Editorial: Parents Can Use Natural Opportunities to Talk About Sex

Sex and relationship issues are difficult things for parents to discuss with their kids. But there are events on television shows, in news stories, and in day-to-day life that parents can use to make the conversation less staged, confrontational, or dramatic than the classic "big talk" about the facts of life. Of course, a big talk is better than no talk, but big talks on anxiety-laden topics are difficult to remember. Moreover, one or two big talks cannot cover the many phases of a child’s development and experiences.

As a pediatrician, you can write or suggest guidelines for parents on ways to use these natural opportunities to discuss sexuality. This column’s suggested approach generally works for children aged 10 years and older who see or hear about real events in late elementary, junior high, or high school, but it can be adapted for younger children.

If you have an office newsletter, you can feature a sexually meaningful event in your community, or an item from the news or a popular television show as a starting point to discuss both sexual mechanics and related human values. Guide parents on age appropriateness, and suggest that parents use these natural opportunities to talk about their values around relationships and sexuality in a context that is understandable from a developmental perspective.

Watching popular television shows with children is a great opportunity. Many shows target certain age groups and raise relevant issues. It’s easier – and "safer," in many instances – for parents to discuss teenage pregnancy, drinking, dating violence, and other real-life challenges when they are displaced, fictional, and happening to someone else.

One of the shows I suggest for young and middle adolescents is "Friday Night Lights" (www.nbc.com/friday-night-lights). It’s the story of a Texas football coach, his wife’s work as a guidance counselor, and their family. The show features multiple relationships: The football players have girlfriends, the wife faces difficult guidance situations, and there are family tensions. There also are young marriages, births out of wedlock, divorces, and separations as students graduate; at the end of the series, the coach’s daughter has a crush and a very rapid affair with a married teaching assistant in college. If a teenager in your practice is in high school, virtually every sexual and interpersonal crisis in the show is an opportunity: first to listen, and then to share information and values.

The show also addresses how "rebound relationships" and the vulnerability of excessive drinking can make teenagers more vulnerable to sexual advances and related violence. Although laying down the law with "No drinking until you’re 21" might feel decisive, most pediatricians know that teenagers will benefit more from a reality-based discussion that attempts to build good judgment.

There seems to be no shortage of news stories about the sexuality of well-known politicians and celebrities. When appropriate, parents can ask their adolescents for their take on reports about people like Tiger Woods or Arnold Schwarzenegger. What does their behavior tell you about the use of sex, how we value ourselves, and the deeper issues of intimacy?

There also are local events in day-to-day life that are just perfect for a discussion about sexuality, from the mechanics of sexual behaviors to interpersonal issues, safety, and values. Pediatricians can use these situations in a community-health approach to alert parents that these should be topics of conversation rather than events to ignore. These events can become progressive opportunities to make children’s judgments more sophisticated as they grow into young adults.

Adolescent pregnancy, for example, occurs in many communities. A real example is a junior high school student who comes home and reports that a 13-year-old at school is pregnant. I start such conversations by listening to the story and then, gently and without judgment, asking questions to gauge the child’s understanding and perspective. Parents can use the same technique.

For example, parents can ask the following:

• "Do you have any guess of how it happened?"

• "Do you think she knew what she was doing?"

• "What do you think is going to happen to her?" or "What do you think she’ll do with the baby? What are her choices?"

• "What did your friends think about it?" This is another great question and parents don’t need to ask the child to name names.

• "Is this a girl who was very active in dating, even at age 12? Was this her second or third boyfriend?"

• "Do you think she was using guys to feel better about herself?"