Ruth McDonald, MD
Vice President and Associate Chief Medical Officer, Medical Operations
Seattle Children’s
41% of U.S. high school students report having had sex, according to the Centers for Disease Control and Prevention. Sexual activity comes with a range of issues from emotional connection to sexually transmitted diseases to pregnancy. Pediatricians are in an excellent position to educate their patients about sexuality and sexual health, yet a review of well-care visits showed that one in three adolescent patients (33%) did not receive any information on sexuality from their pediatrician, and when they did the conversation lasted less than 40 seconds. Clinicians who didn’t address sexuality and sexual health cite being pressed for time, uncomfortable with the topic, and/or concerned about offending patients or parents.
In the updated clinical report released in 2016, the American Academy of Pediatrics urged pediatricians to participate more intentionally in these conversations and provide accurate, developmentally appropriate information about sexuality and reproductive health to children and teens. The report offers tips for integrating sexuality education into routine medical practice. Dr. Cora Breuner of Seattle Children’s shared lead authorship of the report.
Here are some tips for getting the conversation going:
- Ask honest, open-ended questions.
- Don’t assume an adolescent is – or isn’t – having sex.
- Start by asking if any of their peers are having sex, since adolescents tend to engage in the behaviors their friends are also engaging in.
- Don’t try to use slang or lingo, but do explain terms in ways the adolescent can understand. If a teen uses a term you don’t know, just ask what it means.
Important topics to cover include pregnancy prevention and planning, STDs, sexuality and orientation, and safety in relationships (including intimate partner violence and coercion).
Offering accurate and reliable reproductive health information impacts adolescent development and future potential. Teens who are empowered with appropriate tools to reduce risk have better outcomes. As pediatricians, we have the privilege and responsibility to be a trusted resource to our patients.
Resources: For pediatricians, healthcare providers, parents, caregivers and teachers:
- Bright Futures: Promoting Healthy Sexual Development and Identity
- The Future of Sex Education Initiative: National Sexuality Education Standards for K-12
- Get Real sexual education curriculum for middle and high schools
- Health Education Curriculum Analysis Tool, Centers for Disease Control and Prevention
- Parent Advocacy Coalition for Educational Rights (for children with disabilities)
For teens:
- Scarleteen is an independent, grassroots sexuality and relationships education and support organization and website founded in 1998.
- Sex, Etc. is published by Answer, a national organization that promotes unfettered access to comprehensive sexuality education for young people and the adults who teach them.