LEARNING PATHWAYS

PARENTING

COMMUNICATING

REPRODUCTIVE HEALTH TOPICS

This section provides parents with the facts about sexual health AND gives specific tips on how to talk about sexual health topics like condoms, relationships and abstinence. Click on any of the topics below to begin exploring the six reproductive health topics.

Puberty includes the physical and emotional changes that every child goes through. Puberty can be a wild ride for some young people and their parents. Every child will go through puberty differently, at a different pace and with different milestones along the way. Your role as a parent may be to assure them that while these sudden changes may be scary (or perhaps exciting), that they are also normal. Families who know what to expect will likely have an easier time talking about these changes.

What do I need to know to talk with my children?

The names of sexual body parts

What do you call it?

Growing up, children learn a lot of different words for sexual or reproductive body parts. When talking to your children, use the correct terms, but you may want to mention the slang words too. Often times, children may have heard slang words at school or from other family or friends. It can also be very helpful to ask your child what they call a certain body part. You might be surprised to learn what terms they have learned. By doing this, you can clear up any misunderstandings and make sure your child knows what you are referring to.

For the correct terms, view each of the interactive anatomy images for both the female and male body parts. You will be able to hover over labels in the images to learn more!

The Female Anatomy

An image of the internal female reproductive organs.
An image of the external female sexual organs.
An image of the female breast.

The Male Anatomy

An image of the male sexual organs.

The timing of puberty

Understanding the timing of puberty.

Puberty does happen to everyone, but it does not happen on the same schedule. Girls generally start earlier than boys. Girls’ bodies can begin changing at age 8, while some don’t start until age 14. Boys’ bodies usually start to change between ages 10 and 12. Most often the changes are done by age 16, but puberty can go on through the teens.
(Source: Planned Parenthood Federation of America)

Emotional changes during puberty

What is going on emotionally?

Independence:

  • Puberty is a time when children will begin to move towards independence during middle/junior high school. During this time, they will want to blend into their peer group and not stand out. They will begin to feel self-centered and self-conscious and have concerns about their looks. Also, they will begin to test boundaries and limits of their family as they push for independence. They can experience mood swings, which can be evident with family relationships.
  • As children begin puberty, they develop skills in decision making as they become more independent. They start to think about future goals of careers and occupations as they shift from play-centered activities to school and academics. They start getting advice from peers and look to the media for advice and information. They also begin developing abstract thought and have the ability for social consciousness. They can understand more complex issues such as war and poverty.

Sexuality:

  • Sexual thoughts begin at puberty as well. Children will begin to develop crushes and start to develop sexual feeling for others as new dimensions within relationships. They will have an emerging sense of self as a young adult and feel conscious of their sexuality and how they express it. This is a natural time for them to ask questions about what their sexuality is, and who they are attracted to. This may start to have a feeling about what their sexual orientation is, and perhaps even define themselves as straight, gay, lesbian, bisexual, queer, etc. Modeling openness, a non-judgmental attitude and curiosity about this topic makes it more likely they will talk to you, though they may feel shy about discussing sexuality issues with their parents and other caregivers. They may act like they know everything already. They will also value privacy highly. See our Communication Section for communication tips.

Physical changes during puberty


The difference between changes that occur in boys during puberty and the changes that occur in girls during puberty

What happens to boys going through puberty?

  • For boys going through puberty, the first thing they may notice is their testicles growing larger and some pubic hair. This usually happens between ages 9 and 13.
  • Later, a boy may notice his penis is growing larger. As boys’ hormones change, erections occur more often. It is common for erections to occur even if a boy is not thinking about sex, called a spontaneous erection. Spontaneous erections often do not last very long, but can be embarrassing for boys. Let them know that a well-placed jacket or book bag can prevent others from noticing.
  • Between the ages of 12 and 16, boys generally begin producing semen (also called sperm). They may have their first ejaculations during masturbation or during sleep (wet dreams, often called nocturnal emissions). It is important to tell boys about wet dreams before they happen to prevent any unnecessary concern on the part of the boy.
  • Boys will begin to develop hair on their face, underarms, and chest. Some boys’ breasts may become larger and more feminine looking for a while, which is called gynecomastia.
  • Boys will have a growth spurt, usually around age 14 and their shoulders will broaden.

(Source: Planned Parenthood Federation of America)


What happens to girls going through puberty?

  • For girls going through puberty, the first thing they may notice is breast growth. Girls develop swelling around the nipples or breast “buds.” Buds usually develop between ages 8 and 13. Pubic hair may develop shortly before, or more likely, after.
  • Over the next few years, breasts will grow slowly. At times, one breast may be a little larger than the other. This is not unusual. You can reassure your daughter that this is normal and that their breasts may not be as different as they get older.
  • Girls usually have a growth spurt around age 12 and will notice their hips widening.
  • Most girls begin menstruating between the ages of 10 and 16. Her first period is called “menarche.” Some girls will feel cramps weeks or days before her first period, others will notice more vaginal discharge in the weeks prior to her period, and some girls have no warning signs.
  • It is important to prepare girls before their first periods. You can show your daughterhow to use sanitary pads or tampons. Pads are usually the easiest for girls to use at first. Make sure she knows how to put a pad in her underwear, how long to wear the pad before changing it, and how to throw out used pads.
  • Remind girls that they can carry a pad in their purse or backpack if they are concerned about starting their periods unexpectedly.
  • Girls may notice an increase in vaginal lubrication as they mature and become sexually aroused. They can also start having erotic dreams. Remind girls that this is perfectly normal and healthy.

(Source: Planned Parenthood Federation of America)

What do I tell older versus younger children?

Younger children

Even younger children should be taught the proper names for body parts and that these are areas that should be kept private to them. As your child begins to approach the age of puberty, let them know a bit about what they might expect. You don’t have to go into great detail. You can still help them understand the basics (for example: increasing breast size, preparing for start of period, noticing hair growth).

If your family enjoys reading books together, it might be helpful to base your conversations around a good beginner’s guide to puberty, such as the book, The Care and Keeping of You 1: The Body Book for Younger Girls by American Girl.

Older children

As children get older, they will be ready for more details about puberty and anatomy. Explain to them both what they might experience during puberty themselves, and also some of the changes the opposite sex might be experiencing. Teach them about the various sexual organs and what each one does. Sharing our interactive male and female anatomy diagrams with them might be a good place to start!

There are many different types of birth control. Some types of birth control are taken every day in order to be effective, while others can be taken once a week or once a month. Some types of birth control can last for several months or years. Which one is right is different for each individual. All of these methods can also be used for other reasons such as to control problems with periods, acne, and other medical problems.

What do I need to know to talk with my children?

How pregnancy occurs (the biology of pregnancy)

Inevitably, if you are going to talk about contraception, kids will have questions about how pregnancy occurs. Just about every parent will know that it takes having sex, or the coming together of male (sperm) and female (egg) parts to make a baby. But often kids have more questions than that. Here we give you answers to some of those questions.

Option #1: Women have eggs and men have sperm, and in order for a pregnancy to happen, an egg and a sperm must meet to make a fertilized egg. Then the fertilized egg needs to implant in the woman’s uterus. The only sexual behavior that carries a real risk of pregnancy is vaginal intercourse. So, if someone doesn’t want to get pregnant, they need to abstain from vaginal intercourse or use a reliable method of birth control.
(Source: Sexuality Information and Education Council of the United States)

Option#2: Pregnancy happens when a male’s sperm joins with (fertilizes) a female’s egg. For a woman to get pregnant, sperm has to get into her vagina. Sperm can get into her vagina a few different ways.

  • Sperm is in the fluid (sometimes called “ejaculate” or “cum”) that spurts out when a guy ejaculates (“comes”). The main way sperm get into the vagina is when a guy ejaculates during sexual intercourse.
  • Sperm also sometimes can get into the vagina in pre-ejaculate (“pre-cum”). This is a little bit of fluid that leaks out during sex before a guy ejaculates. A guy wouldn’t know that pre-ejaculate was leaking out. That means a woman could get pregnant even if he pulls his penis out before he ejaculates.
  • Sperm can get into the vagina even if a woman is not having sexual intercourse. This can happen if sperm get on the outside of the vagina and swim inside.

 

For a woman to get pregnant, one of her eggs has to be in the right place at the right time. You can read all about how an egg is released during the menstrual cycle and how the female reproductive system works. Keep in mind that:

  • It’s hard to know exactly when an egg is released, which means that avoiding sex at certain times of the month is not a very reliable way to avoid pregnancy.
  • A woman can get pregnant if she doesn’t have regular periods.
  • A woman can even get pregnant during her period!

(Source: Girlshealth.gov)

Risks of pregnancy when not using contraception

For most girls and women, once they begin having periods, they are at risk for getting pregnant if they have sex and do not use a birth control method correctly and regularly.

A figure of 90% is often quoted as the proportion of young women who will become pregnant after a year of sex with a male partner without contraception. Whether you get pregnant depends on a lot of things, but age is very important.

  • As of 2016 teen pregnancy is at an all-time low
  • Since its peak in 1990, the teen pregnancy rate has dropped by more than half
  • Still, 1 in 4 teen girls in the US will get pregnant at least once by age 20

Source: National Campaign to prevent teen and unplanned pregnancy

Types and characteristics of birth control

bc-table-all-web

(Source: Reproductive Health Access Project)

Another great resource explaining contraceptive options is bedsider.org.

Activity

Here is a great list of true/false questions about myths regarding pregnancy risk: Click here

Understand how to get contraception

Teens can get birth control methods from lots of places. Some birth control methods are sold in stores like supermarkets and drugstores. Condoms, contraceptive sponges, spermicides, and some kinds of emergency contraception are sold in these kinds of stores. All other kinds of birth control require a visit to a healthcare professional. Some people get contraception at a family planning clinic, where services are confidential (kept private) and often cost less or are free. You can find a family planning clinic online. To find a teen-friendly clinic in the Philadelphia area, check out our Find a Clinic page.


Does my child need an exam before starting to use birth control?

No. Your adolescent does not need a physical exam before starting on a birth control method. However, many doctors will do a basic exam, that includes listening to your child’s heart and lungs, feeling their belly, and may also take a look at their breasts and the outside of the vagina. Usually, your child will not need an exam inside the vagina in order to start a birth control method.


Who pays for birth control?

In the United States, most insurance companies have to pay for the whole cost of an appointment to talk to a doctor about birth control and for most types of birth control a doctor prescribes.

If your child is covered under your insurance, your insurance company may send a statement home (called an Explanation of Benefits) that says that your adolescent went to a clinic to talk about birth control.

If your adolescent wants to keep this information private, in Pennsylvania, that is their legal right. But to keep this information private, your adolescent may need to go to the health department or a family planning clinic to get birth control. These places often have programs that allow them to provide adolescents with confidential birth control services and will not bill parents’ insurance.

Legally, providers do not have to tell parents that an adolescent got information about birth control or started using a birth control method. However, they do have to get an accurate medical history to make sure that it is safe for the adolescent to use a medication. They will also usually see an adolescent for regular return visits to make sure they are not having side effects, understand how to use the method correctly, and use it regularly.

These clinics also talk with your adolescents about abstinence, healthy relationships, and using condoms to prevent sexually transmitted infections. It is their job to make sure your child is healthy, not just to give birth control.


Does my child have to see a doctor regularly after starting birth control?

Anyone who is having sex should see a health care professional regularly to protect their health even if they aren’t going for birth control.

Others reasons to use contraception

Several kinds of medical conditions can be helped with birth control pills, including:

Polycystic Ovary Syndrome (PCOS) is a hormonal imbalance which causes irregular menstrual periods, acne, and excess hair growth. Birth control pills work by lowering certain hormone levels to regulate menstrual periods. When hormone levels are decreased to normal, acne and hair growth often improve.

Endometriosis: Most girls with endometriosis have cramps or pelvic pain during their menstrual cycle. Birth control pills are often prescribed continuously to treat endometriosis and work by temporarily preventing periods. Since periods can cause pain for young women with endometriosis, stopping periods will usually improve cramps and pelvic pain.

Lack of periods (“amenorrhea”) from low weight, stress, excessive exercise, or damage to the ovaries from radiation or chemotherapy: With any of these conditions, the hormone “estrogen” is not made in normal amounts by the body. Birth control pills may be prescribed to replace estrogen, which helps to regulate the menstrual cycle. For girls whose menstrual periods are irregular (too few or not at all), birth control pills can help to regulate the menstrual cycle to every 28 days and provide the body with normal amounts of estrogen. Normal estrogen levels are important for healthy bones.

Menstrual Cramps: When over-the-counter medications don’t help with severe cramps, birth control pills may be the solution because they prevent ovulation and lighten periods.

Premenstrual Syndrome (PMS): Symptoms of PMS such as mood swings, breast soreness, bloating, and acne can occur up to two weeks before a young women’s period. Birth control pills may be prescribed to stop ovulation and keep hormone levels balanced. Symptoms may improve, particularly when oral contraceptive pills are prescribed continuously.

Heavy Menstrual Periods: Birth control pills can reduce the amount and length of menstrual bleeding.

Acne: For moderate to severe acne, which over-the-counter and prescription medications haven’t cured, birth control pills may be prescribed. The hormones in the Pill can help stop acne from forming. Be patient though, since it takes several months for birth control pills to work.


Other Medical Benefits

Because there is less menstrual bleeding when taking birth control pills, you are less likely to get anemia (low number of red blood cells, which carry oxygen from the lungs to the tissues). Birth control pills also lower your chance of getting endometrial (lining of the uterus) cancer, ovarian cancer, and ovarian cysts.
(Sources: American College of Obstetricians and Gynecologists, and The Center for Young Women’s Health at Boston Children’s Hospital)

What do I tell older versus younger children?

Younger children

For younger children, it may be enough for them to understand how someone can become pregnant and that there are methods available to prevent pregnancy from happening.

Older children

When talking with older children, you will be more likely to discuss the various contraceptive methods that are available and the pros and cons of using each type.

Condoms are a barrier method of contraception. This means that they form a wall (or barrier) to prevent sperm or STDs from entering the body. Condoms are the only method of contraception that protects against both STDs and pregnancy.

What do I need to know to talk with my children?

Understand why using condoms is important

Condoms are the ONLY method of contraception that protects against both pregnancy and STDs.

Being able to convey how effective condoms are in preventing pregnancy and STDs and the consequences of not using condoms will be important for your child to understand and will likely influence their decisions to use condoms.


Male Condoms

  • Each year, 2 out of 100 women whose partners use condoms will become pregnant if they always use condoms correctly.
  • Each year, 15 out of 100 women whose partners use condoms will become pregnant if they don’t always use condoms correctly.

(Source: Planned Parenthood Federation of America)

  • Consistent and correct use of latex or polyurethane condoms is highly effective in preventing sexual transmission of HIV, the virus that causes AIDS.
  • Consistent and correct use of latex condoms reduces the risk for many STDs that are transmitted by genital fluids (STDs such as Chlamydia, gonorrhea, and trichomoniasis) and for genital ulcer diseases, (such as genital herpes, syphilis, and chancroid), only when the infected area or site of potential exposure is protected.
  • Consistent and correct use of latex condoms may reduce the risk for genital human papillomavirus (HPV) infection and HPV-associated diseases (e.g., genital warts and cervical cancer).

(Source: Centers for Disease Control and Prevention)


Female Condoms

  • If the female condom is always used correctly, 5 out of 100 women will become pregnant each year.
  • If the female condom is not always used correctly, 21 out of 100 women will become pregnant each year.
  • Female condoms reduce the risk of many sexually transmitted diseases, including HIV.

(Source: Planned Parenthood Federation of America)

Understand the types of condoms

A male condom can be used to cover the penis during any type of sexual act (oral, anal, or vaginal) to protect against sexually transmitted infections (STDs) and pregnancy. It prevents male semen from entering the partner. Condoms come in different sizes and can be made from a number of different materials.

  • Latex: Latex condoms are the most readily available and the most cost effective (about $1.00 each).
  • Polyurethane: For people who are sensitive to latex, polyurethane condoms offer protection. These condoms are made from a type of plastic.
  • Lambskin: Lambskin condoms are made from the intestines of sheep. This type of condom is not recommended for STD prevention.

 

Female condoms are another option for protection from both pregnancy and STDs. The female condom is a polyurethane sheath with flexible rings at either end that is placed inside the vagina or anus before intercourse. Female condoms are available in most places that male condoms are and cost about $3.60 each. Male condoms should NOT be used at the same time as female condoms.

Understand correct ways to apply and remove condoms

Adolescents will most likely learn about condoms at some point in their lives. However, it is most important that they know how to put on and take off a condom correctly. If a condom is not used correctly, then its effectiveness at preventing both pregnancy and STDs is compromised.

This video demonstrates how to correctly apply and remove a male condom.

Condoms should only be used ONE time. A male condom and female condom should NEVER be used a the same time. It is important to use a new condom each time you have sex.

If the condom breaks during sex, there are options for Emergency Contraception that can be considered.

How can you, as a parent, teach your child to negotiate condom use?

It is important to understand some of the things that can make it easier or harder for adolescents to discuss the decision to use a condom with their partner. These include:

  • Pressure from sexual partners, especially because partners might insist that they do not have STDs or that sex feels better without a condom.
  • Influence of the sexual behaviors of peers, siblings, other important people in the adolescent’s life, or even social norms in the community (for example, if an adolescent thinks most people they know are using condoms or not). Your child might take action based on what these people say they do.
  • Alcohol or use of other drugs like marijuana, cocaine, or anything else that makes it harder for an adolescent to think straight. Using these substances might make it harder for an adolescent to remember to use condoms, to use condoms correctly, OR properly address the potential issue of a condom breaking.
  • Using an alternative form of contraception to prevent pregnancy might influence your child’s decision to use condoms consistently.

 

It is important to talk with your adolescent about these things and help them think about how they can speak up to ensure they use condoms with their romantic partner, resist peer pressure, and negotiate their way through risky situations.

Encourage your child to have a conversation about sex with their partner before it actually happens. Having a conversation about how to prevent sexually transmitted infections and unwanted pregnancy should come a long time before sex, but sometimes it’s not discussed because one or both partners feel too embarrassed to bring it up.


Questions your adolescent might ask you:

My partner thinks I don’t trust him/her because I want to use condoms. What can I tell him/her?

You can reassure your partner that it’s not that you don’t trust them, but that you would feel a lot safer and less stressed if you used condoms every time you have sex. You can let them know that your health care provider wants you to protect yourself from HPV, herpes, and other STDs. Aside from protection from STDs, condoms can also prevent unwanted pregnancy. Even if the female partner takes oral contraceptives, it’s better to use two methods to prevent pregnancy. You can talk about how you don’t want (her) to get pregnant and would rather not stress about the possibility of getting pregnant after having sex.


My partner said that we don’t need to use condoms because I’m/she’s on the Pill.

You can tell your partner that although they’re usually 97-99% effective, the Pill is not 100% effective and you don’t want (her) to be one of the 1-3% that gets pregnant while on birth control. Also the Pill does not protect against STIs, some of which show no symptoms!


What if I feel uncomfortable talking about condom use?

Talking about condoms may seem a bit uncomfortable at first, especially if you don’t know how your partner will react. However, healthy relationships are based on trust and communication, so you should be able to talk about how you feel. Having a face to face talk about using condoms shouldn’t be a big deal, but if you feel that it would be easier to chat about it over the phone or via text message, do that instead. Any communication is better than none at all.


What if I’m afraid of my partner’s reaction when I tell him/her I want to use condoms?

In healthy relationships, when partners have problems they discuss them and work together to find a solution. If you’re afraid of how your partner might react, it might be a sign that you’re in an unhealthy relationship.


What if I already know my partner doesn’t want to use condoms?

Relationships involve two people, so why should your partner get to make the decision regarding condom use? Even if you already know that your partner doesn’t want to use condoms, you need to have a conversation about it. Be honest and state your concerns and the reasons you want to use condoms. You can also say, “No glove, no love.”


What are counter-arguments to my partner’s excuses?

  • If they say: “If you love me, you’d let me have sex with you without a condom.”
    You can: Make it clear that this isn’t a valid reason. For instance, you could have used the same line and said “If you love me, you’d use a condom,” but you didn’t. You came up with mature, valid reasons regarding your health and well-being.
  • If they say: “Stopping to put on a condom will ruin the mood.”
    You can: Tell them that this doesn’t have to be true. If you keep condoms nearby and/or come up with a fun way of putting them on, it can actually add to the mood instead of taking away from it.
  • If he says: “My penis is too big for condoms.” (Some guys actually say this, but it’s not true.)
    You can: Tell him that condoms stretch to accommodate different sizes. If he’s putting the condom on correctly and it really is too tight, there are brands of condoms that come in extra large. You can even offer to buy a pack for him.

 

For more conversation tips, check out this site or this site.

What do I tell older versus younger children?

Younger children

For younger children, it may be enough for them to understand that pregnancy or STD may result from having sex, and that condoms can help prevent these things.

Older children

When talking with older children, you will be more likely to discuss the types of condoms and how they are correctly used. You may want to share the video with them on how to correctly apply and remove a condom. And you will definitely want to be sure they understand how important they are and that they should insist on using condoms! Reviewing information and scenarios related to negotiating condom use may be very valuable.

As adolescents grow, they will experience many different kinds of relationships. It is important for them to understand what healthy and unhealthy relationships look like so they can make good decisions in their own relationships. Healthy relationships are fun and make people feel good. A healthy relationship can be with anyone in your life, including family, friends, and dating partners. Relationships take time, energy, and care to make them healthy. The relationships your child makes in their teen years will be a special part of their life and will teach them some of the most important lessons about who they are.

What do I need to know to talk with my children?

What makes a relationship healthy?

Communication and Sharing:

  • The most important part of any healthy relationship between two people is being able to talk and listen to one another.
  • You can share your feelings with the other person and trust that they will be there to listen and support you.
  • In healthy relationships, people don’t lie. Communication is based on honesty and trust.
  • By listening carefully and sharing your thoughts and feelings with another person, you show them that they are an important part of your life.

 

Respect and Trust:

  • In healthy relationships, you learn to respect and trust important people in your life. Disagreements may still happen, but you learn to stay calm and talk about how you feel.
  • Talking calmly helps you to understand the real reason for not getting along, and it’s much easier to figure out how to fix it. In healthy relationships, working through disagreements often makes the relationship stronger.
  • In healthy relationships, people respect each other for who they are. This includes respecting and listening to yourself and your feelings so you can set boundaries and feel comfortable. You will find that you learn to understand experiences and feelings of others as well as having them understand your experiences and feelings.

 

Common Interests:

  • You enjoy doing things together, but no one feels forced to do anything
  • If you have a disagreement- and it’s OK to disagree- you both get to say what you want, talk until you’re both happy, and then go out and enjoy what you’ve planned

 

Being with Each Other or Being Apart:

  • You enjoy each other’s company and feel happy when together
  • You want to feel free enough to have your own friends and interests outside the relationship

(Source: Center for Young Women’s Health)

Ways to make your relationship healthier?

  1. Show you really care by sharing your thoughts and feelings. Listen to what your partner has to say
  2. Talk about the other person’s interest
  3. Have a life outside of the relationship
  4. Resolve disagreements with love and respect

(Source: American Academy of Pediatrics)

 

What makes a relationship UNhealthy?

Many times a relationship can start out as healthy but become unhealthy over time. Not all unhealthy relationships are abusive, but sometimes they can include abuse. Also, a friendship or dating relationship can seem healthy at some times and unhealthy at others, and abuse often occurs in cycles.


What are the signs of an abusive or unhealthy relationship?

There are many signs of an abusive or unhealthy relationship. Take a look at this list of “warning signs” and see if these statements describe your relationship or a relationship your child is in.

These are just a few of the signs of an unhealthy or abusive relationship. Sometimes there are only one or two warning signs, and sometimes there are many. If any of these statements are true for your child’s relationship, you should talk to them right away.

Crossing The Line
Sometimes it can be hard to tell the difference between what is unhealthy, and what is abusive. There are, however, some things that should never happen in a relationship.

  1. Pushing, shoving, hitting, or kicking in anger
  2. Trying to control the other person’s behavior
  3. Forced or non-consensual sex (and here’s a great resource for talking to your child about consent at any age!)
  4. If one of you does not get your way, a threat is made to hurt either the other person or yourself

If the behavior in a relationship is “crossing the line”, the relationship is abusive. If you are having trouble ending a relationship, seek the help of an adult who cares about your well-being.

Helping your child understand how to engage in healthy relationships

Relationships are a way for your child to grow and learn about themselves and about what they are looking for in a partner. They are an important part of their development. As a parent, you will want your child to have healthy relationships. However, while children are developing into young adults, they deal with many emotional and physical changes. It is important to recognize when these changes are part of their development or are coming from unhealthy romantic interactions. In order to effectively intervene, your adolescent must feel respected and listened to. It is important for a teen to understand that they cannot fix their partner. Additionally, it is valuable for them to understand that jealousy, possessiveness, and physical harm do not signify love.

Communication between family, friends, and partners can be tough for teenagers. Encourage them to use the following steps to ensure that they have good communication as a basis for healthy relationships:


(Source: The University of Texas at Austin)

Parenting LGBT & Questioning Teens

It’s natural for teenagers to wonder if they are gay, lesbian, or bisexual. And in fact 1 out of 4 families has someone in it who is lesbian, gay, bisexual, or trans. The first step towards feeling comfortable talking about sexuality is getting comfortable with some terms.

Sexual orientation: What gender(s) a person is attracted to, sexually and/or romantically. Sexual orientation might change over time, but people don’t choose or decide to change who they’re attracted to.

  • A woman who is attracted to other women often calls herself gay or lesbian
  • A man who is attracted to other men often calls himself gay
  • People who are attracted to both women and men often called themselves bisexual
  • People who are attracted to people of opposite genders often call themselves heterosexual or straight
  • People who don’t have any sexual attraction to anybody often call themselves asexual
  • Some people don’t like to use these labels at all.

What’s the difference between sex and gender?

  • Sex is biological. It includes your genes, hormones, and physical parts (like genitals) that people use to determine if our bodies are female, male, or intersex (people whose bodies aren’t clearly female or male).
  • Gender is how society thinks we should look, think, and act as girls and boys, women, and men.
  • Gender identity is how we feel about our sex and gender and how we express those feelings by the way we dress, act, speak, etc.

What do transgender and cisgender mean?

  • Transgender is the “T” in LGBTQ. Some people have a gender identity that doesn’t match up with their biological sex — for example, they were born with “female” sex organs (vulva, vagina, uterus), but they feel like a male. People in this community sometimes call themselves transgender or trans. Don’t use terms like transgendered, tranny, or, he-she — they’re old-fashioned and can be hurtful.
  • Most people who have female bodies feel like girls or women, and most people who have male bodies feel like boys or men. These people are often called cisgender (or cis).
  • Trans can also include people who don’t identify with the strict or stereotypical male/female gender roles. Sometimes people who don’t feel either male or female call themselves genderqueer.

Reference: Planned Parenthood (https://www.plannedparenthood.org/teens/lgbtq/all-about-lgbtq)

How do I talk to my LGBTQ teen?

It is usually very challenging for teens to “come out,” or tell their parents they are gay, lesbian, bisexual, or transgender. They might be worried about losing their family and their home. That’s why the most important thing a parent can do if their teen comes out to them is to let them know they’re loved no matter what. You don’t always have to know what to say, you just need to show that you accept them and want to know them better.

If your child comes out to you, praise them for coming to you to discuss their sexuality, and encourage them to keep you in the loop. Ask them questions. Then, learn about what kind of support, services, and education are in place in your community so you can be an ally to your child. And always remember to respect your teen’s wishes by asking them for permission before you share their coming out story with others.

Learn more about how to support your LGBTQ teen here
Learn even more about supporting your transgender teen here
Learn more about CHOP’s medical and emotional support for your transgender teen here

Here are some other great resources if you want to learn more about the LGBTQ community:

GLSEN
The Trevor Project
Planned Parenthood
My Kid is Gay
PFLAG

Here are some great activities and exercises:

These may help your teen learn more about healthy versus unhealthy relationships.

Cool or Not Cool Quiz

Are We Right for Each Other?
Questions to consider for adolescents starting, staying in, or ending a relationship

Relationship Checkup Quiz

What do I tell older versus younger children?

Younger children

Even younger children should be taught to tell the difference between healthy and unhealthy relationships. You can talk about their friendships and the differences between good and bad friends.

Older children

As children get older, it more important that they understand how to find a healthy relationship or navigate their way out of an unhealthy relationship.

STD or STDs stands for Sexually Transmitted Infection or Disease. These infections can be passed from one person to another during sexual activities. There are different types of STDs. Most STDs can be prevented by using condoms, some can be treated and cured, and some stay with you for life.

What do I need to know to talk with my children?

Understand types of STDs and how they are treated

There are many different types of STDs and while they are all treatable, they are not all curable. STDs can be caused by bacteria, viruses, and parasites.

  • Bacteria are microscopic germs that can live by themselves by feeding off of their surroundings. They can be treated and cured by antibiotics. Examples of STDs that are caused by bacteria are gonorrhea, chlamydia, and syphilis.
  • A virus is a germ so small that it cannot be seen under a microscope. They cannot live on their own; they must live inside another cell to be able to reproduce. They are harder to treat than bacteria and are not curable. Examples of STDs that are caused by viruses are HIV, herpes, and genital warts/HPV.
  • Parasites are tiny little animals that live on or in our bodies and benefit at the expensive of human health. They are dependent on our bodies for survival. Examples of STDs that are caused by parasites are pubic lice (crabs), scabies, and Trichomoniasis (Trich).

 

Visit this site for more information about the various types of STDs and how they are treated.

Understand how STDs are transmitted

STDs can be passed from one person to another during sexual activities. This includes vaginal, anal, and oral intercourse. STDs are either passed by fluids (for example- semen, vaginal fluids, blood) or through skin to skin contact. There are STDs that can be transmitted even without penetration, so if you are having contact with another person’s genital area, even if you are not “having sex,” you may still be at risk of contracting an STD (e.g. HPV, herpes). Adolescents who have multiple sexual partners or change partners often, have unprotected sex, or take part in other high-risk sexual behaviors are at greater risk of getting an STD.
(Source: U.S. Department of Health and Human Services)

  • STDs are NOT passed through urine, sweat or tears.
  • STDs are NOT passed through casual contact like hugging, hand holding, sharing drinks, clothes, toilet seats, or towels with someone who is infected.

An STD can be passed among multiple partners over time, if it’s not treated or cured. Here’s how that could look:

You might want to have your teen consider the following stats:

If you had unprotected sex with three people per year, and they each had unprotected sex with three others per year, after four years you will have been potentially exposed to 635 Sexually Transmitted Infections.

If you had unprotected sex with 10 people per year, and they each had unprotected sex with 10 people per year, you will potentially have been exposed to 135,000 Sexually Transmitted Infections.
(Source: University of Washington)

Here’s a picture to help you understand how exposure to STDs works. Even if an individual has just one partner, they may be exposed to an STD based on their partner’s previous contacts:

Understand how STDs are prevented

This is an easy one. Most STDs can be prevented by abstaining from sexual activities or by correctly and consistently using condoms. STDs can also be prevented by getting tested regularly, and by knowing if your partner(s) also get tested regularly. Specifically, the risk of HPV can be reduced by the HPV vaccine, and HIV risk can be significantly reduced with PrEP (pre-exposure prophylaxis).

What do I tell older versus younger children?

Younger children

For younger children, you can provide a general definition of an STD and maybe list the main types. More importantly, be sure they understand that STD transmission is a risk associated with having sex.

Older children

Older children will be more ready to understand the difference between bacterial, viral, and parasitic STDs and whether and how different STDs can be treated. Reinforce that abstaining from sex or using condoms correctly and consistently are the only two ways to reduce the risk of infection. You may want to provide your child with resources, such as where to get condoms or get tested for STDs.

Abstinence means that a person makes the choice to not have any sexual contact with another person. Abstinence is the only choice that works 100% of the time to prevent pregnancy and sexually transmitted infections. Your child will need to decide if they will remain abstinent.

What do I need to know to talk with my children?

Facts about abstinence

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How you can help your adolescent remain abstinent

It is important that your adolescent understands that they are the one in control of their decision to be abstinent and that they always have the choice to decide to hold off from having a sexual relationship.

It is also important that you let your adolescent know that many people find that practicing abstinence can be hard at some point in their life. Abstinence is therefore a choice that they will need to make every day. Practicing abstinence takes self-control and responsibility.

Adolescents find it easier to stay abstinent if they are clear in their own minds about their reasons for making this choice. This way, if they find themselves questioning their choice to be abstinent, they can remind themselves of all the reasons why they decided to be abstinent.

As a parent, you can help your adolescent by encouraging them to think about the advantages of being abstinent and identify their own reasons for making this choice. The next few paragraphs describe topics you can discuss with your child to help them think this through.

It is important that your teen decide what they want to do about sex at a time when they are feeling clearheaded, sober, and good about themselves. The first time they think about whether they want to be abstinent or whether to have sex should not be when they are faced with making a decision in a sexual situation.

It is helpful to decide in advance what sexual activities (if any) your child is willing to participate in with another person. They should take time to consider exactly what being abstinent means to them. It is also beneficial if your adolescent plans ahead for how they will say “no” to sexual activities, when faced with a sexual situation. They should think about things they can say or do that will tell another person that they do not want to have sex. You should help your adolescent to practice these words or behaviors out loud. Let’s think about it, the first time a doctor does a surgery, do you think they practiced? Yes! So help your adolescent to practice handling a sexual situation to be sure they know how to make a healthy choice.

They should know what kinds of situations make it more likely that sex may happen – such as being alone or getting into the back seat of a car. Things that make it hard for your child to think clearly— like drugs or alcohol – will also affect whether they are able to stick with their decision to be abstinent.

Remember, everyone is abstinent for some time during their lives. And many people become sexually active during their late teens and young adulthood. As a parent, you can help your child to make a well thought-out choice regarding their mind, body, and sexual health.
(Source: Dawn Stacey, PhD,  verywell.com)

 

This video also provides helpful tips for helping your child remain abstinent.

True or False?

Once a person has had sex, that person can never choose abstinence.

Answer: False. Abstinence is always a choice for anyone at any age.

Abstinence means a person cannot have any feelings of attraction toward another person.

Answer: False. Having sexual thoughts and feelings is completely normal, but a person does not have to act on them.

Peer pressure is never a good thing.

Answer: False. Peer pressure can also encourage your child to make healthy decisions, like choosing abstinence.

What do I tell older versus younger children?

Younger children

For younger children, you can help them understand that most people don’t start having sex until they are older teens/young adults and that abstinence is a choice.

Older children

For older children, you can discuss the main benefits and challenges of staying abstinent, strategies for staying abstinent, and what to do if they decide to no longer remain abstinent (condom use for STD prevention, contraceptive use).