Research & Action Report, Spring/Summer 2016

By Jennifer Grossman Ph.D.

Think about it—in many of our parents’ and grandparents’ generations, there was little family conversation about sex. Often, for religious and cultural reasons, family communication about sex was considered taboo. Many teens did not know what sex was or how to protect themselves from pregnancy or sexually transmitted infections (STIs). This has changed in many families, as cultural expectations have shifted and there is growing recognition that teenparent sexuality communication can protect teens from early pregnancy and STIs. Many parents also have reflected on the potentially harmful effects that ignorance about sexuality had on their own teenage years and lived experiences. Parents now often commit to talking with their children about sex, breaking from traditions of family silence from past generations, as a way to support their children’s healthy development.

And for good reasons. Talking with teens about sex can make a difference. Many studies show that teens who talk with their parents about sex are more likely to delay having sex and, when they do engage in sexual behavior, they are more likely to use protection. Research tells us that it is critical for teens to learn about sexual issues from a trusted adult before they have sex, which can be a challenge, because many parents underestimate their teens’ sexual behavior. According to the Centers for Disease Control and Prevention (CDC), almost one-third of girls and boys have sex by ninth grade, which puts these young teens at risk for poor school and health outcomes.

It’s my belief that family communication about sex is particularly important for the current generation of teens, who face new challenges of navigating media messages and online social networks that provide early access to sexual messages that may put teens at risk. Many parents are daunted by changing technology and are unaware or disconnected from their teens’ online involvement. However, parents’ awareness and engagement with their teens’ social media are critical to supporting their teens’ sexual health.

Despite the importance of family communication about sex, only about half of teens report talking with their parents about sex. That puts a lot of adolescents at risk. However, it is not easy to talk with teens about sex. Parents often struggle with how to initiate conversations about sex with their teens; they feel embarrassed talking about sexual issues, and many lack the skills, information, and confidence to talk comfortably or confidently about such a sensitive issue with their teens. But, there is help. Increasingly, there are resources available to support parents and their teens. I have found that sex education programs provide a wide range of approaches for how parents can engage in talking with their teens about sex. These programs aim to increase the frequency and quality of teen-parent communication about sex as well as to increase parents’ comfort and self-efficacy in talking about sexual issues. These skills are essential. We know that those teens who see their parents as being good listeners, comfortable talking about sex, and open to questions about sex are more likely to truly engage in the conversations.

The most common approaches to involving parents in sexuality communication programs involve face-to-face participation, with interventions for groups of parents alone, or parents and their teens together, often in clinics or other community settings. While these programs can be effective in increasing family communication about sex and reducing teen sexual risk behavior, they require a high level of investment of time by staff, parents, and teens. Alternately, some school-based sex education programs give students and parents “homework” activities to complete together. Such programs can provide greater outreach to parents with lesser burden on staff and families, however, they also provide little direct opportunity to enhance parents’ actual communication skills. Several of these programs—which have explicit parent-teen communication modules—have shown effectiveness in delaying sex or reducing risky sexual behavior.

Here are some examples:

• It’s Your Game: Keep It Real is a school-based sex education program for seventh and eighth graders that includes six teen-parent homework activities each year, designed to promote conversation about friendship, dating, and sex. An evaluation of this program in an urban, predominantly African American and Latino school district in Texas found that teens in the comparison group (those who did not receive the intervention) were 1.29 times more likely to initiate sex by ninth grade than teens who received the intervention.
• Get Real: Comprehensive Sex Education That Works* is also a school-based comprehensive middle school sex education program with 24 lessons, which include a teen-parent activity in each lesson for sixth, seventh, and eighth graders. An evaluation of a diverse, urban sample in the Boston area found that in schools where Get Real was taught, 16 percent fewer boys and 15 percent fewer girls had had sex by the end of eighth grade. The findings also showed that completing family activities predicted delayed sexual debut for boys.
• Families Talking Together is a clinic-based program for mothers of 11–14 year-olds that provides 30 minutes of individual parent support for teen sexuality communication, as well as a packet of written materials and family communication activities, and includes two booster phone calls. An evaluation of this program with African American and Latino families in New York, NY, found that nine months after the intervention, the group that did not receive the intervention showed an increase in teen sexual activity from six percent to 22 percent, while sexual activity remained at six percent for the group in the intervention condition.
• Keepin’ it REAL is a community-based HIV prevention program for mothers and their 11–14 year-old adolescents. The life skills version of this program includes seven faceto- face meetings that mothers and teens attended as well as take-home communication activities, which addressed issues such as HIV prevention, communication skills, and talking about sex. An evaluation of the program with a predominately African American sample in Atlanta, GA, found that teens in the intervention group were more likely than the adolescents who did not receive the intervention to use condoms when they had sex.

A recent area of program expansion that I think is crucial to teens’ sexual health is support to help parents engage with their adolescent children’s online activities. Some programs involve opportunities for parents and teens to do online skill-building activities and access information that can enhance their sexuality communication. While there have been few evaluations of online programs to date, recommendations include activities such as having teens give their parents a “tour” of their digital world, allowing the teen to serve as the “expert” while empowering parents with strategies to understand, monitor, and respond to teens’ risky online engagement, such as setting parameters for provocative chats, not allowing the sharing of explicit imagery, and limiting video dating.

One concern that I have with existing programs that support parent-teen communication about sex is that the vast majority of parent participants are moms. While mothers are often their children’s primary sex educators, fathers also play a key role in sexuality communication, and their interactions have been shown to protect some teens over and above communication only with mothers; specifically, fathers’ involvement in sexuality communication may be of greater importance for sons, for example, as shared understanding and gender-based experiences, contribute to teens’ comfort in talking with parents about sex.

Finally, let’s consider other caring adults in our teens’ lives. Research on adolescents and risk-taking behaviors, such as alcohol and drug use, school truancy, and risky sex have shown that having even one trusted adult can make all the difference in the life of a teen. In many families, that trusted adult may not be a parent. I believe we need to look at aunts, uncles, older siblings, cousins, and godparents—all those extended family members with whom teens often find it easier to broach sensitive topics like relationships and sex. As with fathers, these family members need to be recognized as part of teens’ support systems and considered as potential resources for sex education programs. However, unlike research with mothers and fathers, no studies have investigated whether teens’ talk with extended family about sex and relationships can reduce risky sexual behavior. I aim to study this in my future research as well as how adolescents’ conversations about sex with parents and extended family change as the teens move through their middle and high school years. Do older teens still talk with their parents about sex and relationships? Do they increasingly reach out to others in their family network? Do these experiences differ for young women and young men?

We can support today’s teens’ health by recognizing their social challenges, identifying diverse resources, and finding effective ways for adults to talk with teens about sex and relationships.