Doctors and Clinics
What parents need to know about teen sexual health issues.
Youth who engage in sex at an early age are more likely to have a greater number of lifetime partners and engage in unprotected sex. These factors make youth susceptible to sexually transmitted diseases and unwanted pregnancy. Beyond the mantra about teen moms and HIV, other important sexual issues involved with early sexual debut include adolescent dating patterns, decision making, communication and negotiation skills, social and environmental influences, and dating violence. (See J Obstet Gynecol Neonatal Nurs. 2011 Mar;40(2):217-224. doi: 10.1111/j.1552-6909.2011.01217.x. Epub 2011 Feb 1 Fantasia HC, Fontenot HB)
Sexually Transmitted Diseases
STDs are a serious concern for adolescents. It is estimated that one in two sexually active youth will acquire an STD by age 25.1 Undetected STDs can lead to serious health concerns. STDs are not equal opportunity offenders; the prevalence of STDs is highest amongst young people under 25. For these reasons, we encourage STD testing for sexually active teenagers. For parents who encourage their teens to delay sex, it is medically accurate to say that abstinence is the only risk-free prevention method of STDs. It is important to be clear with your teens that condoms do protect from some, but not all STDs, because some can be spread by skin-to-skin contact in areas not covered by a condom. When talking with your teen about STDs, gender specific conversations can be helpful. Males tend to be vectors (transmitter of disease). Females have higher disease incidence.
If a teen thinks he/she may have an STD it is important to see a doctor or nurse practitioner. At the clinic teens can be screened for a variety of tests which could be a blood test, urine test, or swab of urethra or cervix.
1. Cates JR, Herndon NL, Schulz S L, Darroch JE. (2004). Our voices, our lives, our futures: Youth and sexually transmitted diseases. Chapel Hill, NC: University of North Carolina at Chapel Hill School of Journalism and Mass Communication.
Sexual Activity: The good news is more teens are choosing to delay sex (about 50% of teens 9th-12th grade). However, older teens are more likely to have sex. A significant amount of teens who do have sex are not using condoms or contraception that reduces the risk of pregnancy or STDs. However, the number of teens who use condoms has increased over the decades. Youth Risk Behavior Survey, 2015. Youth Risk Behavior Survey provides reliable reports about sexual behavior by state, age, ethnicity, and other factors.
Decision-making Research on the adolescent brain help explain why teens make risky decisions. The prefrontal cortex (rational brain) development lags behind the limbic system (emotional brain) –this gap in functional development may account for the risky period in teens. Help teens through this period by guiding them through rational decision making, goal setting and support. (Source: Ann N Y Acad Sci. 2008 Mar;1124:111-26.
Why do we suggest abstinence as a better choice than condoms for teens? Although condoms are 82% effective at preventing pregnancy, human use reality rates paint a different picture about “safe sex”.
What to expect at Clinics
Paying for the Visit: Low cost services are available in Bexar County. University Health System (UHS) clinics offer low-cost health care. Medicaid or the State Children's Health Insurance Program (SCHIP) offer free or reduced-fee medical insurance to uninsured teens. Some clinics are funded by Title X government funding dedicated to providing comprehensive family planning, access to contraceptive services, supplies and information. Priorities are given to low-income families. Read More about Title X at http://www.hhs.gov/opa/familyplanning/index.html.
Scheduling an Appointment: Teens can receive an appointment within 48 hours at University Health System Clinics. When a teen calls the clinic they should say “I am a Teen.” Some other clinics have special teen hours. Most clinics are required by Texas Law to have permission from your parents to receive services, especially for insurance purposes.
At the Clinic: The clinic visit is similar to other doctor visits. Some clinics require ID and paycheck stubs from the teen or parents. The visit could include some, but not all of the following: counseling with a healthcare provider, a urine test, blood test, swab of urethra or cervix, contraceptive counseling and dispensing of contraceptives.
A word on confidentiality.
A teen cannot see a healthcare professional for sexual health services except at Title X clinics without parent/guardian consent. Your teen may choose to keep conversations with the health care professional private. There are some clinics where teens may receive free birth control. If a teen discloses a relationship or a fact that presents significant emotional or physical harm the healthcare provider is required to report to Child Protection Services.
Getting Birth Control
There are some clinics where teens can obtain birth control regardless of age. It is not as simple as walking in and getting a bag of condoms and pills. Teens receive extensive counseling regarding risks and benefits before they are dispensed birth control.
Why do we refer teens to clinics?
If a teen is sexually active they should see a healthcare professional.
- Early detection of STDs is essential for reproductive health.
- Healthcare providers can educate teens about sexual health including the risks and benefits of sex, contraception, and serve as a trusted, reliable source of information.
- The American College of Obstetrics and Gynecology recommends that a teen should establish a relationship with a gynecologist before the age of 16. Some girls go sooner if they experience problems with menstrual cycles or have other concerns.
- Teens should also see a health care provider if they are sexually active or considering becoming sexually active.
- All women should see the healthcare provider when they are 21 years old, even if they are not sexually active.