Dec 10

When you call a girl a slut

By Dr. Micaela Wexler
When I say “girl,” I am talking about females who have not yet reached adulthood. Girls start being subjected to this abuse starting at the age of 10, if not earlier. By “slut,” I am not just referring to the actual word, but also to any language that shames a girl for expressing her sexuality. And, when I say “you,” I am limiting myself to the adults in girls’ lives who do this who are supposed to be supporting and nurturing these girls: parents, step parents, parents’ girlfriends, aunts, older sisters, teachers, neighbors.

This behavior is so wide spread that a word defining this behavior is now part of our lexicon: slut-shaming. Slut-shaming is defined as “publicly or privately insulting a woman because she expressed her sexuality in a way that does not conform with patriarchal expectations for women.” As a child psychiatrist, I hear slut-shaming several times a day. And, sadly, it is usually women who engage in this behavior. Examples I have heard include:

- a teacher I spoke to about a bullying incident said, of the 12 year old in question, “excuse my language, but if she didn’t dress like a slut . . . ”
- a woman, speaking about her stepdaughter: “she is 15, and she’s already a slut”
- another stepmother, speaking of her husband’s 14 year old daughter, “she goes prancing out the door with skirts up to here, make up that makes her look cheap, to hang out with a bunch of kids to do who-knows-what. I don’t like that sort of behavior around my 12 year old son. You should see how he looks at her. I wish she would just go away.”
- a woman whose boyfriend has a 16 year old: “instead of making her babysit (their one year old), he let her go out with her friends. All she does is go out and screw everyone she sees.”

The implications behind this slut-shaming behavior is that these girls are unworthy of our love, support and protection. In each of these examples, the girls’ behavior was being used as a rationale for not considering her needs. In the first example, the teacher is absolving herself of any responsibility for protecting a 12 year old girl because of how she DRESSES. The other examples all involve stepchildren. So, not only do the girls in question have to suffer the calamity of their parents’ divorce, but they now have a new slut-shaming person in their lives.

In every single example, the needs of the girls are completely ignored. The 14 year old girl mentioned above is entitled to safety in her own home regardless of how she dresses. The 12 year old son would benefit from being taught to respect females rather than watching the behavior that is undoubtedly being demonstrated. If it really is true that the 16 year old is “screwing everyone she sees,” that is a tragedy, not an opportunity for derision.

As a child psychiatrist, I have to think that the women in these slut-shaming examples, and others like them, do not truly wish these girls harm. The teacher chose a helping profession and has dedicated several years to serving middle school children. All the mothers in these examples are incredibly nurturing to their own children.

So, why do you do this? One reason, in my opinion, is that you are truly overwhelmed by the daunting task of shepherding girls through these turbulent years. Raising teenagers, both boys and girls, has become very complicated. Families face constant intrusion from the world at large, through the media, social media, as well as from economic pressures that expose families to risky situations. Many of you are the products of a society that gave you negative images and limited opportunities. You live in a world that offers your family very little support.

I have to believe, also, that you are unaware of the damage this behavior causes. Slut-shaming causes deep, long lasting damage to a girl’s self perception. When girls are slut-shamed by the adults in their lives, they are shunned, isolated, left to navigate the dangerous waters of the teenage world alone, without protection, information and support. This places boys at risk, as well. Slut shaming leaves boys without any meaningful tools they can use in communicating with girls. They are being asked to view potential friends and romantic partners in a negative, one dimensional fashion which ignores who they are as people.

When we make negative comments about how a girl dresses, we are are objectifying that girl, and teaching her, and her male peers, that her value is based on how she looks. Whenever we slut-shame, we make it harder for these girls to defend themselves against rape, child molestation and relationship abuse. We also make it difficult for these girls to develop a healthy sexual identity. Some girls react by exaggerating this behavior. Other girls react by shutting down their sexual side, acquiring negative attitudes about their sexual feelings.
By slut-shaming, you are adding to the turbulence all teenagers face. Since I know that this is not at all your intention, I ask, for the sake of all teenagers, that you examine this behavior and why you engage in it. Next time you get the urge to do this, instead find out what the girl’s behavior means about how she feels as a person. Reach out to her and help her navigate the treacherous waters she and all teenagers find themselves in.

Nov 27

Genital warts: what to tell your teenager

By Dr. Micaela Wexler
One wouldn’t expect a child psychiatrist to be writing about this, but it turns out a common source of severe anxiety for teenagers is discovery of a sexually transmitted infection. Genital warts is one such infection, which is poorly understood by teenagers. Once they have it, they hear just two things: 1) it’s forever; 2) it’s transmittable. In most cases, no one has ever sat down and had an in depth discussion with them about genital warts.

First, parents always want to know: HOW do you talk to your teenager about GENITAL WARTS?

Here’s a way I know of that has worked for parents. This is the phrase that you can use for just about anything:
“This may not ever happen to you, but I was reading an article about it, and I want you to be prepared if it does happen to you, or if it happens to anyone you know.”

Practice saying that to yourself, and then practice saying that phrase to your teenager. Start by using it for a topic that isn’t so sensitive, like, how to avoid being pick-pocketed. You can then segue to topics about health, like, how to treat a urinary tract infection, how to avoid constipation, all the way to talking about sex.

Once you’ve used it a few times on these less sensitive subjects, don’t waste your currency. Dive in and use it before it “expires.” You can say, “now that we’re on the topic of things I’ve read about, what do you know about genital warts?”

Here’s the skinny on genital warts.

Genital warts are warts that are located near or in the genital areas. In a female, that means on or near the vulva (the outside genital area), vagina, cervix, or anus. In a male, that means near or on the penis, scrotum, or anus. They look like bumps or growths. They can be flat or raised, single or many, small or large. They tend to be whitish or flesh colored. They do not cause pain. They do not drain or ooze.

Genital warts are caused by a type of virus, the Human Papilloma Virus (HPV). There are 100’s of types of HPV warts, and they infect multiple parts of the body. Some types of HPV cause plantar warts, which appear on the bottom of one’s foot. Other types infect the genital area, and a smaller subset of those can cause cancer.

Typically, a wart will show up between three weeks to six months after exposure. Sometimes warts can take even longer, up to years, to appear; the virus can live in the body for a very long time without causing any symptoms. This makes it difficult to know who gave you HPV.

Because warts are caused by a virus, they need to INCUBATE in order to cause a visual wart. In simple terms, what this means is that the virus needs to take over the cell’s genetic machinery, and then change those cells to become cells that look like warts. This takes time; it doesn’t happen in just a few days. And, while the virus is going through all the steps of creating a wart, our body’s immune system is fighting the virus at each step. So, if a person is healthy with a good immune system and living a stress free life, the body could potentially fight off HPV enough to keep a wart from appearing.
To better understand this, think about chicken pox, which is also caused by a virus which causes skin eruptions. The chicken pox virus is much stronger than the HPV virus: no matter how healthy and stress free you are, you’re going to get skin eruptions after being exposed (unless you have been vaccinated). Chicken pox requires at least 10 days to incubate and cause skin eruptions, ie, it takes at least that long after exposure to get the chicken pox rash.

How contagious are warts?

HPV transmission can be complicated. If you have a wart, or a lesion, then you are very contagious. For women, this can be a problem, because they could potentially have an eruption on a part of the body they can not see, like the vaginal canal, and not even know they have HPV. The male sexual partner could then get the virus on his penis, and then give that virus to another female, and SHE could get HPV. All of this could happen without anyone knowing anyone has HPV. This complicated transmission is a strong case for using condoms. However, condoms are not 100 per cent protective, because a male could have a virus on his scrotum and transmit it to a woman’s vulva.

How dangerous are genital warts?

Some types of HPV can cause cancer. In women, they can cause anal or cervical cancer. In men, they can cause penile cancer. For this reason, they should not be ignored. Because of the complicated transmission described above, ALL women are advised to get annual pap smears. (Pap is short for papilloma.) Men should examine their genital area on a regular basis, including the penis, the scrotum and the anal regions. If they see or feel a lesion, they should have it looked at by a doctor. Some physicians provide “anal pap smears” for people who have engaged in receptive anal sex.

How can genital warts be prevented?

The only 100 per cent way to prevent genital warts is to abstain from all sexual activity. For many people, especially married people, this is highly impractical. There are ways to reduce the risk of genital warts: 1) use condoms; 2) get the Gardisil vaccine; 3) know your sexual partner well enough to examine the genital area; 4) get annual pap smears; 4) let your partner know you have “tested positive in the past for HPV.”

The last one is important. Many teenagers will neglect to tell their partners out of fear that they will be ostracized, or accused of intentionally spreading STDs. However, saying “I have tested positive for HPV” is clinically no different than saying “I have genital warts,” but much easier to get out of your month. If teenagers are informed with the knowledge in this article, they can at least have the proper “ammo” to disclose this important information.

Click here for more information on genital warts.

Aug 18

Talk to your kids about sex (love)

By Dr. Micaela Wexler
Whenever I perform a psychiatric evuation on a new teenage patient, I always take a sexual history. In ideal situations, I am able to do this outside of the parents’ presence, and then bring it up again when the parents have re-entered the room. Sadly, the ideal situation is rare, as I tend to encounter a great deal of resistance from parents and teenagers alike.

Too often I find that my adolescent patients have never had an in depth discussion about sexuality with their parents. In the best case scenarios, they have been told about pregnancy and STDs, but usually sex has been presented as a a forbidden activity, with the emphasis on religious prohibitions, and it is obvious that the topic has been presented in an atmosphere of discomfort and embarrassment. There is rarely any discussion about relationships, intimacy, sexual expression, body image, masturbation and acceptable behavior. Parents seem to be oblivious to the fact that according to the Guttmacher Institute, 46% of teenagers age 14-19 report having had sex at least once.

Failing to talk to your teenager about sexuality puts him or her at grave risk for a variety of dangers ranging from the obvious – pregnancy – to others that are less obvious but potentially more life threatening, like depression and relationship abuse. Depression is the greatest risk factor for teenage suicide. Romantic break ups are a common trigger for depression in teenagers. Teenagers most at risk for depression following a relationship break up are those who have limited support and poor coping skills. Parental support is a potent protection against teen dating violence.

It is never too early to talk to your child about sex. Ideally, the “sex” talk should begin at birth. Use correct words for genitalia when changing diapers or giving your child a bath. Make positive statements about their body (and yours) throughout their childhood. Early childhood is when boundaries should be taught, that their private parts are their own and no one else should touch them. The same is true about other people’s private parts. Introduce the physiological aspects of sexuality in the elementary school years, with anatomy lessons, including the different processes that occur, such as hormonal and physical changes, pregnancy and orgasms.

I recommend that birth control and STD protection issues be brought up during elementary school years, even if you are a strong believer in abstinence before marriage. Hearing about both birth control and abstinence at the same time does not lead to children engaging in sexual activity earlier. Parents should remember that children hear alternative, even conflicting views about many topics in their lives. Presenting children with choices teaches them decision making skills.

Children are being exposed to sexual topics outside of the home at an earlier age, and they will be safer if they have heard about them from you. In addition, talking about birth control and STDs helps children open up about other sexuality related topics; they are less shy about sharing what they have been exposed to at school and in the media. Don’t be afraid of letting them know the meanings of words they hear, ie blow jobs, fuck, cunt, etc. These are valuable opportunities for parents to express their views on acceptable sexual behavior.

Explore your own thoughts and feelings about sexuality. If you are uncomfortable discussing the topic of sexuality, try to figure out why. Are you unhappy with your own sex life? Are you disappointed with the level of satisfaction you are achieving? Maybe you have a history of domestic abuse or childhood sexual abuse. Were you taught negative views about sexual expression during your own childhood? Or, perhaps you are mourning the loss of a relationship. Getting in touch with your own emotional feelings regarding your sexuality will help you address the emotional impact sexual expression has on your teenager.

Studies show that most parents do not discuss the emotional aspects of sexuality with their teenagers. They do not discuss intimacy, relationship conflicts and violence in relationships. Teenagers are left to navigate the confusing world of dating, relationship building, sexual expression without any skills and with no one to turn to when problems occur. Whether they are engaging in sexual activity or not, teenagers experience very strong emotions when it comes to relationships. Due to their raging hormones, every aspect of the relationship is magnified. This is a dangerous time to withdraw parental support.

Once you have talked to your child about all the concrete aspects of sexuality, you have set the groundwork to talk about the complex emotional issues surrounding sexual expression. It is important to approach the topic in a non- judgmental and non-threatening manner. Open the discussion by asking if their friends are in relationships. Rather than focusing on sex, focus on issues like trust, mutual respect, friendship and honesty. Guide your teenager through a relationship conflict. Be on the lookout for signs of teenage violence. Do not trivialize their feelings. Teach your teenagers that their sexuality is a gift that should be treasured, and that it should never be used to hurt them.