Did the topic of sex come up at your teen’s latest doctor’s appointment? Probably not, according to a new report from the American Academy of Pediatrics (AAP). The report, “Sexuality Education for Children and Adolescents,” found many pediatricians don't discuss sexuality with adolescent patients despite studies that prove sexuality education helps prevent and reduce the risks of teen pregnancy, HIV and STDs.
“One in three adolescent patients did not receive any information on sexuality from their pediatrician,” says the report’s lead author and Seattle Children’s Hospital attending physician Dr. Cora Collette Breuner. “And if they did, the conversation lasted less than 40 seconds.”
This needs to change, she says. Pediatricians are well-suited to complement sexual education offered at home and in school but many don’t due to concerns about offending parents and patients.
“I try to teach pediatricians to kick parents out of the room for part of every appointment starting at age 12,” says Breuner. "Parents and caregivers need to trust that the pediatrician will take care of their children and will let them know if there is anything of concern that they need to know.”
By not educating teenagers [about sex], we’re basically giving risk-loving teens a hall pass to experiment.
Parents can help with this oft-awkward request by letting their doctor know ahead of time that they’d like sexuality discussed during an upcoming visit.
“Give them a heads-up that you personally trust them to talk about this topic,” says Breuner. “During the appointment, say, ‘I need to step out for a few minutes.’”
Not talking about sex isn’t an option, she adds. “It’s like a law of omission,” says Breuner. “By not educating teenagers, we’re basically giving risk-loving teens a hall pass to experiment.” Brenuer acknowledges how difficult such a conversation might be, which is why she recommend parents practice.
Doing so works, according to the AAP. A review of 12 related studies found parents who received training from doctors on how to talk about sex with their teens had better communication on the topic than parents who didn’t have training. Locally, parents can seek such help from Great Conversations, which delivers sexual health programs at hospitals including Seattle Children’s, and from sex educators (and frequent ParentMap contributors) Amy Lang and Jo Langford.
The important thing: Just start talking. Research shows that parent-child conversations are associated with a delay in sexual debut and increased use of birth control and condoms.
Breuner recommends that parents remove abstinence from these conversations as research shows such programs are often ineffective.
“Saying you can’t have sex until you are married also assumes everyone is straight and leaves out information about how to have safe sex,” says Breuner. “Sex education is about more than when to have sex. Conversations with kids cover healthy sexual development, interpersonal and consensual relationships, affection, intimacy and body image.”
While American teen births and pregnancies have been decreasing, the United States still leads many industrialized countries with one of the highest rates of adolescent pregnancy. Hence the need for pediatricians and parents to start talking.
“As pediatricians, we worry that it’s not OK to bring up sexuality, but when we don’t mention this topic, a later appointment might be for a sexually transmitted infection or after a sexual assault or a pregnancy,” says Breuner. Not talking about sexuality, she adds, "is not giving kids the tools they need to help them lead a healthy, happy and productive lives.”