Teens and Sex Education at the Doctor's Office

I was heartened by a recent story in the Houston Chronicle discussing how some Texas moms concerned about their teens and sex have found a suitable alternative to sex education when their daughters' schools teach only abstinence: the gynecologist. While most of us feel comfortable having the basic birds-and-bees discussion with our girls, these parents rely on a gynecologist to answer the kinds of questions about sex that their daughters may not feel comfortable asking or that they themselves may not know the answers to: Will I gain weight on the pill? Can I get a sexually transmitted disease even if I don't have intercourse? Why is one breast larger than the other?

It may sound strange to take a 13-year-old to the gynecologist, but many moms are doing so these days. Some bring their daughters in for the Gardasil vaccine against the cervical-cancer-causing human papillomavirus. Others figure it's a good transition time from pediatrician to family doctor. In fact, the American College of Obstetricians and Gynecologists recommends a first visit to the gynecologist for those ages 13 to 15 and, in this helpful online pamphlet written for girls, says this visit "may just be a talk between you and your doctor" and won't necessarily involve a pelvic exam.

Using a trusted gynecologist, preferably one who specializes in adolescent medicine, as a resource for health information is probably a wise choice, given the other sex-education options teens are turning to. Their peers, of course, can be a wealth of misinformation. So, too, are websites, even widely trusted ones. New research from Lucile Packard Children's Hospital found that about half of the most popular health websites that tell teens about sex—including Mayoclinic.com—are often fraught with errors and omissions. The research team identified six teen sexual health myths that are spread on highly trafficked websites that appeared among the first 10 to 15 hits on Google searches of terms such as "birth control," "morning after pill," and "sexually transmitted disease."

[Read why teens need to hear about oral sex as part of their sex education.]

For instance, sites often failed to say that minors can buy Plan B emergency contraception from authorized pharmacists in nine states. (While the study was performed before the recent court ruling directing the Food and Drug Administration to allow the sale of Plan B to 17-year-olds, I wonder how many websites have updated their information on this ruling.) The researchers also found that 60 percent of the websites said the birth control pill causes weight gain, despite recent research showing that the newest formulations don't affect body weight. And only 19 percent of the websites made it clear that intrauterine devices are safe for adolescents. What's worse, only about half of the websites correctly stated that some STDs, such as herpes, can be transmitted through skin-to-skin contact or kissing.

Another surprise: A full 40 percent of the websites didn't accurately tell girls when to begin Pap smears. These sites recommended them following the initiation of sexual activity despite the fact that ACOG began recommending in 2003 that screening begin three years after initiating sex or at the age of 21, whichever comes first. This misinformation could lead to a lot of unnecessary Pap smears among teens and a lot of unnecessary worry over abnormal results that turn out to be nothing.

The researchers identified the most reliable sites for teens. These include:

• Go Ask Alice, a question-and-answer service maintained by Columbia University
• Center for Young Women's Health, an educational effort of Children's Hospital Boston
• TeensHealth, a part of KidsHealth.org
• Teen Wire, an educational site for teens maintained by Planned Parenthood