Adolescent Sexuality by Dr. Karen Rayne

Last week a teenage girl e-mailed me with the following question:

Ive been reading your blog and can’t find the answer. My mom says that I need to go to the gynecologist cuz I’m hooking up. She says I need to get tested for diseases. I don’t feel sick. Is this real or is she just trying to get in my private life?

And, because as she points out I haven’t given the explicit answer to that question here on my blog, here’s my answer:

This is a great question.

It depends on what kind of hooking up you’ve been doing and what kind of protection you’ve been using. Just kissing and feeling each others bodies with clothes on? You’re fine. When you go further, have you *always* used condoms or other STI protection? Be honest with yourself here, even if you don’t want to admit it to anyone else. Because if you haven’t been extremely careful you *certainly* need to get tested.

But actually, regardless of your answers to those questions, it’s a good idea to get tested. That way you won’t be too freaked out to get tested if you do start feeling some burning or itching down there. Plus, it’s always better to know you’re clean than to worry about it.

There are three important things to remember about STIs:

1. You *can* get diseases from oral sex (blow jobs). Here’s a site where you can find out what kinds of diseases you can get from what kind of sexual activity: http://www.dph.sf.ca.us/sfcityclinic/stdbasics/stdchart.asp
2. You don’t always feel sick with STD/STIs, and they can still be stomping around in your insides. If you wait too long they may do damage you can’t fix. Also, you’d be passing them on to other people without knowing it.
3. Your mom doesn’t have to get into your private life for you to get tested. Most places that do STD/STI testing (including Planned Parenthood) will do it for anyone over 14 without parental permission. In addition to Planned Parenthood, if there is a free city-run clinic in your town, they generally do testing for teenagers without parental permission too. Sometimes even the county will do it.

Please let me know if any of that’s unclear or if you’ve got follow-up questions.

And here was her follow-up question:

It happened kind of fast like a surprise I guess so no condoms. Do I have to do the gyno exam? I read about it somewhere and it sounds totally gross. Thanks

And my answer:

Yep, you need to do the testing. The best website for just really straightforward information like this is www.scarleteen.com. Here’s what they say is involved in the STD testing/exam:

“The clinician will do a visual examination of your genitals. S/he will be looking for evidence of sores or lesions. If you are a woman you will go through the same procedure as you would for a pelvic exam (you might want to read up on that in the Your First Gynecologist Visit article for more details). During the pelvic exam the doctor will take a small sample of cells and fluids called a smear or swab test. It is similar to a PAP smear test, except that in this case, when the technician or doctor looks at the cells through a microscope, she or he will be looking for signs of the various microorganisms, antibodies, or cell changes related to specific STIs.”

It might be a bit uncomfortable, but it’s not too gross. Sometimes they take urine or blood samples. And remember, you don’t have to do it with your mom. Take care of yourself, and she can’t complain. If she keeps getting on your case about doing it her way or whatever, ask her to e-mail me (karen.rayne@gmail.com).

If you need help finding a place to get tested in your area, let me know.

P.S. Oh, and your partner should get tested too. If you two are still hanging out, go do the testing together.

Friends with benefits–Two good friends who have a sexual relationship without being emotionally involved. Typically two good friends who have casual sex without a monogamous relationship or any kind of commitment. (definition taken from the Urban Dictionary)

Are these kinds of relationships good or bad? Well, it depends on your perspective.

The NYTimes published an article about FWB yesterday. Although they don’t make an explicit judgment call on the properness of FWB relationships, they seem to imply that it’s fine as long as both people are aware of the potential downsides. According to a recent study, sex in a friendship can become a bit of an albatross: it’s always there, but never spoken about. The fear in a FWB relationship is that one person will become more invested in the relationship than the other person. That someone will fall in love - or at least in more than lust - and both the friendship and the sexual relationship will be ended. The study found that 60% of Michigan State students had been involved in at least one FWB relationship.

Here’s what the study says about how these relationships end:

• 1 out of ten became romantic relationships
• 3 out of ten stopped the sexual part but remained friends
• 2.5 out of ten stopped both the sexual and friendship part of the relationship
• 3.5 were still in a FWB relationship

So back to our original question: are these kinds of relationships good or bad?

Well, as a general kind of relationship they’re fine. They offer a way to be sexual without the emotional distractions and inherent issues of a romantic engagement and without the safety issues involved in hook-ups or one night stands. And let’s be honest: most college students are sexual. So FWB widens the options to have safe, respectful sex.

On the other side, some may argue, sex belongs in a monogamous, committed relationship. Maybe even - gasp! - only after marriage.

But that’s just not how people in their 20’s are having sex these days. And the critical part of our sexuality is that it feeds our soul and supports us as we learn more deeply about ourselves and those we are in relationship with. And FWB is one way to do that.

So what is your experience? Have you ever had a FWB? How did it end up? How do you perceive the relationship with the increased clarity of hindsight?

Yesterday we talked about what bits of information are important for a girl to know about masturbation. Today we’ll be talk about what bits of information are important for a parent or other trusted adult to tell a boy about masturbation. Some things are the same, and some are different, but mostly there are just more things that are helpful for boys to know.

• Masturbation is a private activity. (This is often more relevant for younger children and toddlers to learn.)
• Masturbation normal and healthy.
• Almost all boys masturbate, and particularly as teenagers, with some regularity.
• Lotion is a good idea, get yourself some or ask a parent to get you some.
• What to do with the socks or t-shirts or whatever after using them to clean up. Notably, not flush them down the toilet or throw them away.
• His imagination is his best friend. Porn will only make it more difficult to transition to actual sex with a real girl. And nobody wants that.
• Masturbation is a great, completely safe way to have lots of fun with a girlfriend or boyfriend (thanks for the reminder, Ruth!)
• and, of course you should mention that…
• Masturbation is fun!

Someone recently asked me if this conversation should include a discussion of moderation. Well, I don’t think so. Unless there is some indication that a boy is spending all of his time masturbating, in which case of course it’s warranted.

This information needs to come from somewhere. If it’s not going to come from a parent, the parent needs to make sure someone else steps up to the plate and winds his or her way through that conversation. Generally, boys will need some of this information earlier than other parts of it, so it really needs to come as part of an on-going discussion about sex and sexuality.

But what do you think? What else do you think is important for boys to learn about masturbation?

Several parents have asked me what they need to say to their children/teenagers about masturbation. That, of course, differs by gender. So here are a few of the things girls need to know about masturbation, in no particular order. Come back tomorrow, and I’ll have a post about boys.

• Masturbation is a private activity. (This is often more relevant for younger children and toddlers to learn.)
• Masturbation normal and healthy.
• Many girls masturbate, many girls do not.
• It is helpful to masturbate before beginning to have sex. Knowing what feels good to you will help you enjoy a sexual relationship even more. (This, clearly, is a conversation to have with a teenager who may be on the brink of beginning a sexual relationship.)
• and, of course you should mention that…
• Masturbation is fun!

Now, this can be heady stuff for parents to actually talk with their daughters about. But it’s important, helpful information, and girls need to learn about it somewhere. If you can’t screw up the gumption to have this conversation with your daughter, make sure someone else does. Ask a woman who is close to your daughter to do it. Send your daughter to this website. Find another website and send her to that one. Just make sure she gets the information from somewhere.

But what do you think? What else do you think is important for girls to learn about masturbation?