Sex Ed for Guys

Nov. 20, 2000 -- "Can anyone tell me what's involved in male reproduction?" a medical student in a white lab coat asks the young men scattered around a waiting room. "Don't be shy."

"The penis," a tough-looking teenager in a black leather jacket says softly, breaking the silence.

"This is the urethra," medical student Jason Klein continues, pointing to an illustration projected onto the wall. "Does anyone know what it does? Anyone? It's a tube that comes out of the penis, and urine and ejaculate come out of there."

He shows a photo of a pair of testicles. "Does anyone know what's wrong with this picture?" he asks, scanning the room as more people enter. Some of the guys are reading magazines. Others are whispering among themselves, and still others are staring into space zombie-like. "It's common for one testicle to lie lower than the other," Klein picks up. "It's completely normal and nothing to get worried about." Dressed in low-slung jeans and puffy jackets, the young men make a point of appearing not to listen, but their body language says otherwise.

Klein shows a photo of a penis covered with syphilis lesions and 19-year-old Rodrigue winces. When Klein holds up a long swab that doctors insert in a guy's urethra to get a tissue sample for an STD test, Rodrigue scrunches his face in horror and collapses onto his girlfriend's shoulder. Then Klein delivers the good news: "We don't have to use swabs anymore. Now you can just pee in a cup."

Welcome to the Young Men's Clinic of the Columbia University School of Public Health in New York, one of the few health clinics for men in the country. Klein, a fresh-faced, first-year medical student at Columbia, spends four hours a week at the clinic, which provides physicals, STD tests, and medical treatment to men aged 14 to 34 in Washington Heights, a community of Hispanics and African Americans. Many of these young men are on public assistance. More than 90 percent are sexually active, and a third have helped create a pregnancy. More than a quarter of guys who come here for a routine physical end up being treated for an STD.

"Neighborhoods like ours where men are so underserved need a place like this," says Bruce Armstrong, DSW, the clinic's founder and director. "Our goal is to interject reproductive health at every visit and help these young men communicate with their partners about birth control and condoms."

When it comes to reproductive health, adolescents and young men often seem to be left out of the equation. Of the five million patients served by the nation's 4,600 federally-funded family planning clinics, only about 3% are men, according to the federal Office of Family Planning. Recent studies, however, suggest that young men want to be involved in reproductive health issues. For instance, data from a national survey of 2,526 men ages 20 to 39 found that at least two-thirds viewed decisions about sex and contraception as shared responsibilities and nearly 90% felt that way about having children, according to a September/October 1996 report in the journal Family Planning Perspectives.