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Calling all Parents
Kate Ott, RN, BSN
November 23, 2011

Have you ever asked yourself why it is so difficult to discuss sex with your children? The topic of sex is the 900 pound gorilla in most U.S. living rooms. Our kids are exposed to sexual messages in TV shows, movies, the internet and their peers every day. Why is it so hard to talk about?

I recently asked a group of high school juniors and seniors from whom they had learned about sex. Like me, most had not heard about it from their parents. Apparently, in the last 40 years, not much has changed when it comes to parents talking to their kids about sex.

When I became a mother I made a conscious decision to be more open about sexuality with my child than my parents had been with me. It helped that I was a nurse. Even so, it was difficult breaking out of my conservative religious upbringing to discuss sex with my son.

These are some strategies that worked for me.

Think logically

• Face it, your sweet 10 year old will eventually have sex; maybe in 5 years, maybe in 15 years, but eventually.

Start early

• It is more difficult to discuss sex for the first time with a 16-year-old than a nine-year-old.

Try to be matter of fact

• Talk about sex with the same tone of voice you use when you talk about other bodily functions.
• If this is difficult for you to do, admit to your child that you are a little uncomfortable but keep talking.

Don't stigmatize genitalia

• Body parts are body parts; head, shoulders, knees, toes, penises, and vaginas. No, I am not recommending a new children's song.
• Remind kids like their hands, feet, and noses, their genitals belong to them. It is okay to look at them, wash them, touch them and ask questions about them. This is also a good time to point out that in our society people keep these body parts covered with clothing.

Be honest, be positive and give only the information requested

If your nine year old asks you what sex is, tell him. You do not need to have the whole conversation about condoms, birth control and sexually transmitted diseases the first time out. My conversation with my son went something like this, "You have a penis. Girls have an opening near where their pee comes out, called a vagina. When adults have sex, the man puts his penis in the woman's vagina. It may sound sort of weird, but is actually pretty cool because it is how women are able to get pregnant and have babies."

Build on previous conversations

If you have never spoken to your child about sex and decide at the age of 15 it is time to start, your messages may be received less than enthusiastically. Your teen may feel embarrassed or even resentful. Besides, there is too much information to cover in one or two conversations. Sex is complicated.

Use teachable moments along the way while watching TV together, after seeing a movie, or when a sexual issue makes the news. Sometimes adolescents will share information about a peer's STD or unintended pregnancy. Use these opportunities to address false assumptions and to see where your teen weighs in on responsible sexual behavior. Be careful not to "freak out" or worse yet, lecture.

As my child entered adolescence, I also covered:

• The advantages of abstinence.
  • It is okay to include your hopes for your child in this regard. I told my son, it would be preferable to wait for marriage (my religious upbringing speaking here) but if this was unrealistic thinking on my part, he needed to protect himself from both fatherhood and sexually transmitted diseases.

• The importance of developing trusting relationships prior to engaging in sexual activity.
• The risk of acquiring an STD.
• How condoms work and where to acquire them.
• Why it is a good idea for sexually active girls to use birth control in addition to condoms.
• Outcomes of an unplanned pregnancy
  • Tough decisions; abortion vs. adoption vs. raising a child.
  • Stress on the relationship itself.
  • Limitation of life choices; education, living arrangements, etc.
  • Emotional and financial responsibilities of being a parent.

Finally, if neither parent is able to discuss sex with their child/teen it may be helpful to involve another trusted family member or a health care provider. A favorite aunt, uncle, grandparent or older sibling may be an alternative as long as they are able to provide accurate information.

The pediatrician's role

Most pediatricians will ask to speak with adolescents alone at some point during an office visit. I was surprised when I was asked to step out at a visit when my son was 13. Some parents disagree with this practice and refuse to leave the exam room. Try to be open-minded and again, think logically. You have trusted your child's doctor since that first well-baby visit. The pediatrician's concerns are the same as yours; your child's health and well-being.

A thorough adolescent exam involves taking a sexual history and it is often easier for a teen to answer sensitive questions without Mom or Dad in the room. Trust your child's doctor to address those questions which might otherwise go unasked and unanswered. Additionally, this may create an excellent opportunity to bring up the topic of sex later by asking questions like:

Did the doctor talk to you about sex after I left the room?
Were you embarrassed?
How did you feel about it?
Do you have any questions for me?

Parenthood is not for the faint-hearted. There are many challenges along the way. We protect our children from the day they are born. Are they safe? Are they physically healthy? Are they okay emotionally? These are the same questions we need to ask of our adolescents. If we as parents continue to ignore the 900 pound gorilla in the room, we will miss opportunities to protect our kids from diseases, unintended pregnancies and the emotional distress that these create.

Sources for Parents

General information: http://www.cdc.gov/sexualhealth/
Facts and figures: http://www.guttmacher.org/pubs/FB-ATSRH.html
Professional advice: http://www.aacap.org/cs/root/facts_for_families/talking_to_your_kids_about_sex

December, 2011