Let's Talk About (Teen) Sex
- wifisher
- Mar 21, 2024
- 6 min read
As of 2018, the United States birth rate for teens dropped 72% from its peak in 1991, which coincidentally (or maybe not coincidentally) was when Salt-N-Pepa released “Let’s Talk About Sex”. I graduated from high school in 1992, and teen pregnancy was everywhere (and so was that song). It was the topic of endless movies, conversations, and rumors. Thankfully, today it is much less prevalent. But why is it less common and as parents, what do we need to do to help guide our kids through adolescence and to adopt a healthy attitude towards sex?
One reason is that teens are having less sex. From 2002 to 2017, the percentage of male teens who had had sex dropped from 55% to 38%. Of female teens, 42% had had sex as of 2017. I couldn’t find more recent numbers, but at least from what teens are telling me in the office, I think it might still be falling. The reasons why they are having less sex is unclear, but I suspect it may be due to spending more time at home, exposed to their parents (a good thing) and the internet (a bad thing), and they seem to be a little less independent as compared to previous generations, as well as a little more awkward in relation to dating.
Another reason why things are going better, is that in general, they do use birth control. In 2015 97% of females reported using a condom during sex, followed by withdrawal (60%) and the pill (56%). Implantable hormones and intrauterine devices (IUD) make up a minority, but growing form of teen birth control. It does worry me that withdrawal is used by 60% of teens. If that is their only form of birth control, a teen couple having sex routinely over the course of a year, would end up pregnant 22% of the time, so clearly this is a poor option.
Another study showed that while IUDs and implantable birth control went up from 1% to 5% from 2010 to 2019, condom use went down from 78% to 72%. I don’t find that very surprising because IUDs are so good at preventing pregnancy, that it is likely making adolescents feel less stressed about pregnancy and less likely to use a second form of birth control such as condoms. But that leads to a different problem, the increase in sexually transmitted diseases.
Sexually transmitted diseases have been on the rise in the US over the last 10 years, and adolescent teens and young adults (15-24 year olds) account for 50% of all new STDs diagnosed! Gonorrhea and Chlamydia are the most prevalent STDs in teens, and often have no symptoms. Prolonged infection can lead to chronic pain and infertility, which is more likely if the patient has no symptoms or has a hard time getting treatment.
In summary, while teen pregnancies are down, STDs are on the rise. As parents wishing the best for our kids, what are we to do? Salt-N-Pepa said it best:
Don't be coy, avoid, or make void the topic
Cause that ain't gonna stop it
The point being, not talking to your kids about it will not make the problem go away. Humans are going to have sex, and without your guidance, your child will depend on friends and the internet to teach them about sex. Also, studies show parents are more effective than schools or physicians at stopping their kids from engaging in high risk behavior, but only if they are having routine talks with them about these topics.
These conversations can be very awkward, but there are a few tips that can make it easier. One is to avoid eye contact, which I know sounds strange, but your teen is terrible at making eye contact anyway, and when having embarrassing conversations, teens are more likely to open up if they don’t have to see you. Driving alone with your teen is a perfect environment for “the talk”. Unless your kid is a trained stunt person, they can’t get out of the car while it is moving, and eye contact is impossible. I know for a fact this works, because it was the technique my Dad used while he and I drove to pick up Chinese carry out (although his speech was super awkward, I remember it to this day). Using real life examples is also helpful, because it doesn’t point the finger directly at your child. For instance, using a news story or something that happened at school as an opportunity to talk about some other teen’s sexual behavior, is an opportunity for you to impart your knowledge and values without your teen feeling like you are accusing them of anything. It is also helpful to remember that you were a teen too, and based on the statistics, what your teen is doing is likely not as bad as what you were up to, so try not to judge your child too harshly, once you put them on the defensive, it is less likely you will have an impact! The last thing to remember is “the talk” is not one talk, but a series of conversations about sex that you have with your teen that will eventually make the conversation easier to have, and will result in your voice haunting your teen when they are living away from you, and making decisions without fear of you finding out.
One of the consequences of the supportive, loving, non judgmental series of conversations about sex with your teen that you will be having after reading this article, is they may actually tell you they are having sex or are planning on having sex! If this happens, it is a critical moment in your parenting career - on the one hand, you should be proud of your teen that they opened up and trusted you with something so scary and personal, and you should be proud of yourself for fostering the type of relationship that made it possible for them to confide in you. On the other hand - your teen is having sex! At this point I encourage my parents to let the kids know what their values are, but if those values are different from the values and intentions of your teen, your next obligation is to make sure they are safe. Is their partner treating them well, without bullying or coercion? Do they have a plan for pregnancy and STD prevention? Do they have access to a doctor for testing and possibly initiating birth control? Did they get their HPV vaccine (hopefully done between 9-12 years old)? And, it is very important to stress to them that even though they may be on birth control, they can still get STDs and still get pregnant. As a parent, you probably now know that people are not always truthful with their sexual history or how monogamous they really are, but your teen will think that their partner would never do anything wrong. Teens also think that if they have no symptoms that they have no infections, but it is important for them to know that due to how their bodies work, they “catch” certain sexually transmitted infections easier than adults, and often will have no symptoms. I would also remind them that if 100 teenage couples depend on withdrawal to prevent pregnancy, 22 of them will be pregnant after the first year.
Hopefully with knowledge, help, and guidance from their parents, and support from their community, teens can be as safe as possible in regard to sex. When a teen comes in and wants to talk to me about sex, I ask the parents to leave the room, but sometimes the teen says, “They can stay, they already know everything.” I can’t help but think how fortunate that family is, and what a fantastic job those parents did. I also always congratulate the teens for involving their parents, which in 1991 (as I witnessed as a Junior in high school) was incredibly rare, and probably part of the reason the teen pregnancy rate was 72% higher. You have more influence than you think you do, even when your teen turns their head with red cheeks, looking out the window on the way to Chinese carry out, they hear and remember every word you said! (Thanks Dad)
Until next time, good luck parenting!
Dr. William J. Fisher
Fisher Pediatrics
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