Beyond the birds and the bees: talking to your child about contraceptives

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Raising a teenager is challenging. From the incessant social media consumption to the hormonal surge, now you have to talk about sex? 

Texas Children’s chief of pediatric and adolescent gynecology, Dr. Jennifer Dietrich has five helpful tips for having this conversation with your teen.

When do I need to talk to my child about sex?

A 2017 statistic from the Centers for Disease Control and Prevention showed that about 2% of girls and 4.5% of boys report having been sexually active under age 13. In the early high school years (grade 9), 17% of girls and 23% of boys report sexual activity. This number increases to approximately 55% and 58% respectively by grade 12.

These numbers are not meant to scare you, but to inform you that because teens are often exposed to information early in life, it is ideal to start having the conversation before age 13 to encourage them to ask questions early and to keep them safe and healthy.

How should I approach my teen about sex and contraceptives?

The most important thing is to encourage an open and honest conversation. Ultimately, you want your teen to come to you first for information and for your teen to feel like you will be open to talking about it, rather than hearing things through peers or the internet first.

Sometimes teens will ask questions after having a health class and that is a perfect time to discuss things if your teen is already asking questions about sex. Another option is to start the conversation when you have some quiet time together on the weekend. It may be a good time not only to talk about school and friendships, but about whether teens her age have started to talk about sex, birth control and sexually transmitted infections.

It is always a good idea to let the teen talk about what he/she knows first. From there, the conversation can cover these important topics based on how you feel your teen responds to the information, how interested he/she is learning more and what topic is important for him/her to learn more about.

What do I need to address when talking to my child about sex and contraceptives?

Important topics to cover include contraception, sex, safety, partner violence and sexually transmitted infections. This can feel like a lot to cover at once and can quickly overwhelm you and your teen, so don't feel pressured to cover all the topics at once.

It is helpful to have a series of discussions. Sometimes teens may not engage in all of the information and may be ready to hear just a smaller portion of it. Repetition is also helpful to reinforce the information already discussed. For example, you may use a scenario in a movie to discuss what a healthy relationship looks like or vice versa. The goal here is to keep the communication lines open as this may also help relive any pressure build up you may have about having "the talk" with your teen.

What do I need to know about contraceptives?

There are many different contraceptive options to fit teens’ needs these days. The most effective forms of contraception are the long-acting reversible contraceptives, such as the hormone implant and the intrauterine device (IUD). These are most effective as they last for three years and up to 10 years, depending on the type of IUD chosen. Other options include injectables, combined rings, combined patches or oral contraceptive pills, which come in single or double hormone forms. There are also emergency forms of contraceptives available.

Finally, it is very important to stress that while contraceptives are effective for birth control, they do not prevent sexually transmitted infections. It is therefore always important to review the importance of barrier forms of contraception to prevent transmission of sexually transmitted infections.

There are many wonderful resources online. For patients interested in more information, the North American Society for Pediatric and Adolescent Gynecology (NASPAG) has a number of handouts directed at common questions about hormonal contraceptives: https://www.naspag.org/page/patienttools.

Do I need to take my daughter to a gynecologist?

The American College of Obstetricians and Gynecologists (ACOG) recommends adolescents see an OB/GYN between the ages of 13-15 years. This allows providers to not only answer questions about puberty and periods, but also to provide anticipatory guidance related to health behaviors.

The major thing is not judging the preteen or teen who is asking questions about contraception. The teen is looking to a parent as a role model during this challenging time in their life and it is wonderful they want to approach you about it.