Your Questions Answered
I am a mother raising two adolescents, a daughter and a son, and I am faced with the questions of when should my daughter start seeing a gynecologist and how do I help both my children make good and safe decisions regarding sexual activity?
Though there may be different strategies in how and when to communicate with our growing children and adolescents, it is likely that every parent wants for their child to view their body and sexuality in a positive light, and in a way that ensures their safety and good health.
To answer the first question – when to bring your daughter for her first pap and gynecologic exam – we typically suggest that an adolescent has her initial gynecologic exam at the age of 18, or sooner if she is sexually active or is planning to be sexually active. There is, however, no absolute need for an actual exam/pap to take place by 18 if she is not sexually active, has no plans to be, and has no gynecologic concerns or issues. Sometimes just a conversation provides all that is needed at that time. It is always a wonderful opportunity for an adolescent to be seen at around age 18 (or earlier), just to talk about her developing body, to answer any questions that she may have, and to establish a safe environment that she can return to for future care.
Addressing some of the more specific questions pertaining to children, adolescents, and sexual development, we are taking the opportunity this month to review a book titled Sex and Sensibility: The Thinking Parent’s Guide to Talking Sense About Sex (2001) by Deborah Roffman. A veteran sex educator, Deborah Roffman provides an inclusive and exhaustive look at where we’ve been and where we’re going (culturally speaking, in the U.S.) as relates to our ability to converse effectively about sex with our growing sons and daughters. Her book Sex and Sensibility covers a range of topics, across a range of ages in development. Roffman concretely answers questions about how much and what kind of information is too much or too little for developing children of different ages. She re-defines “sex” in a way that promotes an understanding of the many layers of “sexuality,” challenging the notion that sex is just about intercourse. There is careful attention paid to the complicated overlay of values and sex – and Roffman competently tackles issues relating to how we educate our youth in a setting of conflicted values. She points out that generally speaking, we as adults/parents/educators are failing to meaningfully discuss sex. This is a complete contrast to the reality that children are growing up in a world bombarded with images and messages about sex in music, TV, film, and advertising. Our own inability to communicate about sex creates an environment of silence, and this void is filled by the media.
Roffman talks a great deal about the challenges in effectively imparting positive sexual decision-making skills in an adolescent population. As an example, adolescents are typically concrete thinkers, and have a more difficult time with hypothetical or abstract thinking. Therefore, a teenager who finds himself/herself in a sexual situation is likely to avoid the concrete or very tangible danger such as the fear of looking “uncool” or of feeling embarrassed. The abstract or more invisible concern of becoming pregnant or acquiring a sexually transmitted infection is hypothetical, and therefore more difficult to grasp, and therefore less likely to be avoided in that same scenario. This creates a huge potential for unsafe decision-making and negative consequences. Though the challenges in encouraging adolescents to make safe and healthy decisions are many, Roffman provides an enormous amount of information and guidance aimed at helping the adult or parent do so.
Wonderfully, Deborah Roffman is able to leave the reader feeling empowered and educated in the topic of sexuality itself, and in the art of talking with a child or adolescent at any stage about sex. It is not a quick or simplistic read, but one that delves honestly and informatively into the many layers of the topic of talking with our children and adolescents about sex.
For more information or suggestions, feel free to contact one of us at Harbour Women’s Health.