“So, you’re having sex, right?”

Standard

“So, you’re having sex, right?”  “Well, why not??”

This is how our adolescent medicine doctor/professor opens that conversation with the teens that she sees in her office on a regular basis.  Ballsy, right?  A little uncomfortable?  As in, what on earth is she getting at?!  Why would you assume that they are having sex, and then ask why not if they say “no?”  Before you freak out, I have to say, it’s pretty brilliant.  See, most of us in our PA class are thinking to ourselves “how on earth am I going to talk to teenagers about drugs, sex and rock’n roll in a way that isn’t school-marmy, authoritative, wrist-slappy, awkward,. nausea or cricket noise inducing….” and I feel like after listening to this particular professor share how she communicates with them, I actually may not need to take a benzo before walking into the room.  The fact is, she says she rarely has kids lie to her (concern #14 on my list,) and asking this way is disarming because it shows that you have a realistic grasp on current adolescent behavior, and are not going to judge them.

So read below, the statistics are also unsettling.  I was a teen not too long ago, and I’m not sure how much has really changed in youth behavior- when your noggin isn’t fully developed until your twenties, you will do stupid thing after stupid thing. The following statistics are from surveys taken in schools.  So that disregards how drop outs, private school attendees and homeschoolers would respond.  I have a hunch that these numbers are actually HIGHER in reality.

  • 17% of female HS students have seriously considered suicide in the prior 12 months before being surveyed
  • 13.2% actually made a plan
  • 10.5% male students considered it
  • 9.6% actually made a plan
  • 11.4% 12-17 year olds reported using cigarettes in the prior month, that would be 6.5% 8th graders and 20.1% 12th graders
  • 14.6% 12-17 year olds consumed at least one alcoholic drink in the prior month, 8.8% had binged
  • 10.9% 8th graders, 23.9% 10th graders, 32.4% of 12th graders had abused marijuana at least once in the year prior
  • 1.9% 8th graders, 6.7% 10th graders, 9.7% 12th graders had abused vicodin in the prior year
  • 20% of high school students who drank or did drugs before sex (same stats since 1991!)
  • 46% of high schoolers who admitted to having ever had sex
  • 40% are not using condoms, 80% are not using birth control pills
  • 34% (the largest proportion) of NEW HIV INFECTIONS annually are aged 13-29

So, if your kid’s senior high school class has 200 kids in it, 34 girls and 20 boys are considering suicide, over 40 are using tobacco, thirty or so are drinking every month (probably way more than that), sixty are smoking pot (that’s right- SIXTY), twenty are abusing prescription pills, FORTY are using drugs and/or drinking before sex, half the whole class is or has been sexually active, most of them are not using protection from STDs or pregnancy, and many of them will obtain HIV transmission because of their sexual behavior.  WHAT?!!!!

Would you want your kid to go to that school?  Unfortunately, this is reality.  So, is it really that inappropriate to ask,

“So you’re having sex, right?”

But there’s follow up there, if they say “no,” and I ask “why not?”  I can get a sense of that young person’s courage, moral decisions, family involvement, concerns, education, and I can ENCOURAGE them in their choices.  If they say “Yes,” well then it doesn’t take much time looking at the above risks to see where our conversation will go next, as in, “let’s talk about how to protect yourself from STDs and pregnancy!”  There’s still a LOT of work to be done out there, obviously.  Sure we wish that everyone would make safe sexual choices, but when half the kids are having sex, a bunch are using drugs or alcohol at the same time (you’re not using condoms if you’re drunk or high,) and a huge percentage are using no protection at all, we need to wake up and smell the coffee, People.  Folgers hasn’t changed, and neither has kids’ behavior.  Not to mention all the risks of abusing drugs, alcohol, prescription meds, etc.

I think my major take-home message is I MUST ASK ABOUT EVERYTHING.  If perfect-looking soccer moms are abusing crystal meth and benzos, then you can be damn sure that high honors star lacrosse player Suzy is sleeping with her boyfriends and smoking pot, and maybe has contemplated ending her life.  ASK, ASK, ASK.  Because if I make an assumption about someone’s behavior based on my impression of them, I may miss one of the most important conversations I need to have with them.  Like how much they’re at risk for HIV or other STDs, and how we can prevent it.  Or how to avoid a scholarship-ruining pregnancy.  The stats show that they’re doing these things, so I better be prepared to ask about it in a way that is less “you’re not doing drugs, are you???” and more “So tell me about your drug use.”  Here’s hoping that our whole society will be more open and frank with our adolescent population, so that I’m not the only person they are talking about it with.

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