I have been called a freak so many times by my daughter that I am beginning to wear the label as a badge of honor. Why? I am usually called a freak when I say things like these:

• “I am going to call and make sure there will be parents at this party.”

• “Do you know how prevalent sexually transmitted infections are in our area?”

• “You need to call or be home by 10 p.m.”

• “No, you may not watch a movie behind closed doors with a boyfriend.”

• “Please wait until you are married and 25 before you date anybody.”

Although the last comment might have been a little over the edge, the rest are very reasonable. As an obstetrician-gynecologist, I realize that I have a skewed view of teen behavior.

Teens have so much cultural pressure to act older than their years. They are encouraged to look provocative. Many young teens are pressured by their peers to have intimate relations.

In my experience as an OB/GYN, young adults engage in “high risk” sexual behavior. Young men and women are expected to make choices that are beyond their maturity. In spite of all the mandated “health” education courses and the Internet information explosion, most teens do not know much about the consequences of sexual behavior.

Many are also unaware of their ignorance. Unfortunately, unplanned pregnancy and sexually transmitted infections (STIs) are the difficult consequences of poor choices.

If it will help to keep a teen from unwanted pregnancy or disease, I give myself – and all parents – permission to be deemed a “freak.” In other words, talk to your teens about intimate touch, sexual relations, STIs and pregnancy prevention.

Based on my experience as an OB/Gyn and a parent, I have a few suggestions.

• It will be uncomfortable to bring up the topic and just as uncomfortable to continue the discussion. All your child’s verbal and nonverbal cues will scream at you to stop. They really do not want to have the conversation with you. Continue. Being a good parent is not always comfortable.

• Talk about how pregnancy occurs and how a woman protects herself from pregnancy. This can lead from a discussion about periods and when ovulation occurs (on average 12 days from the first day of the cycle). Most teens, and many adults, do not understand about ovulation timing and conception. Explain about sperm and the motility of sperm. (A woman can be virginal and still conceive.) Even though you are recommending abstinence, talk about birth control and condom use.

• Let them know that sexually transmitted infections are common and that even condom use does not protect from all STIs. In my experience, teens are more frequently involved in non-traditional intimate relations. Abstinence is the only sure way to protect from STIs.

• Rules are good. At an appropriate time, let them know what your rules are. This is especially important for young teens. They do not need to be in a situation to make choices for which they are not prepared.

• Dress codes. Making sure hemlines and necklines don’t draw attention. If Grandma would not approve, it should not be worn.

• Curfews

• Limit opportunities for sexual relations. No closed doors, no private time with opposite sex. Adults must be present at all parties. Encourage group dating.

• Zero tolerance to drugs and alcohol.

• Encourage abstinence. This is the best way to prevent unwanted pregnancy and STIs. Be clear that this is your expectation.

• Encourage your teen to talk with you openly, but realize they probably will not. Every time I hear a parent say, “We have an open relationship,” I cringe. In my experience, teens will rarely be honest with their parents about their sexual behavior. They do not want to disappoint you and they will lie to protect you.

When parents say, “I will not be angry or upset if you are having sex,” teens do not believe it. Rightly so. Parents are usually upset and angry when they find out their child is having sexual relations, is pregnant, or has an STI. Be honest. Let them know you will be upset if they choose to have intimate relations outside of a married relationship.

• If they are having intimate relations already, I recommend an appointment with their physician to obtain testing for STIs and discuss birth control options. In a young woman, pap smears and a pelvic exam do not have to be routinely performed until age 21. A simple urine test and blood test can check for STIs. Do not use an exam as “punishment” for their behavior.

I realize I have a jaded view of the world. I have seen too many young men and woman have difficult, and at times, even life-threatening, consequences from sexual behavior at a young age.

I encourage you to talk with your teens. I stand behind being a “freak” who sets limits and expectations for my child’s behavior.

Mary Kay Durfee, M.D., FACOG, is an obstetrician/gynecologist with Generations Healthcare for Women. She is board certified by the American Board of Obstetrics and Gynecology and serves as OB/GYN section head for Northwest Medical Center. To learn more, visit www.generationsobgyntucson.com.

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