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Sexual Health

  • Puberty, Sexual Health, Teen Pregnancy

    We all go through it…The Change

    Puberty – How Your Body Changes

    Your body is changing; your moods may be unpredictable and sometimes hard to explain. Don’t worry. These changes are normal. Our guide to teen health is designed to help you understand the common physical and emotional changes you are going through, and deal responsibly with new personal and social situations you may encounter. These changes are called puberty.

    Puberty lasts for several years and marks the life stage when your body is changing from a child to an adult. Hormones help trigger and guide this process. Hormones are natural chemicals in your body that produce gradual physical changes during this time and may also cause emotional changes that can sometimes seem uncontrollable. These changes are common during puberty, and they happen to everyone. Although it may seem that these changes and feelings are out of your control, don’t worry—you’re still you, just the “growing up” version.

    Common Physical Changes in Girls

    Girls going through puberty often notice physical changes, such as larger breasts, hair growth in new places, acne and changes in the shape of your hips, waste, bottom and thighs. Below are some of the common physical changes you may experience.

    Menstrual Periods & PMS

    Menstruation is a turning point in your development from a child to a teenager. It’s important to remember that this is natural and something that makes being a woman special.

    Larger Breasts

    One of the first changes you will notice are your breasts growing, usually between the ages of eight and 12. Once your breasts start growing, you will most likely want to buy a bra.

    Common Social and Emotional Issues

    Today’s young women face many emotional and social challenges during puberty. Below are some of the common tough issues you may find, and tips for handling them.

    Self Esteem & Peer Pressure

    The foundation for positive self-esteem is built at an early age and is influenced by relationships between you and your family. Your feelings about yourself will change as you grow.

    Sex & Sexually Transmitted Diseases

    When to engage or not engage in sexual relations is one of the most important decisions a person can make. From getting pregnant to becoming infected with an STD, make sure you understand the risks.

    Mental Health & Abuse

    Overall health means more than simply being in shape and eating properly. Mental health, which includes your thoughts and feelings, is just as important as physical health.

    Hair Growth

    Hair will start to grow under your arms, on your legs and on your pubic area. Shaving your underarms and legs is a personal choice, but talk about it with one of your parents first.

    Acne

    This aggravating condition may be mild (blackheads and whiteheads), moderate (larger inflamed-looking blemishes) or severe (large cysts or nodules). Acne is caused by a build-up of oil, microorganisms and dead skin cells in the hair follicles under the skin.

    Eating Disorders

    With a more prevalent preoccupation with appearance and weight in today’s society, girls may be at risk to develop eating disorders.

     

    Substance Abuse

    During your teenage years, it is a good idea to take some risks, like trying new activities or sports. However, some risk-taking behaviors, such as drinking alcohol, smoking and using drugs have negative effects.

     

    Visiting Your Doctor

    Before the onset of puberty, discuss your questions and concerns with your health care professional. It is also a time for you to gather printed material on a variety of health issues, including your menstrual cycle, contraception and sexually transmitted diseases (STDs).

  • Sexual Health, Teen Pregnancy

    Sexual Health & What You Need To Know

    • Puberty lasts for several years. It is the stage of your life when your body is changing from the body of a child to the body of an adult. Hormones, which are natural chemicals in your body, orchestrate these alterations in your body.
    • During puberty, one breast might grow larger than the other. Once your breasts start growing, the differences will most likely be slight. And your breasts will even out before they are finished developing. Even if they don’t, no need to worry—many women’s breasts don’t match each other exactly.
    • It might take a while, perhaps even a year, for your periods to become regular. During the first year, your cycle (from the start of one period to the start of the next) may be as short as three weeks or as long as six weeks. Even after your period becomes regular, exercise, stress or a change in diet could throw it off track. If you are sexually active and skip a period, talk to your health care professional immediately—you could be pregnant.
    • An estimated 3.2 million cases of sexually transmitted diseases (STDs) occur among teenage girls every year; this translates to one in four teenage girls.
    • Suicide is the fourth leading cause of death for persons between 10 and 14 years of age and the third leading cause of death for those aged 15 to 24 years. Actions or talk of suicide are cries for help.
    • Today, an increasing number of teenagers express dissatisfaction with their bodies Media portrayals of idealized body images that are unrealistic for most people are partially to blame for the increase in teenagers’ dissatisfaction with their bodies. And this idealized body image among young women—and increasingly for young men, as well—is leading to an increase in the number of teenagers with eating disorders. Eating disorders are not just a preoccupation with food, dieting and weight, however; they are serious mental disorders that can have serious consequences. Two common eating disorders are bulimia and anorexia nervosa.
    • About 53 percent of all teenage school girls are not having sex, according to a 2002 study by the U.S. Centers for Disease Control and Prevention (CDC).
    • You are most likely to get an STD during your teen and young adult years—more than two-thirds of all STDs occur in people younger than 25.
    • According to the National Institute on Drug Abuse, in 2007, 39 percent of eighth-graders, 62 percent of 10th-graders, and 72 percent of 12th-graders reported having tried alcohol. It is the drug most often used by 12- to 17-year-olds.
    • The Harvard College Alcohol Study found a sharp rise (from 5.3 percent in 1993 to 11.9 percent in 2001) in frequent binge drinking was noted among women attending all-women’s colleges, and a lesser, but still significant, increase of the same behavior for women in coeducational schools.

     

    Questions to Ask

    Review the following Questions to Ask about teen health so you’re prepared to discuss this important health issue with your health care professional.

    1. What is going to happen during puberty?
    2. I get horrible cramps with my period. Is there anything I can do?
    3. One of my breasts is larger than the other. What is going on? Will they stay this way?
    4. What are sexually transmitted diseases (STDs) and how do I know if I have one?
    5. I am thinking of becoming sexually active, and I want to know the safest form of birth control.
    6. Will you tell my parents what we talk about?
    7. How can I tell if I am pregnant?
    8. What is the best way for me to get rid of my acne?
    9. My friend tells me she sometimes thinks about killing herself. Is there anything I can do to help her?
    10. My boyfriend is pressuring me to have sex with him. What should I do?

    Q&A

    1. How long will my period last?

    Young women usually start menstruating between the ages of nine and 16. A period lasts from three to seven days each month. Don’t count on your period being regular during the first year or so. Dieting can alter regularity, as can stress and the amount of exercise you get.

    2. When is a menstrual cycle considered abnormal?

    You should call your health care professional immediately if

    • you are sexually active and skip a period
    • you experience severe pain or excessive bleeding
    • your bleeding lasts more than ten days
    • you have bleeding or spotting between periods
    • you have not had a period for the last six months

     

    3. What is an STD?

    Sexually transmitted diseases (STDs) are infections most commonly spread through sexual intercourse or genital contact. According to the CDC, 3.2 million cases of STDs occur among teenage girls every year; this means one in four teenage girls has an STD. Unprotected sex and multiple sex partners place young people at risk for HIV infection, other STDs and pregnancy. If you are sexually active, a latex condom is your best protection against getting an STD. It is important to know how to use a condom properly.

    4. Do I have to have a Pap test?

    You should have a Pap test about three years after you become sexually active; if you’re not having sex, you should have a Pap test by age 21. A Pap test will be done in the health care professional’s exam room and only takes a minute or two. The health care professional will insert a speculum into your vagina and lightly swab your cervix. A lab technician will analyze the results, looking for anything abnormal. Abnormalities could be signs of cervical cancer or viral infections such as human papillomavirus (HPV).

    5. I have been dating the same boy for more than two months and he is asking me when we are going to have sex. When do I have to have sex with him?

    You never have to have sex with someone. There are no rules regarding when to have sex and when not to. This decision is a personal one and should not be forced by anyone.

    6. My boyfriend broke up with me three weeks ago and I just can’t get over it. What should I do?

    Ending relationships can be painful at any age. Learning how to work through your feelings during and after a break-up is important now and for relationships you will have in the future. If you can’t shake your blues by spending time with friends or concentrating on activities you enjoy, talk to your parents, a counselor or mental health professional. You may be having trouble adjusting. You may also be experiencing depression, especially if you answer yes to several of the following questions:

    • Do you cry more now than you used to?
    • Do you think your life is hopeless or meaningless?
    • Do you have a hard time sleeping, either sleeping too much or falling asleep at night?
    • Do you spend more time alone than you used to?
    • Do you ever think of hurting yourself?
    • Do you often feel worn out?
    • Have you gained or lost weight in the last month or two?
    • Have you noticed significant changes in your appetite?
    • Are you more irritable than usual?

     

    7. What do I do when I get my period?

    You’ll need to wear some form of protection to prevent staining your clothes. You can choose from an assortment of sanitary pads, panty liners and tampons. You can continue activities and sports that you enjoy. However, for activities involving water, you will have to wear a tampon instead of a pad.

  • Sexual Health

    Understanding Sexual Health

    Coming up with a definition of sexual health is a difficult task, as each culture, sub-culture, and individual has different standards of sexual health. ASHA believes that sexual health includes far more than avoiding disease or unplanned pregnancy. We also believe that having a sexually transmitted infection or unwanted pregnancy does not prevent someone from being or becoming sexually healthy.

    Here is ASHA’s definition of sexual health:

    Sexual health is the ability to embrace and enjoy our sexuality throughout our lives. It is an important part of our physical and emotional health. Being sexually healthy means:

    • Understanding that sexuality is a natural part of life and involves more than sexual behavior.
    • Recognizing and respecting the sexual rights we all share.
    • Having access to sexual health information, education, and care.
    • Making an effort to prevent unintended pregnancies and STDs and seek care and treatment when needed.
    • Being able to experience sexual pleasure, satisfaction, and intimacy when desired.
    • Being able to communicate about sexual health with others including sexual partners and healthcare providers.

     

    Defining Sexual Health

    ASHA Board member and professor of pediatrics at Indiana University School of Medicine J. Dennis Fortenberry, MD, considers the term sexual health, how it is used, and how it can be defined.

    The phrase “sexual health” encompasses a range of public health and clinical issues related to prevention of sexually transmitted infections. I use the phrase a lot in my own work and its widening currency is a welcome new paradigm in our field. In fact, the concept of sexual health seems to me of fundamental relevance to all aspects of prevention of sexually transmitted infections.

    To be honest, though, all of the talk about sexual health doesn’t seem to have influenced the day-to-day particulars of our work. Sex still is primarily seen as a set of risk factors that we counsel against. I am convinced that this perspective on sex and sexuality as “risk” legitimates the stigma associated with sexually transmitted infections and contributes to our society’s poisonous intolerance of sexual diversity. A sexual health perspective incorporates the concept of personal and epidemiologic risks of sex, but recognizes the pervasive importance of sex in our lives.

    However, I’ve begun to wonder if I know what sexual health means in the first place. It’s a big concept, and maybe it’s natural that definitions seem idealistic, overwrought, and self-righteous. Consider the well-known working definition of the World Health Organization:

    “Sexual health is a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled.”

    There is a lot to agree with in this definition, especially in its recognition of the complex physical, emotional, mental and social attributes of sexual health, and the anchoring of sexual health in universal sexual rights. But, I find this definition to be quaintly admonishing and parental (“…the possibility of having pleasurable and safe sexual experiences…”). More importantly, however, the definition is sexually vague. No matter how many times I’ve read, used, and cited this definition, I can’t derive from it even a rudimentary vision of how sexual health operates in people’s daily lives. I feel the same about the more recently wrought definition of the U.S. Centers for Disease Control & Prevention, particularly because sexual rights and of sexual pleasure are absent from that sexual health definition.

    So, maybe I need to get clearer with myself about what sexual health is. And, sexual health should be more than just the negatives: not coerced; not discriminated; not violent. The prevalence of these negatives in many people’s lives tells us how far we are from achieving a just and equitable society. But I think that sexual health ultimately requires much more active involvement from all of us, and it seems quite insufficient to hope that sexual health will arise on its own if coercion, discrimination, and violence are finally conquered.

    From: ASHA

  • Sexual Health

    Are You Ready for Sex?

    Sexual expression is an amazing gift. Sex, in its many different forms, can provide a way to express love, and learn about yourself and the ways in which you communicate with other people. With that said, sex is also deeply personal, and can result in feeling vulnerable to another person. Your reaction to sexual expression is uniquely yours, and only you can determine, in any relationship, when you’re ready to have sex.

    Even more importantly, no one ever has the right to pressure you into having sex. If you’re not ready–even if you and that person have had sex before–you always have the right to say no. It can be hard to say “no,” even if you want to; you might feel badly about hurting someone else’s feelings, or feel that there are expectations about what is supposed to happen. But you are the only person who should have control over your body.

    MAKE THE RIGHT CHOICE FOR YOU

    Are you ready for sex?

    The best way to prepare for the decision to have sex is to become comfortable with communicating about your needs. Choosing to take part in one kind of sexual activity doesn’t automatically mean that you’re up for anything. The best way to make sure that your limits are understood and respected is to have sex with a partner who not only respects you and your body, but who will talk with you before you have sex about your concerns and boundaries.

    Communicating these things before you’re actually in a sexual situation can be very helpful in making sure that you are both on the same page. If you don’t feel right about something, say so! Anyone who challenges your choices about whether or not to have sex is not giving you the respect that you deserve. Pay attention to your feelings, and don’t let anyone make you feel guilty for making decisions that are right for you.
    Your Feelings Are Your Own

    Because sex can bring about new feelings, it is helpful to think about your reactions, emotions and possible risks associated with sex. Make sure you take time to think about how to prepare yourself for an experience that could be wonderful, but can also be hard emotionally. These questions can be helpful:

    • How will you feel about yourself after you have sex?
    • Why is it a good idea to have sex now, with this person?
    • How will you feel about your partner after you have sex?
    • Can you talk to that person about how you’re protecting yourself against pregnancy and STD/STIs?

    If you’re new to sexual activity, have you spoken with someone you trust about how to find and use that protection (i.e. birth control methods, condoms, etc.) correctly?

     

    Abstinence

    Choosing abstinence, or making the decision not to have sex at all, is your option at any time. Even if you’ve had sex before, it’s still totally your right to decide that it’s not something that you want to do. You might choose not to have sex at all for a long time; you might decide not to do so after you’ve been sexually active for several years. Remember: it’s your body! Pay attention to your feelings, and give yourself time and space to make the best choice for you.

    Asexuality

    Asexuality is another thing that might come into play in your life. Being asexual means that you don’t feel sexual attraction to anyone. Remember that it is absolutely normal to experience phases in your life that don’t include sex. However, if you want to learn more about your own feelings of asexuality or feel uncomfortable about them – especially if they come about abruptly – don’t hesitate to talk to a doctor or therapist.

    From: ASHA

  • Sexual Health

    Recognize Problems in Your Body

    Recognize Problems

    It’s important to know how your body works, and be able to recognize when something isn’t quite right. If something changes or doesn’t seem quite right, get checked by a qualified healthcare provider.

    If you have any symptoms that you’re just not sure about, get evaluated. But you don’t have to have a symptom to get checked, though. All sexually active women under age 26 are recommended to be tested yearly for chlamydia. Older women with risk factors (new or several partners) should also be tested. If you have questions about testing for sexually transmitted infections (STIs), don’t be shy about talking to your healthcare provider (learn more how to do that here).

    Also, ask about pelvic exams (see more below) and Pap tests. While not designed to detect STIs, these simple exams are an important part of a woman’s sexual and reproductive health. The American Cancer Society recommends women begin Pap testing within three years of first intercourse, or by age 21.
    Learn to Recognize Problems

    Menstrual

    Irregular Cycles
    In a perfect world, women would have their period on a regular cycle of 28 days. In reality, the range is more like 21-45 days. A young girl who is just beginning to have her periods and an older woman who’s at the end of her reproductive life may both have erratic periods.

    Get checked if:

    • You’re sexually active and skip a period. You may be pregnant.
    • Your period still hasn’t settled into a relatively predictable pattern after three years, or if you have four or five regular periods and then skip a period or becomes irregular.
    • Your cycle is less than 21 days or more than 45 days or if you don’t get a period for three months after first beginning your period.
    • Heavy, prolonged periods or no periods at all

    Either extreme can be a sign of trouble. The cause may be as simple as a hormone imbalance or as serious as a structural problem.

    Get checked if:

    • You’re soaking through at least one sanitary napkin (pad) an hour for several hours in a row
    • You have periods that last longer than 7 days
    • You haven’t started your period and you’re three years past the first signs of puberty or 16 years old
    • You’ve had normal periods then suddenly stop having periods for more than six months or for three of your usual cycles

    Painful periods
    Having cramps for a day or two of your period is normal, but if they’re severe enough to keep you from participating in your normal activities, it’s time to get checked.

    Abnormal bleeding
    This could be a sign of many things, such as endometriosis (tissue growing outside the uterus) for example, or other conditions. Get checked.

    Toxic shock syndrome
    This illness is caused by toxins, which create a bacterial infection. While linked with tampon use, it can also associated with the use of contraceptive sponge and diaphragm. If you have a high fever, diarrhea, vomiting or are in shock, get checked right away. Of course, the symptoms may not be related to toxic shock syndrome, but better to be safe than sorry.

    Sexually Transmitted Infections

    If you are sexually active, you have to protect yourself from diseases and infections. Obviously, the best protection is abstinence, but if you are having sexual intercourse, use a condom every time.

    Using a condom doesn’t mean you can forget about sexual health. You still need to be vigilant. Remember, many STIs do not produce symptoms.

    However, if you notice any of the following:

    • pain in the pelvic area
    • pain in the lower abdomen
    • pain when having sex
    • discharge from the vagina
    • a bad smell
    • bleeding between periods
    • burning when you pee

    Or if you notice a problem with the following:

    • painful bowel movements
    • nausea, vomiting or loss of appetite
    • fever or fatigue
    • blisters, sores, warts (or any odd skin change, including rashes and yellowed skin)
    • itching or swelling
    • inflammation (redness)

    …get checked.

    Having a symptom doesn’t mean you have a disease. The symptoms (or lack of) are so many and varied, it’s hard to tell if, for example, bleeding between periods is simply the result of a normal, age-related hormone imbalance or a sexually transmitted infection. Get checked anyway.

    Each year, one of every four sexually active teens will get an STD/STI. By age 25, half of all young people will have acquired one or more infections. If you have any symptoms that you’re just not sure about, get evaluated.

    What to Expect at Your First Pelvic Exam

    Whoever you choose—male or female doctor, nurse practitioner or physician’s assistant—let the provider know this is your first exam. He or she will be more apt to explain the procedure as you go along. Your provider will examine your external sexual organs for any changes or abnormalities. They will also use an instrument called a speculum to open your vagina and take a look at your cervix. A Pap test is often done as part of a pelvic exam. While the vagina is open, the healthcare provider will use a small stick or brush to take a collection of cells from your cervix. These cells are then sent to a lab and examined under a microscope for anything that looks abnormal. The Pap test is an important means of preventing cervical cancer.
    The whole exam is quick, painless and necessary.

    Once a baseline has been established, any changes in your body will be noticeable and easier to diagnose. If an abnormality exists, it can be treated.

    Bottom line? Pay attention to your body and how it works. Make sure a qualified healthcare provider is tracking your reproductive health. If something changes or doesn’t seem quite right, get checked.

    From: ASHA

  • Birth Control, Sexual Health, Tough Questions

    Types of Birth Control and Their Pros and Cons

    Which Birth Control Method is Best for You?

    Birth control can sometimes be a taboo subject and can be especially uncomfortable for teens to talk about. It is important to remember that birth control is used for numerous reasons such as helping with regulating periods, treating symptoms of endometriosis, and preventing unwanted pregnancies, which is the primary purpose. It is essential to know your options when getting birth control. Most people think the pill is their only option, but there are several different forms of birth control. Some factors one might consider when deciding which type of birth control to use include its effectiveness for preventing pregnancy, the frequency with which you renew it, and how well or poorly your body reacts to it. Here are the four main types of birth control on the market which one should consider when thinking about getting on birth control.

    1. The Pill

    The pill is the first on the list because it is the most obvious. The pill is good because you can take it just a day at a time, and if you want to quit then you just stop taking it. The downside to taking the pill is that you DO have to worry about it every single day, and if you forget to take it then it can throw you off. While birth control is used for more than just protecting against pregnancy, if you do use it while being sexually active and you miss just one day, it can result in pregnancy. Even if you don’t forget, the pill only works 91% of the time when protecting against unwanted pregnancy, which most people don’t realize. Many people end up taking the pill because they don’t know there are other options available to them.

    2. Depo-Provera aka “The Shot”

    Depo-Provera is birth control in the form of a shot given by your gynecologist every three months. The main pro is not having to worry about it as often as the pill, but you still have to remember to get your shots on time for it to be effective for whatever reason you may be getting it. When using it to protect against pregnancy, it protects about 97% of the time and can protect up to 99% of the time if you get your shots regularly and on time. The shot is a good middle ground because it is more effective than the pill but is somewhat less effective than the implants. It also requires less frequent attention than the pill, but more attention than the implants which can last for years.

    3. The IUD

    The IUD and arm implant are similar. The IUD is placed in the uterus and works by releasing hormones directly into the uterus which keep the sperm from reaching the egg. Most people who have an IUD can also expect to experience no menstruation at all, so it is also great for those who have heavy periods. This option prevents pregnancy more than 99% of the time and can last anywhere from 3-5 years depending on what kind you get. Some people, like myself, tend to avoid this option because they don’t like the idea of having something placed into their uterus. The uterus is a sensitive area, and having something foreign placed there can cause complications every so often. Even though this is not common, there is still the possibility, and it does happen on occasion.

    4. Implanon/Nexplanon aka “The Arm Implant”

    The implant is the birth control which I personally use because, to me, it seemed like the easiest option. However, the majority of women do not know about this option. I did not know about it until I started researching the types of birth control which exist on the market. I did not want to worry about taking a pill every single day and, even though I was using it to regulate my period, 91% effectiveness in pregnancy prevention did not sit well with me, had I needed to use it for that reason. The implant is basically a small white stick about 1.5 inches long and 2mm in diameter. It is inserted into your upper left arm by your gynecologist, and that’s it; you are good for three years. You don’t have to think about it for a while, and it protects against unwanted pregnancy more than 99% of the time. The con to this option is that people are prone to bleed over a period of time after they receive the implant. For me, I had a period for two weeks, but after it finally ended, I didn’t have a period in the two years between then and now. Others aren’t always so lucky. Some women have bled for up to six months and just decided it wasn’t worth it. Basically, some people don’t react well to it. Talk to your gynecologist about the best options for you and the concerns you may have if you are thinking about getting the implant. Every woman is different, and our bodies react differently to different medicines.

  • Articles, Sexual Health

    Usher and Consent

    News broke recently that R&B and pop singer Usher Raymond, better known simply as Usher, is being sued by at least three people for exposing them to the herpes virus without informing them beforehand. There is no cure for herpes once someone is infected. This is clearly a serious accusation, no matter who is being accused. But there is more to why it is serious than might meet the eye.

    The biggest reason this is an issue is because of consent. This word frequently pops up when people are discussing sex, but many people do not know exactly what it means. Consent at its most basic means permission. When someone consents to something, that means they are giving permission for it to happen.

    So, when it comes to sex, many resources say, “You need to get consent before you have sex.” This is true; otherwise, it is not sex that is occurring, it is rape. But consent encompasses much more than a lack of a “no.”

    To get consent, a “yes” is required. The lack of a “no” is not consent; the presence of a “yes” is. If a partner is silent, that is not a yes. If a partner is unsure but does not quite say no, that is not a yes.

    In addition, if a partner does not know what they are consenting to, that means that they have not given consent. This brings us back to Usher. The people accusing him may have said yes to having sex, but they thought that they were saying yes to sex with someone who did not have any sexually transmitted diseases. The fact is that Usher may have gotten consent, but he did not have what is referred to as informed consent. Informed consent is extremely important. Without it, there is no respect, and there is a risk of legal action.

    Consent is mandatory. According to the attorney representing the accusers in the Usher case, one of her clients has been diagnosed with herpes. The reason this is a big deal is because the person who contracted herpes from Usher did not decide for themselves to take the risk that they might get herpes. They decided that they would have sex with him, yes, but they did not decide that the risk of herpes was worth it. Had they had been informed before having sexual contact that Usher had herpes, they may not have decided to have sex with him.

    Informed consent is essential because everyone has a right to know what they are getting into before making any decisions. No matter how much you want it, having sex is never more important than a partner’s right to decide whether they want to have sex with you and, if applicable, expose themselves to any diseases that you know you have.

    Usher was definitely in the wrong here. Hopefully he will learn from this and not repeat his mistakes. Everyone has a right to decide whether they are going to give consent, even when it’s a celebrity that they are talking to.

    (Written by Megan Flint.)