Neither child nor adult, adolescents constitute an age class by themselves with specific health and behavioral problems, which has prompted some hospitals to create specialized adolescent departments. These units have as their goal the medical, psychological and social management of these individuals in all their complexity. The encounter between the teenager and the medical community nonetheless remains ambivalent, colored by a relational avidity but also a fear of becoming dependent. This age group, which covers the transitional period between childhood and adulthood, is increasingly recognized as having is own pathologies that merit an adapted approach. Does the term youth rhyme with health? An inquiry conducted in 1999 by the Centre de Recherche d'Etude et de Documentation en Economie de la Santé (CREDES) on 2,309 youths, 11–20 years old, showed that 45% suffered from dental problems, 13% had dermatological diseases (especially acne), 7% of the girls had genitourinary infections and 6% had respiratory diseases.

Behavioral disorders, however, characterize particularly well the health problems of today's teenagers: addictive behavior, attempted suicides, road accidents, aggression and/or eating disorders. Although early maternity has always been part of the history of women, pregnancy is often an 'accident' associated with high-risk behavior. Pregnancy can express the anxiety of everyday living, or it may be a poorly adapted response to an already precarious situation or a simple continuation of the family's history.

Pediatric and Adolescent Gynecology  1. Gynecologic Clinical Examination of the Child and Adolescent  2. Imaging in Pediatric and Adolescent Gynecology  3. The Prepubertal Girl     L Ambiguous Genitalia in the Newborn: Diagnosis, Etiology and Sex Assignment     L Vulvo-Vaginal Disorders     L Precocious Puberty (Complete, Partial)     L Ovarian Cysts in Prepubertal Girls     L Sexual Abuse in Prepubertal Children and Adolescents  4. The Adolescent Girl     L Delayed Puberty     L Menstrual Irregularities     L Adolescent Dysmenorrhea     L Hyperandrogenism in Adolescent Girls     L Ovarian Masses in Adolescent Girls     L Breast Diseases in Adolescents     L Sexually Transmitted Diseases     L Contraception for Adolescents

Teenage Sexuality and Sex Education

In France, the mean age at the time of the first sexual relationship has remained 17 years for both sexes since 1985. In contrast, the age distribution for the first sexual experience indicates ever younger participants: 21% of the boys and 10% of the girls first had sexual intercourse at 15 years or younger.

Between 15 and 18 years, 47% of the boys and 41% of the girls have already had sexual intercourse with penetration. In the USA, 56% of the girls and 73% of the boys 15–19 years old have had sexual experiences, whereas about 20% of the girls and 33% of the boys have been sexually active before 15 years of age. The mean age for the first sexual experience is the same as in France, i.e., about 17 years for girls and 16 years for boys. All studies have shown that the earlier sexual intercourse is practiced, the more often it is an act of submission rather than of desire.

In 1994, the French national campaign against human immunodeficiency virus infection and its acquired immunodeficiency syndrome (AIDS) made condoms the primary method of contraception for first sexual experiences.

Sexual intercourse during adolescence tends to be sporadic (5–15 times/year) and unplanned (63% occurring during vacations). Furthermore, these relationships are of short duration, rarely exceeding 1 month, which partially explains the first-line use of condoms.

Younger teenagers are especially vulnerable to coercive and non-consensual sex. Involuntary sexual activity has been reported by 74% of sexually active girls younger than 14 years and 60% of those under 15 years.

The contraceptive pill is often started several months later because adolescents primarily associate condoms with prevention of AIDS and sexually transmitted diseases rather than with unwanted pregnancy. Nevertheless, use of the pill markedly increases with regular sexual activity to the detriment of condoms.

Thus, the dual message 'pill and condom' has been poorly integrated into the mores and often remains temporally disassociated.

The national investigation, 'Adolescents', conducted in 1993 by M. Choquet (Director of Research at the Institut National de la Santa et de la Recherche Medicale, INSERM) and S. Ledoux found that level of education appears to influence the regularity and number of sexual experiences. Still, 21% of sexually active girls do not use any means of contraception. This should be kept in mind during the preparation of messages to be transmitted to teenagers.

Teenage sexuality passes through two phases: first, infantile sexuality, corresponding to the discovery of one's body and pleasure of the organ, and then, genital sexuality, reflecting the capacity to reach orgasm and to reproduce.

The latter phase, in turn, is composed of two stages: first, the discovery of one's body and its power, and second, the discovery of the repercussions associated with the complementarity of the sexes (the need for the other). For the young male, when it 'works', he is satisfied. For the young woman, the question of fertility is always lying just under the surface and is what exposes her most to the risk of pregnancy: the need for 'verification' of the good functioning of her body.