'The Talk'

Talking with your kids about sex may be uncomfortable, but here are some tips to help make this important conversation easier.



Hello!

My name is Corey Babb, and I’m an OB/GYN with OSU Physicians, as well as the Director of the Oklahoma State University Center for Women’s Sexual Health.  For my last blog in this series, I’m going to address something that most parents dread, the “talk.”  Talking with your kids about sex may be uncomfortable, but I’m here to give you some hints and tactics that can make it less awkward.  I’ve organized this blog into “topics,” so if you’re just looking for a specific area, you don’t have to search the entire text.

Anatomy

“Boys have a penis, girls have a vagina.”  Thank you, Kindergarten Cop.  I’ve talked about female anatomy in a previous blog, but in case you didn’t get to read it, here’s the short version. 

The female reproductive system is entirely internal and is composed of the ovaries, uterus, and vagina.  The ovaries are two grape-sized organs that produce hormones and release an egg during ovulation.  Two fallopian tubes connect the uterus and ovaries and transport eggs into the uterus, a pear-shaped organ that houses a baby during pregnancy.  The cervix joins the uterus to the vagina, which is a muscular tube that is open to the outside world.

The male reproductive system, on the other hand, is different in that the majority of it lies outside the body.  The testicles, a pair of egg-shaped glands, are contained within the scrotum and kept away from the body to allow for sperm growth and development.  A set of tubes called the vas deferens connect the testicles to the urethra.  The male urethra, unlike the female, transports both urine and semen and connects to the outside world by way of the penis.

If you need a more visual refresher, here are some resources that contain easy-to-read, yet anatomically sound, diagrams. 

Anatomy diagram #1

Anatomy diagram #2

Sexual Development

As a country, our youth are entering puberty at an earlier age than they did in previous generations.  The average age of puberty in girls is between 10-14, and for boys, it is 12-16.  This age is typically even lower in children of color, or if they are overweight (with some children entering puberty as early as age 8!).  As such, we are seeing a younger age of coitarche - the age of first intercourse - and the number of women diagnosed as 'Young for Maternal Age' (pregnancy earlier than age 14) is increasing, too.  It may, therefore, be prudent to start discussing sexual topics in conjunction with talking about puberty and bodily changes.  

So when is the best time to talk to my child about sex?

First of all, you know your child better than most people, so definitely take that into consideration.  As for an actual age, there really isn’t one.  As I stated in the previous paragraph, there is the possibility of a spark of hormones around age eight, so starting that conversation prior to fourth grade may be prudent.  If your child is precocious, consider starting earlier than that.  Of course, there’s nothing wrong with introducing the idea of sexuality earlier, but a four-year-old, for example, isn’t normally developmentally able to process that information in a meaningful way.  I personally tell patients that there isn’t necessarily a correct time to have that discussion, but if it comes up (“Where do babies come from?”) introducing general ideas at an early age may make the actual talk easier.

Contraception

As I stated in my first blog, contraception could be a topic in itself.  The idea/necessity of contraception, however, is something that should be discussed when talking about sex with your children.  You don’t have to go into specifics, but introducing the idea that pregnancy is a potential consequence of sex, and that there are methods to prevent it, should not be ignored.  The take-home point for contraception is this:  While there are many ways to prevent pregnancies, condoms and abstinence are the only effective methods of preventing both sexually transmitted infections (STIs) AND pregnancy.  Some schools and doctors’ offices, as well as the health department, all have free condoms, so cost doesn’t need to be a factor in preventing pregnancies and STIs. 

What do I need to know about safety and STIs

Sexually transmitted infections are a type of infection that is spread, as you may imagine, via sexual contact.  STIs are divided into bacterial or viral infections.  The most common STI in Oklahoma is chlamydia, with gonorrhea coming in a close second.  Both of those diseases are bacterial and respond to antibiotic therapy, unlike viral conditions such as herpes simplex, HIV, or human papilloma virus (HPV).  Viral STIs are a lifelong infection in the majority of cases and are often asymptomatic after the initial infective period.  The most important thing to communicate to your children about sexually transmitted infections is that you do not need to have penetrative vaginal intercourse to spread them.  Almost all STIs are content to infect mucus membranes of any type, including the mouth and anus.  As such, safe sex discussions should include protective measures, such as male, female, and oral condoms.  This might be an especially awkward conversation to have with teenagers, but it’s still necessary.

Many teenagers feel that oral and anal sex are either without risk or carry significantly less risk, but unfortunately that’s just not true.  The delicate tissue of the anus is much more likely to tear with intercourse, and it’s that tearing that facilitates transmission of viral particles from one partner to another.  Oral sex, while usually less traumatic, can still lead to the spread of infection, especially in the case of herpes simplex virus.  As a gynecologist, I have personally seen women present with new cases of genital herpes after having oral sex alone. 

Masturbation

Despite what you may have been told, there is nothing medically wrong with masturbation.  It will not make you go blind, nor will it cause hair to grow on your palms.  The act of touching oneself can feel very good and can have a number of positive health benefits.  As you may know, children begin touching themselves during infancy as a means of self-exploration, and while there is nothing sexual in that act, many parents are uncomfortable seeing this.  If you see your child touching their genitals, you may consider saying something like, “It’s OK to touch yourself, but why don’t you do that in your room?”  Obviously, as your child ages, and especially during puberty, I advise respecting basic privacy, and knocking on doors, or announcing your presence before going into their rooms to avoid an uncomfortable situation for both you and your kid! 

Consent

Besides discussing pregnancy and STI prevention, talking about consent is one of the most important sex-related conversations you can have with your child.  We are horrible as a society when it comes to discussing this basic human right.  Consent is a person’s way of saying “I am valuable as an individual and worthy of respect.” Your child, regardless of gender, needs to understand that if someone tells them “no,” that means no, and that they need to respect themselves enough to say “no” if they are not comfortable in any situation that involves an invasion of their space.  Sexual abuse, human trafficking, and other areas of non-consent need to be discussed, too, with emphasis on identification and prevention of non-consensual situations.  According to Pattie Fitzgerald, the founder of Safely Ever After (an L.A.-based company that deals with sexual abuse prevention), “A kid who is educated is a big deterrent.”  One sex offender Fitzgerald interviewed said, “I would never bother with a kid who says ‘you shouldn’t touch me like that,' because it’s clear that’s a prepared kid, who will be trouble if they’re pursued.” Even better, she says, is the phrase: “You’re not supposed to touch my penis. My parents already told me that’s not okay.”  Simply asking your child “What do you think about someone touching you in a way you’re not comfortable with?” may open the door for a conversation about consent.

Should I be the one to tell my kids about sex, or should their teacher/pastor/doctor do that?

Honestly, I feel that both approaches have their place in today’s society.  Having someone who can explain sex in a professional, appropriate manner is invaluable to the majority of families, especially if they use a standardized curriculum that you and your child could discuss at home. Many schools have implemented sex education programs and have someone on staff that can serve as an educational resource for students.  I will say that if you’re wanting a longer discussion, especially one where you can be sure your own ideas about sexuality are included, consider initiating the conversation yourself.  Now if you’re a single parent, and have kids of opposite gender, it’s normal to have more discomfort in discussing the, no pun intended, nuts and bolts of the matter.  In that case, it may be better to have someone explain details, but I still feel that you should be a resource and sounding board for your child.  If you’re the type of parent that uses books in conjunction with discussion, here are some to peruse:

It's So Amazing!: A Book about Eggs, Sperm, Birth, Babies, and Families (The Family Library) by Robie H. Harris

Let's Talk About S-E-X: A Guide for Kids 9 to 12 and Their Parents by Sam Gitchel

Where Did I Come From? by Peter Mayle

It's Not the Stork!: A Book About Girls, Boys, Babies, Bodies, Families and… by Robie H. Harris

Well, that wraps up my blog series. I’d like to thank TulsaKids Magazine for giving me this opportunity, and for you, the reader, for reading what I have to say!  I have additional resources online on my Facebook page, @DrCoreyBabb, where I do Facebook Live videos, answer questions, and post links to relevant women’s health issues.  Remember you are your best advocate, so take charge of your own health!


Dr. Corey Babb is a graduate of the Oklahoma State University College of Osteopathic Medicine, and completed his postgraduate training in Obstetrics and Gynecology at the University of Oklahoma-Tulsa, as well as Oklahoma State University Medical Center. He is board-certified in Obstetrics and Gynecology, and is a fellow of the American College of Osteopathic Obstetricians and Gynecologists, the International Society for the Study of Women’s Sexual Health, and is a North American Menopause Society Certified Menopause Practitioner. His practice is devoted to the evaluation and treatment of female sexual dysfunction, and he is the only physician in the state of Oklahoma that specializes in women’s sexual health. He is currently an assistant professor of Obstetrics and Gynecology at the Oklahoma State University Center for Health Sciences, and is the director for the Oklahoma State University Center for Women’s Sexual Health.

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