Lay Audience: You Can’t Stop Her Growing Up - Why Open Conversations about Sex Matter

One of the most challenging experiences you’ll have as a parent is watching your daughter become a young woman. You’d much rather stay in denial and avoid the awkward ‘birds-and-bees’ conversation. But having ‘the talk’ is not only easier than you believe, it is extremely important.

Making peace with the idea that your adolescent daughter may be sexually active isn’t easy. After all, she’s still your baby girl, and it’s difficult to see her in any other way. A 2004 survey of 1,000 American adolescents and their parents revealed that 83% of parents believed their teenager had not gone beyond kissing.[1] They held on to the idea that their child was still just that—a child.

While you know contraceptives protect against pregnancy, two concerns are likely weighing on your mind:

1. That access to contraceptives will encourage your daughter to engage in sexual activity.

2. That contraceptives are unsafe for adolescents.

Compounding these concerns is how uncomfortable you feel at the idea of talking about sex with your daughter. However, avoiding difficult conversations won’t stop her from growing up. This is an opportunity to guide her through this new stage of life. It may not be easy, but it’s time to face the facts.

Statistics show that in Western countries, the average age of a woman’s first sexual intercourse encounter is 17, and by age 20, 80% of young women have had sex.[2] In 2021, a survey of American high school students revealed that 3 in 10 straight girls had been sexually active, with 23% engaging in sexual activity within the last three months.[3] Shockingly, 87% of these girls did not use any form of birth control—not even condoms—before their last sexual encounter.[3] So, chances are your daughter may already be sexually active, with or without your consent, and most likely without contraceptives.

With sex comes the possibility of pregnancy. Without contraception, even more so. If your daughter faces an unplanned pregnancy and doesn’t feel comfortable discussing it with you, she might find herself having to make a very difficult decision as an adolescent. Abortion, a choice that often feels like the only option for scores of young women, could have traumatic mental health consequences.[4] 

A 2020 study uncovered the experiences of 20 Texan women facing unplanned pregnancy, aged 16 to 19 years old. The first emotional hurdle was the shock and disbelief of their pregnancy discovery. One respondent recalled dropping to the floor in tears: “My mind and heart were racing!” Others feared disclosing pregnancy to their parents, anticipating shame and disapproval and feeling overwhelmed and alone.[4]

Clearly, these young women were severely stressed and, importantly, their adolescent brains were still developing; planning, prioritizing, and decision-making skills only mature in the mid-to-late 20s.[5] This physiological immaturity increases the chances of emotional illnesses such as anxiety and depression because adolescents are more likely to experience a stressful event as traumatic.[5] 

Trauma occurs when an event is experienced as physically or emotionally harmful or life-threatening and has lasting mental, physical, social, emotional, or spiritual effects.[6]

 The next overwhelming internal conflicts surround the young woman’s decision to abort, such as:[4,7]

• Feeling trapped by financial dependence

• Dread of judgment and rejection

• Shame about feeling emotional relief

• Guilt about perceived religious or moral sin

• Fear of future infertility or death as a complication

Thus, many young women take risks—physically, emotionally, and socially—to keep their abortion a secret. Unfortunately, without family support, a traumatic event like this may increase your daughter’s risk of depression, anxiety, delinquency, substance abuse, suicidality, and Post-Traumatic Stress Disorder (PTSD).[8]

Given the weight that these decisions carry, it's important to have open, informed conversations about sex, contraception, and emotional health. Ensuring your daughter is equipped with the knowledge and resources to make informed choices can help alleviate some of the stress.[7]

You’ll be relieved to know that contraceptives are generally safe for adolescents and, if needed, your daughter can start any form of contraceptive as early as age 10, as long as she has started having menstrual cycles.[2] You might have heard that contraceptives will affect your daughter’s future fertility or increase her cancer risk; these are myths.[9,10] Firstly, when hormonal contraceptives are stopped, or intra-uterine devices are removed, normal menstruation usually returns within a few months. Also, fertility rates are the same as the general population within the first year of attempting pregnancy.[9,10] Secondly, the risk of certain cancers is actually decreased: endometrial, ovarian, and possibly colon.[2,11] Studies also cannot prove a concrete link between contraceptives and breast cancer risk.[2,11]

Not only will contraceptives protect your daughter from pregnancy and possibly cancer, but hormonal methods, if appropriate, may offer other benefits such as:[12]

·         Regulating menstrual cycles

·         Reducing premenstrual symptoms

·         Minimizing heavy periods

·         Treating acne

Hopefully, you now know why it’s so important to talk to your daughter about sex and contraception. Doing so during adolescence may also benefit her into emerging adulthood; between 18 and 25 years of age, less parental dependence means she will explore her identity and take more risks.[13] Believe it or not, studies reveal that college students actually appreciate chatting with their parents about sex and relationships![13]

Your last mental obstacle is having the ‘birds and bees’ conversation, which doesn’t have to be awkward with these fantastic resources at your disposal from the Mayo Clinic and CDC.

When you’re ready, continue offering your daughter support by booking her a doctor’s appointment so that her physician can advise on an appropriate contraceptive, serving to reassure you and guide her on this journey toward adulthood.

References

1. SIECUS. Survey Provides Additional Insight About Teen Sexual Health, Behaviors, and Attitudes - SIECUS. January 31, 2004. Accessed September 8, 2024. https://siecus.org/survey-provides-additional-insight-about-teen-sexual-health-behaviors-and-attitudes-2/, https://cbs.siecus.org/survey-provides-additional-insight-about-teen-sexual-health-behaviors-and-attitudes-2/

2. Todd N, Black A. Contraception for Adolescents. J Clin Res Pediatr Endocrinol. 2020;12(Suppl 1):28-40. doi:10.4274/jcrpe.galenos.2019.2019.S0003

3. Youth Online: High School YRBS - United States 2021 Results | DASH | CDC. Accessed September 9, 2024. LT&SO=ASC https://nccd.cdc.gov/Youthonline/App/Results.aspx?TT=A&OUT=0&SID=HS&QID=QQ&LID=XX&YID=2021&LID2=&YID2=&COL=S&ROW1=N&ROW2=N&HT=QQ&LCT=LL&FS=S1&FR=R1&FG=G1&FA=A1&FI=I1&FP=P1&FSL=S1&FRL=R1&FGL=G1&FAL=A1&FIL=I1&FPL=P1&PV=&TST=False&C1=&C2=&QP=G&DP=1&VA=CI&CS=Y&SYID=&EYID=&SC=DEFAULT&SO=ASC

4. Coleman‐Minahan K, Stevenson AJ, Obront E, Hays S. Adolescents Obtaining Abortion Without Parental Consent: Their Reasons and Experiences of Social Support. Perspect Sex Reprod Health. 2020;52(1):15. doi:10.1363/psrh.12132

5. The Teen Brain: 7 Things to Know - National Institute of Mental Health (NIMH). Accessed September 12, 2024. https://www.nimh.nih.gov/health/publications/the-teen-brain-7-things-to-know

6.  SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach.

7. Zia Y, Mugo N, Ngure K, et al. Psychosocial experiences of adolescent girls and young women subsequent to an abortion in Sub-saharan Africa and globally: A systematic review. Frontiers in reproductive health. May 19, 2021. Accessed September 28, 2024. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9580653/

8. Darnell D, Flaster A, Hendricks K, Kerbrat A, Comtois KA. Adolescent Clinical Populations and Associations between Trauma and Behavioral and Emotional Problems. Psychol Trauma Theory Res Pract Policy. 2019;11(3):266-273. doi:10.1037/tra0000371

9. Barnhart KT, Schreiber CA. Return to fertility following discontinuation of oral contraceptives. Fertil Steril. 2009;91(3):659-663. doi:10.1016/j.fertnstert.2009.01.003

10. Girum T, Wasie A. Return of fertility after discontinuation of contraception: a systematic review and meta-analysis. Contracept Reprod Med. 2018;3:9. doi:10.1186/s40834-018-0064-y

11. Kamani M, Akgor U, Gültekin M. Review of the literature on combined oral contraceptives and cancer. ecancermedicalscience. 2022;16:1416. doi:10.3332/ecancer.2022.1416

12. Coelingh Bennink HJT, van Gennip FAM, Gerrits MGF, Egberts JFM, Gemzell-Danielsson K, Kopp-Kallner H. Health benefits of combined oral contraceptives - a narrative review. Eur J Contracept Reprod Health Care Off J Eur Soc Contracept. 2024;29(2):40-52. doi:10.1080/13625187.2024.2317295

13. Grossman J, Jones C, Richer A. “I put it all out there. I have nothing to hide. It’s my mom”: Parents’ and Emerging Adults’ Perspectives on Family Talk about Sex. Sex Educ. 2023;23(4):449-463. doi:10.1080/14681811.2022.2062591

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