Your Checkup Checklist: 18 Years Old

​If your 18-year-old's annual health screening is coming soon, this may be a natural time to talk about how they will manage their own health care as adults. Though they may not be leaving home just yet, you can begin turning tasks such as scheduling regular checkups over to your teen. Planning for this visit together can be a helpful first step.

Key issues for 18-year-olds

• Future plans. At this age, career and college plans may loom large. Youth surveys show that many teens feel intense pressure to succeed. Kids who feel less driven may compare themselves to others and feel inadequate or defensive. With all this happening, it's not surprising that your teen might feel irritable, confused and dismissive of guidance (even when it's given gently). Keeping an open door and an open mind can help.

• Personal identity. Many young adults struggle with issues of identity and self-worth. If your child has faced bullying, discrimination or extreme peer pressure, the challenges may be even greater. Older teens who identify as LBGTQ+ face especially high risks for anxiety, depression and suicidal thoughts.

• Sexual health. Research has found that nearly 50% of all teens have their first sexual encounters in high school. Regardless of their experiences, your teen can benefit from open, honest conversations about safe sex, consent, sexting and tough topics like dating violence.

What to expect at your 18-year-old's yearly checkup

Teens may prefer to meet with the doctor one-on-one for at least part of the visit. Making a list of topics to discuss helps ensure they'll get the support they need. If you have questions too, ask the doctor to set aside time to discuss them.

Your teen's doctor may ask:

• Are you looking forward to life after high school? What's the next chapter?

• Any big life changes in your life lately (or on the horizon)? How do you feel about them?

• Do you feel good about yourself most of the time? Why or why not?

• Do you have at least one adult you can count on for unconditional love and support?

Your get-ready checklist:

✅ Immunizations

Pediatricians and family doctors recommend a yearly flu shot for teens and young adults. A review of your child's health record might show they've missed vaccines for meningitis, diphtheria, tetanus, pertussis (whooping cough) or human papillomavirus (HPV), which can be safely given now.

✅ Physical health

Your 18-year-old's checkup will include a full physical exam. Tests might include a lipid profile to check for high cholesterol. Depending on your teen's overall health and other factors, the doctor may also test for:

• Anemia (low iron in the blood)

• Tuberculosis

• Sexually transmitted diseases
  

Questions the doctor may ask:

• Have you gone to the ER since your last checkup?

• Do you get at least one hour of exercise a day?

• Any difficulties putting digital devices down when you need to?

• Do you smoke, vape, or use smokeless tobacco?

• Do you use alcohol or drugs? How often?

• How much sleep do you get? Any problems falling or staying asleep?
  

✅ Emotional and mental health

Mental health has a strong influence on lifelong health and wellbeing. Though many young adults find it hard to open up about this subject, it's an important one – and a topic that pediatricians and family doctors seek to address openly and respectfully. At this visit, the doctor might ask your 18-year-old:

• Do you ever feel sad or hopeless? How long does it last?

• Have you ever had thoughts of ending your own life?
  

• Are you sometimes so anxious or angry that you can't cope with everyday life?

• Have you ever felt bullied or threatened by anyone?

• Do you get into physical fights sometimes? Does anyone ever hit or hurt you?

• Do you have a favorite way to deal with stress?
  

• Do you need more support with any of these issues?

✅ Sexuality

Since many older teens have had sex, topics such as contraception and sexually transmitted diseases become part of regular health checks. Kids who identify as LGBTQ+ may have more difficulty talking about their experiences, especially if they haven't fully come out yet.

Pediatricians and family doctors make it a point to help teens feel comfortable discussing sex as part of adult health.

Questions your 18-year-old's doctor might ask:

• Are you sexually active?

• If yes, do you practice safe sex and pregnancy prevention?

• If not, do you ever feel pressured to have sex? How do you handle it?

• Has anyone ever touched you in a way that felt wrong? How did you protect yourself?

• Do you watch pornography online? Does it change how you feel about sex or your body?

• Do you need more support with any issue relating to sex?
  

✅ Healthy eating

Many 18-year-olds have taken full charge of their diet, but they can still benefit from family-based support. Asking their preferences and offering healthy choices will strengthen good habits. Emphasize fruits, vegetables, lean proteins, low-fat dairy and other healthful options at home. Set a positive example by enjoying caffeine, sports and energy drinks and sugar in moderation.

In talking about nutrition, the pediatrician might ask your 18-year-old:

• What foods do you love to eat? Any you would NEVER eat?

• Do you skip meals sometimes? How often?

• Do you count calories, carbs or fat when you eat?

• Do you sometimes work out to burn off a big meal?

• Do you drink plenty of water each day?

• Any worries about your weight or body shape?
  

✅ Safety

• Online. Older teens may know about internet risks, but downplay their own vulnerability. Families that maintain an open conversation about online porn, gambling, and AI-generated content can help young adults avoid online dangers (and ask for support when they make mistakes).

• In their body. Concerns about sexual assault and abuse remain relevant as young people move into adulthood. They may have heard messages about body autonomy, but feel unsure how to hold or honor boundaries with sexual partners. Even if your teen has never had sex, they will appreciate knowing they can talk freely with their doctor (and you).

• At home. Gun safety has become a nationwide issue. If there are firearms in your home, your doctor may ask about safety rules that can prevent death and disability.

• Away from home. Your 18-year-old will carry the positive training you've given them into adulthood. By now, they're clear on water safety, sunburn prevention and safety equipment like mouthguards in sports. If you have specific concerns—for example, healthy living while they're at college—ask your teen what they think. Emphasize that you're asking out of love and concern, not as a way to control what they do.

On the topic of safety, the doctor might ask:

• Do you generally feel safe in the world? Why or why not?

• Have you ever had to get emergency help for yourself or a friend? Anything you'd do differently if it happened again?

• Do you feel confident saying "no" to anything that feels dangerous, no matter who asks you to try it?

✅ After your visit: communicating with your child's doctor

Your child's ongoing health is your pediatrician's top priority. Wherever life takes them, young adults can feel confident that the doctor(s) who cared for them in childhood are still there as a valuable resource.

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