How to talk to teenagers about sex & relationships Fiona Sizmur Consultant Community Sexual and Reproductive Health
Know your stuff
Why should we talk to our children about sex and relationships?
The Law and Under 16’s
Confidentiality
SRE / PHSE – what’s covered already in schools
What’s new in contraception and sexual health
Learn a life saver
Know your stuff
Why should we talk to our children about sex and relationships?
The Law and Under 16’s
Confidentiality
SRE / PHSE – what’s covered already in schools
What’s new in contraception and sexual health
Learn a life saver
What do we know about teenage sexual health?
the average (median) age at first heterosexual intercourse was 16 for both men and women
nearly a third of men and a quarter of women aged 16–19 had heterosexual intercourse before they were 16
about 80 per cent of young people aged 16–24 said that they had used a condom when they first had sex
less than one in ten had used no contraception at all when they first had sex
ONS survey 2008-9 Great Britain 16–19 year olds
What do we know about teenage sexual health?
Regret
Numbers of partners
1:5 young men and nearly half of young women wished they had waited longer to start having sex. both young men and women aged 16–24 had had an average of three heterosexual partners in their lifetime The Gay Menʼs Sex Survey in 2006 found that 25 per cent of men aged 14–19 had had one male sexual partner in the last year, 41% had 2 – 4 partners and, and 34% had 5 or more.
Sexuality
0.9 per cent men, 1.6 per cent women of 16–24-yearolds had had one or more new same sex partners in the previous years.
ONS survey 2008-9 Great Britain 16–24 year olds
What do we know about teenage sexual health? Same sex relationships
Men under 20 were significantly more likely to have had both male and female partners (11.3 per cent) than men in other age groups (6.4 per cent–7.9 per cent).
In a separate survey of lesbian and bisexual women, the under-20s were more likely to have had sex with both men and women (24 per cent).
ONS survey 2008-9 Great Britain 16–24 year olds
What do teenagers know about contraception?
among those using contraception, 47% said they used condoms and 46% the pill (15% used both)
Typical pill failure rate – 8%
Typical condom failure rate – 15%
88 per cent had heard of emergency hormonal contraception (EHC)
17 per cent had used EHC at least once in the previous 12 months.
ONS survey 2008-9 Great Britain 16–19 year olds
What do we know about teenage sexual health?
Under 25’s most at risk - 63% with chlamydia, 54% with genital warts, 47% with gonorrhoea, and 41% with genital herpes were under 25 years.
nine out of ten people aged 16–24 years knew that chlamydia is an STI.
62% of men and 83% of women aged 16–24 years old knew that it doesnʼt always cause symptoms
46% of men and 64% of women aged 16–24 years old knew that it is easily treated by antibiotics.
Of all 16–19 year olds diagnosed with an STI in 2009, at least 11 per cent of women and 12 per cent of men will become re-infected within a year.
Sex and the law
The Sexual Offences Act 2003
Current sexual offences throughout the UK are gender neutral.
The law is not intended to prosecute mutually agreed teenage sexual activity between two young people of a similar age, unless it involves abuse or exploitation.
Specific laws protect children under 13, who cannot legally give their consent to any form of sexual activity.
All legislation can be accessed at www.legislation.gov.uk.
Consent and confidentiality
Contraception/STI treatment and under 16s
Health professionals in the UK may provide contraceptive advice and treatment to young people under 16 if, in their clinical judgement, they believe it is in the young personʼs best medical interests and they are able to give what is considered to be informed consent.
Consent from parents is not legally necessary, although the involvement of parents is encouraged. (A parent is someone with legal parental responsibility. This is not always a biological parent.)
What is consent?
England, Wales and Northern Ireland: if a person ʻagrees by choice and has the freedom and capacity to make that choiceʼ.
Any competent young person in the United Kingdom can consent to medical, surgical or nursing treatment, including contraception and sexual and reproductive health. They are said to be competent if they are capable of fully understanding the nature and possible consequences of the treatment.
Fraser Guidelines
young person understands the advice and has sufficient maturity to understand what is involved
the doctor could not persuade the young person to inform their parents, nor to allow the doctor to inform them
the young person would be very likely to begin, or continue having sexual intercourse with or without contraceptive treatment
that, without contraceptive advice or treatment, the young person’s physical or mental health would suffer
that it would be in the young person’s best interest to give such advice or treatment without parental consent.
Consent and confidentiality
 Young people are owed the same duties of care and confidentiality as adults.
 Confidentiality may only be broken when the health, safety or welfare of the young person, or others, would otherwise be at grave risk
Consent and confidentiality in schools
Health professionals, including school and community nurses, may provide confidential contraceptive and sexual health advice and care in response to individual requests from young people. In this case they are bound by their professional codes of conduct.
However, health professionals contributing to a school sex education programme must follow the school’s sex education policy.
Teachers are not legally obliged to inform anyone if they learn of or suspect sexual activity in pupils under the age of consent if there is no evidence of abuse or exploitation.
What is taught in schools 
Reviews of international research show that schoolbased SRE, particularly when linked to contraceptive services, does not increase sexual activity, but can have a positive impact on young people's knowledge and attitudes, delay sexual activity and/or reduce pregnancy rates by the use of contraception and safer sex.

There is no evidence that abstinence-only education programmes delay the initiation of sex, increase a return to abstinence or decrease the numbers of sexual partners.
What is taught in school
Legal framework for SRE - The Education Act 1996
The sex education elements of the National Curriculum Science Order are mandatory for all pupils of primary and secondary school age. These cover anatomy, puberty, biological aspects of sexual reproduction and use of hormones to control and promote fertility.
Secondary schools are required to provide an SRE programme which includes (as a minimum) information about sexually transmitted infections (STIs) and HIV/AIDS.
Other elements of personal, social and health education (PSHE), including SRE, are non-statutory.
Teenagers and contraception
40 – 50% will discontinue their chosen method within first 6 months
65 – 70% discontinue at 12 months
What do teenagers know about contraception?
Myths and misconceptions –
Weight gain Acne Moods Bleeding problems Bones
Thrombosis – 9-10/10,000 (cf 4-5 or 30) Cancer – No overall increased risk Breast (1.24/2000) Cervical – both reduced after 10 yrs discontinuing Protective against ovarian and uterine
What’s new in Contraception/Sexual Health
How do I talk about it?
What do I say?
If you’ve never spoken to them about sex they may not want to talk to you about it
But you can let them know you’ll always listen if there’s anything they need to share.
Make sure they know who else they can talk to, for example a nurse or counsellor at school or college.
Relax, they’re just worry warts!
What do I say?
Teenagers want to know about
relationships,
How to deal with Sexting
love, emotions,
We want them to know about
How not to get pregnant
Treating each other with respect
friends, resisting pressure into having sex. Porn
How not to catch an STI Relationships mean considering the needs of their partner and talking to their partner.
How do I say it?
Start early
Everyday situations – films, videos, music, newspapers, school events, friends.
When you’re doing something else ……. or when you get home!
Humour – not always appropriate
Websites / Books
Ask opinions – “it’s all about me” What do you think? What would you do if? What do you think the consequences would be if?
I’ve just looked at my son’s internet history and seen the porn sites he’s visited – what should I do?
Try asking: – what did you learn from watching that? Is it something that taught you more about love? Stress that porn doesn’t teach about emotional relationships.
“porn is like junk food or chocolate – not ultimately very satisfying,”
“Porn is just there to stimulate and arouse, while real sex is quite different. It leads to unrealistic and exaggerated expectations of sex, body image and relationships.”
Research carried out worldwide shows that people who grow up on a diet of porn have more difficulty forming relationships.
My daughter is concerned that her friend has been the subject of “Sexting” what should she do?
It's illegal for anyone under 18 to film or photograph themselves topless or in an erotic pose and post it onto the internet (including social networking sites).
It's illegal to send/email/Bluetooth/text pictures of friends who are under 18 having sex (whether it’s oral, anal or vaginal). This is classed as ‘distribution of an indecent image of a child’ and carries a maximum prison sentence of seven years. People convicted of this offence go on the sex offenders register.
Learn a lifesaver
Resources
Familylives.org.uk (prev. Parentline Plus)
“Speakeasy” book – how to talk to your children
FPA – family planning association.org.uk
for children with disabilities
All about us – DVD FPA Contact a family
LGBT –
fflag.org.uk Stonewall.org.uk Beaumontsociety.org.uk