Is 36 seconds enough time to talk about sex?

A new study published in JAMA Pediatrics shows that doctors are spending an average of 36 seconds talking to teenagers about sex, that is if they talk about it at all. One-third of teenagers receiving a yearly check-up didn’t have any mention of sexual health or development.

Physicians can play an important role in teaching adolescents about healthy sexual development, sexually transmitted diseases and pregnancy prevention. In fact, the American Academy of Pediatrics recommends that physicians participate in an ongoing conversation with children and their parents throughout middle childhood into adolescence and adulthood as they navigate the changes in their bodies, explore romantic relationships and establish their identities. A teenager’s understanding of their sexual development can dramatically impact their mental and physical health as well as the health of their relationships later on in life.

While adolescents are undoubtedly bombarded with messages about sex from a variety of sources, physicians have a unique opportunity to support healthy sexual development by delivering accurate information in a safe and secure environment. The question is, why aren’t they?

Why aren’t doctors talking to teenagers about sex?

This study doesn’t answer that question directly, but perhaps it can offer us some clues. Discussions of sexual health were more likely to occur when doctors initiated the conversation. Doctors were more likely to initiate the conversation with patients who were older adolescents, female and African American. Doctors least likely to initiate the conversation were those of Asian descent.

This suggests there are some personal and cultural influences that affect a physician’s decision to initiate the discussion. Perhaps doctors themselves are uncomfortable talking about the topic and, depending on their family backgrounds, have differing opinions about the appropriateness of such conversation. Also, perhaps they believe that talking to females is more effective or more necessary than talking to males.

The study also found that discussions regarding sexual health were more likely to occur if talk of confidentiality also occurred during the visit. Perhaps once they understand their rights and the boundaries of confidentiality, teenagers are more likely to engage in honest conversation about their sexual health.

The likelihood of these conversations increased with the length of the visit as well. Doctors who took more time with their patients in general took more time talking about sexual topics.

What you should expect from your doctor

• Your child’s doctor should address the upcoming stages of sexual development when your child is between 7 and 10 years of age. They should discuss what is normal in puberty and what to expect. Ideally, this is a continuation from early childhood of a discussion about normal development that occurs regularly as the child matures.
• This conversation may start with the parents, but should also include the child and gradually transition from a relationship between doctor and parent to doctor and teenager.Your adolescent’s doctor should explain a patient’s right to confidentiality
• Doctors can discuss with adolescents concerns about sexual maturation, contraception, sexually transmitted infections, pregnancy and healthy decision-making.
• Health care providers should discuss these matters in a way that is nonjudgmental, culturally sensitive and with an understanding of the family’s and the adolescent’s values.

What you can do

• Help make your child or teen comfortable talking to their doctor. Explain the value of the information a doctor can provide that can aid in their decision-making and lifestyle choices.
• Initiate the discussion of sexual health and development with your child before their doctor does. Share your cultural and familial values in an ongoing conversation over time.
• Form a long-lasting relationship with one physician. You and your child will feel more comfortable approaching sensitive topics with someone you know and trust.
• Allow your child privacy and confidentiality with their doctor
• Initiate the conversation with your child’s doctor if it goes unaddressed.