“The Talk”: Discussing Sex, Drugs, and Risky Behaviors with Your Teenager

For some parents, it’s their worst nightmare: sitting down face-to-face with their teenage son or daughter to have the dreaded conversation about sex, drugs, and other risky behaviors. In fact, it can be so intimidating for some parents that it even has a name. But “the talk” doesn’t have to be so difficult. And believe it or not, your child’s pediatrician can help.

Annual well visits are a great time for doctors to promote a wide range of healthy behaviors. From diet and exercise to sex and seatbelts, these checkups present a prime opportunity for doctors and teens to talk about the dos and don’ts of a healthy lifestyle. However, recent studies suggest that “the talk” doesn’t happen often enough – at home or at the doctor’s office.

A study in the Journal of American Medical Association (JAMA) Pediatrics found that less than two thirds of doctors talk to teenage patients about sex, drugs, and other sensitive topics. The study goes on to say that of the doctors who do talk to teens about risky behaviors, they only spend about 30 seconds of a 22-minute appointment on the topics.

The findings are an important reminder for parents and physicians alike: Together we need to do a better job of informing our kids about risky behaviors.

When to Have “The Talk”

Many parents wonder when it’s appropriate to start having these conversations. Because all kids mature at different ages, I encourage parents to use their judgment to determine what makes sense for their individual child. However, the American Academy of Pediatrics recommends that physicians begin talking to their patients between the ages of 12 and 17.

Preparing for the Visit

Prior to the visit, call your child’s pediatrician and ask him or her what will be discussed. Make sure the physician is aware of any personal beliefs. For instance, if you believe in abstinence, let the doctor know. Conversely, if you want your child to practice safe sex, let the doctor know that it’s okay to discuss birth control options. This is especially true if you know or believe your adolescent is sexually active.

What to Expect

In order to ensure an open and honest discussion, it’s important that parents step out of the room for this portion of the appointment. If your doctor does not ask you to leave, volunteer. This will encourage your teen to talk openly.

Below is a list of topics your teen may discuss with their pediatrician:

• School concerns
• Social concerns (lack of friends, bullying, negative peer influence)
• Emotional concerns
• Family concerns
• Difficulty managing anger
• Depression
• Sexuality
• Substance abuse
• Tobacco use
• Dangerous behaviors and safety precautions (drunk driving, texting while driving, use of seatbelts and helmets)
• Medical concerns
• Weight and body image
• Physical activity
• Proper nutrition

Following Up

Once the appointment is over, parents are primed to have their own discussion. You can start by asking some basic questions. Do any of your friends smoke? Do any of your friends have girlfriends? What would you do if one of your friends had a few beers and decided to drive?

Use these questions to encourage your child to talk, letting them know that it’s okay to share information with you. If they don’t feel comfortable answering you face-to-face, tell them they can text or email you.

For parents and pediatricians alike, talking to teens about these topics may seem a bit scary, but if you have the conversations often and encourage a constant dialogue, your child will be equipped with the information they need to make good choices.

Photo by Anton Petuckhov / CC BY