The imperative of understanding normal adolescence

This week’s article is contributed by a Guest Columnist and Consultant Psychiatrist; Dr Olatunde Ayinde, as a follow-up to last week’s article. Happy reading.

Today, we examine the case of Fatima (not real name), the 13-year-old girl who wrote a love letter to her teacher, and was publicly punished and humiliated, and later took her own life. Let us say quickly that this tragic event was a failure of parenting, the school system, government and society.

This discussion will be in two parts:

1. Adolescent sexuality
2. Adolescent sexuality and sexual health education

Adolescent sexuality

Was anything wrong with Fatima?

I have witnessed situations where adolescent boys and girls who were having sexual thoughts and dreams were taken for deliverance for being possessed by “demons of sexual immorality”. Most Nigerian parents have a predictable approach to adolescent sexuality and sexual health: absolute silence on information, use of fear and threats, heavy use of religion and total lack of respect for the adolescent. Often, it is not out of malice. It is a cover for their own inadequacies on the subject.

Adolescence is an important period of development between childhood and full adulthood, and entails physical, emotional and cognitive changes. For many adolescents, it is a period of great confusion that requires all the support systems available to them.

The onset of adolescence varies for different individuals. However, for convenience, let us say it starts from late primary school and ends in the university, and is conveniently divided unto early, middle and late adolescence.

A number of events occur for the first time in adolescence. Breasts and other secondary sexual characteristics develop. Hormones begin to surge and course through the blood stream. The young woman is confused in all of this. She is preoccupied with her body. This is when body image, self-esteem, gender and sexual identity become important. This is the period of increased self-awareness, increased sexual thoughts and fantasies, as well as experimentation.

It is the period when girls are acutely aware of the opinions of their peers and are interested in intimate relationships. Unfortunately, cognitive development does not keep pace with the physical and emotional changes. Early adolescence is still marked by childhood thinking and decision making patterns, which may make sexual decision-making difficult. ALL OF THESE ARE NORMAL!

By middle adolescence many girls “fall in love” for the first time. Their physical attractiveness, self-esteem, acceptance by peers of both sexes and sexual thoughts are one intricate web. Unfortunately, girls go through puberty a bit earlier than boys, and may therefore prefer older boys or men.

So, Fatima’s behaviour is understandable and within the spectrum of adolescent sexual behaviour. Only that she was not equipped with information and skills. Her humiliation was unnecessary and rather unfortunate. Adolescent girls are a special risk group for emotional problems. We may never know her eventual pathway to suicide.

Sexuality and sexual health education (SSHE)

An alarming percentage of adolescents have never had any formal discussions on sexuality and sexual health. Yet a US study found that six per cent of students had sexual intercourse at least once before age 13, and by the end of high school that figure had jumped to 46 per cent. There is a role for parents, schools government and civil society in SSHE.

Simple guidelines for parents

• Open communication, where children can express feelings on any subject, including sexuality around them.
• Non-judgmental, non-punitive attitude towards discussions on sexuality.
• Gain trust of young persons, and show that they are valued, respected and accepted just as they are.
• Update their information on adolescent sexuality. Discuss same with their wards in age appropriate doses and manner. Topics to discuss include puberty, emotional issues, friendships and relationships, sex, decision making concerning sex, pregnancy, STI, HIV, abstinence, protection, birth control etc.
• Use lots of humour and “teachable moments” (random opportunities that crop up in day to day conversations).

For schools

• Non-bullying, non-humiliating learning environment.
• Self-esteem building to accompany discipline.
• Secondary schools to have a minimum of a counsellor, who is firm, youth friendly; knowledgeable in adolescent behaviours, physical and mental health as well as adolescent sexuality and life skills.
• Ministry of Education to develop robust curriculum on SSHE.
• Continuing education for teachers on SSHE.
• Non governmental organisations interested in adolescent sexual health to partner with schools
• Collaboration of parents and schools on SSHE.

A discrete referral to the school counsellor and a firm non-judgmental, non-punitive approach would have done Fatima a world of good. A school wide campaign can then be instituted much later without making reference to her case. Of course, all of these do not guarantee that Fatima would have lived, but we would have given her a chance. The link between adolescent sexuality and emotional wellbeing will be covered subsequently.