Beyond the Birds and the Bees: Talking to kids about sex

My parental resolution for this year is to do a better job of talking about sex with my children.

It's not that I've done a bad job—at least I don't think I have. I'm a pediatrician, after all. My husband and I have tried to create an atmosphere of openness, answering questions as they come up. By mid-elementary school, we've made sure the children know where babies come from. My oldest two (we're raising five), are in 11^th and 10^th grade now, less interested in talking with me than they were before—but I've bought books for them and made it clear that I'm available to talk, so I assumed I was doing my job.

Three months ago, I had a moment that made me re-evaluate that assumption. My toddler woke me up around 2am; after settling him I had trouble falling asleep because of cramps. My period is about to come, I thought, and then it hit me: my eldest, Michaela, didn't have her period. She always gets hers a few days before mine. I started to panic. She'd told me she wasn't having sex, but was she lying? I certainly lied to my parents at her age. Was she — gasp — pregnant? Suddenly I realized how little she and I had really talked about sex. There was so much I wanted her to know that I hadn't told her. How had I let this happen?

I woke her up and asked her if she was having sex — I couldn't sleep, and I figured the element of surprise might make her more truthful. She looked at me like I was bonkers, and said she'd never had sex. And indeed, her period came two days later. My husband thought I was bonkers too. But I knew I wasn't.

I started doing research. Here are some sobering statistics from the CDC, based on Youth Risk Behavior Surveillance data gathered from U.S high school students. In 2005, 34% of 9^th graders reported that they'd had sex, as did 43% of 10^th graders, 51% of 11^th graders — and 63% of 12^th graders. I really don't think that all those parents know that their children are having sex. And there's more:

• It's not just a one-time thing: 34% were sexually active in the month before the survey
• Of those who had been sexually active, 23% had drunk alcohol or used drugs before their last sexual encounter
• 34% of all surveyed had not used a condom the last time they had sexual intercourse
• 7% had been forced to have sex; 9% reported dating violence
• 6% said they'd had sex before they were 13

Studies show that adolescents whose parents communicate with them about sex are more likely to delay intercourse — and if they do have it, they are more likely to use birth control and have fewer partners. But what kind of communication are they talking about? We tend to think of the Big Talk, when parents sit down with their child and explain the Birds and the Bees — and everyone goes off relieved and wiser. When I started seriously looking into the subject of teen sex, I found that as much as we parents might like that to be enough, it's not. Here's what experts suggest:

• Talk early. Don't wait until high school. You should actually start in preschool, by teaching children the actual names of their body parts and talking about feelings. When they are 10-12 you should start talking about sex; if you've laid the groundwork, it won't feel weird.
• Talk often. One time won't do it. Kids have limited attention spans, and both kids and parents have limited comfort zones — but any parent of a teen will agree that repeated sit-downs to talk about sex aren't happening. So steal opportunities. I've been using time in the car: they are captive audiences, we don't have to actually look at each other, and it's easy to change the subject if somebody gets uncomfortable. Dinner prep and clean-up is another opportunity. If sexual topics come up in music or the media, talk about them at that time.
• It's more than just about where babies come from. Kids need good information about topics such as masturbation, nocturnal emissions, contraception, sexually transmitted disease (including HIV), oral sex, anal sex, and sexual orientation. My teens get a lot of that in health class, but studies show that education is more effective if it's reinforced at home.
• Talk about feelings, too. Teens need to know that sexual urges are normal, and that sex can make you feel very good or very bad, depending on the context. They need to know about the role peer pressure plays, too.
• Be practical. We all have disconnects between what we know and what we do; it's not always easy to translate knowledge into daily life. Give kids ideas about what to say or do if they find themselves in a difficult situation.
• Impart your beliefs — but don't preach. There's nothing that shuts down conversation like preaching. As for me personally, I believe that my children should abstain from sex until they are in a loving, committed, long-term relationship. But I'm going to bet that most of the parents of the 63% of sexually active high school seniors feel the same way I do — and yet their kids are having sex. It's not easy, but as we teach our children our values we need to allow for the fact that they may disagree (that's what adolescence is all about, after all), and make sure they know that a. we most want them to be emotionally and physically healthy, and b. we will love them no matter what.

Recently (during dinner clean-up) I told Michaela that if she was thinking seriously about having sex I would take her to get birth control. "You would do that?" she said. Of course, I said. I wouldn't be happy about it, but I'd do it to keep her safe. She looked at me like she was seeing me differently. Maybe I'm imagining it, but since then she has seemed more willing to talk to me about sex.

I'm stealing opportunities a lot more now, not just with my teens but all of my children (the 10-year-old and I are talking about her changing body, the 7-year-old and I are talking about a gay couple she met, the 2-year-old is learning to say "penis"). Sexuality is part of life. If we miss our chance to help our children make good decisions about sex, we are missing a chance to help them lead happy and healthy lives. I know I'm not going to miss any more chances.

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