By: Raina Voss, MD, MPH, FAAP
There is a lot to know and consider when making healthy choices about sex. While it may feel awkward at first, there are many ways you can help support your teen.
You can use any opportunity that your teen provides to chat about the topic—or bring it up yourself. Either way, it helps to:
Keep things
positive and supportive.
Focus on health and safety.
Break the
conversation into smaller pieces.
Read on for conversation starters and tips on what to say to your teen.
When is it OK to start having sex?
There isn't a specific age when it is OK to start having sex. This decision will be different for everyone. It is something that you and
your teen should discuss ahead of time. This helps ensure they can make a thoughtful and educated—rather than impulsive—decision.
Things to consider when a teen is thinking about having sex
Do I want to have sex?
If your teen is considering having sex because a partner is pressuring them or their friends have started having sex, they should think again. Having sex when you don't feel ready can cause feelings like guilt, shame or regret.
Your teen should also think about the various types of physical intimacy and sex. For example, they may be comfortable holding hands, but not kissing. It's important for them to understand their own boundaries and make sure their partner understands, as well.
Do I want to have sex with this person?
Encourage your teen to reflect on whether they have a trusting, safe relationship with someone they are considering having sex with. Have they talked about sex with their partner? If not, are they ready to have that type of conversation? If they have talked, did they feel like their partner was listening and respecting their point of view? Would their partner be OK if they changed their mind or decided to stop?
This is a good opportunity to talk about consent with your teen.
What does consent mean?
Saying yes—which is different than just not saying no.
Saying yes without pressure. Pressuring someone to say yes is called coercion.
Saying yes when you are thinking clearly. Consent cannot be given when someone is under the influence of alcohol or drugs.
Saying yes each time. Consenting to have sex once doesn't mean consenting forever, and it is OK to change your mind.
Saying yes to everything you do. Remembering that saying yes to kissing, for example, does not mean saying yes to intimate touching. And certain expectations, like "yes, but only if we use a condom" need to be respected.
Age of legal consent
There are specific ages of legal consent. These vary by state and it's good to be familiar with your state's laws. Some states have laws that specify the maximum allowable gap in age between two people having sex. Do I have a plan to have sex safely?
Read on for tips on preventing infections, pregnancy, and avoiding substance use. These are all things that you and your teen should consider before they start having sex.
What about STIs?
Sexually transmitted infections, or
STIs, are common. In fact, adolescents and young adults have the highest rates of several STIs than any other age group.
STIs can be prevented. Some STIs are curable, like chlamydia and gonorrhea. Others, like HIV and herpes, can be treated but not cured.
STIs may have symptoms, like pain, sores or discharge, but they are often "silent." This means that a person may have an infection without any signs or symptoms.
Even if a partner has been tested, they may unknowingly have an infection like herpes that is not usually tested for. It's important to take steps to prevent getting an STI, even with a partner that you know well and trust.
How to prevent STIs
There are a lot of ways to prevent STIs, in addition to delaying having sex. The most important one is using condoms (barrier protection),
every time they have sex.
Your teen should know the right way to use a condom:
Put on the condom before starting to have sex.
For an external condom, leave a little space at the tip of the penis. That space should not be full of air, or the condom may pop like a balloon. After sex, hold the condom at the base and pull out.
Internal condoms have a loose-fitting polyurethane sheath and two flexible rings. (They are available with a prescription.) To use an internal condom, place one ring on the inside of the vagina, anus or mouth. The other ring fits on the outside.
Another form of STI protection is a dental dam. This latex or synthetic sheet is placed over any part of the body. A dental dam is not intended to prevent pregnancy.
Use a new condom if you have sex again.
STI testing
In addition to using barrier protection, your teen and their partner should
get tested for STIs regularly if they have had sex. Test at least once a year, or more often if there are new partners or any concerns about infection.
Other ways to lower the risk of STIs are to avoid having sex with multiple different partners or partners they don't know well and avoid using drugs and alcohol. Some people take medications to prevent HIV, known as
pre-exposure prophylaxis. And don't forget, vaccines like the
hepatitis B and
HPV shots also help to prevent STIs (and types of cancer)!
How is sex supposed to feel?
If your teen is having sex, or thinking about it, it's important for them to understand that sex should feel good—both physically and emotionally. If they are having problems like pain during sex or feeling ashamed, they should stop. They can talk with their partner. It can also be helpful to talk with a trusted adult, like a parent or health care provider. Feelings of guilt or shame might mean they aren't ready for sex or should re-think their decision to have sex with this partner.
Pain with sex might mean they need to adjust positions, go slower or use lubrication (lube). There are many different types of lube. In general, it's best to use a lube that is water or silicone based and not flavored. This is to avoid irritation or breaking the condom.
Should my teen use birth control?
It is best to wait to become a parent until after the
teenage years. Having a baby as a teen can lead to challenges with continuing education like high school or college, difficulty with getting jobs and financial hardship.
Talk to your teen about avoiding pregnancy. They can choose to wait to have sex, or if they are sexually active, they should use condoms and birth control.
There are many types of birth control available today. Teens can safely use all forms of birth control, including IUDs (intrauterine devices), contraceptive implants, injections ("the shot"), patches, vaginal rings as well as the pill. They can learn more
here and talk to their health care provider to decide which choice would be best for them.
In some states, teens can get birth control without a guardian's consent. But it's always good to be part of the conversation, if possible, to help them consider their options and navigate things like pharmacy refills.
It's best for teens to use birth control rather than relying on methods that involve
tracking their cycles. Research shows that these types of strategies are less effective in teens.
What about online safety?
Talk with your teen about what content they are seeing (and sharing) online and whether any of it is sexual. Be up front in discussing porn, which often depicts sex that is not intimate or not consensual. It is normal to be curious about porn. However, it is important to be aware that there is a variety of content, and some types of porn may lead to a distorted idea of what sex is really like.
Help your teen think about the concepts of consent and healthy relationships in terms of their internet and social media use. Remind them that sending naked photos or sexual messages to others is a risky decision because their photos or texts can then be shared with others without their consent. And remind them that if they are talking with someone they don't know and the conversation turns toward sex, they should stop and tell an adult.
Remember
Talking with your teen can help them learn how to make healthy choices about sex. When you and your teen feel comfortable talking, it makes sharing concerns and questions easier for everyone.
Resources
About Dr. Voss Raina V. Voss, MD, MPH, FAAP, is an adolescent medicine specialist at Ann & Robert H. Lurie Children's Hospital of Chicago and an Assistant Professor of Pediatrics at the Northwestern University Feinberg School of Medicine.
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