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Posted on 09-30-2015

The Seventh-Grade Talk
This past month has been busy at the office with back-to-school physicals and sports physicals.  For me the most challenging of these exams is the seventh-grade physical, which in our office includes the “seventh-grade talk.”  Throughout my career the move into seventh grade has signaled a time to make sure that our patients understand the facts of life.  This means, for me, that all seventh graders need to know how babies are made and how risky behavior, pornography, drugs, tobacco and alcohol can affect their lives.  It is a time that we talk about accident prevention as well as suicide.  The importance of asking about helmets is superseded by asking if they understand what “blow job” means.  
I understand that some parents would rather be the ones to impart this information.  Because of that I start the conversation with something like “We like to talk about some sensitive topics at this visit- is that ok with you?”  I encourage the parents to stay if they would like to, and usually ask if there is anything else the parents would like to share.  This allows the opportunity for further discussion since the patient knows that the parent also knows that they have heard about the topic.  Of course, if the parent feels the adolescent would respond better to being alone with me or Teena that is fine as well. The reality of it is that in the exam room your child is unlikely to stick their fingers in their ears and go running out of the room – a real possibility at home.  Sometimes kids are afraid they will look stupid if they ask questions about sex.  I can tell you that I have had at least five patients this summer who had heard of sex but did not actually know what sexual intercourse entails. This puts them at risk not only of embarrassment but also of abuse from other students who have more information.
So when should you start the discussion about sex?  It really depends on the child but the short answer is: whenever they ask.  Of course sometimes it is hard to know what they are asking.  One day when my younger daughter, Michelle, was six, she came to me and asked “What is sex?”  I was ready this time, having blown it when my older daughter asked (but that’s another story), and told her the whole reality of what sex meant.  She listened pensively but still seemed confused.  
 “Did that answer your question?” I asked.  It was then I noticed that she was holding a school form in her hand. She pointed to a question.
Sex – circle F or M
“Not really,” she replied.  “I still don’t know whether to circle ‘F’ or ‘M’ on this paper!”
“F” I said.
“OK” she replied, and walked off.
I certainly don’t get it right all of the time either.
 

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