Public health experts are encouraging doctors to spend more time addressing issues of sexuality with teenage patients, after a growing body of research has demonstrated that teens aren’t hearing enough about sexual health at their check-ups.
Few pediatricians offer regular screening, counseling, and vaccination for sexually transmitted infections. One recent study found that when doctors do bring up sex with teens, they only address the topic for an average of 36 seconds. Teen boys in particular usually don’t hear any information about pregnancy prevention from their physicians. That lack of doctor-patient interaction isn’t helping address the country’s high rates of teen pregnancy or low rates of HPV vaccination.
“There is this very clear gap between recommendations and practice,” Veenod Chulani, the director of adolescent medicine at Arnold Palmer Hospital for Children in Orlando, told the Wall Street Journal this week. “It’s partly lack of training for physicians. Oftentimes pediatricians feel unprepared to deal with issues of sexuality.”
Chulani is one of the medical professionals who volunteers with Physicians for Reproductive Health, which works to train doctors about how to effectively address sexual health. The organization’s Adolescent Reproductive and Sexual Health Education Program (ARSHEP) gives free education sessions for providers about how to best meet the needs of their teen patients. Topics include caring for LGBT youth, discussing emergency contraception, counseling young men about their reproductive health, and providing confidential sexual health services for teens who may not want their parents to know.
One barrier to these types of conversations can be the lack of privacy when teens visit the doctor. Once kids enter puberty, doctors recommend that their parents allow them to enter the exam room alone; that way, they’ll be able to discuss topics they may be uncomfortable bringing up in front of their mom or dad. Studies have found that teens are very wary to disclose medical information that makes them feel embarrassed or judged, and their physicians need to work to create an environment that’s as welcoming as possible. In one of the training videos in its site, Physicians for Reproductive Health offers some tips for asking a parent to step out.
But not every parent will agree to leave the exam room. Earlier this summer, a Michigan mother made national headlines after she refused to give her teenager daughter five minutes alone with her physician, calling it an “erosion” of her parental rights. “No doctor or nurse is going to sequester my children in an exam room and talk to them privately,” she wrote in a blog post about the incident. “What they want to do is talk to your child about sex and drugs (maybe rock and roll — who knows?) without your input.”
That approach to teen sexuality is the same reason why too few teens are receiving the cancer-preventing HPV shot, something that continues to frustrate medical professionals. There’s a pervasive attitude that providing kids with sexual health resources will encourage them to become sexually active or make riskier choices. But research shows that giving young adults access to the HPV vaccine or to the birth control method of their choice does not actually spur them to have more sex.
In fact, kids who receive medically accurate sexual health education in school are more likely to delay sex. But a patchwork of state laws in this area ensures that many teens don’t get those classes early enough. Experts say that’s exactly why doctors have an important role to play. “Health care providers nationwide can focus their attention on what’s most important — helping their young patients make informed decisions about their reproductive and sexual health,” Physicians for Reproductive Health points out.