A new recommendation — Sexual and Reproductive Health Care Services in the Pediatric Setting — from the Committee on Adolescence at the American Academy of Pediatrics, reminds pediatricians how important they are in the sexual health of their teen patients.
It makes the case by giving these statistics:
- 45 percent of 15- to 19-year-old male and female youth in the United States report having had vaginal intercourse with an opposite-sex partner
- 2.5 percent of 15- to 19-year-old male youth report having had oral or anal sex with another male
- 11 percent of 15- to 19-year-old female youth report having had a sexual experience (including oral sex) with another female.
- 65 percent of reported Chlamydia and 50 percent of reported gonorrhea cases occur among 15- to 24-year-olds
- Teen-aged birth rates in the United States have declined to the lowest rates seen in 7 decades yet still rank highest among industrialized countries
- Pregnancy and birth are significant contributors to high school dropout rates among female youth
- 50 percent of teen-aged mothers earn a high school diploma by 22 years of age versus approximately 90 percent of females who did not give birth during adolescence
And it reminds them they they have opportunities in those pediatric well checks to talk about
- healthy relationships and whether they feel safe in their current relationships
- how to avoid risky sexual situations
- prevention of STIs including HIV
- prevention of unintended pregnancies
- reproductive health-related cancers
- planning for the timing and spacing of children
- planning for pregnancy
- delivering preconception health care
They also can facilitate a discussion between parent and child about sex, but the academy also recommends pediatricians have the opportunity to talk confidentially to the child about sex when the parent is not in the room. It recommends starting to have these confidential talks without parents in the room beginning with the 11-year-old well-check.
The study also looked at what pediatricians are currently doing and found:
- Only one-third of teens reported receipt of information on contraception and STI and/or HIV prevention.
- 86 percent of pediatricians said they discussed puberty and reproductive health.
- Two-thirds reported talking about abstinence, contraception and condom use with teens.
- Only 18 percent talked about sexual orientation and gender identity.
- When observed, 65 percent of adolescents had a discussion with their doctor about sexual issues, but those discussions lasted about 36 seconds.
Those 36 seconds probably don’t cover much. Imagine if you’re a teen who doesn’t feel comfortable talking to your parent or your parent doesn’t feel comfortable talking to you. Where are you supposed to get your information? Probably not in school, though there is some talk of sexually transmitted diseases in health class or science class, but it’s not much.
In the locker room? In the cafeteria at lunch? Where? And if you’re getting it from your friends who are getting it from their friends, how accurate is all of it?
But if your doctor gives you information, more than just a handout, and let’s you ask questions, wouldn’t that be better information for you?