If there’s anything that gives parents and their offspring a collective shudder of embarrassment, it’s “the talk.” It may seem easier to surreptitiously place a copy of a book about procreation on your child’s bed and hope they read it, but the absence of an open, age-appropriate dialogue about sex can lead to mental and medical problems down the road. For advice on holding a dialogue that is age- and family-appropriate, we spoke with Dr. Mike Mehrvarz, an adult and child psychologist at International Medical Center Beijing (IMC). We also spoke with Dr. Lyn Wren, a family physician and maternal and child health specialist at International SOS, for advice on ensuring that teens remain in optimal sexual health.
An Open Door Policy
Dr. Mehrvarz emphasizes that when establishing and maintaining an open, trusting dialogue with your children: “It all comes back to the parents. Leave the door open to your children.” He recommends a weekly family meeting, in which all family members talk about important family issues, including school, friends, and other pertinent topics. The regular communication will provide a platform for discussions about sex later on.
Actually feeling at ease talking to your kids about sex is another matter entirely. Having a truly open dialogue with your child requires taking a look at your own sexuality. Dr. Mehrvarz suggests asking yourself, “What’s so embarrassing to me about sexuality?” and really thinking about the answer. “We are all human; we have the same needs and desires,” he continues. “Find your embarrassment issues and understand that. If you need professional help, make sure it’s taken care of before you talk to your child.”
Kids can sense your embarrassment; if your hands start to shake and your ears turn red because you’re nervous or embarrassed, your kids will pick up on that and get the impression that sex is something to be embarrassed about.
This doesn’t mean that parents should try to adopt an attitude far more liberal than their beliefs; it just means that parents need to be comfortable enough to forgo judgments and teach their kids about anatomy, bodily functions, and later, the consequences of sex and the finer points of preparedness.
Building Up to “the Talk”
An open discussion about sex can work within any culture or religious beliefs, and Dr. Mehrvarz recommends that the initial discussion cover general anatomy a few years before a child hits puberty. Emphasize that physical changes, like erections or menstruation, are a natural part of growing, that you’ve been through it, and that a child can return to ask questions at any time.
“It’s important to remove embarrassment and taboo about sexuality in a child’s mind,” explains Dr. Mehrvarz. This ensures that kids are informed, and it can help [deter]problems down the road. He reminds parents that kids going through puberty are lonely, confused, scared, and embarrassed, “[so]it’s important for kids to be nurtured in the right direction and be positively guarded. Kids are naïve and we have to prepare them to face life. Hang-ups about sexuality cause problems later, and then it’s [the psychologist’s]role to fix those problems.”
Further conversations should cover hygiene, sexually-transmitted infections (STIs), and pregnancy. As kids age, discuss how to know when you’re ready to have sex, what to do if you feel pressured to have sex but aren’t ready, and what to do if you are the victim of sexual harassment or unwanted sex. Desire is another important but difficult topic. Dr. Mehrvarz approaches it this way: “When we are thirsty, we drink water; when we are hungry, we eat food. We also have this feeling of desire that we need to nurture when the time comes, but you have to take your time and be with the right person at the right time.” Work within your family’s beliefs and morals to establish ground rules, and do your best to reserve judgments.
Instituting Birth Control
Dr. Wren explains: “Studies show many teenagers engage in sexual activity that is not planned ahead of time.” Hence, education about birth control methods and STI prevention is vital. How active a role you take in procuring birth control for your teen is up to you. If you feel comfortable providing your teen with condoms or birth control, that’s your decision; but avoiding the subject of birth control altogether can be detrimental to your teen’s health. Just because they have
access to birth control doesn’t mean they’ll have sex, and the converse is similarly true.
“The age at which teenagers begin having sex depends on many factors, including cultural variations, social trends, and individual personality,” says Dr. Wren. “Studies suggest that the main advantage of teaching teens about safe sex and giving them access to birth control is a significant reduction in the risk of STIs and unplanned teenage pregnancy.” She continues to say, “If they are not comfortable talking to you, support them in seeking medical advice.” It’s essential to keep your child’s health a priority. If you and your teen decide to pursue birth control, take him or her to the doctor, who can help choose the best and safest birth control option for your child. Oral contraceptive pills (OCP) are a common choice for teenage girls, but Dr. Wren doesn’t recommend taking it without seeing a doctor first.
The HPV Vaccine
In many countries, the most common STD for men and women is the Human Papilloma Virus (HPV). HPV is often asymptomatic, and several types of HPV cause cervical cancer.
Be aware that there is controversy surrounding the HPV vaccine, but Dr. Wren explains: “When the vaccine was new, there was a perception that it was not safe, as some teens experienced side effects. But governing bodies like the Center for Disease Control and Prevention (CDC) in the US continue to review the safety data for all vaccines and there are currently no new safety concerns regarding the HPV vaccine.”
The CDC and organizations in other counties recommend the HPV vaccination, which significantly reduces the risk of cervical cancer. It protects against some, but not all, strains of HPV, so make it clear to teens that condoms are still essential to preventing STDs. In the last few years, the USFAD recommends the vaccine for boys aged 9 to 26 and for all girls (as early as age 9, according to the USFDA), though Dr. Wren recommends the vaccination at 11 to 12 years old for girls.
Getting the vaccine takes some planning. It’s a three-part vaccine injected over the course of six months: the second dose should be
administered two months after first dose, and the third dose six months after the first dose. Dr. Wren notes, “[It is] not part of the routine
vaccination schedule in Mainland China and is therefore not available.” She advises that children be vaccinated while visiting their home country or traveling in a country where it’s available.
When the Deed Is Done
If you find out that your teen is already sexually active, remaining calm is paramount. “If you yell, you’re going to have backlash,” cautions Dr. Mehrvarz. “You need to nicely and calmly talk about what happened, how it happened, discuss protection, and make sure the child is not being abused by an adult.” He emphasizes logic, because when we get too emotional, productive communication goes out the window. “If the child is comfortable,” says Dr. Mehrvarz, “[he]will be open to you more, and will listen to your constructive advice.”
Once girls have become sexually active, Dr. Wren recommends a yearly checkup with a doctor who has expertise in women’s health, during which the doctor is likely to screen for “silent” STIs like Chlamydia. After two years of sexual activity, or by the age of 21, girls should start getting Pap smears regularly, a test that checks for abnormal cells that may become cancerous later in life. Boys or girls who have multiple partners or unprotected sex should be screened for other STIs as well.
No matter how old your child is, it’s not too early to start thinking about how to discuss any topic. Start communicating now, look within yourself, and remember that an imperative part of raising a happy, healthy child is keeping an open door of communication.
International Medical Center Beijing 北京国际医疗中心
Child and adult psychologist Dr. Mike Mehrvarz speaks English, Mandarin Chinese, Farsi, and conversational Japanese.
Daily 24hrs. S106, S111, Lufthansa Center, 50 Liangmaqiao Lu, Chaoyang District (6465 1561/2/3, counseling hotline 158 0131 9796, firstname.lastname@example.org, email@example.com)
International SOS 国际救援中心
Family physician and maternal and child health specialist Dr. Lyn Wren speaks English.
Daily 9am-6pm. Suite 105, Wing 1, Kunsha Building 16 Xinyuanli, Chaoyang District (Clinic: 6462 9112, 24hr hotline 6462 9100, firstname.lastname@example.org)
www.internationalsos.com, www.clinicsinchina.com 朝阳区新源里16号琨莎中心一座105室
photo by LOVA