Using the anatomical names for private parts and getting vaccinations against HPV by age 12 can help keep children healthy into adulthood
By Eve McDavid
Staring at the speckled gray tiles of the exam–room ceiling, I planned out my last day at Google before maternity leave while my OB/GYN performed a pelvic exam. Once we wrapped, I’d zip to the office to tie up loose ends. Instead, I heard her say “irregular” as she discovered a tumor, and my world collapsed.
There are an estimated 36,000 cases of cancer related to the human papillomavirus (HPV) in the United States annually; last year, my Stage 2B cervical cancer diagnosis was one of them. Miraculously, my son arrived safely five weeks early, and I responded incredibly well to treatment. In time, our young family rebounded; I proudly reached remission this year.
As a systems expert who studies patterns in consumer behavior, I felt compelled to understand why so many women are underinformed when it comes to the importance of cervical health care. What I found is that experiences and lessons from childhood can influence a person’s understanding of their own sexual health, and affect the quality of care they receive.
So, how do we help our children — boys, girls and gender non-conforming — become comfortable with their bodies, speak up when issues arise and understand the importance of preventive care? I spoke with public health and medical experts to identify foundational childhood experiences that can normalize sexual health and, most importantly, keep our kids healthy.
Teach the names of private parts
It’s hard for a person to be proactive about sexual health when they’re not comfortable using proper anatomical names for genitals. “Private parts” was the only acceptable term in my upbringing; it was a conscious, necessary adjustment to teach my children to call and recognize their genitals by “vagina” and “penis.” Even if it feels awkward at the beginning, keep going. A 1992 study in the Journal of Sex Education and Therapy found that children whose parents taught them the anatomical names, because of the modeling at home, were most likely to remember.
Children unashamed of their genitals are also more likely to speak up if they’ve experienced sexual abuse or another health issue, says Princess Nothemba Simelela, who leads the World Health Organization’s Cervical Cancer Elimination Initiative.
Simelela says that by age 5, children can understand their bodies and associated boundaries. Using stories and animated graphics, she has taught young girls about what kind of touches are not okay. The same lesson can be taught to boys, too, she says: “You know, if you touch here and here, it’s inappropriate … If somebody fondles you or touches this part of your body, you must let someone else know.”
Get your children vaccinated against HPV by age 12
The Centers for Disease Control and Prevention says the HPV vaccine is the best protection against six cancers caused by the virus and recommends that all children ages 11 to 12 get vaccinated (though kids as young as 9 can receive a shot). A recent U.K. study found that vaccinating girls ages 12 through 18 against HPV could substantially reduce the incidence of cervical cancer, particularly when vaccination happened at age 12 or 13. Education about this issue is particularly important in Black and Hispanic communities, where cervical and other HPV-related cancers are more prevalent.
I received the HPV vaccine in my 20s after I’d contracted a high-risk strain, so it wasn’t as effective; I’m practically counting the days until my children are 9 and I can provide them with the gift of cancer prevention.
“That we have this vaccine that can prevent the virus, it’s kind of a magic bullet,” says Jessica Rose, an OB/GYN at Bellevue Hospital in New York and assistant professor in the Department of Obstetrics and Gynecology at NYU Grossman School of Medicine. “There’s nothing else out there that can do it.”
Twenty years of evidence supports the HPV vaccine, says Maria Trent, chief of adolescent and young adult medicine at Johns Hopkins University.
“The first thing is that the vaccine is safe. It’s been tested on millions of people, and the thing is that we’ve seen change, just like we’ve seen change with the chickenpox vaccine,” she says. “I haven’t seen a case of chickenpox in years because we vaccinate people. Nobody should suffer like I did when I was 3 with chickenpox, right? We’ve seen the same thing in HPV.”
Trent urges decoupling the vaccine from sex, which prevents some physicians from administering it.
“I don’t think you have to have ‘the talk’ to give your kid the HPV vaccine. It’s just not a requirement,” she says. “No one is going on tangents about your Tdap [a vaccine to prevent tetanus, diphtheria and whooping cough], you know, other than to say, ‘If you step on a rusty nail, this is going to help you.’”
The vaccine is also recommended for boys because it protects against HPV transmission as well as anogenital, penile, and head and neck cancers. “The data suggests there are risks for subsets of men related to cancer,” Trent says, “and we want to prevent people from having genital warts, too.”
Make sex education part of family conversations
Researchers discovered the link between HPV — the most common sexually transmitted infection — and cervical cancer in the 1990s, around the time I first attended sex education in public school. But, like most women, I never learned about this in school. Instead, I found out about the link after my HPV diagnosis.
“You can’t leave the conversation about the first menstrual event to somebody else,” says Simelela of the WHO. “Make it something that the family talks about like we talk about their grades, their performance on the sports field. You’ve got to make this a day-to-day conversation. That’s what I tell a mom, that ‘it’s your responsibility … It’s you, at the end of the day, you take responsibility for this and for the well-being of your child.’ ”
“We spend billions of dollars on STD [sexually transmitted disease] management and unplanned pregnancies in the United States; the least we can do is tell young people how to take care of themselves, how to prevent adversity down the road,” she says. “If they don’t have that information, they can’t incorporate that into their decision-making.”
Navigate difficult topics with trusted health-care providers
As a young adult, I went to my first gynecology appointment alone, unprepared for the stark difference from seeing my pediatrician. Lacking the language to comfortably discuss sexual health, I only sheepishly spoke up. After cancer, I realize that being afraid to ask questions can affect the care patients receive and doctors can administer.
Now I view my health as a trusted partnership between myself and my provider, and that’s a value my husband and I instill in our children. At home, we talk as a family about the many reasons to visit the doctor. Eventually, we’ll discuss what my cancer diagnosis means for the kids as they grow up and independently seek care.
Find a pediatrician or adolescent-medicine provider with whom your child is comfortable discussing difficult topics.
“I would also say to parents that it’s important for them to allow their young person space when they need to talk to [their doctor],” Trent advises, “knowing that we always would loop parents back in if their young person is in trouble.”
Rose, the Bellevue OB/GYN, says gynecologists are working to improve the care continuum from adolescence into adulthood. “There’s been a move in our specialty to make the transition smoother,” she says. “For patients, there’s a lot of normalizing why women go to the gynecologist. There are plenty of reasons to see a gynecologist, even if you’re not sexually active.”
For parents, there’s no end to the child-rearing advice we receive. Having just survived cervical cancer, I believe this may be the most important: Give your child the gift of life that preventable cancer won’t cut short.
As Simelela of the WHO says: “Here you may have such a unique opportunity to leave a legacy for the next generation where they can never experience this painful disease, and instead read about it in a museum. It’s possible.”
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