11/2/2015

Discussingadolescentsexuality

OfficialreprintfromUpToDate
www.uptodate.com2015UpToDate

Suggestedexamplesofdevelopmentallyappropriatewaystodiscuss
adolescentsexualityandscreen,counsel,andpreventsexually
transmittedinfections*

Issue
Puberty

Developmentalstage
Earlyadolescence

Middleadolescence

Lateadolescence

10to14yearsold

15to17yearsold

18yearsold

"Hasyourmom/dad
talkedtoyouabout
puberty,andtheway
yourbodychangesas
youbecomea
teenager?"
"Doyouhaveodorfrom
yourarmpitsand/oruse
deodorantnow?"
"Doyounoticethat
your
breasts/penis/testicles
orballsaregetting
bigger?"

"Itlooksasifyourbody
isfinishing/finished
puberty,butthatdoes
notmeanyouhave
finishedalltheother
tasksandgrowingof
puberty."
"Doyouhaveany
concernsaboutyour
body?"
"Doyoulikeyourbody
ordoyouhavestrong
feelingsaboutany
particularbodyparts?"

"Haveyouexperienced
somethingcomingout
ofyourpenisduringthe
night?Wecallthese
nocturnalemissionsand

"Youhavecompleted
pubertybutstillhave
additionalbrain,social,
andemotionalgrowth
ahead."
"Howdoyoufeelabout
whereyouareinyour
development?"
"Doyoufeelconfident
andcompetenttomake
healthdecisions?"
"Doyouhavequestions
aboutthesocialand
emotionaldevelopment
thatoccursasyouleave
forschoolorajob?"
"Asyougetolderwe
willstartdoingregular
breastorchest
examinationsand/or
cervicalpapscreenings
tocheckfororprevent
cancer."

theyareverynormal."
"Mostgirlswillgetsome
dischargeorfluidand
mucousthatcomesout
ofthevaginawhichis
normalandrelatedto
hormones."
"Doyouhaveany
concernsaboutthe
changesyourbodyis
startingtogothrough?"
Gender

"Mostofuslearnabout
beingagirlorboyfrom
earlyon.Whenyou
thinkaboutyourbrain
andbody,doyou

"Iaskallmypatients
whentheycomeinfor
checkups:'Doyou
consideryourselfagirl,
boy,orsomewherein

"Howdoyouidentify,
regardinggender?That
isdoyoufeelorregard
yourselfasawoman,
man,orsomethingin

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11/2/2015

Sexuality

Discussingadolescentsexuality

consideryourselfagirl,
aboy,somewherein
between?Areyou
happyandcomfortable
beingaboyorgirl,ordo
youhavequestions
aboutyourgender?"

between?Howdoyou
describeyourgender?'"

between,orsomeother
way?"

"Therearelotsofways
thatpeopleexperience
orexpressgender.Iam
opentodiscussingthis
oranyquestionsabout
genderwithyou."

"Doyouhaveany
questionsorconcerns
aboutyourgender?"

"Haveyouandyour
parent(s)talkedabout
sexandhowtomake
decisionsaboutgetting
involvedinaromantic
orsexualrelationship?"

"Areyouattractedto
girls,boys,orboth?"

"Areyouattractedto
women,men,orboth?"

"Whohaveyoubeen
romanticallyand
sexuallyinvolvedwith
inthepast?"

"Whohaveyoubeen
romanticallyorsexually
involvedwithinthe
past?"

"Haveyoueverhad
sex?"(Seespecific
questionsrelatedto
typesofsexbelow.)
"Doyoufeelsafewith
yourpartner(s)?"

"Howmanysexual
partnershaveyouever
had?Whattypesof
sexualbehaviorshave
youtriedorare
currentlyhaving?"

"Whatdoyoudofor
sexuallytransmitted

"Doessexfeelgoodand
satisfyingforyouand

"Whathaveyouand
yourparent(s)talked
aboutsofar?"
"Ifyouweretohavea
crushorromantic
feelingstoward
someone,wouldthat
someonebeagirl,boy,
both,orneither?"
"Doyouhavesomeone
thatyoulikeorthat
youwouldliketotalkto

"Whatdoyouusefor

yourpartner?Doyou
haveanyconcerns

pregnancyprevention?"

aboutorgasm,
ejaculation,oryour

ordate?"

"Whatdoyouknowor

sexualfunction?"

"Doyouhaveany

whatwouldyouliketo
knowaboutbirth

questionsaboutyour
sexuality?"
Sexualbehaviors

infectionprotection?"

controloptions?"

"Doyouhaveany

"Whatkindsofsexhave

"Whatkindsofsexand

questionsabouta
commonwaysome

youhad?

partnersdoyouhave?"

youngpeopleyourage
aresexuallyactive,
suchasmasturbationor
touchingyourself?"

Kissing

"Somepeoplefeel

Pettingortouching
breasts

uncomfortabletalking
aboutsex.Ihopethis
canbeasafeand

Touchingapenisto
masturbateand

"Whatsortsofthings

makeitcum

haveyoubeentaught
orheardaboutsex?"

Fingeringorputting
fingersinvaginaor

comfortableplacefor
youtotalkaboutsex."
"Thereisavarietyof

anus

waystobesexually
active.Doyouhaveany

Puttingyourmouth
onapenisorvagina

questionsabout
differentwaystobe

Havingsomeoneput

sexualorhavesex?"

theirmouthonyour
penisorvagina
Puttingyourpenisin
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11/2/2015

Discussingadolescentsexuality

avaginaorpenisin
ananus
Havingsomeoneelse
puttheirpenisin
youranus?"
STIprevention

"Doyouhaveany
questionsabouthowto

"Whatdoyouknow
aboutsexually

"Areyoucurrently
havingsexand/orina

besafeinasexual
relationship?"

transmittedinfections?"

relationship?"

"Whatdoyouknow

"Whodoyouhavesex

"Whathaveyouheard
aboutwaystoprotect

abouthowtoprotect
yourselforapartner

with?"

yourselfifyoudohave
sex?"

fromsexually
transmittedinfections?"

"Doyouknowabout

"Haveyoueverhad:

condoms?Howweuse
them?Howtheycan

chlamydia,gonorrhea,
genitalwarts,or

whetheryour
relationshipis
monogamousor
whetheryoubothwill

helppreventpregnancy
andsexually
transmittedinfections?"

herpes?"

alsobehavingothersex

"Haveyoueverbeen
testedforsyphilisor

partners?"

"Whatdoyouknow
aboutsexually

HIV?"

andrespectedinyour
relationship?Doyou

transmittedinfections?"

ortriedinorderto
preventsexually

feelsafeinyour
relationship?"

transmittedinfections?"

"Whatwouldorcould
makeyourrelationship

"Whathaveyourused

"Whathasworkedfor
you?Whathasnot
workedsowellforyou
inthepast?"
"Wouldyouliketesting
forsexuallytransmitted
infectionstoday?"

"Haveyouandyour
partnerdiscussed

"Areyoufeelingvalued

better?"
"Untilage26,we
recommendatleast
annualsexually
transmittedinfection
testingcanwedothis
today?"

HIV:humanimmunodeficiencyvirus.
*Thisisnotmeanttobeacomprehensivelist,buttoprovideexamplesofthedevelopmentaldifferences
amongearly,middle,andlateadolescents.Questionsrelatedtodatingviolencearediscussedinthetopicson
daterape.
CourtesyofMichelleForcier,MD,MPHandJohannaOlson,MD.
Graphic85699Version2.0

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