This month, we review topics in adolescent sexuality not covered very frequently in the pediatric literature: contraception, sexually transmitted diseases, screening adolescents for sexual identification preferences, and the mental health aspects of adolescent sexuality, particularly those who identify as gay, lesbian, bisexual, or transgender. For pediatricians (especially more senior ones), even though these are concerns that need to be discussed with adolescents and families, we may not be ideally trained to do so. The informative articles in this issue, guest edited by Pediatric Annals Board Member Meera S. Beharry, MD, FAAP, provide valuable tools and information to help prepare practitioners for working with patients affected by these issues.
Health Trumps Politics
Nine states and the District of Columbia have now legalized same-sex marriage, with Maine, Maryland, and Washington being the first states to do so by popular vote. There’s no doubt that the national and local elections of 2012 revealed a generational gap in attitudes and beliefs around the definition of marriage and the acceptability of alternate lifestyles. Many opinion polls have documented that attitudes toward sexuality clearly differ by age, and that they have changed rapidly. For example, in a survey by the Pew Forum on Religion and Public Life respondents who said they favored same-sex marriage increased from 37% to 49% between 2009 and 2012, with sizeable increases in all age groups during this short time: from 23% to 33% for those older than 67 years; from 32% to 41% among Baby Boomers 48 to 66 years old; from 41% to 51% for Generation Xers 32 to 47 years old; and from 51% to 64% among the Millennials 18 to 31 years old.1
Regardless of a pediatrician’s perspective on gay, lesbian, bisexual, or transgender (GLBT) lifestyles, there are still health concerns that affect adolescent patients, not simply because they are GLBT, but because they are still young and immature, and may engage in risky behaviors or because of poor judgement otherwise find themselves in situations that can endanger their health. As pediatricians, it is our duty to be there to support them.
This Month’s Stamp
The stamps shown here come from the striking 2012 souvenir sheet titled “Great Scientists of the World” issued recently by the Marshall Islands, which is a presidential republic in free association with the US, located in the northern Pacific Ocean. Three of these 20 scientists, William Harvey, Andreas Vesalius, and Gregor Mendel, are very important figures in the history of medicine. For their scientific contributions, 15 others merit at least a brief notation in the history of medicine. For example, Galileo devised a microscope and invented the alcohol thermometer. Only two of these 20 “great scientists” go unmentioned in Garrison’s classic text “The History of Medicine”: André-Marie Ampère, the physicist and mathematician who founded the field of the electromagnetism, and Robert Fulton, who invented the first practical steamboat.
William Harvey (second from left, top row) (1578–1657) was an English physician who was educated in Canterbury and Cambridge and graduated in 1602 from the famous medical school in Padua, Italy. Harvey earned eternal fame for his epic work “De Motu Cordis,” published in 1628. In it, he describes in complete detail the systemic circulation, including the function of the heart and the movement of blood in a circuit, throughout the body.
Souvenir sheet issued in 2012 by the Marshall Islands titled “Great Scientists of the World.”Image courtesy of Stanford T. Shulman, MD. Reprinted with permission.
Andreas Vesalius (left, third row) (1514–1564) was a Flemish physician and anatomist who was educated in Paris, Louvain (Belgium), and also graduated from the medical school in Padua in 1537. By his careful observations from a very large number of detailed human dissections, Vesalius corrected misconceptions about human anatomy dating more than 1,000 years earlier to Galen. He published the seven-volume “De Humani Corporis Fabrica” in 1543.
Gregor Mendel (left, bottom row) (1822–1884) was an Austrian monk and botanist who was educated at the University of Olmütz and later at the University of Vienna. From 1854 to 1868 he studied the inheritance of various characteristics of pea plants, which led to the laws of segregation and independent assortment and established the fundamental principles of genetics and heredity. The importance of his work was not recognized until several decades after his death.