Most Doctors Aren’t Talking About Sex Enough With Their Teen Patients

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Thanks to a patchwork of insufficient state laws, most teens in the U.S. aren’t guaranteed to get medically accurate information about sexual health at school. And according to a new study, most of them aren’t getting that information from their doctors, either.

Researchers at Duke University taped over 250 doctor’s visits at clinics in North Carolina, and found that many medical professionals aren’t asking teens about sex during their annual physicals. The ones that do bring up the topic spend an average of just 36 seconds on it — hardly enough time to cover the major issues related to sexual health, like using birth control, preventing sexually transmitted infections, or having healthy dating relationships. The study also found that teenagers won’t broach the topic themselves if their doctor doesn’t bring it up first.

Previous studies have also found that doctors tend to avoid talking about the issues surrounding birth control with teenage boys, furthering a gender divide that tends to place the burden of sexual responsibility solely on young women.

“It’s hard for physicians to treat adolescents and help them make healthy choices about sex if they don’t have these conversations,” lead author Stewart Alexander, an associate professor of medicine at Duke University, pointed out. “For teens who are trying to understand sex and sexuality, not talking about sex could have huge implications.”

Both the American Medical Association (AMA) and the American Academy of Pediatrics (AAP) recommend that doctors should be bringing up topics related to sex with their teenage patients. In light of an ongoing STD epidemic among U.S. youth, the AAP also advocates for comprehensive sex education policies and expanded access to condoms in public schools.

Some doctors may avoid bringing up sex with their teen patients because they don’t want to appear as though they’re encouraging sexual activity. But the assumption that discussing sexual health pushes teens to become sexually active is a myth. Talking to adolescents about sexual health — including messages about healthy relationships and delaying sex until they feel ready — actually help them make safer decisions. Planned Parenthood, the largest sex ed provider in the country, recently launched an initiative to help encourage parents and kids to have more of these kinds of conversations at home.

But these conversations need to be happening in the doctor’s office, too — and there are some simple steps that medical professionals can take to ensure they occur more frequently.

“We need to create environments in our office to make it comfortable to have these conversations,” Dr. Ron Feinstein, a pediatrician with Cohen Children’s Medical Center, explained in an interview with Everyday Health. “Physicians need to have some form of confidentiality between the teens and their parents in order to properly have the conversation, which means they need to tell the parents that there will be some private time where it will just be the patient and doctor.”

Bradley Boekeloo, a professor of behavioral and community health at the University of Maryland School of Public Health, told NPR that the good news is that teens actually welcome these discussions. They may be too embarrassed to bring up sex themselves, but previous studies have found that teenagers are glad when their doctors talk about the subject. “It’s ultimately important to the adolescent,” Boekeloo noted.