Let’s talk about teen sex baby!

Good morning everybody! I thought I would launch right in on a “sensitive subject” that really shouldn’t be that sensitive. Teen sex. Just hearing those two words together sends tons of people straight to the sand to bury their heads or at least running to the other room to avoid the conversation. Stop avoiding it! It’s not doing any good…for us parents or for our kids.

The thing I hear the most from parents is ” I just know that she is not sexually active, but we are just here for a check up, “just to be safe.” These words often signify some glaring truths. The communication and trust lines are not fully open between the parent and child. The parent has suspicions and just cannot get them verified, but is hoping that I can. The parent already knows and is hoping that I can somehow shame the adolescent into stopping their behavior since they have been unsuccessful. Last, but not least, the parent truly does have his or her head in the proverbial sand and truly has no idea what their child is up to. Let me be clear. These statements are postulations that do not apply to everybody and every parent child relationship. I am just speaking from 27 years of experience and some things I have seen.

Reality check time. A lot of teens are having sex and it is essential that we at least attempt to communicate with them and at least try to give them the tools and opportunities to value themselves and be safe. The Centers for Disease Control and Prevention release the Youth Risk Behavior Survey every other year. This survey is conducted among high school students across the nation. Let’s take a peak at the most recent results. 39.5% of high school students said that they were having sex( 41% male and 38% female. 30% of these students had sex in the three months just prior to the survey. 46% of these students were not using condoms!. Just to drive these statistics home further, another CDC report showed that about 50% of the 20 million new sexually transmitted infections reported each year were in the 15 to 24 year old age group. Whaaat?! Now add to these statistics the emerging teen sex trends, the gender fluidity of sexual behaviors and the increasing rates of bisexual, pansexual, transsexual and polyamorous behaviors among teens. Currently, 48% of teens currently identify themselves as bisexual and 28 percent report that they are uncertain about their sexual identity. My head spins on the daily with all of the new terminology that I hear from my daughters’ friends and I have been told directly by teen patients that “being straight just isn’t cool anymore.” In the interest of further head spinning, I have had patients tell me that they have had 30+ partners between the ages of 15 and 18 without batting an eye.

Being a physician and seeing teens on a daily basis in the office( and being a general counsellor to my daughters’ friends) these statistics do not surprise me, but they are sobering and sometimes confusing to say the least. However, I have to keep these feelings in check somewhat if I want to be able to communicate freely with teens and encourage them to do the same. I still persist that open communication is the key to opening the door to attempting to help these adolescents value themselves and stay safe! I consider myself to be intelligent and I know that sometimes my teen patients tell me things just to see if they can shock me. What they don’t realize is that what they say doesn’t really shock me per say, but it merely strengthens my resolve to try to communicate with them and educate them. I guess you could say it is kind of an unintended reverse psychology situation…lol I also realize as I say this, that my openness is not for everyone. I am fully aware that I will never be invited to participate in sex education classes or lectures at my local schools because I cannot bring myself to go along with the abstinence only discussion. I am too practical for that. I bring slides, present non-judgemental facts, tell anecdotes, point out the pros and the cons, and provide them with the tools and information to keep them safe. This to me is far more preferable that to stand in front of them, thumping on a religious reference and watch all of their eyes close and their proverbial lights go out within seconds. Oh well, I will save my counselling for the office then I guess.

Speaking of the office, let me take you through one of my typical teen office visits. Every teen that I see in the office gets one on one time with just me in the room….with their clothes still on! There is no communication buzzkill quite like having to be naked in a flimsy drape while discussing personal details. So, with clothes on, and phones off( I insist on no distractions) we begin our discussion. If the teen is sexually active and/or is interested in having sex, we begin a dialogue. The first thing that I do is ask them what I call “the big question.” It is something that I ask with hope, but no expectations. I ask them point blank how they knew that they were ready to have sex. In 27 years I have only gotten a handful of thoughtful answers. Most of the time I just hear ” I don’t know” or “It just happened.” or ” if I didn’t I was going to lose (insert partner name) What I am really after with this question is finding out if any kind of thought process went into making that huge decision to have sex. I realize that most of the time the answer is no. I use this question as the lead in to our discussion about sex and its pros and cons. Usually it is a good ice breaker. After the question is let out into the open, I explain to the teen why I was asking in the first place. I explain to them that I am hopeful that when they make huge decisions for themselves that they stop and think about it first. I tell them about my observations over the last 20+ years with my teen patients and we talk about self worth and their own sense of value. I emphasize to them that their own self worth is not just measured by their body parts or their sexual activity. I point out to them that they are incredibly important and they are really masters of their own destiny and every decision that they make affects their future. I also let them know that if they are already worried that their bodies are the only thing left to give, we have much bigger things to talk about. Then we gently transition into a discussion about the pros and cons of having sex as a teenager. I set aside my temptation to soapbox and just discuss some facts. I point out the great disparity in social maturity between men and women at that age. I discuss the potential permanence of relationships at that age. I talk about the reality of how long the act itself might last despite the promises and bragging of most teenage men. I discuss with them the fact that the first several acts of penetrative intercourse may be painful. We talk about the risks of getting pregnant. We talk about proper use of condoms and birth control. I often get some squeamish faces at this point and reluctance to talk about male body parts or even call them by name. It is at this point that I am able to point out that being unable to even say the word penis or be comfortable with “dressing it appropriately” PROBABLY means that it does not belong inside their vagina. This often gets a laugh…..and then an abrupt serious and thoughtful look. I am not sure what that means, but I am hopeful that it means that the patient is at least considering what I said for a minute. We then also talk about the possibility of getting a “reputation” and the consequences of that. Then, we wrap it up together by stacking the facts up against their perception of what the pros might be( these depend on the patient), and give them the chance to evaluate. If the teen decides that no behaviors will be changing that day, we then start talking about how to keep them safe and without early unplanned pregnancies and I arm them with as much info, tools, and options After that discussion is over, we then talk about the best way to keep them healthy and whether or not an exam would be warranted and then that would be scheduled a different day. We will get to the discussion of teens and exams in another blog.

The bottom line is, we have got to be willing to at least attempt to be open with our teens about the realities of sex and keep our eyes on the prize goal: Keep them safe and healthy both mentally and physically. That is all we are really talking about. It is not always easy by any means, but it is definitely important. Have a fantastic day!

Dr. Katz

“My mom’s a gynecologist, so she knows.”

This title is a direct quote from my now 15 year old to another child when she was correcting her on the proper terminology for body parts, at the ripe old age of 4 or 5. To be fair, she may have butchered the term gynecologist a bit and made it her own, due to pronunciation difficulties. Nonetheless, the message was the same. As I think about it, I am quite sure that growing up with a gynecologist as a mother has presented an intricate balance of advantages and disadvantages…for both sides. It has definitely made life interesting, to say the least. I remember thinking, before I had children, that it was going to be sooooo amazing to be a gynecologist mom. I couldn’t wait to have daughters so that I could be the best information resource ever about all things “sensitive.” I was convinced that we would share so openly about sex and biology and all things gyn that my kids would never want for knowledge and certainly would come to me with ANY questions or concerns they might have. Well, this hasn’t exactly turned out the way I had hoped.

Let’s start from the beginning. From the time my kids were little, there simply wasn’t room for any body part baby talk in our house. There were no weewees or hoohoos. There were penises and vaginas, right from the start. I was determined to give them the proper terminology, thinking I was starting off right in removing the taboo. After all, I wasn’t teaching them swear words or anything, just basic biology terms. What’s the harm right?

Well, I need to tell you a little story about how this semi-backfired almost immediately. We were sitting in a restaurant one day. It was my husband, myself, our oldest and my two year old. The meal was meh, but the conversation was nothing if not interesting. Right in the middle of her mashed potatoes, my 2 year old suddenly bolts up out of her chair and announces very plainly to us and the whole restaurant in general(cue squeaky high-pitched two year old voice)..” Mommy, my vagina hurts real bad and I can’t sit here any more.” You could have heard a pin drop. The silence was deafening, except for the sounds of every single head in the restaurant snap-turning in my daughter’s direction with a look of horror on their faces. It was as if she just quoted a line from a soft porn movie, complete with cusswords. My oldest was trying to stifle a laugh into her pot pie. My husband was sitting there open-mouthed. My 2 year old was grinning, very proud of herself for getting all the words right. I knew it was up to me to handle this. I stood up immediately and said,” It’s ok folks. It’s ok. I am a gynecologist and I can take care of this.” I turned to my two year old and asked her if she wanted to switch seats. She did willingly. I then asked her if she felt any better. She looked at me and said,( cue toddler voice again) ” Oooooh yes. My vagina feels muuuuccchhh better now. Thank you Mommy.” She then sat down, smiling and proceeded to start in on her mashed potatoes again. Meanwhile, the rest of the room did not seem nearly as relieved that the problem had been solved. Ever the fixer, I felt like I had to address the again. I said,” It’s alright now. She feels better. Problem solved. Everyone please go back to enjoying your meal.” Needless to say we never ate there again.

My now 15 year old took a completely different spin on it. She learned and embraced all those terms with relish early on. In fact, she would correct every child that she came across who dared to use improper terminology for their body parts….all the time! As a matter of fact, she was so keen on all of her little friends knowing the right words to say, that even if the subject of body parts did not come up in polite conversation, she would bring it up so she could have the opportunity to “educate” them. This did result in more than a few phone calls from the school. It was as if we had turned the tide on the terms wee wee and hoo hoo and now they had become the bad words.

My youngest was also always fascinated with what her Mommy did, especially the part about delivering babies. She thought that was really something special.(and hopefully still does) However, I did not really grasp just how special she thought it was until one day when I got a different kind of phone call from school. Mind you, at the time, both of the girls were attending a private Lutheran school, so they were getting their daily dose of religious education right along with their ABCs. I got a phone call at work saying that I needed to come to the school as soon as I could, but that it wasn’t an emergency. I hung up confused, of course and tried to head there as soon as I could. I arrived at the school and headed right to the preschool day care room. As soon as I walked in I noticed a long line of little girls leading up to the play tent in the corner. I asked the daycare teacher what was going on. She smiled at me and said, “Oh you’ll get a kick out of it.” She motioned me over to the tent and there was Katy, dressed like the virgin Mary, delivering each little girl’s baby one by one. She saw me and immediately smiled and informed me that she was delivering their babies just like me. Everyone still had their clothes on and each baby was a doll, but the main objective was still clear. She was very proud. I thought it was pretty clever that she combined her admiration for me and the Virgin Mary all in one. However, all of the other parents did not exactly share my sentiments and thus, the baby tent had to go.

All in all, I still think I did the right thing in teaching the proper terms to my kids. I think we have to stop thinking of body parts as taboo for little children. It is only natural to be curious about them. Psychologists say this starts naturally as young as the toddler age. I think that if we contribute to removing the taboo from the words themselves, it might be a first step in being more comfortable talking to our kids later in life about their sexuality and arming them with useful information and resources instead of shouting about abstinence only or leaving them to fend or themselves.

Yes, i went there. I started talking about teenagers and sex. This leads to yet another tricky aspect of having a mom as a gynecologist. My girls went very quickly from being fascinated with what I do and happy to receive whatever tidbits of wisdom I wanted to impart to being mildly horrified and unwilling to engage in the sharing extravaganza that I had in mind. I learned very quickly that, despite all my efforts to the contrary, they had no problem coming to me with concerns or questions on behalf of their friends, but that it was just too embarrassing to talk too much in depth on a more personal level. Nevertheless, I still continued, and will still continue to encourage open conversation whenever possible. Whatever my girls decide to do, I have armed them with resources and information to help them make safe decisions. Teenagers in general are known for poor decisions and getting guidance from google, their friends, snap chat, and tik tok, but I am hoping that my guidance will help pave the way to better ones. I will always be hoping.

Well, that’s all for now. Gotta get to work. Have a fantastic day!

Dr. Katz

Introductions

Hello everybody! My name is Laura Alyce Katz. I have decided to celebrate my 50th year of life on this earth by starting a blog. After decades of living and working, and some significant coaxing from outside influences, I decided to give blogging a go to express my thoughts on an endless array of subjects. Here’s hoping that you may find this blog informative, engaging, and entertaining. As the title of my blog suggests, I am prepared to talk about just about anything. I have packed many years of working as an obgyn and aesthetics practitioner under my belt, as well as being a mother to some amazing daughters and living the life of a musician before that so my life and work experiences are widely varied to say the least. I have found myself espousing in public on an infinite array of subjects verbally already so why not write some of them down? Hopefully some of you might find the information useful or at least worth reading about. So, here goes.

Like I said, I am a 50 year woman. That really does not require further explanation I just thought I would say it again to let it sink in. Wow 50! I guess I don’t really feel any differently, except for the fact that I have more hot flashes and joint pains. I am thankfully relatively wrinkle deficient, thanks to years of working without much sun exposure. I do get a bit crabbier and more short-tempered. But, overall I think I am doing pretty well. Hopefully, those around me would agree…lol

Ok onward. Now a little about myself. I have been a practicing solo obgyn in Monroe, Mi since 2002. My practice has evolved to include everything from general obgyn care to aesthetics to minimally invasive surgery to treatment of sexual pain disorders and even addiction management. Why such a variety you ask? I feel like it is my duty to patients and myself to continue evolving and learning as long as I possibly can to continue to strive to be a one stop shopping place for safe, compassionate, comprehensive care for women everywhere. That is one of my top life goals. People always ask as well…What were you thinking being a solo obgyn? Don’t you want any kind of a life? Don’t you ever want to see your family? To that question I have multiple responses. The first is that, as a solo practitioner, I can be assured of the quality of care that I provide almost 100 percent of the time and I can be sure that that care follows my codes of ethics, responsibility and duty. The second is that I have been conscious of family/work balance from the very beginning of my career and have made every attempt to balance my patient and office load with my home life as much as possible. I am not the person that sees 50 + people in the office every day or delivers hundreds of babies every year. That is by intent for two reasons. One, when you get that busy, you find yourself getting into a herd of cattle mentality with regard to your patients and could very likely miss crucial diagnoses that could affect their health. I am a person that gives 110% in everything that I do and I couldn’t live with myself if I inadvertently put someone in harm’s way because I didn’t have the time to spend with them. Two, I would virtually guarantee that I could never make it to a single recital, sporting event or family gathering. That is just not me. My family comes first. I never signed up to be a guest star in my personal life. Having said that, there is an trade off in that I make less money. But, I did not start this profession with money as main goal anyway. That is not what I became a doctor for.

A little more about myself. I am a wife and a mother….to two teenagers! ( Sometimes three if you count my husband….jk) In all seriousness, I have been head-over-heels in love with and married to my best friend for 20 years now. There is not a day that goes by that I do not realize how lucky I am. My husband, also a physician, is the first person I think of to call when anything good or bad happens. At our best, we really do make a great team and I would not have it any other way. I have two teenagers in the house at the moment, both girls. My daughters are both intelligent and amazing and yes I am completely biased. This estrogen-heavy household scenario does make for some interesting tribulations for my husband and the dinner table conversation often drifts to a variety of female “sensitive subjects.” There is also no shortage of drama, depending on the time of the month, but overall we do ok.

Well, those are just some introductory thoughts. Talk to you again soon! Have a fantastic day!

Dr. Katz