Thursday, June 9, 2016

Let's Talk about Sex, Baby.

I saw a preteen in clinic the other day. She was going into 6th grade. When I examine this age-group, I like to keep things light. Cheerful. Safe. Interesting. I ask questions, even with the parents in the room, about everything. I ask them as if it's totally normal to bring up questions of grades, schoolwork, friends, safety, peer pressure, alcohol, drugs, puberty and yes, even sex. I almost always bring up the more stereotypically "awkward" subjects by first assessing the patient's level of knowledge or experience, and open it with this simple question: "Have you had health or sex education at school yet?"

YET. I always use that word, as, silly me,  I thought it was standard in ALL school curriculum to teach children/teens about not only their bodies, but one of the MOST BASIC of all human interactions: intercourse. You know. Procreation. How a species survives. One of our most primitive and natural instincts. One's sex drive is so vital to human existence that it is one of the 4 major groups we use, as physicians, to assess quality of life. When meeting a patient for the first time and/or screening for things such as Major Depression I ask about these basic things: Appetite, Sleep, Mood and Libido. (Admittedly, with some well-adjusted, healthy seeming adults, I will just inquire into one or two of these categories and leave it at that, but only sometimes.)

So, I proceed with my usual exam with this patient, and I ask her my usual question. She sat there somewhat silently, so I looked to her mother, who was shaking her head, as if to say "no". I responded, "oh really? I thought most schools did this in 5th grade, but maybe it's 6th." The mom continues to shake her head. No? "They don't teach sexual education at ## #####." I'm fairly certain my jaw dropped to the floor. I'm still looking at the patient, and I ask, "Did they teach you about the menstrual cycle, or periods?" While continuing to avoid eye contact by looking down, I hear a rather meager, "no, they don't teach us anything to do with that kind of stuff". I ask if she and her girlfriends have talked about it. Still a no!! This visit continues, I give some education, ask some questions. Talk to both the mom and daughter, trying to keep communication lines very open, make it clear to her mother that she needs to be sure and continue this education at home, and that the daughter should feel comfortable to go to her mother, me or a teacher if she has any questions or concerns. I print some materials for them both to read and discharge them on their way.

What just happened? Why would this be cut out of a curriculum? I don't care your religious beliefs, there is no way to remove procreation from the equation.  Our bodies were created for it. Girls start bleeding. Boys...well, I have four boys, I really don't want to think about what happens to boys. But I HAVE to!!! My boys ask me questions all the time, and though I mostly keep it scientific, they are getting honest, real answers with true anatomical names. I am educating them. Preparing them for life, a happy life, a realistic life...and hopefully, an open, honest and respectful one.

I don't just answer questions about their boy parts either. I put them to bed at the same time every night. When they try to fight this, I explain (futile as it may be) how important sleep is to their little growing bodies and huge growing brains. When I offer food to them, I try to help them understand healthy choices. No, my kids don't get a fruit and vegetable every single day, or probably even week for that matter. I think we just had pepperoni pizza for the fourth night in a row tonight, but, yes, I still talk about nutrition when the opportunity arises. When they are having a tough day, or a melt down, I try to bring awareness and validation to their feelings, so hopefully, in the future they can deal with their anger or sadness appropriately...and not like a 2 year old. (By the way, 2 year olds were NOT meant to be 40lbs. Makes picking them up or forcing them in a car seat A LOT harder.)

What I'm saying, is it's not just about sex. Kids need to learn about life. Everyday. We are cultivating their future attitudes and decisions towards VITAL human needs. And by we, I mean adults. It doesn't have to be mom and dad. It can be aunt, friend, teacher, coach, doctor. I am slightly enraged that an entire generation of children that have gone through this school (and I'm certain it's not the only one) will secretively discuss sex amongst their peers. Will feel so insecure when they have their first menstrual cycle. Will have been led to believe that sex is a taboo subject that should not be freely and openly discussed. Will think that something as vital to the human existence {experience} as sleep is to be ignored, shushed, brushed under the rug, left to those much less qualified to teach. I can't help but wonder what kind of sex education a male college student got from his school, parents, peers, that led him to rape an unconscious woman? Insomnia leads directly to psychosis. Lack of dietary eduction leads to obesity or other major health concerns. What does ignorance of sexual drive lead to...? I can't help but wonder.

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