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Paediatr Child Health

v.13(7); 2008 Sep

PMC2603520

Paediatr Child Health. 2008 Sep; 13(7): 624–625.
Correspondence: Canadian Paediatric Society, 2305 St Laurent Boulevard, Ottawa, Ontario K1G 4J8. Telephone 613-526-9397, fax 613-526-3332, Web sites www.cps.ca , www.caringforkids.cps.ca
Copyright ©2008 Canadian Paediatric Society. All rights reserved
Heterosexual: Those who are attracted mainly to people of the opposite sex. Heterosexual males are attracted to females, and heterosexual females are attracted to males. Heterosexuals are sometimes called ‘straight.’
Homosexual: Those who are attracted mainly to people of the same sex. Females who are attracted to other females are known as lesbians; males who are attracted to other males are known as gay. The term ‘gay’ is sometimes used to describe homosexuals of either gender.
Bisexual: Those who are attracted to both sexes.
with homosexual fantasies or dreams;
when a person realizes she is attracted to someone of the same gender;
with a feeling that she is different from her friends and classmates; or
the social stigma that can come with homosexuality;
a lack of homosexual role models; or
few opportunities to socialize with other teens who are having similar feelings.
All sexually active teens, gay or straight, should be routinely tested for STIs.
Girls between 9 and 13 years of age should get the human papillomavirus (HPV) vaccine. To work the best, the vaccine needs to be given before any sexual activity starts.
All girls who are heterosexually active or who have shared sex toys with someone who has sex with males should have a Pap test (a test where cells are collected from your cervix and then examined through a microscope to make sure they are normal and healthy) 2 to 3 years after initiating sex to check for cervical cancer. A sexually active lesbian who has not done these things should still have a Pap test done in her early 20s.
Safer sex practices, such as using a condom, will help reduce the risk of other infections. Encourage your teen to discuss all safer sex options with a health care provider.
The most important thing is to let your teen know that you love him or her.
Be available and open-minded if your teen wants to talk about sexual orientation, but don’t try and force the issue.
Encourage your teen to talk about sexual health with a paediatrician or other health care provider.
Many Canadian cities have a chapter of Parents and Friends of Lesbians And Gays (PFLAG), an organization that has helped many parents whose children have ‘come out’ to them.
Adolescent sexual orientation, a position statement of the Canadian Paediatric Society. < http://www.cps.ca/english/publications/AdolesHealth.htm >
The Society of Obstetricians and Gynaecologists of Canada. Sexual and gender orientation. < http://www.sexualityandu.ca/teens/orientation.aspx >
Articles from Paediatrics & Child Health are provided here courtesy of Oxford University Press

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Adolescence is a time when youth explore their relationships with peers, both as friends and potential romantic or sexual partners. Despite the excitement, flirting, dating and sexual experimentation can cause stress for young people. It can be more challenging when a young person is attracted to people of the same sex.
A person’s sexual orientation defines who they are physically and emotionally attracted to – that is, to people of the same or opposite sex. Youth have a sexual orientation even if they are not yet sexually active.
Although there are many possibilities between being totally heterosexual and totally homosexual, people are usually grouped in 1 of 3 ways:

The process of declaring a homosexual identity is often called ‘coming out’. It can start:

These feelings can cause uncertainty for a young person and could be made worse by:

It can be very difficult for teens to decide to tell their parents about their homosexual identity. They may hate the idea that they are ‘lying’ by not telling their parents, but they also worry about how their parents will react.
Sometimes parents suspect that their teen is gay. However, sometimes what you think to be true is not. Wait until your teen is ready to talk. Some teens are not ready to announce their sexuality until they are adults. If there is a homosexual theme in a comic strip or on a TV show, you can have a discussion about that, hopefully finding a way to let your son or daughter know that they are loved no matter what their orientation.
Some teens will tell a sibling or cousin before they tell a parent, and often they will choose one parent to tell first.
Parents sometimes bring their teen to the doctor wanting a ‘diagnosis’. They can’t believe what their teen is telling them. There is no blood test or other for sure way of telling if someone is gay.
Just being gay does not have any health risks. However, the reality of being gay in our society means that gay teens are at a higher risk of depression and suicide. Anyone, gay or straight, who has unprotected anal sex, has a high risk of sexually transmitted infections (STIs). Although lesbian teens are less likely to get STIs than heterosexual teens, they may have sex with males (for many reasons), which increases their risk.

This information should not be used as a substitute for the medical care and advice of your physician.
There may be variations in treatment that your physician may recommend based on individual facts and circumstances.
May be reproduced without permission and shared with patients and their families.
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Our conversations are sprinkled with slips, pauses, lies, and clues to our inner world. Here’s what we reveal when we speak, whether we mean to or not.

Valentine's Day seems like the right time to offer a few words of advice to parents about talking to preteens and young teenagers about sex. In fact, it's probably easier to do this before your teen has become sexually active than after.
Study after study shows that teenagers want more information about sex than they are getting. When asked how they would choose to learn about sex, nine out of ten say from their parents-yes, their parents-not from their friends or a health class or books. When asked if they actually talk to their parents about sex, however, only about one in ten says yes. The reason, according to most teenagers, is that their parents hold back.
Why are parents reluctant to discuss sex with their teenagers?
• "I don't want to encourage sex." Many parents believe that talking to young people about sex will lead to premature sexual activity; that children will interpret their parents' willingness to talk as permission to become sexually involved. Both beliefs are false. Researchers who have studied this question extensively find no evidence-repeat, none-that sex education , from whatever source, increases sexual activity. What they do find is that lack of education increases unsafe sex. The message children get from discussions of sex is the message you communicate. If you say that you do not think teenagers should have sex, your child will hear you. He or she may not agree with you, but if you say nothing, you will never learn what your child thinks, nor will your teen know where you stand. • "My child knows more than I do." Some parents believe that they don't need to discuss sex because their children already know whatever they need to know, from sex education in school or other sources. And some young adolescents are convinced they "know it all." They don't. The sex education provided in a typical junior or senior high school consists of a total of five to ten hours of instruction and/or discussion. The emphasis is usually on anatomy and physiology-the "plumbing." Sexual feelings and sexual relationships-the issues that concern adolescents most-are rarely mentioned. If contraception and STDs (sexually transmitted diseases) are introduced, it is often in the eleventh and twelfth grades, which may be after the fact. In short, sex education in school tends to be too little, too late, and boring . So young people turn to their friends, older siblings, and whatever books, magazines, and TV shows are available, and they come up with a few facts, a good many half-truths, and almost as many untruths. Your adolescent may have an advanced sexual vocabulary, but this doesn't mean he knows what he's talking about. • "I don't know how to begin." Perhaps the main reason parents feel awkward about discussing sex is that they don't know how. Today's parents likely came of age after the sexual revolution, but sex may still have been a taboo subject in their homes. When the time comes to talk with their children, they don't have role models for being parents of sexually open teenagers. In spite of what they think they should do, a part of them feels it is inappropriate to include frank sexual discussions in their child's upbringing. One generation's prohibitions have a way of becoming the next generation's inhibitions.
How can parents overcome their own hesitations and their young adolescent's resistance? Here are some suggestions:
• Don't postpone discussions of sex until you think the adolescent is involved in a relationship. Ideally, you should start talking to your child before he or she has become sexually active. Ten- to 12-year-olds are less likely to take the discussions personally and react defensively and more likely to say what is on their minds. It is much less embarrassing to ask and answer a hypothetical, "what if" question than one based on last night's experience or tomorrow night's expectations. If you wait until your daughter is 15 or 16 to bring up contraception, for example, she may feel that you are accusing her of being sexually active or invading her privacy. A younger adolescent won't take your views as a judgment of his or her maturity. Conversations are less likely to become emotional, and doors to future conversations (and the teenager's room) will not be slammed shut. Having said this, I must add that it is never too late for you and your adolescent to have the conversation (or several of them). If you've put this off, say so. "We should have talked before now; you've grown up so fast I just didn't realize. That's my fault, but I'd like to start now." • Don't try to say everything at once. Many readers will remember the Big Talk. Out of the blue, your father folded his newspaper, glanced knowingly at your mother, and said, "Let's go for a walk, son." Or your mother came to your room, closed the door, and announced solemnly, "It's time you and I talked woman-to-woman." If you remember anything about the Big Talk, it is probably that you and your parent were both horribly embarrassed. (Besides, you had already discovered where your father kept his condoms or your mother her diaphragm.) Heart-to-heart talks have their place, but the Big Talk tends to overdramatize sexuality , making natural developments seem like momentous, mysterious events. The adolescent won't learn very much from a single lecture anyway. If you want your child to consider sex a normal-not scary or compulsive or superglorious-part of life, the most natural approach is to weave discussions of sexual topics into everyday conversation. TV shows (both serious shows and sitcoms), magazine articles, the advice columns in newspapers, and even gossip columns provide ample opportunities to discuss sexual behavior and values. (More than 70 percent of the television shows that are the most popular with teenagers contain sexual content.) A program on teenage pregnancy can set the stage for talking about why (other) teenagers take chances and how much your child knows about conception and contraception. Don't overwhelm the young adolescent with information. If your son or daughter asks a question, answer it and ask if there is anything else they would like to know. Your goals should be first to find out what your child knows and correct misinformation and second to let the youngster know that it is okay to talk about sex. The best way to break the ice is to show the adolescent you are interested in his or her views on topics like teenage pregnancy and sexual harassment. • Respect your adolescent's privacy. As teenagers move into adolescence , their desire for privacy increases. They don't want you going through their bureau drawers or email while they are in school, and they don't want you prying into their private thoughts. The rule that sex is private is not for adults only, even if the adolescent's sex life is all fantasy at this point. If your daughter takes you into her confidence , don't rush off to tell your husband or your best friend what she said. Let her decide whom she wants or doesn't want to know about her feelings. The privacy rule works both ways, of course. If you feel comfortable talking about own experience, fine. ("Would you believe that I thought girls didn't masturbate until I was in my twenties?") But if you don't, say so. You and your adolescent can have a useful, informative conversation about sex without going into intimate details.
At some point, nearly all preteens ask "How old do you have to be to have intercourse?" Don't assume that your son or daughter is contemplating an affair. Most young teenagers are looking for reasons not to have sex, and welcome their parent's help in saying no. Even still, it might not be too soon to begin discussing now how to make responsible decisions about sex, and good and bad reasons for having sex.
Telling adolescents that they are emotionally immature or that they only think they are in love (if that is the case) is not likely to make much of an impression. The best approach with preteens is to emphasize the real risk:
• Unprotected sex-at any age, even once-can result in pregnancy. The only way to prevent pregnancy is to abstain from intercourse or to use effective contraception. But no form of contraception is 100 percent effective. Young adolescents are much less likely to use contraception than are older adolescents. • Pregnancy at an early age is both physically and psychologically risky. Very young mothers are more likely to have complicated pregnancies and deliveries than are women in their twenties; their babies are more likely to be underweight, sickly, and slow to develop. Girls who become mothers in their teens are far less likely than other girls to complete high school or go to college. They are also less likely than other girls to marry the father of their baby or, if they do, to stay married. Abortion also entails greater risk when the girl is very young, if only because young teens are reluctant to face the possibility that they are pregnant and delay seeing a physician. • The risk of STDs (sexually transmitted diseases) among teenagers is high. STDs are a leading cause of sterility, among other health problems. Having sex now can reduce the chances of having children later in life. The only way to avoid STDs is to abstain from sexual intercourse or to use condoms.
In short, young adolescents should know that saying no until they are older is important to their health and their future. They should know that having sex doesn't prove that you are glamorous, attractive, and "with it." Sex doesn't prove anything. Saying no at age, for any reason, is okay. You might also want to say that kissing, hugging, and holding hands are good ways of expressing affection that adults enjoy, too. Walking arm in arm on the beach or star-gazing with someone you care for are wonderful at any age. They needn't be a prelude to sexual intercourse.
Laurence Steinberg, Ph.D. , the Distinguished University Professor of Psychology at Temple University, is an expert on adolescence.

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It's no secret that sex is a big deal for teenagers. They think about it, they talk about it. And usually, they do it. On average, both males and females in the US and UK first have sex at 16. Which, if you're the parent of a teenager or young adult, can suddenly start to feel very real. Have you ever wondered where all those teenagers are doing it?
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Sep 15, 2014, 06:56 AM EDT | Updated Nov 15, 2014
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