Tuesday, December 16, 2008

Talking to girls about sex

Teen Sexuality
Talking to your daughter about sex
Adeteju Ogunrinde, MD, FAAP
Children’s Healthcare Center
Waldorf, MD. 20602

Adolescence is …..
  • A time of storm (G. Stanley Hill)
  • Inconsistent and unpredictable (Anna Freud)
  • The confluence of all great physical and psychological changes
  • The time your tail falls off (Kermit the frog)

  • 5 stages in boys and girls
  • Girls- ages 8-13 completed 2-4years
  • Males- ages 9-14 completed in 2-5years

  • What puts adolescents at risks?
  • Changing anatomy and physiology-the immaturity of their genitalia predispose to infection

  • Social milieu and peer pressure
  • Changing behavior secondary to hormonal changes
  • Poor family relationships predispose to lack of self esteem
  • Parents who do not share their disapproval of early sexual activities with their teens
  • Poor school experience
  • Little or no religious identity
  • Your teen has not taken pledge of virginity, works well in a trust relationship where a promise is respected and honored in a household.
  • Poor grades.

  • Statistics
    • Studies shows Parents influencing decision to wait 37%
    • Friends influencing decision 33% so beware of your child's friends
    • Siblings influence 6%
    • Media influence 5%
    • 94% of adolescents and 91% of parents think adolescent should be advised NOT to have sex before completing high school.
    • 87% of adolescents agree it would have been easier to postpone sexual activity if they were able to have more open conversation with parents.
    • More factsIn 2005 studies shows 6.2% of 13y/o girls reported having sex, a drop from 1999 study (8.8%)
      9.0% of boys were active before age 13yrs also a drop from 1999 (12.7%)
      46% of 15-16y/o reported having had sex
      66% of 12-19 y/o reported they wished they had never had sex so early

      Risks associated with early sexual encounter
    • Increase risk of multiple partners
    • Increase of Sexually transmitted Infections (STI)
    • -Increase risk Teenage Pregnancy
    • Increased risk of other mental health issues, and fall in school grades, drug and alcohol use.
    How do we start the "Talk"
    • Be prepared-read about the subject, practice what you have to say, consult with your spouse or a friend.
    • Speak clearly and calmly, be honest.
    • Listen-Give your teen a chance to ask questions.
    • Try to strike a balance-if you meet resistance, explain this is an important topic and would like a few minutes, then talk, your message may get through. Leave a promise for future meeting especially and whenever she is ready to approach you.
    • Ask for help- If you just can not talk to your teen, ask your pediatrician, a mentor, a trusted family member or spiritual leader. Most importantly –don’t give up.

      Is your teen sexually active?
    • Take a quiz online using a Behavior calculator provided by University of Maryland medical systems:
      These behavioral calculator also shows reduced risk of early sexual activity in parochial schools and strong religious belief.
    • Studies shows repetitive open communication with teens reduce the early onset of sexual activity.

    What to talk about.

    Seize the moment- use a TV ad, music to ask or start conversation.
  • Ask what your teen know about sex, STI,
  • Ask about what she learnt from school sex education to get an idea of school's perspective
  • Tell your teen your values and set a feasible goal that you can revisit.
  • Emphasize on abstinence but mention contraception as an option for future discussion.
  • Ask about virginity Pledge or Promise and choose a feasible time as adolescents don't think that far ahead, possibly graduation from high school.
  • Let her know its okay to have guy friends but to be able to talk to you freely about any new friends
  • Let your teen know its okay to talk to you about sex wherever and whenever she has questions.

  • Summary
    • Sex education remains primarily the duty of a parent, every mother is entitled to and will worry about their daughter, we all know how much our parents worried about us, and though some may or may not have listened, that voice at the back of your head is always a reminder to be true to yourself, so keep talking, you never know when a good seed is sown.
    • Schools are encouraged to give sex education early in middle school, studies shows teens influence each other about 40% so if abstinence is one of the cool things taught at middle school life experience, then a whole lot of middle school would have made up their minds about waiting before getting to high school, where the rate of sexual encounters quadruples the rate of middle school.
    • A lot of parents look into religious parochial schools because of the moral values they bring to the table, studies have shown this to be beneficial and should be encouraged where necessary at these schools.
    • Recurrent open communication remains the gold standard of abstinence and safe sex, emphasis being on recurrent.
    Guidelines :
    • Pap smear is recommended at age 21years or 3 years after being sexually active.

  • There after yearly visits.
  • Unless of course there is need for a pelvic exam.

  • Recommended reading/sites:
    A message to teens from your Pediatrician by AAP.
  • www.aap.org