Parents who believe their teens are getting information about sexual health from their pediatricians may be surprised to learn that a new study finds that less than a third of teens report having conversations with their doctors about sex.
The same study found that the majority of adolescents and parents considered health care provider discussions about puberty, sexually transmitted diseases, HIV and birth control to be important, according to the report published in Pediatrics.
“The big gap between what parents and teens want their pediatricians to talk about and what is actually occurring left me a bit surprised,” said co-author Dr. John Santelli, a professor of pediatrics at Columbia Vagelos College of Physicians and Surgeons at Columbia University and a professor of population and family health and pediatrics at Columbia’s Mailman School of Public Health. The good news is that “parents overwhelmingly want pediatricians to talk to their kids about sexual health,” Santelli said.
So what’s going wrong?
Part of the problem is that medicine is currently structured so that doctors don’t have a lot of time to speak with their patients, Santelli said. But that’s not the whole answer. “I think there’s a general reluctance in this society to talk about sex, contraception and even safe dating, interpersonal violence and rape,” Santelli said. “We don’t talk to young people about their feelings and relationships.”
Parents may be able help get the ball rolling by directly telling the pediatrician that they support conversations about sexual health with their teen, Santelli said. “If the doctor isn’t comfortable talking about puberty and other topics, most practices have someone who would be comfortable,” Santelli said. “Or maybe they need to change doctors.”
“You wouldn’t put an adolescent in a car without any advice from anyone and say good luck driving,” Santelli said. “The same goes for sex.”
To take a closer look at how many pediatricians were talking to their teen and pre-teen patients about sexual health and to learn about parent and adolescent attitudes about such conversations, the researchers surveyed 853 parent-child pairs. The children’s ages ranged from 11 to 17 and most self-identified as non-Hispanic white (54%), while 15% identified as non-Hispanic Black, 2% as Hispanic, and the remaining 7% identifying as other racial groups. Just over half of the children were female.
A majority of parents wanted their pediatrician to talk about a variety of sexual health topics, including:
- Puberty: 96.7% of parents of 11-14-year-olds; 95.2% of parents of 15-17-year-olds.
- STDs and HIV: 82.4% of parents of 11-14-year-olds; 89% of parents of 15-17-year-olds.
- Where to get sexual and reproductive health services: 70.6% of parents of 11-14-year-olds; 76.6% of parents of 15-17-year olds.
- Methods of birth control: 60.8% of parents of 11-14-year-olds; 78.7% of parents of 15-17-year-olds.
- Safe dating: 65.4% of parents of 11-14-year-olds; 70.8% of parents of 15-17-year-olds.
- Sexual decision-making: 61.9% of 11-14-year-olds; 66.8% of parents of 15-17-year-olds.
The numbers were smaller when it came to discussions focused on gender identity and sexual orientation, but a slim majority of parents of older kids approved of pediatricians discussing these topics.
Even with such large numbers of parents wanting pediatricians to discuss sexual health, just 24% of younger adolescents and 42.3% of older adolescents had ever had a provider speak with them about the topic.
“This is such an important paper,” said Dr. Elizabeth Miller, chief of the division of adolescent and young adult health at the UPMC Children’s Hospital of Pittsburgh. “The real take home message is, if you are counting on pediatricians to have this conversation, it’s not happening.”
“The fact that so few teens are reporting having one-on-one conversations with their pediatrician really highlights for us the critical need to figure out what the barriers are,” Miller said. “I was not really surprised by the findings, but was dismayed with how much work we need to do.”
“We are all in this together — parents, schools and pediatricians — so what I love is when parents come in with their middle-schooler for a well visit and they say they’d like there to be a conversation about their child’s changing body,” Miller said. “The parents can also encourage the physician and child to take some time alone for the conversation.”