washingtonpost.com
For Some Teens, a Checkup Just Isn't Macho

By Laura Sessions Stepp
Washington Post Staff Writer
Tuesday, April 17, 2007

As boys grow up and become sexually active, they cut back on regular visits to the doctor, sometimes for reasons of cost and lack of health insurance, according to health-care professionals.

A new study cites another factor: boys' beliefs about what it means to be a man.

The study of 15- to 19-year-olds, led by researchers at Johns Hopkins Children's Center, suggests that young men view visits to a health-care provider as a sign of weakness. In addition, young men frequently don't talk openly about health issues such as birth control and sexually transmitted disease to their parents, who, the study's authors report, may not be encouraging annual exams.

The investigation, reported in this month's Pediatrics, analyzed data on almost 1,700 young men. More than half of the subjects said they had had sex, and they were no more likely to see a physician than those who abstained. One out of five had taken part in two or more risky behaviors such as drinking, smoking, cocaine use and forcing someone to have sex. One hundred four young men reported having had a sexually transmitted infection.

About half of the study group held what the researchers called "traditional beliefs" about manhood, responding positively to such statements as "Men are always ready for sex" and "It is essential for a guy to get respect from others." Those were the boys who were less likely to report regular exams, according to lead author Arik Marcell, a pediatrician and adolescent health specialist at the Children's Center.

"The underlying issue is how to do a better job socializing boys into health," Marcell said in an interview. Mothers encourage their daughters to see physicians regularly once they get their menstrual period, he said. Boys are not similarly instructed once they start having wet dreams, which is their introduction to sexuality.

Marcell's study found that boys who talked to Mom and Dad about sexual issues were more likely to see a physician. For the most macho boys, talking to a father was particularly helpful. But what a boy learns -- or doesn't learn -- at the doctor's office can be a problem, says Bill Albert, deputy director of the National Campaign to Prevent Teen Pregnancy.

"In the unlikely event that you get a young man to a doctor, what is the doctor going to say?" asks Albert, whose organization has reported on relationships among kids, parents and health-care providers. "Doctors are not talking to boys about birth control, at least as much as they talk to girls, or about STDs." Federal statistics underscore his point: In 2002, among males 15-19 who had visited a medical-care provider within the previous year, fewer than one in five said they received counseling on birth control, STDs or HIV.

The takeaway message for parents? Once again, they've got to talk about the consequences of sex. Even sex education in school doesn't cut it.

"Parents say, 'Between the doctor and the school, I've got this one covered,' " Albert says. "That is not true."

View all comments that have been posted about this article.

© 2007 The Washington Post Company