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Talking with Your Son or Daughter About Sex

The "facts of life" are just the beginning. Make sex education a part of family life from the start, and keep the lines of communication open at all ages.

By Maria Ringel

The following is reprinted with permission of THE FEMALE PATIENT®. It originally appeared in THE FEMALE PATIENT®. 1999;S16:6-10.

Guiding kids through the labyrinth of sexuality in the ‘90s and beyond isn't a one-shot deal. It's a long-term project that begins when your children are very young and extends through their teen years and beyond. Like many long endeavors, however, the rewards are great. Responsible parents can pave the way to a happy, healthy future sex life for their children—when the time is right.

Kids may not admit it, but they need lots of help learning to navigate their sex drive. Don't let embarrassment prevent you from helping your child make the tough sexual decisions of adolescence and beyond. "Preparing children for adulthood is one of the most important things we do as parents," says Debra W. Haffner, MPH, President and Chief Executive Officer of the Sexuality Information and Education Council of the United States (SIECUS) in New York City.

Communicating or Condoning?

Some parents fear that discussing sex is tantamount to condoning it. That just isn't so. There is no evidence, even after hundreds of studies of the issue, that talking about sex makes kids want to go out and experiment. In fact, studies show that when parents talk about sex, children are more likely to talk about it themselves, to delay their first sexual experiences, and to protect themselves against pregnancy and disease when they do have sex. Research suggests that teens who felt closely connected to their families were less likely to have sex at an early age or to engage in other risky behaviors than were those who felt more distant from their families.

Your child will hear about sex from someone; shouldn't it be from you? As Cynda Ann Johnson, MD, MBA, Professor of Family Medicine and Obstetrics and Gynecology at the University of Kansas Medical Center in Kansas City, tells parents, "This stuff is everywhere. Do you want to get your two cents' worth or don't you?"

It's natural for parents to feel uncomfortable talking to children about sexuality, according to Felix Gardon, outreach coordinator at SIECUS. But by avoiding such conversations, you will indirectly be telling them you are not willing to talk. By approaching the issue when your children are still toddlers, you will have the opportunity to talk first about more comfortable issues like love and responsibility, and then, as they grow, to eventually discuss complex issues such as relationships and sexual behavior.

Parent-Child Dialogue

Effective parent-child communication is the basis of a continuing dialogue about sex, says Barbara Kemp Huberman, RN, BSN, MEd, Director of Training and Sexuality Education at Advocates for Youth, a Washington, DC, organization that's dedicated to helping young people make safe, responsible decisions about sex. Be truthful, advises Ms. Huberman. Admit when you don't know something and offer to look up the answer together. Always respond in a caring way. Don't suggest to a child that there's shame attached to asking questions. On the contrary, say, "I'm glad you asked me that. Let's talk about it."

Urge your children to ask you about the truth of things they hear from their peers. You'll be amazed at the fallacies your child has been told. And don't wait for a "right time" to raise topics and answer questions. "Kids raise questions at the funniest times," says Dr. Johnson, the mother of two boys. Bedtime is a favorite. Though you may want to turn off the light, she says, "Seize the moment. If you wait, it's gone."

Share Your Values

Share your values and beliefs with your kids, and explain the reasons behind them. A good ice-breaker for discussions of sexual values is the behavior of characters in TV shows and movies. Use popular culture and current events as a springboard for discussing sexuality issues, such as homosexuality (see "Don't Hush Up Homosexuality"). President Clinton's sexual encounters provided "some of the most incredible teachable moments" of recent years, Ms. Huberman notes.

What to Say When

Don't try to tell your kids everything in one fell swoop," advises Dr. Johnson. Grade schoolers, for example, can absorb only one take-home point per conversation. Dr. Johnson starts talking to patients at age 5 or 6 (see "What to Say and When to Say It"). She asks parents for permission to talk with their kids long before they become sexually active. Her repeated invitation to talk "if things change in your life" has been rewarded with many calls and visits from teens, she says.

Talking with your kids about sex from the earliest ages also has a practical side: It helps protect them from abuse, molestation, and coercion. Even young children need to be able to resist lures from older children and adults. Protecting kids from predators involves some explanation, because, as Gregory Brotzman, MD, Associate Professor of Family and Community Medicine at the Medical College of Wisconsin in Milwaukee, reminds parents, most pedophiles are family members and neighbors—not strangers. "My three kids know that nobody touches them in their private parts," comments Dr. Brotzman. Instruct your children to tell you if something weird happens, and that "secrets" are not a good thing.

SIECUS advises that you begin talking with infants and toddlers by helping them name all the parts of their body. Answer preschoolers' questions about their bodies, health, and sexuality. Young school-age children can understand more complex issues about health, relationships, and sexuality; answer their questions about how a woman becomes pregnant, how a fetus grows, and so on.

As the age of puberty drops and drops—the average is now 11½, and earlier for African-Americans—you need to start preparing children by age 8 or 9 for that significant change. Explain breast development, hair and body changes, menstruation, and a need for deodorant. Reassure your child that since physical development occurs at different ages in different people, what's happening (or not happening) to them is normal: "Your body is special and unique. When you're ready, it will happen to you." Remind them that the feelings they are starting to have, or will have, are normal.

In fact, "Am I normal?" is the unspoken concern underlying many sex questions from kids. They need to hear that sexual desire and intimacy are a natural, healthy, joyous part of a loving relationship—when they're ready.

The Sexually Maturing Child

Physical maturation may lead kids to try sexual relationships that they're unprepared to handle emotionally. You might tell your daughter, "You've reached puberty and you may be attracted to older boys. But believe me, you're not ready for that."

To set rules and standards is hard, Ms. Huberman grants, but it's also very important. "The earlier you allow your children to participate in adult behavior," she points out, "the earlier they will move up the ladder [of responsibility]." American society has dropped the "age markers" that communities once made clear, Ms. Huberman says, such as when a girl may wear makeup. She suggests joining forces with the parents of your daughter's friends to make such decisions together.

In Dr. Brotzman's view, forbidding dating before age 16 relieves pressure on kids. "You can say, ‘Just because you want something, that doesn't mean it's good for you,'" he suggests. "Kids don't have enough role models saying, ‘This is not the time or place for sex.'" Parents need to give kids permission not to have sex before they're ready, agrees Dr. Johnson. Plenty of kids want to hear that it's OK to abstain, she asserts.

Discourage premarital sex if you disapprove of it, says SIECUS's Ms. Haffner, but add that if sex occurs, it's important to protect oneself against pregnancy and disease (see "Discussions on Birth Control"). Is that a mixed message? Maybe so, she replies, but so is other good advice, such as, "I don't want you to drink, but if you do, call me and I'll pick you up."

Discuss sexual relationships before your child gets involved with someone so that your comments would not be seen as disparaging a specific person. Idealistic kids can't imagine the deep emotional perils of sex gone wrong. Explain that even nice people can be insincere in the pursuit of sex. Use experiences from your own life: "When my best friend had sex in high school and her boyfriend dumped her, she felt used, as if she didn't matter."

Feel free to decline to answer questions about your own behavior, such as, "Were you married to Mom (or Dad) the first time you had sex?" How much you share is up to you.

Each year, as your children grow, you'll have less control over them. The smartest approach, Ms. Huberman advises, is to state, "This is going to be your decision one day. I just want to say that I hope your first sexual experience will be in a loving, honest relationship."

Know where your child goes and what's happening among his or her friends. Stay involved in your child's life, says Ms. Haffner. That goes for drinking, drugs, and other issues as well as sex, she adds.

'My Kid Would Never . . .'

Nearly half (49%) of high school students have had sex, and more than half (58%) of that group don't use birth control regularly. Although teen pregnancy rates are dropping, a million teens still become pregnant every year. Almost all of those pregnancies (95%) are unintended, and almost a third end in abortions.

Dr. Brotzman sees many girls in his practice who become pregnant at age 13 to 15. "Assuming that nothing is going on because you're not talking about it is not a very good deduction. Nothing could be further from the truth," he warns.

"If your child is going with somebody, there's a pretty good chance he or she is having sex," adds Ms. Haffner. "It's time to talk about contraception if you haven't already" (see "Emergency Contraception"). If a teenager has been dating the same person for some time, start a conversation about relationships, Ms. Huberman suggests—something along these lines: "I know you don't want to hear this, but please humor me. I don't think it's appropriate or healthy for you to have sex right now. But if you do, you don't have the right to risk disease or pregnancy for you or your partner." Boys shouldn't assume girls are on the Pill; girls shouldn't assume their boyfriends will use condoms.

Boys Will Be Boys?

Our society often sends out the message that promiscuous sex is okay for boys. Make it clear to your son that it isn't okay. "Boys want connectedness with someone who cares about them," says Ms. Huberman. Teach them to keep sex in a caring framework and to protect themselves and their partners with condoms. These assertions "carry a lot of weight when the parents, not someone else, are telling them."

Where to Turn for Help

Keep one or two age-appropriate books about sex on hand. Read them first to be sure you agree with their philosophy. Older kids generally prefer Web sites and videotapes. Be sure to look at them before the children do.

Most states offer sex education in school, but the lessons vary tremendously. Find out whether the curriculum taught in your child's school jibes with your family's values. "Schools are good at teaching safe sex, but they're not as good at helping kids make choices," Dr. Johnson says. "Teaching morality is the parent's role."

Visit your religious institution's library for guidance on sexuality. Your community school may offer classes for parents struggling to help their children learn about sexuality. Or turn to a YMCA/YWCA, school psychologist, guidance counselor, or teacher.

Your family doctor is another good resource. If his or her values about sex match your own, your child will always have a knowledgeable guide for information and help. When young patients visit Dr. Johnson to get birth control pills, she tells them, "I think your mother would be supportive, so talk to her."

Teens often seek out adults other than their parents to discuss sensitive matters like sex. Don't feel rejected, Ms. Huberman advises. Instead, encourage your teen to talk with those people. Kids' reluctance to confide in their parents has less to do with fear than with tarnishing Mom or Dad's image of them.

It Bears Repeating

It's never too late to open the door to communication. "If you haven't talked about these issues," Ms. Huberman advises, "start today."

A secret to successful sex education at home: "Repeat, repeat, repeat," Ms. Huberman says. Kids ignore what they can't absorb at the time, and you can't expect what you said when they were 6 or 7 to stay with them in the heat of the moment at 16.

"Sex education is a lifelong process," Ms. Huberman observes. "You can never give too much information if you're honest and it's coming from the heart."

Marcia Ringel is a freelance medical writer in Ridgewood, NJ, and a frequent contributor to this journal.

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