The Teen and Pre-teen Years

Of special medical and emotional significance in the pre-teen years is the onset of sexuality.

Recent studies have shown that the proportion of sexually active girls ages 15 to 19 has been decreasing. However, the proportion of sexually active girls ages 14 and younger has increased, and more than 25% of these girls have reported multiple partners. At the same time, fewer than one-third of their parents are aware of this behavior and the girls themselves are not fully aware of the risks.

Studies further suggest that sexuality education should be tailored to the individual, because girls’ views differ based on age, social and culture contexts, and family background. Some girls, for example, describe pregnancy as a “choice,” while others describe it as an “accident.”

Children get their sexuality information from many sources – parents, friends, their school, and the media. However, it is the girl’s physician who may be in the best position to understand when to initiate a conversation on sexuality and to provide both authoritative information and interpretation.

“I think it’s important to take the time to communicate,” says David Chiang, M.D., co-director of OB/GYN Outpatient Ambulatory Care. “I want my patient to understand what is happening to her,” and if I can do that, I will be a successful doctor.”

Sexuality counseling begins with information about the menstrual cycle, what is normal, and what is not. It also includes education about sexually transmitted diseases and how to prevent them. Dr. Chiang cautions that sexuality counseling should stress the importance of regular screening for those who are sexually active. As a physician who keeps up with advances in prevention as well as treatment, he calls the recent introduction of a vaccine against the human papillomavirus (HPV) a “scientific breakthrough.”

That sentiment is echoed by Marie Welshinger, M.D., who is medical director of gynecologic oncology. “HPV is truly a public health issue,” she says. “More than 10,000 women are diagnosed with cervical cancer each year and 3,600 die from this disease. And yet, it shouldn’t occur. “HPV is a sexually transmitted disease that can cause infertility. Since males show no symptoms, girls don’t necessarily know when they’re at risk. “There are 15 types of HPV associated with cervical cancer. We now have two approved vaccines available, both of which protect against the two strains responsible for about 70% of cervical cancer. They are most effective if given before any exposure to HPV, and the recommendation is that girls be vaccinated routinely at age 11 or 12. Also, a girl will still need a Pap smear and GYN exam once she becomes sexually active.”

 
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