ISSN 1363-8394

Journal of Adolescent Health
and Welfare

Volume
11 - No 3 - Autumn 1998

Incorporating
the Newsletter of the International Regional Chapter of the Society for
Adolescent Medicine

Letter from the editor -

Dear Colleagues,

This is the last edition before the 1998 conference
so make sure you are signed up - we would not want you to miss it!

In this edition we include the presentations from
the March 1998 SAM (Society for Adolescent Medicine) International Chapter
meeting held in Atlanta
on exploitation of Youth. We also have news of the Youth Support Website which
I hope you will all visit and note that we can now be reached by E mail at
[email-masked].

May I remind you that the 1996 conference
presentations are published separately as a book of ‘proceedings’ -
they are selling very well and made up quite a nice textbook of adolescence -
so please write in and ask for a copy - price a very reasonable £5.

Diana
Birch

Director
Youth Support

* CONFERENCE ROUND UP *

Personal views of  those
attending recent conferences -

The
Question of Abortion - 19th May 1998 - A
seminar held at St Barnabas Church Beckenham -
Chaired by Dr James Pitt-Payne; with Speakers - Professor James Drife - Professor of Obstetrics and Gynaecology University
of Leeds; Paul Tully National Information Officer SPUC - The Society for the
Protection of Unborn Children and Dr
Diana Birch - Director Youth Support.

A meeting on the subject of abortion is
predictably going to raise strong feelings in participants and audience and
this was no exception. Professor Drife put forward a
balanced personal view of abortion practices and his own involvement in
providing a service in Leeds.
It was acknowledged that this is no easy subject to tackle from a medical or
‘human’ point of view and that neither patients nor doctors
performing abortions take the decision lightly or remain
emotionally unscathed by the procedures.

Paul Tully took the opposite stance and
was firmly anti abortion taking the usual SPUC prejudiced viewpoint and
predictably bringing out strongly emotive, judjemental
and condemning stance towards abortion patients and professionals alike -
talking of ‘murdered babies’ and ‘sinners’. It is
difficult to relate any of his speech or discuss the content without becoming
angry and subjective myself.

To try to get away from these usual
lines of argument Dr Diana Birch
took the line of looking at the motivation behind the abortion debate and what
abortion means to the individual undergoing the procedure and to those involved
in discussing, condemning or legislating on the subject (text of this
presentation overleaf).

The Question of Abortion

Dr
Diana Birch - Youth Support

Is it a   MORAL         RELIGIOUS          ETHICAL

MEDICAL       LEGAL              EXISTENTIAL

PRACTICAL     ECONOMIC

SOCIO CULTURAL  or
RACIAL   (eugenic) issue?

We have heard arguments along each of
these lines numerous times. There are arguments re - foetal / maternal conflict; foetal rights - and there have even
been published papers raising the subject of foetal confidentiality - whether
the foetus has a right to confidentiality in respect of blood test results
performed in utero which perhaps the parents should
not know about - in my mind this
represents the height of the ridiculous!

Are people legally or morally ‘entitled’ to abortion or to choice.

Do people ‘own’ their own bodies and therefore do they have the right to
do what they want to their bodies - (parallel scenarios exist in relation to
drugs self harm etc)

So is the foetus part of your own body and if not when does it stop being part of
mother and become a new being - introducing the concept of self or ‘personhood.’
In considering the question of abortion and the ethics involved there are also
‘Fudging’ issues such as
timing - 1st trimester (the earlier the more OK it seems)

reasons - OK? Rape maternal illness

not so OK? Girls age

not OK
single financial limit number children

Service
issues - include access to services and availability - the control of access to services can be a
subtle way of effecting an imposition of others ideas by limitation of access.
There are always conflicts between the issues of conscientious objectors versus
the concept of duty to provide best possible care.

One could tackle the question of
abortion from an academic viewpoint
or from moralistic preaching of my
personal views. One could also become tied up in statistics and papers -
opinions and figures. This is a fertile ground for dogma and people taking a
‘stance’ a pose which can nearly always be backed up by production
of some statistics and rates -  But
how does this relate to PEOPLE
to REAL PEOPLE - what we would call case histories, although the term
itself belies their individual nature as feeling, hurting people.

When I was a medical student I spent
time at Coppetts Wood infectious diseases hospital
where we had a whole ward devoted to the treatment of septic abortion with
it’s own separate operating theatre - a whole ward full of dying women
with greenish grey faces, all on antibiotic drips. This was pre 1967 abortion
act - they had illegal abortions. Later when I went back there as a young
doctor in 1970 - after the abortion act - the ward was closed. SPUC talks of deaths and murder - but how about the deaths of those
suffering women?

Looking at Young People - Decisions are hard, it can be agonising to choose
abortion but sometimes it is the right choice. But who makes the decisions?
Sometimes there are conflicts within the family or with a boyfriend and it can
be equally disastrous for a young girl to have an abortion against her own will
or to be denied one because of other’s views and feelings. Timing is also an important factor.
Girls conceal or deny pregnancy through fear of the consequences or to protect
their boyfriends with the result that often those whose need for termination is
greatest are denied or are too late for an abortion or have the most dangerous
(later) procedures.  Decision making
is complex and depends on the emotional and psychological development of the
girl - an example of two sisters illustrates this. Carol and Susan  became pregnant in similar
circumstances but Carol had dropped out of school and had no prospects for a
bright future - she became a schoolgirl mother at 15. Susan had done well in
exams, was the bright hope of the family - they had invested a lot in her
future and she was promised a good career - a baby at 15 was not in
anyone’s plans and so she bravely waited until her 16th
birthday and then came for abortion counselling. Her decision was not easy but
it was the right one for her - she was looking at her future - but in order to
do so you need to have a sense of future which some young people have not yet
acquired, and you also need a future worth investing in.

What is the Motivation behind the abortion question? Most if not all of factors
involved in the decision making process surrounding the abortion debate have in
fact nothing to do with the foetus or developing child.  Arguments purporting to consider the
welfare of the foetus are in effect merely used emotively as justification of a position and as a displacement of true feelings and
motivations.

If in fact one truly cared about the
foetus - would one not look at the quality
of life for the child of an unwanted
pregnancy - apart from the obvious cases of children with a congenital defect -
apparently ‘normal’ children born of an unwanted pregnancy have
been reported to suffer from a catalogue of difficulties such as ill health and
are more likely to suffer non accidental injury.

For example a girl who kept her baby
‘for her boyfriend’ watched as he held the four week child under a
hot tap causing severe scalds.
Having babies is not all happiness and fun ..
Dora was depressed throughout pregnancy, hinted she would like an abortion but
could not bring herself to discuss it - her baby was the result of incest with
her father. Another girl was forced by her pastor to keep her child conceived
through sexual abuse by a neighbour. SPUC talks of ‘violence against the
innocent’ is this not violence against the innocent? These girls are further
abused by being forced to carry their babies to term and give birth to unwanted
children.

Unwanted children are also more likely
to suffer increased socio-economic difficulty; have less Education and less
stable marriages
(parents and child) - they are subject to rejection and many end
up in the care system.

Our answers to the abortion question
are dependant on how we perceive the child?
What do we attribute to the foetus? Invest in the foetus. This is based on
our own ‘inner world’ - Looking at the concept of inner child,
inner adult and inner parent -

P     moral, prejudices

A     practical, knowledge
facts

C     emotional - primitive
magical

a young
abused rejected girl will identify with and see the foetus as an
‘internal object ... inner self .. inner child. Such
over-identification will result in a feeling of - if I was rejected - how can I
now reject ‘myself’ the foetus is seen as part of herself - she
cannot therefore make a decision to terminate her pregnancy even if logically
this is the best course of action for her.

For all of us to an extent, there is a
similar mechanism - the developing foetus is felt as part of ourselves -
leading to the male feeling of rejection (of sperm ..
bible seed) .. get rid of my baby .. get rid of me.
This feeling can extend to the third party - for example professional or
anti abortion campaigner who may be identifying with the rejection and thus
bringing their own personal agenda into the argument. They are arguing for
themselves - not for the ‘foetus’.

Symbolism - what does the child stand
for - part of me - inner child  or
part of him ... bit he left behind leading to feelings like - ‘at least
I’ll have something when he’s gone’ the foetus becomes
‘something to keep hold of’ and  ‘maybe he won’t leave me
now’.

When others become emotional about
abortion they are bringing their own inner feelings and concepts into the
equation rather than seeking true answers to the question of abortion. These
feelings also encompass anger punishment and retribution with a need to control
- as in the mother who insisted her daughter carry her baby to term because she
herself was forced to do the same as a teenager ‘your bed, lie on
it!’. Jealousy and vindictiveness can surface when those who want a child
are faced with what they see as ‘someone getting rid of’ a baby -
thus verbal attacks on girls in gynaecology wards by women having infertility
treatment.

So we have a situation where others
attempt to control and impose their own standards, ‘morals’ and
feelings on others - instead of exercising compassion and looking at each
individual remembering that ‘there but for grace of God go I’.

*    *    *    *    *

NEWS -
NEWS ITEM - Study: Gay, bisexual teens more at risk

CHICAGO (Reuters) - Homosexual and bisexual high school students are more
likely to engage in risky sexual and drug-related activity than their
heterosexual peers, according to a study published Monday.  They also are more likely to have
attempted suicide and four times more likely than their peers to have been
threatened with a weapon at school, according to the report by Harvard
Medical
School,
the Massachusetts Department of Education and Wake
Forest
University.

The findings were based on a review of a 1995 government
survey of more than 4,000 youngsters in the ninth through 12th grades,
of whom 104 males and females said they were
homosexual or bisexual. The authors said their findings were consistent with
earlier reports on the hazards facing non-heterosexual youth.

"Previous studies support the notion that many gay, lesbian and bisexual
youth engage in an array of individual behaviours that increase their risks for
a number of negative health outcomes, including suicide, depression, physical
and verbal victimisation, substance abuse and HIV," the study said.  "It has been estimated that that
gay and lesbian youth are two to three times more likely to attempt suicide ...
and may account for 30 percent of suicides among youth annually," it
added. The authors said the new study presented a more complete picture of the
problem because it involved an anonymous, but representative, school-based
population sample, rather than centring on particular groups such as runaways,
youths responding to survey ads in gay newspapers or young people who are being
treated for sexually transmitted disease.

The study said teens who used cocaine, alcohol or marijuana or who had their
first sexual experiences before age 13 were more likely to be homosexual or
bisexual. The number of sexual partners - a risk factor for AIDS and other
diseases -- also was higher among homosexuals and bisexuals, the report said.
The same group was more than three times as likely to have attempted suicide,
said the study published in the current issue of Paediatrics, which is the
journal of the American
Academy
of Paediatrics.

- International Chapter News -

News of the International
Regional Chapter (IRC) of SAM

(Society for Adolescent Medicine)

Co Chairs -
Diana Birch Gustavo Girard
Treasurer Aric Schichor

London      Buenos Aires              Connecticut

England     Argentina                 USA

Our
Chapter Institute at the 1998 SAM  meeting (Society for Adolescent
Medicine) Atlanta
-  March 4th 1998 was
on the subject of

exploitation
of youth - the transcript of the session may be found overleaf.

Any
contributers for IRC 1999 at LA SAM?

SAM 1999 - IRC Institute

“When is a family
dysfunctional? - A cross cultural view.”

The
family provides the ‘stage’ upon which emotional development takes
place and sets the scene for future difficulties, personality problems, and
patterns of low self worth, self harm and abuse. Our concept of
‘family’ has changed from the classical view of the nuclear family
to a variety of models including extended family, single parent, adolescent parent - there is no single concept of
‘family’.  On a more
cosmopolitan level - family structure varies cross culturally and we should
perhaps also consider bands of street kids and runaways as developing their own
‘family’ groups.

What
family structures work for the individual and why? What is a dysfunctional
family? How can we and when should we intervene? By working with families we
hope to break cycles of dysfunctional patterns and enable children to grow into
happy effective adults and future parents themselves.  This institute will explore the above
issues on a cross cultural basis and attempt to draw common lessons from our
joint experiences.

‘Exploitation of Youth - An
International Perspective’

Our Youth are our resource for the future - but are we
exploiting that resource? Across the world employers know that youth are a source of low waged labour, from teens working in fast
food outlets to primary school children whose tiny hands can knot high quality
carpets. They often work in dangerous and abusive conditions. Adolescent
sexuality provides another rich area for exploitation - sexual tourism is on
the increase and young prostitutes of both sexes are a prime attraction.
Presentations will look at types of exploitation in differing cultures from the
USA to the Far East and raise the question of
where lie our responsibilities and our role in prevention?

SAM International Regional Chapter

Institute Wednesday 4th March 1998 - Atlanta Georgia

The Exploitation of Youth

Exploitation of Youth - An overview and Introduction -

Diana
Birch - Youth Support London
England.

The
Exploitation of youth - how
do we define exploitation? In the extreme case, such as in a child or youth
being used in  pornography, the
definition is clear but there remain areas where the dividing line between
‘expectation’ of youth and exploitation is hazy and the ‘goal
posts’ tend to move depending on the perspective of the observer.

Examples abound in family life -
parents differ in their expectations of their children and especially of their
adolescent children. What  one family considers to be a
reasonable degree of involvement in housework, child care or contribution to
the upkeep of the family home may by others be considered abusive or bordering
on slave labour - certainly that is how many young teens see housework and
family chores.  We could use a
commonly applied definition of abuse to help us here in that an abusive
situation may interfere with the well-being of the young person  physically, emotionally or
developmentally  but we do need to
take note of cultural norms. Does being sent out to work hinder the normal
development? Yes -
if it stops you taking part in education - perhaps not so much if
good educational opportunities do not exist. Being made to stay at home to look
after younger siblings is an exploitation which deprives youth of school
attendance but when the family is poor and mother has to work to put food on
the table - which is the lesser evil?

Motivation
can also merge with exploitation - if parents push their
child to succeed academically and the parents aims and aspirations do not match
those of the young person then even a drive for success can be exploitative.
This is perhaps particularly noticeable in sport where the child or teenager
can be ‘doing it for mum or dad’. There is commonly parental over
investment in the activity and it’s results so
that the parent is achieving their own ends in the process. There may be a
symbiotic attachment , a merging between parent and
offspring so that the youth is seen as an extension of the parent’s
‘self’ and they fail to see their son or daughter as an individual
with his or her own goals. Such intense ‘driving’ of young people
to succeed and compete can lead to a sense of failure - never quite good enough
- low self worth and burn out.

Similar processes are seen wherever
there is an opportunity for adults to take vicarious pleasure from the
activities of children or youth - parents, teachers, coaches can all become
involved there are numerous examples in fashion - young models, the media,
beauty pageants , dance competitions ……
Any aspect of life where adults might want youth to do what they could not -
they succeed by proxy.

Attributes
of youth - Exploitation exists on any levels of
society - it is useful to consider what are the attributes
of youth and thus how are these attributes used by others?  Youth, vitality, a need for independence
can be exploited in the labour market.
Youth have been traditionally a source of cheap labour, perhaps menial
and unskilled, often illegal labour  and thus labour which may include
an element of danger and lack of attention to health and safety and labour laws
and rights. The use of child labour in British mines was the issue which
finally provoked the establishment of child protection legislation - although
the animal protection laws were passed first!

Young people have commercial attributes
- they have money to spend , they are a buying power
to reckon with - hence exploited in the market place. ‘Must have …
trainers, clothes, make up etc..

Youth are also sexually
‘alive’ vital and perhaps seductive, they are aware of their body
image and want to look good. They are thus ripe for exploitation in advertising
and by advertising. Sexual exploitation may be overt or covert and cover a wide
range of activities such as titillating magazine pictures, to a range of
pornography, paedophile activities, juvenile prostitution and sexual tourism.

Sexual
Exploitation - Looking more closely at the subject of
sexual exploitation - we are hampered by lack of accurate reporting,
insufficient data, manipulation and ‘doctoring’ of data when
presented by different bodies and a vast difference in quality and quantity of
case material derived from different sources.

In Britain the police statistics,
produced by the Home Office show us only the tip of the iceberg since
statistics are divided into ‘cautions’ - when police warn a suspect
not to re-offend but do not prosecute - and prosecutions, where the case is
taken to court.  Statistics would
seem to indicate that certain offences are more likely to be dealt with by a
caution (young girls soliciting) and others by prosecution (e.g. indecent
photograph of child).  {see graphs}

Graph
- prostitution under 16yrs

Graph
indecent photograph of child

The categorisation of crimes is often
misleading and we also have conflicts over the nature of the offence - for
example an abused and exploited girl who is forced into prostitution by an
older ‘pimp’ is technically an ‘offender’ whereas at
the same time she is also a ‘victim’ - there is confusion between
victim and perpetrator.  The overall
numbers reported via police prosecutions belie the practical experience of
anyone working in the field who can be immediately
certain that the true figures are much, much higher.

The association - AAA Accuracy about
Abuse publish a regular newsletter which catalogues all media reports and items
from a variety of sources piecing together information about paedophilia and
related matters - {it can be reached via e mail on [email-masked] }
Many of the case reports below are included in their data sheets.

Justification-Sexual
Exploitation of youth is a rich field for ‘justification’ of the
practices involved. Some examples include -

·
Pictures - are photographs of children
in naked or sexual poses art or pornography?

·
A recent case in South
Africa - the
Ron Oliver case - highlighted some of the controversies and resulted in court
action.

·
‘Research’ - Sexual
responses of children have been misrepresented and there is abundant controversy
regarding the ‘Kinsey’ findings which had hitherto been regarded as
standards since the revelation that one of the workers ‘testing’
youth was in fact a paedophile.

·
‘Harmless’ - Paedophiles
have argued that sex with children is harmless and that children like it - that
it is an initiation and thus desirable. Many controversies exist and there have
been examples including an Edinburgh
lecturer who was dismissed from his post after publicising such views and
including material on the internet.

·
Statistics - - Criminologists and
Academics -  Have
stated that society over reacts to nudity and there has been no new pornography
in recent years - Such criminologists include a gentleman who turns out to be
on the board of the British False Memory Association and is the author of a
book ‘Sadomasochism’ which states among other things that
sadomasochistic sexual practices including bondage, whipping, humiliation, ice,
hot wax, burns, branding are neither violent nor dangerous. Other
‘academics’ who have been involved have been discovered to be
members of the Paedophile group ‘Paedika’.

·
Prevention - the seriously flawed
argument here is that pornography may be used in prevention in that offenders
viewing pornographic material and fantasising about their practices will be
able to ‘split’ fantasy from behaviour and thus not re-offend. In
practice most professionals would agree that the opposite is true and that
viewing pornographic material incites offending behaviour.

·
‘Treatment’ - a related
argument based on the same  principles as prevention - that
pornographic material can be used for treatment of offenders.

·
Education - pornographic material has
been suggested as useful for educating students in California.
Educated in what one wonders?

Reports
- International basis -  Reports of sexual exploitation
and paedophilia have come from a variety of sources - these following provide a
few examples of the range of problems but also naturally only relate to those
exposed by the police - it begs our imagination to think what else lies
uncovered.

·
In the UK
one of the worst cases was probably the Clwyd inquiry
into children’s homes in Wales
in 1996 when 14 inquiries led to widespread revelations of abuse including the
involvement of children’s workers.

·
In Spain
in august 97 there were reports of 85 victims of sex rings with videos,
pictures, computer diskettes seized and the perpetrators included teachers,
doctors, politicians. This unearthed a ten year
operation with wider international links.

·
France
- June 97 thousands of porn videos were seized which depicted among other
violations at least seven rapes, twenty nine cases of sexual abuse
, two of bestiality and drugs and gang rapes were involved. This
resulted in 600 arrests and it was found that there were over 1,000 individuals
on the mailing list of the material including 31 teachers 2 priests and 2
directors of children’s holiday camps.

·
In Poland
in November 1996 a paedophile ring was uncovered including 100 foreigners and a
government
official.

·
An Interpol and UNICEF report in Europe
found highest rates in Poland
with a new focus on paedophile networks. The Netherlands
was said to be a clearing house with customers mainly in Germany
and France.

·
Holland April 97 British paedophiles
were found to have killed five in ‘snuff’ movies and boys were
being imported from London and eastern Europe and sold in England and Holland

·
In Ireland
in July 97 a paedophile priest was jailed for 12 years.

·
USA Dallas July 97 120 million dollars
damages was awarded against a Roman Catholic diocese involved in paedophilia
and a ‘link up’ organisation.

·
UK
in November 96 ‘father porn’  the biggest ever computer
pornography operator was exposed.

·
Belgium
Jan 97 police exposed sex rings involving murders, rape, torture, videos.

This just gives a short outline of the
problems we are facing in looking at exploitation of youth - certainly it seems
to be a problems which we need to face on an
International basis and this institute would seem to be a suitable venue for
collaboration and sharing of ideas and experiences. Hopefully we will be able
to begin to formulate some recommendations for future work and possibly
intervention.

The Problems in Latin America -
Exploitation of Youth

Gustavo
Girard - Argentina

After investigating the databases of South
America as well as some international ones
too, I found, like Diana Birch, that the statistics were under-reported and not
really true.  I have also noticed
that Argentines don’t talk about child abuse - not even
paediatricians.  Most people say
that is not a problem. Should we look at why society allows this?  Is it new?  I would like to talk about my
experiences rather than give a talk from the books and research.  I have tried to think about problems,
and in this talk I am giving a personal opinion - not a scientific view.

Exploitation is submission, not just to
violence - but submission to someone stronger (in mind or body) than
another.  (like
Cain and Abel from Genesis)

Adolescents have been the same for
centuries - a misquote from 500BC says that
‘Young people speak roughly, insult, have no manners etc’.  What has
changed is not the adolescents, but adolescence. Pre war (2nd WW)an adult male was equated with glasses, age, money,
knowledge and a big belly. The idea was to save for the future, study for the
future and make money for future. Industrialisation for the
future.

Nowadays in post industrial era - most
important thing is ‘today is the future’. The present is paramount,
everything is recyclable. Adolescence is no longer a transition - everyone wants
to be a adolescent.  People desire youthfulness not age.  Models are getting younger and younger
and are now just 16 yrs old, or younger rather than adults, what we see constantly
in the media is adolescence.
Children want to be adolescents not adults.  Everyone tries to wear adolescent
clothes rather than the clothes of their age - from babies to adults.  Religion and spirituality are changing -
people are seeking new religions.

A
Current View of Exploited Youth.

Victims
of exploitation
either

React to the system (An active or passive reaction)

or      Accept the
system.

Presentation - Under-nourishment

Poverty
(misery)

Victims
of violence

Street
Youth

sexual abuse and prostitution

illiteracy

family problems

Reaction      Violent
- illegal - murder

abusers

exploiting others

survival sex

becoming fundalmentalistic

rescuers of society

Passive       Suicide

depressive

killed

Adolescent
mothers

Drug
abuse and addicts

STD
& AIDS

allowing abuse

In Latin
America there is now a ‘new
poor’.  They have the basics
but think they have failed in their lives.
They have accommodation (don’t live on the streets), they have
education, they are not street youth.
But these are the adolescents who are becoming prostitutes.  We have a new problem……
Human Rights can be looked at as encompassing the concepts of Civic rights - 18th
Century (effect you when born); Political rights - 19th Century
(effect you when you become an adolescent); Social rights - 20th
Century?(does anyone have these?)

Having said all of this however,
something is now changing.
Volunteers are trying help the youth.  They are not looking to change the
world, but are trying to help youth recognise the need to change, the need for
self esteem, healthy lifestyles, cultural
development.  Health teams must be
resilient, they believe in adolescents.
Need to works in a positive way to prevention if we are to help them.  Youth exploitation = social
exploitation. It is not just youth it is everyone.  It is clear that we can do some good,
but we shall need more help from other areas.

Sexual exploitation of Youth in Japan.

Yuko Matsuhashi - Hiroshima
University
- Tokyo

Minors under the age of 18 should be
protected by the government.  Only recently has a law doing this has
been created. However there is still much exploitation particularly of young
girls. Many magazines contain photographs of young girls in provocative poses.  Not only the men’s magazines, but
also young girl’s magazines giving the impression that it is OK to look
like they do.

Another problem with exploitation of
youth is the sale of girls school uniforms which sell
in shops for maniacs (Men with fetishes). Girls are aware they can make money
from their clothes and a percentage will sell their clothes including their
underwear The uniforms generally consist of
mini-skirts, white socks, sailor suit blouses and so on.

A third area of exploitation is through
telephone clubs and contacting girls via their beepers and pagers. This is an
area which is expanding rapidly in Japan
now but the government
won’t admit it is a form of rape, saying rape has to be violent. Men pay
to sit in a small room and wait a call from a school girl who will talk to
them. They can then, if they want, arrange a liaison. Young girls have beepers
and pagers in their pockets and they vibrate during classes. The girls can then
call the man back. This is also exciting for the girl -having the pager or
beeper

vibrating
in their pockets during class). It is noticeable that the percentage of young
girls with mobile phones is lower than in the US while the reverse is true for beepers.Looking at motivation 70% of young girls called a
telephone club because they are curious; 55% of young girls call telephone club
because they are bored; and 42% of 14 year olds say they do it to tease the man
on the phone

The young girls are not aware of the
morals.  In 1995 23% thought that it
was OK to talk about sex and 60% thought it was a problem but if she wanted to
it was OK.  Also in 1995 11% said
that prostitution was OK.  In 1997
44% said that their friends had suggested they call the telephone club.  It is becoming clear that girls are
doing things because their friends say they should

Prostitutes who were under age are usually
higher middle class and appear to their parents and teachers as good,working hard and being
obedient at home. Those who have sex with school girls or use telephone clubs
are high socials teachers, police, officials etc. In 1996 the main motivation
for young girls to use the telephone clubs is money whereas previously it was
curiosity. This is because girls are affected by mass media and commercialism.
They want designer clothes and money. They see themselves as a commodity and
can sell their bodies or be photographed. In Japan
value systems have changed, father figures are often out; parents are one of
the problems (not having sex after children and don’t show love for each
other); Students are stressed; Women are discriminated against in work etc;
students don’t have proper sex education; women sell themselves to make
money. The abortion rate is high it is very easy to get an abortion.Pregnancy
rate is high, but not recorded because of abortions. Work is being done to try
and combat all these issues, but it is slow. One way some of this could be
stopped is by getting rid of single-sex schools and uniforms.

The Exploitation of Youth in California

Richard
Brown  -
San Francisco

The Exploitation of Youth in California
with particular reference to homeless youth. This is a complex story  which is
hard to explain there are many sub groups, districts, class etc….. and the terminology is new.

Larkin street youth programme sees

·
1,000 in 12 - 18 year age

·
1,000 in 18 - 24 year age

·
3,000 - 5,000 homeless youth in the
programme

One of the problems which we face is
the mobility of homeless kids.  The adolescents which we deal with move about the West coast - and
don’t stay long in one area.
Thus it is hard to work through their issues with them. Our programmes
see 40% of younger youth come from other states, 60% from California
and 12% only from San
Francisco.

Programme services for these youth may
be outreach -specially night outreach programme; centre based services;or care management
services. The term is no longer ‘high risk youth’ it is
‘youth in high risk situations’.

Night outreach
staff travel around the area of Polk
Street, giving out condoms,
toothbrushes etc.  We also try to
make relationships with the people on streets. Getting them
to trust people etc.

Centre based services
include a drop-in centre.  People
can come in and use the medical centre.
There are also psychological services for the kids and placements are
made there for the shelter at Diamond
Street.

Case Management
- an ongoing provider and relationship.

Exploiters can be every kind of person!.  There is a
need to break down of the barriers that exist in society -  to combine and work together -
hospitals, housing, employment etc. Street Drugs - Speed is highest in the
Tenderloin district; Heroin, alcohol and Pot are highest in the Haight-Ashbury area.
HIV sero-prevalence of homeless Youth aged 12-17yrs
less than 1%; aged
13-19yrs 2-4%; aged 20-24 years 10-20%.

We have found a massive denial of
sexual abuse. It is clear that we have to ask the questions. We also have to be
assertive to bring out their fears and problems. We need to be diligent. It is
clear that it covers the entire spectrum of socio-economics,
there are no longer any specific groups which we can target.

Adolescent Prostitution in Taiwan

Meng
Chi Lee  - Taiwan

In a rapidly changing society,
adolescent prostitution has been one of the matters of great concern  in Taiwan  in the past decade. It is estimated that
in 1993, there were about ten thousand adolescent women aged 13 to 17 years
engaging in prostitution, a prevalence of 0.5%. This estimation was based on
the fact that about 700 adolescent prostitutes were caught by the police in the
same year. Among those 40% were aborigines and 50% were voluntary prostitutes.

Epidemiological studies found that
factors related to adolescent prostitution include poor family economic status
(especially in aborigines) run-away, being raped and drug abuse. Fortunately
the ‘child and teenager prostitution prevention act’ has been
implemented since August 1995 and a number of midway homes and rescue hotlines
have been established to host and protect adolescent prostitutes. Adolescent
health care providers are now working in schools, midway homes, community
mental health centre and adolescent health clinic at varied settings attempting
to intervene in the exploitation of youth.

Summary of discussion points and General Conclusions:-

Diana
Birch

We have had a very interesting
institute and quite some time for discussion so I think it is now time for us
to pull together perhaps some of the threads that have run through some of the
presentations.  We started off by
looking at how exploitation can occur on a number of different levels.  How it can be financial, sexual,
etc.  And I think one of the issues
which has come across is how exploitation of any kind,
including the more extreme forms such as paedophilia and pornography can occur
in any level of society.  When we
talk about any level, it is any level for the perpetrators and any level for
the victims.  As we said, sometimes
the difficulty in sorting this out is that the victim can be seen as the one at
fault or the one indulging in a crime, being involved in a crime, such as young
prostitutes, or the perpetrator can be the one who is subject to the criminal
system.  So it does make it very
difficult to sort out.

Another thing that has come through
loud and clear is the danger involved.
In looking at exploitation, and looking particularly at sexual
exploitation, this is not only danger for the young people who are indulging in
it, but also it would appear, danger for the professionals like ourselves who
are involved, because it occurs on all levels of society. We can have
perpetrators, paedophies etc who are involved, not
only in support services for young people, and are therefore trying to pick up
young people that way, in children’s homes, schools, church, and even as
donors to safe houses, free clinics etc, and when we come, as professionals to
expose these people we can actually expose ourselves to danger on a number of
levels, including of course physical threats.  Because what we are doing in effect, is that we are not only exposing someone’s
activities which might well be illegal or immoral, we are depriving them
perhaps of livelihood and a lot of money.
Young prostitutes earn money for their pimps,
prostitution is a major industry, as is child pornography.  And behind the issue of money and
finance is the issue of power.

It is a power game when young people
are exploited, and they can be exploited, by financial means as we have looked
at but also politically.  Not only
do young people have a vote and therefore this is a political issue, but also
politics and covert politics come in on the level of paedophilia and
pornography - with even government
agents in various countries controlling paedophile rings.  And when you have local politics
involved, this then increases the danger and the power as we have been saying.

We have been a small group this
afternoon, but this has been a very intense matter that we have been
discussing, and I think that we have actually got a lot out of it.  We have discussed how we have all been
on a bit of a rollercoaster this afternoon, with
feelings running in a positive direction, feeling we are all together
discussing this, that we are actually getting something out of this, and may be
we can make some changes.  Then,
have fallen down into the depths (of despair almost) when we see how big the
problem is, how wide-reaching, how multi-disciplinary, across all sorts of
structures of society, and we feel like pawns in the game, quite helpless and
powerless.

To come to this group has needed some
sort of courage from us all, in that we have managed to tackle these very
difficult subjects, and it has been a very hard afternoon, and it is quite
revealing, that although last year a number of people asked for this session,
actually only a small number have been able to come in and discuss this issue
out in the open.  We have seen time
after time in the papers we have been looking at and items that we have been
discussing, how so much of these issues are covert.  I think that sometimes as professionals
we can collude with the covert nature because we don’t really want to
face some of the wider issues.

These issues are world wide.  We have looked at the mobility of the
problem, particularly again when we are looking at the sexual exploitation.
Dick Brown was talking about young people who are homeless who are exploited
very much by society, who are very mobile, going up and down the west coast
from San Diego
to Vancouver.  Also we need to look at the
cross-cultural, cross boundaries movements of paedophiles and their
victims.  Young people who are taken
form London, sold in Holland, were taken from Eastern Europe and sold in the
west, etc, and of course the traffic of young people in the far east etc.  And the big problem of
sexual tourism.  How we are
exporting perpetrators to different parts of the world, to go and abuse kids
elsewhere, and then come home.  So
we are moving across boundaries, and that is why it is so important to an
international meeting such as this where we can look at these things.

We tried to look at what exploitation
means and the definition is, and that was very difficult because of the way it
comes in on so many different levels of society, and maybe some of the minor
points of exploitation, like children in advertising and seeing pictures of
school girls who have still got their underwear on, are smaller matters that
maybe in a way collude with the larger exploitation and that if we allow these
small covert means of exploitation to continue without challenging them, we are
in a way condoning the larger offences and giving the perpetrators excuses to
continue with their activities.
They say ‘Well if that is ok, then this is ok’ and you
increase step by step to something which is wholly unacceptable and
abusive.

Generally speaking what we have said is
that by exploiting youth we are removing their rights.  We are removing their power.

A more difficult issue arose when we
discussed what we might do about the problem. Is this a public health
issue?  Is it a legal issue?  Can we pass laws?  But we know that most of the activities
we are talking about are already illegal, so that doesn’t help - and
should you be passing laws that you cannot enforce or don’t enforce for
what ever reason.

We separated out advocacy from law, in
a way, because advocacy was linked to education, and perhaps this was a way
forward for us as well.  To educate
children from a very young age, from kindergarten etc, in ways of resisting
exploitation of making sure that they don’t get into things they
don’t want to, but on the other side, we also have the seductive,
addictive dependency aspect of being in this situation, just like an abused
child in a children’s home or in a family doesn’t know anything
else and can then become quite seductive, and is also stuck in that level of
functioning, that kind of structure.

We needed to look therefore at the
social structure as a whole.  There
were suggestions of working with the family.  A lot of these kids don’t have
families.  We need to therefore work
with the surrogate family - the children’s home, the social workers etc -
but those are levels where paedophiles can infiltrate in.  So the structure of society is
important.

In may cultures as we have seen, where
there is a lot of exploitation, one of the things is that the value system has
gone, so how do we put that back in?
We have heard from Yuko in Japan
who has said that value system has gone in Japan,
a lot of people are no longer religious, all they look
at is materialism. And because of that they are only thinking of how they can
earn money and if they can earn money by prostitution or by telephone sex, well
why not?  If you don’t have a
value system then these things are not moral or immoral.  The same thing happened in Russia where
when Peristroyika happened, when communism went and
there was no religion there for most of the kids, sleeping with a western
businessman and earning more than your family earn in a month, seems
right.  So, we looked at how we need
to have our own values sorted out, we need to know where we stand so that we
can help young people to formulate their own values.  Not to place our values on them, but
because we are secure our values we can help them to formulate their own.  And as long as you do have a value
system, then perhaps you can respect yourself, value yourself and not allow
others to exploit you.

One of the things which came up was
anger towards young people, and that was possibly anther reason why some people
did not come to this session.
But this is a very difficult problem and very difficult to tackle.  And when you have a problem that you
cannot tackle, you tend to turn on the people who are causing the problems. In
other words these young people are so difficult to help that professionals can
be angry with them.  ‘Why
can’t you be a good patient with a nice disease which I can cure so that
I can feel good as a doctor?  You
have got all these things wrong with you that I can’t do anything about,
you are making me fell bad so I’m angry with you’.  We need to look at this as well.  Anger towards youth, are we being
destructive in our role as professionals.

So just to close I need to say that in
1996 we had a conference run by Youth Support in London
which we called ‘Youth, our resource for the future’.  And it is very important to regard youth
as a resource rather than a commodity.
It is not a commodity that we can use, but a resource that we can value
and value together.  In so doing we
need to encourage youth and not exploit them.  And on that note we end our institute.

Proceedings of our conference 1996

Youth - Our Resource for the Future

Now available from Youth Support

- £5 by mail order -

write to YSH 13 Crescent Road
London BR3 2NF

or FAX 0181 659 3309

or E mail us at
[email-masked]

The Journal of
Adolescent Health and Welfare

is published
by:-   Youth Support,   13, Crescent Road,   London BR3 2NF

Tel No 0181 650
6296
Charity No 296080
Fax No 0181 659 3309