and you can do it in your room;
• I know that you're very curious about how girls and boys are alike or different
• You decided to find out with your friend.

This is a time to be sensitive to situations that may involve coercion and to teach through information and giving skills about healthy limit-setting in sexuality:

• You can say ‘NO! do not touch me’ to a friend
• It is YOUR body.

It is very important for parents and caregivers to understand that children and adolescents usually do not have these skills. Any kind of sexual play between a child of one age and a child of a different age can be thought of as having a coercive element. The adult should intervene to protect each child.

Toddlers and preschoolers are learning what it is to be a boy or a girl and what they are specifically. During these years, children may want to pretend at being a gender different than what they are. Parents and caregivers can be assured that this too is normal and just part of the overall theme of learning about people, roles, and relationships that is essential to healthy overall development.

Middle Childhood

Pre-adolescent children are focused on social relationships with peers and although they may engage in more intentional masturbation, the behavior between peers is less likely to involve sexual play and more likely to involve relationship dramas and issues around the emotional aspects of friendships. This is a great time for parents and caregivers to use the media and current life events as food for conversations about sexuality, including issues about: gender, sexual abuse and victimization, relationship issues involving respect, religious and spiritual meaning around sexuality in relationship, sexually transmitted diseases, among others. It is important for parents and caregivers to remain open to their children having differences of opinion about these issues. It is equally important for the parent/caregiver to listen as well as to share with their children.

This is a time when children are learning to what extent their parent will listen and hear what they have to say. This is critical in influencing the child's decision about whether or not they will inform their parent/caregiver if they are victimized at any time.

This is also a time when cultural beliefs about gender differences begin to have a well-documented impact on a variety of areas of children's functioning, including self-esteem, and academic performance in particular. Research indicates that girls, in particular, experience lowered levels of self-esteem and a decrease in their academic performance as they approach and go through puberty. Researchers speculate that at least some of this has to do with the 'privileging' of expected male attributes (independence, assertion, skills in logic) and the less 'privileging' of expected female attributes (emotional, dependent, passivity). Parents/caregivers might want to generate conversations about these cultural beliefs and encourage a critical and thoughtful posture about these beliefs.

Adolescence

Puberty is marked by changes in hormones, cognition (the ways that adolescents think), and general physical growth spurts that influence the intensity and nature of how sexuality is experienced. Ideally the parent/caregiver becomes a valued consultant to adolescents as:

• They make choices that are impacted by all of the previously discussed developmental stages,
• The pressing reality of the tensions of hormonal drives to become sexually active and
• The equally pressing need to be loved, valued, and live values they hold near to their heart.

It is essential at this time for the parents/caregivers to ride their own tension between:

• Wanting to protect their children from risk or harm and
• The developmental reality that their children are basically young adults, and will, for better or worse, make choices of their own.

The more that parents/caregivers have created a climate of open and receptive conversation, the more that it is likely that their children will utilize them as consultants and supports.

Needless to say the extent to which parents and caregivers experience comfort with their own sexuality and are aware that their own frailties in sexuality very much influences their skills in raising sexually healthy children. It's not that parents and caregivers must be sexually healthy as much as it is important to be conscious of where they are and where they are not 'sexually healthy' (wounds and beliefs that they would prefer to change or shift). When there have been wounds or problems, I encourage parents and caregivers to seek counsel from someone who will listen and hear what it is that needs to be heard, processed and/or healed.

There is a saying that Developmental Psychologist Erik Erikson had that went: ‘The parent who does not fear death raises a child who does not fear life”. So, it might be said about sexuality: ‘The parent who does not fear sexuality and embraces their sexuality raises the child who embraces and values their sexuality.’

In conclusion Debra Haffner (From Diapers to Dating: A Parent's Guide to Raising Sexually Healthy Children) offers several important tips for providing fertile soil for raising sexually healthy children and adolescents:

1. Reward your child's questions instead of brushing them off or worrying about why they are asking.
2. Don't wait for your child to start the conversation. There are more than enough opportunities in our daily lives to talk about sexuality and it is the parent's or caregiver's responsibility to do just this.
3. It's okay if you don't have an answer. Use resources together to find answers.
4. It's okay to feel uncomfortable. Talk about it anyway and you can even share your discomfort with your child. You can be a model for talking about important issues even when you're uncomfortable or afraid to do so.
5. Look for and use teachable moments. There really isn't a day that goes by where something at home, in the community, or in the media occurs that presents a teachable moment about sexuality.
6. Listen, listen, and listen some more to your children. Pay attention to what they are feeling, wondering, what they may already know and think and what's the concern or curiosity.
7. Facts are not enough. Teach through actions as much as through words. Teach about values and the components of caring and relationships as well as about reproduction and hormones.
8. Teach sons and daughters. The capacity to function sexually is not limited to erections and orgasms: it's about taking care of one's body; making thoughtful and responsible choices; awareness of, reflecting and acting on personal values among other things.
9. Children benefit and learn most when both parents are doing the teaching. Children and adolescents need to hear about the adult viewpoint of both genders. In single parent homes or homes with gay or lesbian parents, bring in close relatives or friends to facilitate this opportunity.
10. Remember to talk about the joys of sexuality. Sexuality has offered humankind from the beginning of time a unique and wondrous way of experiencing great pleasure and intimacy. Children and adolescents need to hear about the potential joys of sexuality from their parents, as they will no doubt learn about the possible dangers, abuses, and wounds from a great many other sources.

The Family Book about Sexuality, Mary Calderone, M.D. and Eric Johnson
Understanding Your Child's Sexual Behavior, Toni Cavanaugh
Keys to Your Child's Healthy Sexuality, Chrystal De Freitas
From Diapers to Dating: A Parent's Guide to Raising Sexually Healthy Children, Debra Haffner
Recognizing Healthy and Unhealthy Sexual Development in Children, Phillip Rich, Ed.D., MSW
www.sexualityandu.com
Parenting from the Inside Out: How a Deeper Self-Understanding Can Help You Raise Children Who Thrive!, Daniel Siegel, M.D. and Mary Hartzell
Talking with Your Children about Sex, Dr. Benjamin Spock
The Family Guide to Sex and Relationships, Richard Walker, PhD