What’s the Best Way to Talk to a Teen About Sexual Identity?

A new survey indicates that many teens aren’t getting the information or advice they need about important health issues.

by George Citroner

[A] nationwide survey of almost 200 gay teens found that young males who have sex with other males aren’t receiving proper advice about critical health issues that affect them.

The survey included responses from 198 gay adolescent males. It was conducted by a questionnaire linked from a website popular with that group.

According to some study participants, their primary reason for participating was to help members of their community.

Healthcare providers are a critical source of information about HIV and sexually transmitted infection (STI) prevention.

Before this study, little was known about health communication and services between gay adolescent males and their healthcare providers.

“This is the first study to ask kids about their attitudes on getting sexual healthcare. Pediatricians and general practitioners are the gateway of youth experiences with healthcare, but [these patients] only go once a year, so this is an ideal time to ask [about their sexual activity],” Celia Fisher, PhD, professor of psychology and the chair in ethics at Fordham University in New York who also directs Fordham’s Center for Ethics Education, said in a press release.

Barriers to revealing sexual orientation

Survey responses showed that more than half the teens who participated had decided against revealing their sexual orientation to healthcare providers.

“One of the barriers to discussing the sexual health needs and concerns of adolescent patients was fear that the healthcare provider would disclose confidential information to their guardians. It’s important to also note that whether or not a sexual minority youth is out to his parents doesn’t mean the parents are accepting of their sexual identity,” Fisher told Healthline.

However, Fisher warned in the press release that a doctor may be obligated to say something in certain instances.

“The gray area is if the child is having sex with an adult that might be considered sexual abuse, and that needs to be reported. Even if the relationship is legal and consensual, some youth lack assertiveness skills to demand a condom from an older or aggressive peer partner,” she said.

Initiating a discussion

The findings suggest teens who reported having their healthcare provider initiate a discussion about sexual orientation were much more likely to receive HIV and STI preventive services and testing.

“To ensure that youth get the services they need, I would suggest that doctors make it clear to their adolescent patients that they’re committed to protecting the patient’s confidentiality, but also provide youths with the opportunity to agree to engage their parents in discussion of treatment for HIV and STIs if they believe it is in their best interests,” Fisher said.

Some parents are unsure about asking directly about their child’s sexual orientation.

However, Steven Petrow, author of “Steven Petrow’s Complete Gay & Lesbian Manners,” wrote in the Washington Post: “As for ‘the talk,’ you’re right to wait for your son to come to you. He may not be sure about his identity or isn’t ready to talk with you about it. A direct question can result in defensiveness, a forced coming out or an outright lie.”

What can be done?

Fisher believes that it’s important for medical schools to begin incorporating sexual health training early in the medical school curriculum.

“The small amount of research that has been conducted with physicians indicate many believe they lack the training to speak to young adults about these issues and provide sexual minority youth with information relevant to their sexual health needs,” she said.

How the question is phrased can make a big difference.

“Doctors should not use terms like ‘gay,’ or ‘LGBT,’ because for many young people the terminology is in flux. Youth no longer identify with these traditional behaviors. The question should [instead] be, ‘Who are you attracted to sexually?’” Fisher said.

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