A very interesting study from Duke University, published in last week’s JAMA Pediatrics, reveals that when it comes to addressing sexual issues in teenagers, physicians are not good at initiating “The Talk” at well-child visits:

Our study may be the first to directly observe sexuality talk between physicians and adolescents. We found that one-third of all adolescents had annual visits without any mention of sexuality issues; when sexuality talk occurred, it was brief. Research is needed to identify successful strategies physicians can use to engage adolescents in discussions about sexuality to help promote healthy sexual development and decision making.


Discussing sex topics in the office can be awkward for both doctors and teens.  Alexandra Sifferlin points to the brevity of these discussions:

They found that 65% of the visits did include some discussion about sexuality, but only in passing — the average time spent on these issues was 36 seconds. Only 4% of teens had prolonged chats with their doctors about topics related to sex, which suggested that most doctors were not discussing sexuality at all with their patients who were reaching sexual maturity during the yearly checkup.


Sarah Wickline emphasizes that the time typically allotted for regular checkups might be too short to adequately cover this important subject:

When it comes to broaching the topic of sexual activity with adolescent patients, “the biggest barrier for me is time,” Dyan Hes, MD, FAAP, medical director of Gramercy Pediatrics in New York City, told MedPage Today.

She’s not alone. Ari Brown, MD, FAAP, founder of 411 Pediatrics in Austin, Texas, told MedPage Today that trying to follow the American Academy of Pediatrics’ Bright Futures curriculum for addressing sexual activity and sexual identity “is way more than anyone could cover in a 15- to 20-minute well check.”

“Most practitioners do not even have 15 minutes with a patient for a well visit,” Hes said.


Sexuality is a big topic that requires not only sufficient time, but also mutual respect and trust between the physician and the teenage patient.  When I talk to my patients about sexual health, I assume it is not a novel topic.  In fact, I expect parents have been discussing important sexual concepts with their children throughout their adolescence (which, as a realist, I know isn’t always happening).

Still, teenagers should be hearing from pediatricians about sexual health topics at every well visit.  I’d rather they hear it from me than from their peers, who don’t know what they’re talking about!