By Dr. Micaela Wexler
Whenever I perform a psychiatric evuation on a new teenage patient, I always take a sexual history. In ideal situations, I am able to do this outside of the parents’ presence, and then bring it up again when the parents have re-entered the room. Sadly, the ideal situation is rare, as I tend to encounter a great deal of resistance from parents and teenagers alike.
Too often I find that my adolescent patients have never had an in depth discussion about sexuality with their parents. In the best case scenarios, they have been told about pregnancy and STDs, but usually sex has been presented as a a forbidden activity, with the emphasis on religious prohibitions, and it is obvious that the topic has been presented in an atmosphere of discomfort and embarrassment. There is rarely any discussion about relationships, intimacy, sexual expression, body image, masturbation and acceptable behavior. Parents seem to be oblivious to the fact that according to the Guttmacher Institute, 46% of teenagers age 14-19 report having had sex at least once.
Failing to talk to your teenager about sexuality puts him or her at grave risk for a variety of dangers ranging from the obvious – pregnancy – to others that are less obvious but potentially more life threatening, like depression and relationship abuse. Depression is the greatest risk factor for teenage suicide. Romantic break ups are a common trigger for depression in teenagers. Teenagers most at risk for depression following a relationship break up are those who have limited support and poor coping skills. Parental support is a potent protection against teen dating violence.
It is never too early to talk to your child about sex. Ideally, the “sex” talk should begin at birth. Use correct words for genitalia when changing diapers or giving your child a bath. Make positive statements about their body (and yours) throughout their childhood. Early childhood is when boundaries should be taught, that their private parts are their own and no one else should touch them. The same is true about other people’s private parts. Introduce the physiological aspects of sexuality in the elementary school years, with anatomy lessons, including the different processes that occur, such as hormonal and physical changes, pregnancy and orgasms.
I recommend that birth control and STD protection issues be brought up during elementary school years, even if you are a strong believer in abstinence before marriage. Hearing about both birth control and abstinence at the same time does not lead to children engaging in sexual activity earlier. Parents should remember that children hear alternative, even conflicting views about many topics in their lives. Presenting children with choices teaches them decision making skills.
Children are being exposed to sexual topics outside of the home at an earlier age, and they will be safer if they have heard about them from you. In addition, talking about birth control and STDs helps children open up about other sexuality related topics; they are less shy about sharing what they have been exposed to at school and in the media. Don’t be afraid of letting them know the meanings of words they hear, ie blow jobs, fuck, cunt, etc. These are valuable opportunities for parents to express their views on acceptable sexual behavior.
Explore your own thoughts and feelings about sexuality. If you are uncomfortable discussing the topic of sexuality, try to figure out why. Are you unhappy with your own sex life? Are you disappointed with the level of satisfaction you are achieving? Maybe you have a history of domestic abuse or childhood sexual abuse. Were you taught negative views about sexual expression during your own childhood? Or, perhaps you are mourning the loss of a relationship. Getting in touch with your own emotional feelings regarding your sexuality will help you address the emotional impact sexual expression has on your teenager.
Studies show that most parents do not discuss the emotional aspects of sexuality with their teenagers. They do not discuss intimacy, relationship conflicts and violence in relationships. Teenagers are left to navigate the confusing world of dating, relationship building, sexual expression without any skills and with no one to turn to when problems occur. Whether they are engaging in sexual activity or not, teenagers experience very strong emotions when it comes to relationships. Due to their raging hormones, every aspect of the relationship is magnified. This is a dangerous time to withdraw parental support.
Once you have talked to your child about all the concrete aspects of sexuality, you have set the groundwork to talk about the complex emotional issues surrounding sexual expression. It is important to approach the topic in a non- judgmental and non-threatening manner. Open the discussion by asking if their friends are in relationships. Rather than focusing on sex, focus on issues like trust, mutual respect, friendship and honesty. Guide your teenager through a relationship conflict. Be on the lookout for signs of teenage violence. Do not trivialize their feelings. Teach your teenagers that their sexuality is a gift that should be treasured, and that it should never be used to hurt them.