I’m getting more interested in talking with doctors and their staff about how to talk with teenagers about sex and safe sex.
It seems that many of the stories I hear about doctors is that they just don’t talk with teenagers about sex. My brother, for example, has never had a doctor ask him about any sexual activity – even though he is engaged in sexual behavior. What’s up with that? And the real kicker is that my dad had expected the doctor to talk with my brother about sex – and was quite taken aback that he never had.
So I’m wondering if doctors are concerned that parents don’t want the doctors talking with the kids about sex? Or maybe the teenagers never see the doctor alone – and so the doctor feels awkward talking about in front of the parents? Or maybe the insurance-based-cattle-call-doctor-offices just don’t allow enough time for the conversation to happen?
What it comes down to is that I’m just not sure what’s holding doctors back from talking with their pre-teen and teenage patients about reproduction and safe sex. What do you think?
There is actually a great post on this very topic written by a family practice doctor on RH Reality Check this morning. She starts with this:
“On Wednesday, the Centers for Disease Control delivered some bad news: after steadily increasing their condom use throughout the 1990s, sexually active teens haven’t shown any improvement in four years. They are just as likely to risk STDs today as in 2003.
This is unacceptable. As a primary care physician with special training in family planning, I refuse to stand by while teenagers jeopardize their health and their futures.
Here is what I ask every teenage patient I see: “What are your plans for birth control?” I don’t whisper. I don’t wink. I ask the same way I ask about an earache. Then we talk.”
The whole post is really worth a read.
Right before I left for college, I had to get a physical, with my pediatrician, who also did adolescent medicine. He asked me, “Are you–are you having sex?” and I was relieved that I could say “No,” because I could see he was uncomfortable having to ask that when he’d been taking care of me since the day I was born. In that instance, it would have been easier to talk about sex with a doctor who wasn’t like a member of the family.
Doctors aren’t supposed to pass judgment or really about sexual ethics either I don’t think, so I’m not sure they’re the best people for adolescents to talk to anyway; but they can, of course, provide important information about physical and medical issues.
Oh man, if a doctor had asked me about birth control when I was a teen, I would have passed out from shock!
I think they are being held back by the same thing that is holding back the parents from having the discussion – discomfort about thinking of a teen as possibly sexually active, discomfort about their own ability to address the issue well, discomfort about if it is really their place. Perhaps someone could develop a training module for physicians and offer it as a CEU (continuing education unit – all physicians must have a certain number every year to maintain their license) – calling Dr Rayne!
I have a pediatrician friend who always brings up sex with her teen clients. She works for Kaiser and has only a few minutes with each patient, but she really makes the effort. I think she has mentioned the problem of having a parent in the room, but I think she really tries to see the kids alone. Seems like a natural, but I also suspect, as the previous commenter, that doctors aren’t necessarily any better at “the sex talk” than parents are.
This is something I’ve never even considered. I have to agree with an earlier poster in thinking that discomfort would play a big part. It seems that a pediatrician who’s been caring for a child since birth (the case for my old pediatrician as well as my kids’ doctor) would be pretty uncomfortable raising the issue of sex with a child. Of course that’s no excuse, it’s a good idea. But I also have a feeling some parents would be a bit uncomfortable as well. Birds & Bees chats are such a huge part of the parental realm that many parents may feel that the doc is overstepping his/her boundaries… almost like there would need to be some sort of parental consent involved before the chat.