When Talking About Birth Control, Don’t Leave Boys Out of the Conversation

When a child arrives in his or her pediatrician’s office each year for their well visit, the nurse and provider often go over a long list of questions for the parents and child. Many are related to daily activities; sleep, food and drink intake; activity levels; concerns or problems; and even sometimes social or family issues. With the child chiming in, the parent often answers these questions with ease and comfort.

However, as the child becomes an adolescent, often the provider asks the parent to leave the room for part of the visit to ensure privacy for the patient. During this time, the nurse or provider is able to ask some more sensitive questions, including inquiries into drug or alcohol use, mental health concerns and sexuality.

Sometimes, pediatricians may not be up-to-date on the most current methods of contraception and may find it uncomfortable to begin the conversation about sexual and reproductive health. With females, it seems a given that this discussion should take place as soon as a girl becomes sexually active (and should occur before) to ensure that she has the best method of contraception for her. However, because all forms of hormonal contraception are indicated for females only, boys are often left out of the education or conversation about sexual health.

Statistics show approximately half of high school students are sexually active and approximately 80 percent of teen pregnancies are unintended. Additionally, the CDC estimates that youth ages 15-24 make up just over one quarter of the sexually active population but account for half of the 20 million new sexually transmitted infections that occur in the United States each year.

Boys certainly have a stake in these numbers and should be aware of all risks of unprotected sex, as well as the available birth control methods and how they work. On the internet and abroad, myths and stories about male birth control methods, such as “male shot” and a “male pill,” are abundant. Many teens and parents ask health educators and providers if these methods are available.

Here are a few ways to educate adolescent boys and their parents about sexuality and contraception, and how to help facilitate the discussion about lifelong sexual health:

• Begin the discussion early enough. Often the child already has become sexually active or “thinks he knows everything” by the time the provider or parent approaches topics of sexuality
• Ensure that a discussion about sexual health with an adolescent boy includes an overview of all birth control methods – for boys and girls, including how they work in the body
• Discuss the risks of unprotected vaginal, anal and oral sex, including STIs and unplanned pregnancies and how they occur
• Stress that only condoms and sterilization (vasectomy) are methods currently available to men in the United States that protect against unplanned pregnancies. Only condoms protect against STIs; no other methods are currently available for men
• Include a discussion about consent with sexual partners. Often this is left out of “the talk” yet could have lifelong consequences for the adolescent and partner
• Urge the adolescent to learn the correct way to use a condom EVERY TIME he has sex. Not only will this help prevent STIs, he can be sure the chance of pregnancy is greatly reduced if his partner’s method is not effective.
• Remain open to variations in gender identity, in gender expression and in sexual and emotional attraction. Help connect patients to resources to help support them. Transstudent.org/gender and www.cdc.gov/lgbthealth/youth-resources.htm are excellent resources for GLBTQ Youth
• Help connect the patient to more resources for sexual health and wellness. Stayteen.org, www.bedsider.org and www.plannedparenthood.org and other sites are extremely helpful and provide accurate information
• As a provider, be “askable” and provide a safe space for the adolescent to ask questions that may be awkward to bring up with parents

While the conversation with adolescent boys about sexual heath, birth control and STIs may be awkward and difficult, having an open, honest and informed discussion helps protect patients from potential life-altering risks.