PSY 104 Child and Adolescent Development WK-A

14Gender and Sexuality

Severin Schweiger/Cultura/Getty Images

Learning Objectives

After completing this module, you should be able to:

ሁ Outline the biological, social, and cognitive explanations for the emergence of gender identity. ሁ Form evidence-based arguments on gender differences in development. ሁ Summarize the developmental imperative of physical activity for boys and girls during childhood. ሁ Compare and contrast school achievement and learning between boys and girls. ሁ Describe differences and similarities among heterosexual girls, heterosexual boys, and LGBT

adolescents with regard to romantic relationships and identity formation. ሁ Discuss the psychological effects of puberty. ሁ Evaluate ethnic and national differences in sexual activity among adolescents; explain the

consequences of teenage pregnancy. ሁ Identify different health outcomes of sex during adolescence, including categorizing STIs and the

effects of HIV among infected children worldwide.

Section 14.1The Development of Gender

Prologue Recent stories have led to renewed discussion about sex and gender in society. Sasha Lax- ton from Great Britain; Storm Stocker from Toronto, Canada; and Pop from Sweden have all made headlines as their parents were determined to raise them without regard to gender. The children’s rooms were painted in neutral colors; hairstyles, Halloween costumes, and cloth- ing were chosen without perceived regard for gender standards; exposure to toys and other activities were not limited by what was considered “normal” for a boy or a girl.

As a result, there has been considerable debate among parents, academics, and the media about the potential detriment—and benefit—if children are not aware of how they are “sup- posed” to behave. However, these families are also quite outside the mainstream. It takes tremendous effort to rid a child of messages related to gender, including limiting exposure to media, avoiding certain store shelves, and restricting access to preschool and other social activities.

For most children, though, sex and gender are inescapably connected. It is extremely rare for a child to be born with undifferentiated sex organs. Even so, those children still generally have either XX or XY genes. Biological sex is therefore not particularly variable. By contrast, regard- less of biological sex, gender is much more continuous. Some children are drawn quite strongly to the behaviors and activities of one gender over another, whereas other children engage freely in more varied activities. This module explores these issues, as well as concerns related to adolescent sex and romantic relationships and their developmental consequences.

14.1 The Development of Gender Recall the many different factors involved in the development of the self and the formation of gender identity (see Module 12). Gender is a key component in the development of the self. In psychology, gender refers to the meanings societies and individuals give to female and male characteristics, unlike sex, which is biological. How much of gender is dependent on

Courtesy of Ron Mossler (left); Courtesy of Mary Jaworski (right) ሁ These two siblings, the author’s children, wear different clothes, style their hair differently, and

act according to implied “rules” of behavior, which are quite strong. How do we come to accept rules for gender? As children carve a gender identity, is it a natural part of development, or is it institutionalized by parents and society? This module begins to explore these questions.

Section 14.1The Development of Gender

biological sex is a matter of great debate. Although overwhelming neuroscientific evidence indicates that males and females are born different, reinforcement of gender through social- ization is robust and begins early. During childhood, messages from parents, media, school, and peers strongly shape ideas about gender-specific behavior.

The way people define their own gender has a great deal to do with gender roles. We con- struct these roles based on sociocultural norms of what is considered acceptable sex-typed behavior. Individual experiences and societal expectations play strong roles in their develop- ment. For instance, boys and girls are socialized to dress in a particular manner, play with certain kinds of toys, and assist in specific kinds of chores. Culture is closely tied to this pro- cess as well. Some cultures emphasize one role or activity over another. For example, in some parts of Asia, it is not unusual for boys and men to wear a kind of skirt that would be unusual in Europe or North America. These factors and more contribute to how gender is constructed.

Biological Influences Few areas in social and developmental psychology provoke as much controversy as the rela- tive influences of nature and nurture on gender identity. Like so many developmental areas, evidence is clear that the foundation for gender is at first biologically and genetically driven. Notably, male brains are significantly larger than female brains; however, it is unclear what types of advantages, if any, exist (Ruigrok et al., 2014). Specific anatomical brain differences suggest that sex influences development and behavior (Cahill, 2005). Just like bats have rela- tively large brain centers devoted to hearing, rats rely on smell and have relatively large olfac- tory centers, and humans rely on sight and have a sophisticated visual cortex, specific differ- ences in areas of the human brain may reflect relative strengths. In females, the limbic system is larger and parts of the frontal cortex related to decision making are denser. It is well estab- lished that, in males, the amygdala—involved in the fight-or-flight response and other emo- tionally laden stimuli—is larger (Goldstein, Kennedy, & Caviness, 1999; Ruigrok et al., 2014). It is possible that the disparities may reflect differences in emotionality and different responses to stress. It has therefore been suggested that the multitude of biological differ- ences between the sexes “pervade all clinical experience” (Federman, 2006, p. 1514). Never- theless, any small anatomical differences cannot account for the multitude of gender differ- ences we see in society.

Perhaps the strongest evidence for a bio- logical influence on gender development is the finding that androgens, the hormones responsible for male growth and develop- ment, have a significant effect on gender- typed behaviors. Girls who are exposed prenatally to higher concentrations of androgens are more likely to later engage in male-type play behaviors, compared to their sisters who had less exposure. In general, higher levels of androgens are associated with more active, rougher play. Conversely, males who are exposed to higher than nor- mal levels of the female hormone estrogen are more likely to display relatively high levels of stereotypically female behaviors

Romrodinka/iStock/Thinkstock ሁ The development of gender identity begins

early.

Section 14.1The Development of Gender

(Hines, 2013; Karaismailoğlu & Erdem, 2013). In fact, early exposure to male hormones has been linked to male-typical behavior across the animal kingdom. Researchers have discovered that sex-based hormonal influences contribute to changes in brain structure, gene expression, and, ultimately, behavior throughout the animal kingdom (Arnold, 2009; Hines, 2011).

Additional evidence indicates that hormones contribute to differences in cognitive process- ing, including the ways in which we interpret emotions (Little, 2013). Furthermore, areas of the brain that are linked to activity, emotion, and self-regulation appear different in male and female brains, beginning at birth. Because these traits are observable early, it is thought that the distinctions in brain organization contribute to broad-based sex differences in infant tem- perament (Baron-Cohen, 2003; Eagly & Wood, 2013; Hines, 2005; Karaismailoğlu & Erdem, 2013). In turn, these differences are likely responsible for the finding that the average male infant is more active and fussier than the average female. Nevertheless, variability within each sex is much greater than the differences between them.

F o c u s o n B e h a v i o r : W i t h i n - G r o u p v e r s u s B e t w e e n - G r o u p D i f f e r e n c e s It is essential to understand what is meant by within-group differences as opposed to between-group (sometimes referred to as across-group) differences. Figure 14.1 expresses the hypothetical distribution of height for 14-year-old boys and girls. At this age, on aver- age, boys are taller than girls by approximately 1.5 inches (3.8 cm). Typical girls can be anywhere from 60 to 68 inches tall (152–173 cm); typical boys range from 60.5 to 69 inches tall (154–175 cm). Therefore, the average difference between boys and girls of 1.5 inches is relatively small, whereas the range of heights within the group of all girls (Figure 14.1a) and the range of heights within the group of all boys (Figure 14.1b) is relatively large. The difference between boys and girls is still significant but not nearly as dramatic as the differences within each group. The effect size refers to the magnitude of the differ- ence (Figure 14.1c). When the difference between groups is small, there is considerable overlap and the effect size is small; when the difference between groups is large, there is little overlap and the effect size is large. These distinctions are especially important when investigating developmental differences between boys and girls.

Figure 14.1: Within-group versus between-group differences ሁ Between-group sex differences are not nearly as strong as within-group differences.

f14.01_PSY104.ai

Inches 63 Inches 64.5

Average height of 14-year-old girls

Average height of 14-year-old boys

Within group differences for girls

Within group differences for boys

Difference between groups

Section 14.1The Development of Gender

Others suggest that physical differences alone account for distinctions in personality and social behavior. Males are stronger, and therefore they play more physically. Traditionally, women have done much of the caring, feeding, and nurturing, so they would also engage in those activities through play and work. This biosocial perspective presumes that an interac- tion exists between sex and gender identity development, but it also acknowledges that we are not destined to be limited by it (Eagly & Wood, 2013; Fisher, 2006). In modern society, there is more flexibility. For instance, neither physical strength nor nurturance is necessar- ily required to become a successful engineer, artist, or accountant. Men and women are not limited to pursuing activities and careers according to their physical types. Although we can identify at birth whether a brain belongs to a male or a female, all brains include a constella- tion of features that are heterogeneous, plastic, and constantly developing; brains cannot be aligned along a male-female continuum (Joel, 2011).

Evolutionary Influences Some observers approach the biological contributions to gender from an evolutionary per- spective. Brains may have evolved differently due to a developmental advantage. For instance, males may show masculine qualities because our male ancestors needed to protect their families from harm. Females may be attracted to males’ activity and perceived strength in leadership. Similarly, it is argued that women propagate the species by showing nurturance, which begins with gentler childhood play (Murray & Murray, 2011). Through natural selec- tion, separate masculine and feminine traits became more valuable to the species.

Now, instead of genes being expressed strictly for the purpose of survival, perhaps they con- tribute to differences in activity levels and social preferences. For instance, on average, boys prefer more action toys and rougher activities. In contrast, girls engage in more role-playing and quieter activities. These preferences begin in early infancy and exist across cultures (Aydt & Corsaro, 2003; Braza et al., 2012; Campbell, Shirley, & Candy, 2004). Evolution suggests they may have been at least partially due to natural selection.

Social Influences and Reinforcement According to the biosocial perspective, each individual has a broad range of potential out- comes based on life experiences. For instance, sex differences in temperament have been observed to affect how adults respond to infant behavior. Psychosocial factors operate in a variety of ways to turn boys and girls into masculine and feminine adults, depending on atti- tudes and culture. Beginning at an early age and continuing throughout adolescence, when boys and girls do not behave in ways that are representative of their sex, they are often rejected or rebuked, and laws of reinforcement and punishment operate to shape gender identity. These mechanisms operate across cultures and nationalities (Ruble, Martin, & Beren- baum, 2006).

Furthermore, the principal mechanism behind social learn- ing theory is the role of imitation. For instance, fathers and mothers model different types of behaviors. Fathers more typically engage in rough-and-tumble play and mothers tend to participate in more nurturing, softer kinds of activ- ities. According to social learning theory, these behaviors either mimic or prescribe the same tendencies in young children. Regardless, the behaviors are reinforced. Even among children exposed to the “wrong” hormones, as

Critical Thinking If the type of parent dyad (lesbian, gay, or heterosexual) indeed has an effect on chil- dren’s behavior, what does this evidence tell us about the origins and development of gender-related behaviors?

Section 14.1The Development of Gender

discussed earlier, there is evidence that parents reinforce atypical sex play. That is, girls who were exposed to (male) androgens have been found to engage in more boy- typical play and are reinforced for doing so (Wong, Pasterski, Hindmarsh, Geffner, & Hines, 2013).

Although boys as young as 9 months old spend more time engaged with traditional boys’ toys than with those labeled appropriate for girls—implying a biological beginning for gender— boys and girls are typically offered different kinds of toys and levels of stimulation—pointing to the importance of learning factors (Laflamme, Pomerleaui, & Malcuit, 2002). Girls more than boys are reinforced for engaging in gender-specific behavior like dress-up. And when girls play more actively, they are met with more disapproval than are boys (Campbell et al., 2000; Lytton & Romney, 1991). In a comparison of lesbian, gay, and heterosexual parents, it was found that children who have same-gender parents have less stereotypical behavior. The children were less inclined to follow typical gender roles. That is, sons of heterosexual par- ents demonstrated the most masculine characteristics, followed by sons of gay fathers; sons of lesbian mothers showed the least amount of masculinity (Goldberg, Kashy, & Smith, 2012).

In addition, male and female babies tend to be spoken to and attended to differently (Clearfield & Nelson, 2006; Lovas, 2005). In one well-known experiment, 204 adults were shown the same videotape of an infant. Half of the participants were told they were witnessing a boy and half were told it was a girl. When the adult raters assessed the infant’s emotional responses, significant differences emerged depending on whether adults thought the baby was a boy or a girl. The “boy” was seen as less fearful and experiencing more pleasure than the “girl.” The same behavior that was labeled “anger” when the adults thought they were observing a boy was more often labeled “fear” when adults thought it was a girl (Condry & Condry, 1976). Although subsequent behaviors of the children were not measured, it is reasonable to assume that different speech patterns and levels of attentiveness result in diverse behaviors.

Differences in adults’ responses persist when children enter school. When there is a potential classroom conflict, kindergarten teachers are likely to treat girls in a gentler manner than boys. From elementary school until the end of high school, boys are more often called on in class, even when they do not initiate the interaction (one of the reasons that some adults advocate for all-girl schools). Boys are both praised and criticized more, yet teachers believe they are teaching from a gender-neutral position (Duffy, Warren, & Walsh, 2001; Garrahy, 2001; Jones & Dindia, 2004; Sax, Arms, Woodruff, Riggers, & Eagan, 2011). These different responses affect self-concept and self-esteem and reinforce how children should behave. These kinds of norma- tive messages are also incorporated into moral development, as examined in Module 12.

Media The media are often held up as fundamental agents of gender stereotypes. Although certainly the demeanor, dress, and behavior of television characters have changed dramatically over the past couple of generations, media of all types are instrumental in prescribing models of behavior. Regardless of the models that parents project, the effect of media is inescapable. From billboards to movies, children are exposed to models that reinforce gender roles.

Analyses of children’s television programming consistently finds differences in male and female characters. Females more often show relational aggression and are more concerned about their appearance; males show comparatively more physical aggression. Male charac- ters in general, and superheroes in particular, outnumber females by two to one. This propor- tion has remained fairly steady for a number of years, despite more progressive attitudes. In one newer study, though, researchers concluded that the portrayals of male and female gen-

Section 14.1The Development of Gender

der stereotypes in one of the three studied television networks (Disney Channel) had disap- peared (Baker & Raney, 2007; Hentges & Case, 2013; Luther & Legg, 2007).

In other research, exposure to male superheroes was found to be associated with both boys’ and girls’ use of weapons during free play. In spite of the increased use of weapons, superheroes were associated with higher lev- els of male-stereotyped play behavior among boys, but not girls. Furthermore, parents were largely unsuccessful when they attempted to discourage the use of weapons during play, especially when addressing their daughters (Coyne, Linder, Rasmussen, Nelson, & Collier, 2014).

As children move into adolescence, there continue to be strong stereotypes on television. Programs geared specifi- cally toward emerging adolescents (“tweens”) continue distinctive and stereotypical portrayals of personality characteristics, behaviors, and concern for appearance (Gerding & Signorielli, 2014). As noted in Module 12, early adolescence is a particularly important stage of identity development. These stereotypical messages no doubt contribute to the shaping of identity (Steensma, Kreukels, de Vries, & Cohen-Kettenis, 2013).

Cognitive Influences In addition to biology and sociocultural factors, children begin to construct gender-type in the same way Piaget would say we construct knowledge about the physical world. That is, accord- ing to cognitive theorists, children interpret environmental clues that teach them how to act. Gender identity (or a schema for gender) is initially acquired in the second year (Campbell et al., 2004). Beginning at this age, children acquire beliefs and expectations about gender and are usually able to identify the differences between boys and girls based on outward appear- ances. As a result, a gender schema guides the way we view the world beginning at an early age. Because of cognitive limitations, however, preoperational children have rigid ideas about gender. For instance, a preschooler may think it is inappropriate or silly for women to wear a tie simply because “only men do that.”

At around 4 years of age, children acquire gender stability. Now they understand that boys become men and girls become women, but only so long as they act in a particular manner. If a boy dresses like a girl, he can become a girl. Finally, a year or two later, children develop an understanding that gender is permanent. This is called gender constancy. Depending on cultural norms, this is the stage at which children may begin to give up hopes of achieving success in an area that is usually reserved for a gender other than the one with which they identify (Karniol, 2009; Ruble et al., 2007). If children aspire to behave in a way that is incon- sistent with gender, self-concept and self-esteem may suffer.

S E C T I O N R E V I E W Summarize the various factors that inf luence how gender identity develops.

Critical Thinking With regard to the Coyne et al. (2014) study just cited, which conclusion do you think is more accurate? (1) Boys view programs with superheroes more frequently than girls because boys have a stronger innate iden- tification with the characters or (2) Higher levels of stereotyped play are the result of relatively more exposure among boys to superheroes. That is, do boys watch superhe- roes because they identify with the masculin- ity of the characters, or do they first watch superheroes (perhaps due to encouragement by peers and family) and then begin to imi- tate the behavior?

Section 14.2Physical Activity of Boys and Girls in Childhood

14.2 Physical Activity of Boys and Girls in Childhood One area of great interest in examining gender development is the nature of activities in which children engage, especially physical activity. As you have learned so far, the strength of a gender type is often measured by how children interact during play. Of course, general- izations are not true for all children. Individual and cultural differences have a role in activ- ity level, as well. Some parents and cultures are more free-spirited in allowing children to play energetically, whereas others are more restrictive. In general, both boys and girls enjoy a variety of activities. Once again, greater variation is observed within groups than between groups. So the question remains, is there more gender-stereotyped play because children are biologically drawn to one type of play, or do they become more strongly socialized for that type of play? This section considers more closely what research tells us about boys and girls and physical activity.

Early and Middle Childhood There is evidence that childhood activity levels are associated with temperament and level of activity during infancy, suggesting a genetic basis for differences in motor activity (Allan, Mikolajewski, Lonigan, Hart, & Taylor, 2013; Strelau & Zawadzki, 2012; Wood, Saudino, Rog- ers, Asherson, & Kuntsi, 2007). Early on, comparatively more boys are interested in move- ment, manipulation, larger play spaces, and more vigorous play. When playing with blocks, boys prefer tall structures that may crash, as opposed to the lower, more balanced creations that girls prefer. A number of cross-cultural studies have shown that physical activity contrib- utes to an increase in overall attention and greater cognitive development throughout child- hood (e.g., Booth et al., 2014; Chen, Fox, Ku, & Taun, 2013; Sibley & Etnier, 2003).

Preschool children of both sexes simply want to move. It is not in their nature to sit still for an extended time, as the preschool years are the most physically active period in the lifespan. Regardless of individual differences, parents and early childhood educators need to provide generous opportunities for physical activity. Opportunities for movement contribute to opti- mal physical, cognitive, and psychosocial development (Ginsburg et al., 2007; Poest, Williams, Witt, & Atwood, 1990). Even simple music and movement programs can have significant posi- tive effects on the motor ability of preschool children (Zachopouloua, Tsapakidoub, & Derric,

STONE SOUP © 2011 Jan Eliot. Reprinted with permission of UNIVERSAL UCLICK. All rights reserved. ሁ Boys and girls are generally interested in different kinds of social interaction; they also mature at

different times.

Section 14.2Physical Activity of Boys and Girls in Childhood

2004). A meta-analysis of 44 independent studies concluded that there is “a significant posi- tive relationship between physical activity and cognitive functioning in children,” including those that are physically or mentally disabled (Sibley & Etnier, 2003, p. 243). So, although adults may sometimes become frustrated when their very young children cannot seem to sit still, not being able to sit still is normal for that age group. Should a 3 year old be expected to sit at a table until the family dinner is completed? That expectation is certainly reasonable, but not if dinner lasts 2 hours.

By 4 years of age, the majority of children segregate themselves by sex and style of play. There are interesting differences in the nature of play at this time, too. Play is more purposeful for boys. For instance, when a newcomer enters a playgroup, personality is less important than whether or not the boy is useful in play. Girls, by contrast, look to other girls with curiosity and friendship. Reflecting this difference, girls remember names of playmates better than boys do (Moir & Jessel, 1992; Sumaroka & Bornstein, 2009).

Adolescence Physical activity tends to decline when children start middle school (Allison, Adlaf, Dwyer, Lysy, & Irving, 2007). Although genetic and maturational variables play a role in this decrease, there are environmental factors, as well. Parents who engage in less-active lifestyles, includ- ing such seemingly harmless activities as driving short distances instead of walking, model inactive behaviors for their children. One group of researchers suggested that only about 20% of a child’s decline in physical activity can be attributed to maturational factors; the remain- der is explained by external causes, including motivation. Longitudinal studies have shown that inactive obese adults serve as models and are more likely to have less active, obese chil- dren (Ornelas, Perreira, & Ayala, 2007).

As children move on to high school, providing opportunities for physical activity continues to reap benefits. Since the passage of Title IX in the United States in 1972, schools receiving fed- eral funds for education have been required to provide equal athletic opportunities for high school boys and girls (as well as college athletes). In only 6 years after its inception, Title IX was responsible for more than a sixfold increase in the number of girls who participated in high school sports, from 4.5% to 28.6% (Stevenson, 2010). Title IX accounted for a substan- tial increase in high school girls continuing their education and about 40% of the rise in employment for those women once they graduated college. Girls who participate in high school sports have lower pregnancy rates, keep better grades in school, and have reduced rates of obesity (Kaestner & Xu, 2010). Long-term effects include better educational and work prospects and better overall health.

Participation in sports is consistently associated with stronger academic performance, as athletes apparently are better able to manage their study time (Bass, Brown, Laurson, & Coleman, 2013; Ruiz et al., 2010; Trudeau & Shephard, 2008). Adolescents who participate in sports activities tend to watch less television and spend less time with video games. High school athletics also appears to increase cognitive control and attention. It is difficult, however, to know whether athletics is actually a catalyst that increases performance

Critical Thinking What do you think accounts for the reduction in pregnancy rates and better educational and work prospects among girls who participate in sports?

Section 14.3Differences in School Achievement and Learning

on cognitive tests. Perhaps athletes as a whole perform better on cognitive tests or—in con- trast to the stereotype—are smarter and more attentive than nonathletes overall.

S E C T I O N R E V I E W What are the developmental advantages of physical activity throughout childhood?

14.3 Differences in School Achievement and Learning Advances in neuroscience and technology allow us to monitor brain activity while girls and boys engage in various tasks. It is not uncommon for researchers to look at activity while study participants are reading, writing, performing calculations, manipulating objects in space, or following a map. Though often a controversial, unpopular topic, we find there are measurable differences in school achievement and learning between girls and boys. When we compare differences, we find that girls consistently perform better at left-brain-dominated language tasks and boys consistently score better on tests of right-brain-dominated mathematical rea- soning and spatial tasks (Guiso, Monte, Sapienza, & Zingales, 2008).

Maccoby and Jacklin (1974) ignited the controversy involving brain differences when they wrote, “Female superiority on verbal tasks has been one of the most solidly established generalizations of the field of sex differences” (p. 74). The researchers were also specific in concluding that there were no sex differences in visual or auditory learning, analytical abil- ity, or achievement motivation. Then, in 2005, the president of Harvard University set off a firestorm (and eventually resigned) when he summarized research and suggested that there were fewer women in math and science fields due to “different availability of aptitude at the high end” (Summers, 2005). That is, he suggested that there may be fewer women who stand out as the “best of the best” in math and science. But, if that is true, what are the implications for academic and career pursuits?

In the United States, sex differences in mathematical achievement remain fairly robust throughout childhood and adolescence, whereas the gap closes slightly in verbal skills as chil- dren transition into adulthood (National Assessment of Educational Progress, 2014). Lan- guage processing tends to be more abstract in girls and is evident in the way boys and girls process language differently, relying on distinctive areas of the brain (Burman, Bitan, & Booth, 2008). Females are traditionally better at nonverbal communication, as well. For instance, they are consistently more accurate than males in understanding emotion from nonverbal cues (Hall, 1984; Sax, 2005). Differences remain across ages, culture, and whether or not males or females are the senders of communication.

In an extensive meta-analysis, the performance of 1.5 million adolescents in reading and math was examined across 75 countries. Though there were some variations, boys scored consis- tently higher than girls in math. In reading, girls scored higher than boys in all 75 countries (Stoet & Geary, 2013). Although this research suggests that biology plays a strong role in gen- der differences, an alternative meta-analysis of cross-national differences in mathematics by Else-Quest, Hyde, and Linn (2010) concluded that gender differences varied widely. In their analysis, boys in some countries scored higher, and in other countries girls did. In still others,

Section 14.3Differences in School Achievement and Learning

no significant gender difference was found. Instead of gender, the researchers said factors like national characteristics of women (e.g., the number of women in higher education) and a country’s overall emphasis on education were the most important factors in predicting differ- ences. Including these variables led the researchers to conclude that sex differences in cogni- tive pursuits are strictly due to “cultural variations in opportunity structures” and overall gender inequity affecting girls and women (Else-Quest et al., 2010, p. 103).

Conclusions reached by Else-Quest et al. (2010) contrast with the gender gap that persists in the United States, where edu- cation is relatively strong. Sex differences remain in specific skill areas, too. For instance, a recent study found that boys sig- nificantly outperformed girls in mechanical reasoning tasks, which are fundamental to many STEM (science, technology, engineer- ing, and mathematics) disciplines (Lemos, Abad, Almeida, & Colom, 2013). Addition- ally, the gap in scores increases throughout adolescence. This finding suggests that boys and girls may be reinforced differently. That is, teachers and parents likely support boys in STEM fields more than girls, leading to a preponderance of males in those fields.

Interestingly, as measured by grades in school, girls outperform boys overall in academic achievement. Though girls earn higher grades, boys outperform girls on the standardized SAT college admission examination (Duckworth & Seligman, 2006; Jackson & Rushton, 2006; Mau & Lynn, 2001). It has been suggested that girls are more disciplined, which affects school grades more than standardized tests. By contrast, differences in test scores may be accounted for by greater test anxiety among girls, greater motivation among boys, or even teacher biases favoring girls. Therefore, it is reasonable to conclude that gender shapes expectancy, self- efficacy, and perhaps how achievement is valued. Boys and girls are expected to pursue cer- tain areas of study as soon as they show a slight interest; similarly, teachers and parents may selectively ignore other interests depending on a child’s gender (Eccles & Wigfield, 2002; Hannon, 2012).

Regardless of gender effects in specific cognitive abilities, a statistically significant difference in overall intelligence between boys and girls does not appear to exist (Halpern, 2012). This finding suggests that gender-related variations are indeed due to factors other than innate differences. It is reasonable to assume that small differences might exist in certain kinds of cognitive tasks, like spatial ability and linguistics. However, small differences are not signifi- cant enough to generalize about how an entire group should approach education. The larger issue appears to be disparities in the messages that boys and girls hear. Indeed, even as each generation of children continues to perform better on standardized tests (called the Flynn effect), the male-female ratio of top students continues to shrink. Whereas there were 13 boys for every girl who tested in the top 0.01% of all math SAT scores in the early 1980s, the ratio was down to four to one 10 years later (Wai, Putallaz, & Makel, 2012). It is perhaps troubling that the ratio has since stagnated, but these data clearly demonstrate that previously gender- typed skills can be nurtured.

Wavebreakmedia Ltd/Wavebreak Media/Thinkstock ሁ Despite a persistent gender gap in education

in the United States, there appears to be no statistically significant difference in overall intelligence between girls and boys.

Section 14.4Romantic Relationships and LGBT Teens

S E C T I O N R E V I E W What are some possible explanations for achievement differences between boys and girls?

14.4 Romantic Relationships and LGBT Teens Of course the most noticeable development with regard to gender differences during child- hood occurs during adolescence. From a psychosocial perspective, when adolescents begin having romantic relationships, they are continuing the process of forging an identity and at the same time learning how to move forward and establish intimacy. Hormones spike sexual interest, but parents and culture usually dictate the formal initiation of dating. For instance, on average, first-generation Asian parents have more conservative views and are more restric- tive of dating behavior than are other parents in the United States. Dating privileges in Asian families are often tied to academic achievement. However, these parental attitudes also result in more scheming as teenagers try to date without telling their parents (Lau, Markham, Lin, Flores, & Chacko, 2009).

Overall, adolescent romantic relationships benefit from positive parental and peer role mod- els. Adolescents with more exposure to hostility and conflicted relationships experience a greater degree of conflict in romantic relationships. Alternatively, adult models who demon- strate warmth and sensitivity contribute positively to dating relationships (Arriaga & Foshee, 2004; Connolly, Furman, & Konarski, 2000; La Greca & Mackey, 2007).

Girls are more likely than boys to identify relationships as romantic. This finding is not surprising, since boys are more likely to hide emotions, whereas girls are perceived as rela- tively more prosocial, kinder, and empathic. The media usually support these differences, as well. Although it is commonly assumed that boys and girls are socialized to behave differ- ently, recall also that brain imaging and evolutionary evidence suggest that girls are better at processing complex emotions (see Module 5). From an evolutionary perspective, emo- tions are more important for females who need to attract a mate, leading to a stronger inclination for modern-day romance. It has been suggested that males deemphasize emo- tions because evolution dictates that they simply need to distribute their genes. However, evidence indicates that males clearly appraise emotional reactions prior to having romantic and sexual encounters (Dawkins, 2006; Domes et al., 2010; La Greca & Mackey, 2007; Shin et al., 2005).

Sexual Orientation When considering sexual orientation (attraction) and the emotions of romantic relationships, not everyone displays clear patterns. The pioneering sex researcher Alfred Kinsey suggested that sexual orientation runs along a continuum with “exclusively heterosexual” on one end and “exclusively homosexual” on the other. That is, homosexuality and heterosexuality are not discrete ends of a scale as was once thought. People who are in the middle of the scale show equal attraction to males and females and are considered bisexual (Kinsey, Pomeroy, & Pomeroy, 1948). As Figure 14.2 indicates, according to most studies, between 1% and 4% of individuals identify as gay, lesbian, or bisexual by the time they reach adulthood.

Section 14.4Romantic Relationships and LGBT Teens

Figure 14.2: Percentage of adults who identify as lesbian, gay, or bisexual

ሁ With one exception, studies indicate the rate of homosexual attraction is between 1.2% and 3.7%.

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National Epidemiological Survey on Alcohol and Related Conditions, 2004–2005

National Survey of Family Growth, 2006–2008 (Age 18–44)

General Social Survey, 2008

California Health Interview Survey, 2009

National Survey of Sexual Health and Behavior, 2009

Canadian Community Health Survey, 2005 (Age 18–59)

Australian Longitudinal Study of Health and Relationships, 2005

UK Integrated Household Survey, 2009–2010

Norwegian Living Conditions Survey, 2010

1.0% 0.7% 1.7%

1.4%

1.7%

1.8%

2.5%

1.1%

0.9%

1.0%

0.7% 0.5% 1.2%

0.5% 1.5%

1.2% 2.1%

0.8% 1.9%

3.1% 5.6%

1.4% 3.2%

1.1% 2.9%

2.3% 3.7%

U n

it e

d S

ta te

s In

te rn

a ti

o n

a l

Gay/Lesbian Bisexual

Source: How many people are lesbian, gay, bisexual, and transgender? By Gary J. Gates, Williams Distinguished Scholar, 2011. Used by permission.

Attraction is not necessarily dependent on either biological sex or gender identity. For example, transgender individuals may be exclusively attracted to homosexuals, exclusively attracted to heterosexuals, or have feelings somewhere in the middle of Kinsey’s scale. Like other human traits, a wide range of sexual attraction would be expected among any group.

Although several notable studies have found substantially higher concordance rates for homosexuality among monozygotic twins compared to dizygotic twins (suggesting a genetic determinant), those studies suffer from poor methodology, including self-selected samples (e.g., Bailey & Pillard, 1991; Kallman, 1952). Nevertheless, more recent research using ran- dom sampling supports the assertion that heredity has a significant role in sexual orientation. Using extensive statistical analysis, researchers found that about 40% of homosexual behav- ior in men and about 20% in women is explained by genetic differences (Långström, Rahman,

Section 14.4Romantic Relationships and LGBT Teens

Carlström, & Lichtenstein, 2010). Other biological evidence for homosexuality includes dif- ferences in brain structure and chemistry between heterosexuals and homosexuals. Finally, there remains virtually no evidence that points to an environmental influence on sexual ori- entation (Meyers, 2014).

Differences in sexual orientation no doubt have an effect on behavior beginning at an early age. On average, the characteristics of play among children who later identify themselves as homosexual are more like that of the opposite gender (Rahman & Wilson, 2003). These find- ings not only support the existence of biological determinants in sexual orientation, but also provide evidence of a neurobiological foundation for gender.

Lesbian, Gay, Bisexual, and Transgender (LGBT) Teens Although there has been a gradual change, romantic relationships among homosexual youth remain stigmatized, and identity formation may suffer because of prejudice and feelings of shame. Homosexual relationships during adolescence are often fraught with additional anxiety for fear of persecution and rejection. Gay, lesbian, and bisexual adolescents will therefore sometimes first date members of the other sex. More than heterosexuals, gay, les- bian, and bisexual teens question their sexuality and their gender, epitomizing what Erikson referred to as role confusion (Carver, Egan, & Perry, 2004; Pew Research, 2013a; Rahman & Wilson, 2003).

Sometimes a specific kind of gender identity crisis occurs when biological sex is inconsistent with cognitive representations of gender (i.e., when physical body parts do not match how the brain thinks about sex and gen- der). This condition is referred to as gender dysphoria disorder, or transgenderism. Note that this term implies a temporary mental state, not a permanent disorder based on sexuality. Whereas the previous term, gender identity disorder, implied that there was an enduring problem with identity, the new term recognizes that context is important: No disorder is indicated as long as people are comfortable with their own gender—regard- less of what behaviors they engage in or the physical appearance of their bodies. In other words, psycholo- gists consider dysphoria (unease) a cause for concern, not any particular gender identity.

Although many children report being confused about gender and sexual feelings, as adults the vast majority no longer feels that way. Compared to children who do not have gender identity issues, when the physical and cognitive advances that mark puberty occur, signifi- cantly more children with gender identity disorder will eventually have a homosexual or bisexual orientation than a heterosexual one (Wallien & Cohen-Kettenis, 2008; Zucker, 2005).

© Image Source/Corbis ሁ Individuals who are comfortable

with their own gender identity and sexual orientation, whatever those may be, experience less depression and higher self-esteem than those who are not comfortable with those aspects of their identity.

Section 14.5Psychological Effects of Puberty

With regard to self-concept, an individual’s comfort with his or her identity as homosexual or bisexual predicts higher self-esteem and less depression than in those who are less accepting. In this regard, what is important is a child’s feelings about his or her gender identity, not what that gender is (Zhao, Montoro, Igartua, & Thombs, 2010). It should not be surprising to learn, however, that LGBT teens are disproportionately the target of bullying and aggression, which usually contributes to negative feelings of worth. As noted previously, the greater exposure to harassment probably contributes to higher rates of substance abuse, depression, and suicidal ideation (Reisner, Greytak, Parsons, & Ybarra, 2014).

S E C T I O N R E V I E W Explain how romantic relationships and sexual orientation contribute to identity formation.

14.5 Psychological Effects of Puberty Becoming aware of one’s sexual orientation contributes to the psychosocial changes that accelerate due to puberty (see also Module 5). This awareness affects the way teenagers view themselves. For instance, it is well known that adolescents are often preoccupied with appear- ance and have unrealistic perceptions of what the ideal body looks like (Carter & Ortiz, 2008). This preoccupation probably plays a role in eating disorders (discussed in Module 6). As girls acquire more body fat and boys add more muscle during puberty, their body images change accordingly. On average, body esteem, or the self-assessment of one’s appearance, decreases for girls and increases for boys during the initial years of puberty (Bearman, Presnall, Marti- nez, & Stice, 2006).

Early-maturing boys view themselves more positively than do late-maturing boys. They are more popular and successful athletically, and some studies show they have a relatively more successful family life and career in adulthood. Perhaps early maturity provides the social advantage of more attention from girls and prepares boys for better future relationships with their spouses, employers, and customers. They have also been found to use tobacco, alcohol, and illegal substances more often and to be more involved in delinquent behaviors, though these behaviors are often only transitory without long-term negative consequences (Taga, Markey, & Friedman, 2006; van Jaarsveld, Fidler, Simon, & Wardle, 2007; Westling, Andrews, & Hampson, 2008).

When girls mature early, their experiences are quite different from those of boys or later- maturing girls. The earliest maturing girls are often uncomfortable in their own bodies as they stand out from their peers and are sometimes the subject of ridicule. In a review of the literature, Mendle, Turkheimer, and Emery (2007) concluded that early-maturing girls are more depressed and anxious, use more illicit substances, and perform more poorly in school. They are also more likely than their same-age peers to elicit attention from older boys, lead- ing to greater rates of delinquency and earlier sexual activity.

Section 14.6Sex

14.6 Sex Regardless of individual timing, sexual maturation is a normal developmental change. Yet few discussions about teenagers and sex emphasize this perspective. Instead, most research focuses on avoiding high-risk behaviors that result in disease and pregnancy. American par- ents have relatively restrictive attitudes about sex, compared to Western European parents. Nevertheless, in the United States as well as in most European countries, the majority of ado- lescents first have sex (sometimes referred to as sexual debut in research literature) during high school. By 17 years of age, over 50% of girls and nearly 60% of boys in the United States report having had intercourse.

As Figure 14.3 shows, there are a number of cultural differences in age of sexual debut. For instance, blacks lose their virginity relatively early, at about 15 years old, whereas Asians on average wait until they are 18 (Cavazos-Rehg et al., 2009). As is often the case, some racial and ethnic differences are confounded by other variables, especially socioeconomic status (SES). Early sexual activity is associated with early puberty, parental discord and divorce, an absent father, lack of parental supervision, poor academic performance, and drug and alcohol use (Crockett, Raffaelli, & Shen, 2006; Darroch, Singh, & Frost, 2001; Davies & Windle, 2000; Ellis et al., 2003).

Figure 14.3: Probability of having sex at each age, by race and gender

ሁ Different racial and ethnic groups have different patterns of sexual behavior. On average, over half of all 17 year olds in the United States have had sex.

C u

m u

la ti

v e r

e p

o rt

e d

a b

s ti

n e n

c e

African American

Caucasian

*Includes multiracial Hispanic

Asian

Hispanic*

Female

Male

Age in years

0

12 13 14 15 16 17

0.1

0.3

0.5

0.7

0.9

0.2

0.4

0.6

0.8

1.0

Source: Adapted from Cavazos-Rehg et al. (2009).

Section 14.6Sex

Sex Education Special challenges exist in educating youth about sex. Although research indicates that a sci- entific approach is best (as opposed to one directed at a particular population or to support specific goals), community and educational implementation remains difficult. Schools often contract out to service agencies that do not share a standardized scientific curriculum, and sex education therefore lacks guidance and consistency (Ott, Rouse, Resseguie, Smith, & Woodcox, 2011). Therefore, the short-term sex education classes that most public schools offer end up being inadequate.

No doubt many children today get their information from the Internet, where unrealistic activities proliferate. Children also learn through peers and other media, including television and film. Sexual content in the media is usually depicted in an unre- alistic and misleading manner: as a carefree, spontaneous event lacking any negative consequences. And the amount of exposure to sex in the media has been found to affect attitudes and behavior about sex, including intentions to have sex (Brown, El-Toukhy, & Ortiz, 2014; Strasburger et al., 2010; Ward & Friedman, 2006).

F O C U S O N B E H A V I O R : S e x E d u c a t i o n Education about sex is most effective when it is an ongoing conversation rather than an uncomfortable week in school with a stranger. At home, parents can successfully edu- cate their children about sex by beginning to talk about it at an early age. Sex education does not need to be a solitary event at a specific age; there is not one best time to have a conversation. Instead, sex education can be an ongoing conversation that begins in early childhood. In fact, research has shown that teenagers who have better communication and higher quality relationships with their parents are also less likely to become teenage par- ents (Henrich, Brookmeyer, Shrier, & Shahar, 2006).

But how should this conversation begin? When children first begin “naming” games (e.g., Where’s your nose? Where’s the ball?), it is an ideal time to intersperse real language that relates to sex: “Where’s your nose? Where’s your shoulder? Where’s your vagina? Where’s your ear?” In this way, children grow up with an appropriate vocabulary to discuss impor- tant issues.

Using euphemisms like “winky” and “hoo-hoo,” or even “privates,” implies there is some- thing uncomfortable about the terms penis and vagina. Children (and parents!) need to first be comfortable using appropriate language before they can discuss body functions in a meaningful way. They will then be able to pursue questions about menarche, nocturnal emissions, intercourse, and other subjects throughout childhood without awkwardness. In this way, healthy, appropriate sex education becomes a normal part of a continuing dialogue.

LEMOINE/BSIP/SuperStock ሁ The education of young people about sex

remains inconsistent and is often inadequate.

Section 14.6Sex

Teenage Pregnancy Probably as a result of more restrictive sex education, much less birth control is being used and rates of teen pregnancy are much higher in the United States than in other Western coun- tries (Darroch et al., 2001; Eaton et al., 2012). Though the number of teenage pregnancies has dropped considerably in recent years, high-risk sexual behaviors persist. The teen pregnancy rate remains up to eight times higher in the United States than in other developed countries, despite similar patterns of sexual intercourse (Martinez, Copen, & Abma, 2011).

As Figure 14.4 shows, in 2013, the overall teenage birthrate continued the decline that has been evidenced since the early 1990s. The rates of pregnancy among 15–19 years old have

Figure 14.4: Rates of teenage pregnancy per thousand, 1990–2013 ሁ The rate of teenage pregnancy has declined significantly for over 20 years.

R a te

p e

r 1 ,0

0 0 w

o m

e n

a g

e d

1 5 – 19

y e a rs

Years

38

36

34

32

30

28

26

20 00

20 01

20 02

20 03

20 04

20 05

20 06

20 07

20 08

19 99

19 90

19 91

19 92

19 93

19 94

19 95

19 96

19 97

19 98

20 09

20 10

20 11

20 12

20 13

42

50

54

56

46

40

48

52

44

58

60

62

Source: Adapted from CDC/NCHS, National Vital Statistics System, 2014.

Section 14.6Sex

fallen over 50% from the 1991 peak. Since first being tracked in 1940, there are now historic lows for all groups: Hispanic, black, white, Alaskan native, and Asian/Pacific Islander (see Fig- ure 14.5). Similar percentage declines are seen in both spontaneous and medically induced abortions, providing strong evidence that the reduction in live births is due strictly to fewer pregnancies, not an increase in abortions. Infants born to mothers aged 10–14 sunk another 15% in 2013, to an all-time low, but it still consisted of 3,108 live births (Hamilton, Martin, Osterman, & Curtin, 2014).

Figure 14.5: Birth rates for teenagers aged 15–19 years, by ethnicity

ሁ Rates of teenage motherhood vary considerably by race, though all have seen a considerable drop over the past 20 years. Rates for fatherhood parallel those seen among mothers (Hamilton et al., 2014; Martin et al., 2011).

1991 2005 2007 2009 2012

All races White Black Hispanic Native American/ Alaska Native

Asian or Paci�c Islander

0

10

20

30

40

50

60

80

70

90

100

110

120

R a te

s p

e r

1 ,0

0 0 w

o m

e n

a g

e d

1 5 – 19

y e a rs

Source: Adapted from CDC/NCHS, National Vital Statistics System, 2014.

Although rates are at historic lows, births to teenage mothers remain higher in the United States than in a number of other developed countries. The United Nations Statistics Divi- sion (2013) found that the birth rate among 15- to 19-year-old teens in the United States was 41.5 per 1,000 teens. By contrast, rates were 14.1 in Canada, 8.2 in Germany, and 4.5 in Japan. Many Central and South American countries had substantially higher rates, though. For instance, Costa Rica had a rate of 62.0 and Uruguay was at 40.8.

Physically, female adolescents are less likely than older women to seek prenatal medical care and therefore have a higher risk of having babies with low birth weights or other complica- tions. These conditions lead to higher rates of birth defects, childhood illnesses, and infant

Section 14.7Sexually Transmitted Infections

mortality. Regardless of differences in health care systems, there is consistency in unfavorable outcomes for adolescents throughout Western countries (e.g., Chen et al., 2010; Da Silva, Her- nandez, Agranonik, & Goldani, 2013; Kingston et al., 2012; Liran, Vardi, Sergienko, & Sheiner, 2013; Pérez-López, Chedraui, Kravitz, Salazar-Pousada, & Hidalgo, 2011).

There are negative psychosocial and cognitive outcomes, as well. In the United States, girls from low-SES households use birth control less often than their higher-SES peers and con- sequently have more unwanted pregnancies (Strasburger et al., 2010). Low SES and teenage pregnancy are associated with poor academic performance, lower rates of parental educa- tion, physical violence in the home, and less supervision. Consequently, teenage mothers have a higher risk of dropping out of school and living in poverty. Their female children are at high risk of becoming pregnant themselves, perpetuating the cycle of poverty. However, young mothers are not necessarily locked into perpetual negative outcomes if there are interven- tions aimed at reducing risk factors. The key to breaking the cycle of poverty is to delay future births and continue education (Albert, 2010; Coyne, Långström, Lichtenstein, & D’Onofrio, 2013; Wheeler, 2010).

Surveys have found that parental influence is the most compelling factor cited by teens want- ing to avoid pregnancy. Children of parents who are involved both emotionally (e.g., sharing information about friends, school) and in activities (e.g., attending athletic events, cooking dinner together) are more likely to delay sexual debut and have a reduced chance of teenage pregnancy (Cavazos-Rehg et al., 2010).

S E C T I O N R E V I E W What factors are associated with teen pregnancy? What are the developmental consequences?

14.7 Sexually Transmitted Infections Another area of concern relates to sexually transmitted infections (STIs). Adolescents have the highest rate of STIs of any age group. About one out of every four sexually active adoles- cents will eventually contract an STI; nearly 20% of adolescent girls are infected with just one STI, the human papilloma virus (HPV, or genital warts). Since 2006, a vaccine has been available that has been found to prevent the transmission of HPV to females, and in 2009 the U.S. Food and Drug Administration approved the vaccine for males aged 9 to 26. It is recom- mended that boys and girls be vaccinated beginning at 11 or 12 years of age (Centers for Disease Control and Prevention, 2013b).

STIs can be contracted through oral, vaginal, or anal contact, including penetration of fingers if there is exposed tissue due to large or (sometimes unseen) small cuts. Lower age of sexual debut and lower SES are the strongest predictors of STIs (Crosby & Danner, 2008). When left untreated, infections cause sterility, death, and other serious health complications, as well as birth defects in children born to infected mothers.

Section 14.7Sexually Transmitted Infections

Either viruses or bacteria can cause STIs (see Table 14.1). In general, bacterial infections like chlamydia, syphilis, and gonorrhea are treated fairly easily with antibiotics. In contrast, infections caused by viruses cannot be cured. Human immunodeficiency virus (HIV), the virus that causes a constellation of symp- toms referred to as AIDS, is appropriately the most feared STI worldwide. Even though it is the most deadly STI, surveys show that youth throughout the world are naively unconcerned about contracting it. More than 75% of some American youth and young adult groups are unaware that they have even become infected, yet education about sex and repro- ductive issues can have a strong positive effect (Crosby & Danner, 2008; MacKellar et al., 2005; Melaku, Berhane, Kinsman, & Reda, 2014; Oncel, Kulakac, Akcan, Eravasar, & Dedeoglu, 2012).

© CORBIS

ሁ STIs have long been a public health concern, as this Works Progress Administration poster from the 1930s indicates.

Table 14.1: Most common sexually transmitted infections of adolescence Infection Symptoms Cause/treatment Consequences

Chlamydia If symptoms do occur, they usually appear within a few weeks. Often no symp- toms. Sometimes burning sensation while urinating or unusual discharge.

Bacteria/antibiotics If untreated, can lead to infections and diseases that produce sterility.

Syphilis Average appearance of symptoms at 3 weeks, but can be up to 3 months. Painless sore (chancre) appears at point of entry (e.g., anus, vagina). Chan- cre disappears without treatment, but new secondary symptoms will occur. These may include a rash, hair loss, and flulike symptoms (e.g., fatigue, headache, fever, sore throat, muscle ache).

Bacteria/antibiotics Though symptoms may disappear, the infection does not without treat- ment. Last stages include damage to internal organs, nerves, and systems. Can cause paralysis and death.

(continued)

Section 14.7Sexually Transmitted Infections

Infection Symptoms Cause/treatment Consequences

Gonorrhea Vaginal discharge or burning sensation during urination. Many women and some men show no symptoms.

Bacteria/antibiotics If untreated, can lead to a range of physical compli- cations, including infertil- ity and blindness. Strongly associated with birth defects.

HPV (genital warts)

Genital warts on penis or vagina.

Virus/warts can be removed but virus persists

Predisposes those infected with increased risk of cervical cancer. May cause cancer of penis, vagina, and anus.

Herpes Active infections resemble cold sores.

Virus/antiviral treatments can reduce frequency and severity of outbreaks

Lesions can be painful, but periods between out- breaks have no symptoms.

HIV/AIDS Extensive cold or flulike symptoms, extensive weight loss, organ inflam- mation, tuberculosis, Kaposi’s sarcoma (cancer), gastrointestinal problems, and other opportunistic infections.

Virus/management or delay of AIDS symptoms through antiviral therapy

Eventual death. Newest data show life expectancy can be extended by over 20 years with treatment.

F O C U S O N B E H A V I O R : S T I O R S T D ? AIDS and HIV epitomize the trend toward using the term sexually transmitted infection (STI) instead of sexually transmitted disease (STD). A person can be infected with HIV and show no symptoms. While the virus remains dormant, it can still be transmitted through contact with bodily f luids. The infection can be transmitted before the disease of AIDS (including physical symptoms) occurs. Previously, an STD was referred to as a venereal disease. In general, all three terms refer to viruses or bacteria that are transmitted via sexual contact.

In general, STIs have lower prevalence in whites than in blacks and Hispanics. These dispari- ties are likely due to differences in SES, including access to health care and contraception. As is the case for unwanted pregnancies, teenagers whose parents are involved, responsive, and economically advantaged have fewer STIs. Community leaders and health organizations must acknowledge these disparities so that they can direct services more effectively.

A Global Perspective Worldwide, the rate of HIV infection varies dramatically. Sub-Saharan Africa remains the epi- center of infections, accounting for approximately 70% of the worldwide total. Since 2001, the rate of infection among children with HIV declined by over half worldwide (UNAIDS, 2014). Most of the 3.3 million children living with HIV were infected by their mothers, either in the womb or while breastfeeding; about two-thirds of children are not treated. With effective antiretroviral medicine, mothers can reduce the risk of passing along the virus in vitro, during

Wrapping Up and Moving On

delivery, or through breastfeeding to less than 5%. However, only about 62% of women have access to proper treatment (Hargreaves, Slaymaker, Fearon, & Howe, 2012; UNAIDS, 2014).

Condom Use Abstinence is the only definitive protection against STIs. However, it is unrealistic to assume that teaching only abstinence will provide a comprehensive solution to unwanted pregnancy and STIs among adolescents. In Iraq and Afghanistan, the majority of survey respondents say that executing a woman for engaging in premarital sex is justified (Pew Research, 2013c). Yet even at risk of death, people in oppressed countries still have sex, demonstrating a develop- mental imperative. Therefore, among adolescents who are sexually active, condoms still pro- vide the best protection against infection.

Despite gains, compared to adolescents in Western European and other developed countries, U.S. teenagers are still less likely to use condoms. The percentage of teenage girls who used contraception the first time they had sex rose from 56% in 1985 to 84% in 2011. How- ever, according to survey data of sexually active high school students, only 66% of male and 53% of female respondents reported using a condom the last time they had sexual intercourse. In addition, reported condom use declined in every demographic as students progressed from 9th to 12th grade, an oddly alarming trend (Eaton et al., 2012; Kann et al., 2014; Strasburger et al., 2010). An additional 30% of sexually active girls in the survey used hormone-based birth control. If samples are representative, the dis- crepancy between males and females in reported condom use (66% versus 53%) illustrates the difficulty in obtaining accurate information about sex from adolescents. As long as most intercourse is heterosexual, the two percentages should be relatively similar.

It has been suggested that media images depicting the difficulty of teenage motherhood have contributed to the decline in risky sexual behavior. Shows such as Teen Mom and The Secret Life of the American Teenager walk a fine line between glamorizing teenage parenthood and accurately portraying the financial, emotional, and health hardships of unplanned teenage pregnancies. At the very least, they have offered an avenue for conversation that perhaps has not existed in the past. In one survey, 79% of girls and 67% of boys said that teen pregnancies depicted on television made them think about how to avoid pregnancy (Albert, 2010). Other effects of media are explored in the next module.

Wrapping Up and Moving On The basis of gender differences is still largely unknown. A multitude of factors and processes likely explain the wide set of gender-related behaviors. Though evidence shows that brain differences between boys and girls do indeed exist, the ways in which adults respond to those

Critical Thinking Why do you think condom use declines in high school?

S E C T I O N R E V I E W Identify the most common sexually transmitted infections. What are the typical long-term effects of ignoring treatment?

Summary and Resources

differences probably have a much greater influence on later behavior. Parents, teachers, and peers reinforce certain behaviors and skills, according to sex. For example, traditional gender roles require girls to be more sensitive. Girls are often expected to be more nurturing and emotionally responsive, so in many ways they are trained to be different. Even during infancy, adults express more emotions and display more sensitivity with baby girls than with baby boys. Therefore, evidence is inconclusive about the relative influences of biology and social experiences in gender differences.

Regardless of existing differences, boys and girls each have their own strengths that should be celebrated and respected individually, not necessarily in relation to each other. This is espe- cially important as we move into the last module. The interactions that we have with peers, at school, and in society have a potentially profound effect on individual, long-term develop- mental outcomes.

Summary and Resources • Sex and gender are integral to identity. Although research finds biological differ-

ences between boys and girls beginning at birth, the effect of social learning on gen- der is undeniable, including the use of different colors to designate boys and girls, toys, different kinds of social interactions, and the media.

• As with much of what we have explored so far, there is empirical support for biologi- cal, evolutionary, social, and cognitive influences that help to explain gender devel- opment. Taking an interactive approach to gender development once again appears to be the most relevant perspective.

• Evolution suggests there are advantages for each gender. It is thought that, through natural selection, separate masculine and feminine traits have become more valu- able to the species.

• Cognitive theories suggest that children go through a set of prescribed stages of gen- der development, culminating in gender constancy at about the time children enter formal education.

• Although it may make intuitive sense that playing with gender-typed toys is entirely learned, evidence does not support this view. Boys are more physically active than girls, which may predict different kinds of activities.

• It is hard to know if gender differences in achievement are attributable to socializa- tion or biology. Although there are definitive differences in the brains of girls and boys, we do not know what the differences mean.

• Sexual activity is a developmental process. Surveys reveal that, by the end of high school, the majority of adolescents in the United States have had sexual intercourse, which is another avenue of psychosocial change. Nevertheless, romantic relation- ships leading to sex are often discussed as a kind of risky behavior rather than as something that is developmentally appropriate.

• LGBT teens are often at special risk because of the possibility of peer rejection, persecution, or a sense of shame. Many will first have a heterosexual relationship, epitomizing the identity crisis described by Erikson.

• Late-maturing girls and early-maturing boys generally have psychosocial advantages.

• Although trends have shown substantial improvement over recent decades, sexually transmitted infections and unwanted pregnancies remain problematic. Especially among low-SES groups, early pregnancy often has long-term negative effects.

Summary and Resources

• In some parts of the world, most notably in Sub-Saharan Africa, children infected with HIV are a common occurrence. Because of increased access to health care, fewer pregnant mothers are passing on the virus to their children.

• Because abstinence is not usually a reasonable alternative to sex, use of condoms and other birth control methods should be an important part of adolescent sex education.

Key Terms AIDS The disease caused by the human immunodeficiency virus.

androgens The hormones that are respon- sible for male growth and characteristics.

effect size The statistical and practical magnitude of the difference between two groups.

estrogen A hormone responsible for female growth and characteristics.

gender A social and psychological concept that refers to masculinity or femininity.

gender constancy The understanding that people are permanently male or female.

gender dysphoria disorder (or transgen- derism) Mental discomfort that results when an individual’s physical appearance

(having a penis or vagina) does not match the individual’s personal schema for gender.

gender identity The masculine or feminine qualities with which people identify.

gender roles Roles based on sociocultural norms of what is considered acceptable behavior based on the sex of the individual.

gender stability The awareness of the sta- bility of gender over time.

human immunodeficiency virus (HIV)  The virus that causes the disease AIDS.

sexual debut Age at first sexual encounter.

sexually transmitted infections (STIs)  Infections or diseases that are transmitted during sex.

Web Resources See links below for additional information on topics discussed in the chapter.

Amygdala

http://www.sciencedaily.com/articles/a/amygdala.htm

Chlamydia

http://www.cdc.gov/std/chlamydia/STDFact-Chlamydia.htm

Fight-or-Flight Response

http://health.howstuffworks.com/mental-health/human-nature/other-emotions/ fear2.htm

Gonorrhea

http://www.cdc.gov/std/gonorrhea/STDFact-gonorrhea.htm

Summary and Resources

HPV

http://www.cdc.gov/std/hpv/stdfact-hpv.htm

Laws of Reinforcement and Punishment

http://allpsych.com/psychology101/reinforcement.html

Limbic System

http://webspace.ship.edu/cgboer/limbicsystem.html

Syphilis

http://www.cdc.gov/std/syphilis/default.htm

Title IX

http://www.titleix.info/Default.aspx