It's 10pm, Do You Know?

Brad, 15, has had oral sex with three different partners, only one of whom was his girlfriend. The other two girls were "just friends," he says.

It's common among his friends for girls to perform fellatio on boys they aren't dating. In fact, he says, they do it all the time--at parks, parties, and even at school.

Ashley, 14, agrees with Brad. She says that oral sex is definitely more common than intercourse among the teens she knows. She first performed fellatio when she was 11, she says, but most of her friends started later, around 12 or 13. Though she says that at her school people don't have oral sex with friends like they do at Brad's school, in most cases it's the girls doing the giving, often because they feel they have to in order to keep their boyfriends.

"Girls don't have to sleep with their boyfriends, but boys will say, 'Give me a blow job, or I'll break up with you,'" she says.

Whitney, 16, hasn't had oral sex because it's "nasty," but she says that almost everyone she knows has done the deed.

"My friends tell me that I'll like it if it ever happens to me," she says. "They tell me that giving it is not so bad."

Of the 25 teens interviewed, almost all said that the girls performed fellatio on the boys. The only time the guys reciprocated was when the girls were their girlfriends. In a few cases, as Ashley described, some girls seem to feel they have to perform oral sex to keep the guy's interest. Alcohol and drugs are sometimes part of the equation. Several teens described the girls who casually perform oral sex as "druggies."

The drawbacks for girls in this situation are obvious and typical. As well as potential infection, girls also face long-standing preconceptions about sexual availability--being "easy" if they "give it up" to a boy.

However, oral sex doesn't always fit into the same category as intercourse. In today's girl-power world, some girls view oral sex as a means to assert control over when and how they are sexual. Some may even use oral sex as a way to maintain their virginity while still pleasing their boyfriends.

A Kiss Goodnight

These North Bay teens are part of a growing segment of teenagers embracing a more casual view of oral sex. Healthcare professionals and educators alike are starting to see evidence that teens as young as middle school are viewing oral sex as a fun activity to be done among friends. Some even view it as another kind of kissing. Often, teens see oral sex as a safer alternative to vaginal sex, because they are unaware that STDs can be transmitted through oral sex.

On the May 7 episode of the Oprah Winfrey Show, Winfrey and her psychological sidekick Dr. Phil, who recently launched his own show, showcased a group of teens who shared this new, casual view of oral sex. Shocked parents and audience members watched as teens described having oral sex with people they weren't dating, simply because they wanted to. The teens said that parents who thought of oral sex as intimate and to be done after vaginal sex were old-fashioned. The show called oral sex the new "spin the bottle."

But Winfrey's show was not the first to tackle this issue. Back in 1997, articles appeared in major newspapers such as the New York Times, Washington Post, and USA Today talking about this new trend. While the anecdotal information continues, few studies have emerged giving factual data on how serious this issue has become.

However, a 2000 study by the Alan Guttmacher Institute in New York revealed that there was a lack of information among teens on oral sex and other noncoital behaviors, such as mutual masturbation and anal sex. According to the study, "many teenagers perceive oral sex as safer and less intimate than intercourse. Teenagers seem to be especially misinformed about the STD risks of oral sex."

How serious is this issue in the North Bay? Are more local teens practicing oral sex, or is this another example of media exaggeration?

"In the past five years, we have seen an increase in oral sex among teens," said Barbara Branagan, RN, Sonoma County's Public Health Services director and head of the Sonoma County Public Health Clinic. "Teens are definitely more casual about oral sex and view it differently than other generations have. Some teens are having it at parties, in groups, and they don't see anything wrong with it."

Just how many students are doing this remains a question. Branagan is quick to point out that she does not believe the majority of teens are having oral sex, just that her clinic has seen an increase.

Branagan acknowledges the girl-power issue plays a role. "It's almost as if the girls are getting a kind of reversed power out of it," she said. "Instead of sex, which is thought of as something boys do to girls, they are doing the oral sex to the guys."

Of the 25 teens--between ages 13 and 17--interviewed for this article, the results were mixed. While plenty of teens had views like Brad and Ashley, almost an equal number have not had oral sex, and several of them called it "immoral behavior."

Among the five 13-year-olds I talked to, none of them had had oral sex. However, all but one student said that either their friends or other students at school talked in detail about having had oral sex.

"They are having it," said Shannen Farrell, matter-of-factly. Farrell is a health information specialist who presents sex education through the Sonoma County Public Health Clinic to county schools. "Many students have talked to me about this issue. And I can see it on their faces when I talk to them about oral sex. It's not all of them, but it's clear that a lot of them are. It's fair to say that the number of students having oral sex is increasing."

The clinic has heard of parties where teens have group oral sex, doing it in front of each other as past generations played kissing games. The change in attitude has shocked more than one educator.

A principal of a local middle school called the clinic about a teenage couple in the parking lot of the school caught masturbating and performing oral sex on each other. When confronted, neither teen thought it was a big deal.

"To older generations, oral sex is something that comes after sex, something that is considered quite intimate," said Farrell. "To this generation, it's more casual and seen as something that comes before sex. For some teens, it's almost a part of getting to know each other."

Presidential Precedents

Experts say the reason for the shift in attitude toward oral sex is partially due to our sex-soaked culture. The Monica Lewinsky and Bill Clinton scandal made oral sex seem more acceptable, and some teens have used it as an excuse for their behavior, according to Lynn Ponton, a psychiatrist at UC San Francisco. "Kids tell me over and over in my office, 'The president did it.'"

In the media, sexual images are aimed at younger audiences. MTV seems to get more sexual every year. For example, this season of the reality-based TV show The Real World, set in Las Vegas, has already featured young, attractive cast members engaging in a threesome--a far cry from the aspiring poets and police officers the show put on when it first started in 1990.

Recently, during an episode of The Real World, MTV aired a commercial encouraging the awareness that oral sex is not safe sex. The ad, with four women sitting around a cafe table, was a spoof on HBO's Sex and the City.

Pop music is being manufactured for younger teens--the new target demographic--while it is becoming more sexualized. Singers like Christina Aguilera, Shakira, and Jennifer Lopez sport less and less clothing and more provocative dancing and lyrics. Britney Spears, whose fan base is grounded in junior high-aged teens and younger, presents a particularly conflicting image, talking about saving herself for marriage while prancing around half-naked and singing lyrics fraught with sexual innuendo.

"There is a lot of talk about not doing it before you're married, like Britney Spears telling us that, and then we found out she lied," says Jennifer, 14. "It gives you a more broader view of day-to-day life. You see it happening a lot on TV or movies, which we seem to copy."

A lack of education also contributes to why some teens are adopting new attitudes about oral sex. While kids are bombarded with sexual imagery in their daily lives, they don't necessarily understand the risks involved with the sexual behavior. Forty percent of the teens interviewed for this article had not been taught about oral sex in school. In addition, many of the students didn't consider oral sex to be sex.

Some sex educators encourage this view, leaving personal definitions up to the student. Jennifer Weaver, community health director for Planned Parenthood, teaches sex education throughout the Bay Area. She tells kids that they need to decide for themselves whether they are virgins or sexually active.

"Everyone views it differently," she says. "Some people view mutual masturbation or oral sex as sex, and some don't. I just try to define terms for them and let them decide for themselves."

For the past two decades, sexual education has focused on intercourse with an emphasis on abstinence. Oral sex is sometimes ignored because sex education doesn't always break down all sexual activities, one reason why there is so little data on teens and oral sex.

Most research surveys ask whether or not a student is sexually active. To many teens, being sexually active means having sex. So even if they are engaging in other sexual activities, like oral sex, when asked if they are sexually active, they will often answer no. Thus, researchers are gathering data from a question that many students misunderstand. When the term "sexual activity" is broken down, the answers are quite different.

"You ask them, 'Are you abstinent?' and they will say, 'Oh yeah, I'm abstinent,'" said Farrell. "Then when you start to break down the different kinds of sexual activities, you hear a different story. We break abstinence down for them as absolutely no sexual activity with another partner."

A 1996 UCLA study of 2,026 teens revealed that while 47 percent said they were virgins, 35 percent of those same teens engaged in sexual activity ranging from mutual masturbation to oral sex and beyond. Another survey by Twist magazine of more than 10,000 girls revealed that though 80 percent said they were virgins, 25 percent of those virgins had had oral sex.

Because of spotty education, many students are unclear about whether STDs can be transferred through oral sex. A 2001 survey by the Kaiser Family Foundation of more than 500 teens said that though 72 percent were sexually active, 93 percent didn't think they were at risk for an STD. One quarter of those teens didn't think an STD could be spread through oral sex.

Of course, STDs such as herpes I and II, gonorrhea, and syphilis are transmitted through oral sex. HIV and chlamydia can also be transferred through oral sex, though to a lesser degree. Condoms and dental dams reduce the risk of transferring STDs through oral sex.

Data on STDs in Sonoma County is not broken down into whether the diseases were transmitted via vaginal or other sexual activities. However, the 2000 Sonoma County Adolescent Health Perspective, which focused on the 13 to 19 age group, found that gonorrhea had increased 25.4 percent for males and 26.9 percent for females. Chlamydia has also increased in the last few years among teens, according to Branagan, but she says there is no evidence that the higher rate is related to oral sex.

Two-thirds of reportable STDs occur in people under 25 years old, according to the Kaiser Family Foundation. Part of this is because the reproductive systems of younger women are less resistant to infection, so they are more vulnerable to disease. Sonoma County is seeing higher rates of abnormal Pap smears in women under 20, and the rate is now comparable to abnormal Pap smears seen in 40-year-old women a few years ago, according to Branagan.

Educating the Educators

The first step to combatting this problem is a shift in how sex education is presented. A May 27 U.S. News and World Report story focused on how abstinence education has failed to hinder the high rates of STDs among certain groups of teens. The Sonoma County Public Health Clinic developed its sex education curriculum around how to maneuver a relationship, and the dangers of different sexual behaviors.

"We're trying to get teens past thinking sex is just sex and that it's not just hopping into bed with someone," said Farrell. "We want them to think about the consequences of their actions, to realize that sex is emotionally complex, and that potentially getting a disease or pregnant is a serious thing. We are trying to show them that it's not emotionally or physically easy to deal with something like having an abortion, for example."

The sex education program explains what constitutes a sexual behavior and the dangers of each behavior.

"I really rail on the oral sex so they are clear," adds Farrell.

Parental involvement is also deeply needed. Many parents are unaware that oral sex is a separate and complex issue from vaginal sex. Not a single student interviewed for this article had talked with his or her parents about oral sex, though many had had "the sex talk" (well, except for John, 16, whose Dad told him that it "doesn't matter if a man is good in bed, as long as he's good at oral sex").

Sex educators suggest that parents define all possible sexual behavior with their teens, including oral sex, and talk about the emotional and physical ramifications of each behavior, as well as when it should be done and with whom. Parents should be prepared for arguments like "it's not a big deal" and "everybody is doing it." Also, avoid making assumptions about what teens know or don't know regarding sex.

As a society, however, this trend speaks to a larger problem.

"We really need to ask ourselves as a society what we are teaching our children with this saturation of sexual images like we have," said Branagan. "It's not that the teens don't have a responsibility in this issue, but in a way, they are mirroring back what we are teaching them.

"We need to really look at the images we're sending out to our children."

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