Less than two-thirds of doctors and teenage patients talk about sex, sexuality, or dating during yearly checkups, according to a Duke Medicine study published in JAMA Pediatrics last December. The conversations that do occur usually last just over thirty seconds, on average.
“It’s hard for physicians to treat adolescents and help them make healthy choices about sex if they don’t have these conversations,” says a lead author, Stewart Alexander, associate professor of medicine at Duke. “For teens who are trying to understand sex and sexuality, not talking about sex could have huge implications.”
To capture naturally occurring conversations, Duke researchers gathered audio recordings of annual visits, including camp and sports physicals, for 253 adolescents. The teens, ages twelve to seventeen, visited pediatricians and family-medicine physicians at eleven clinics in North Carolina.
The researchers listened to the recordings for any mention of sexual activity, sexuality, or dating. They found that physicians brought up sex in 65 percent of visits, with conversations lasting an average of thirty-six seconds.
Adolescents’ engagement in these discussions varied, with female adolescents more than twice as likely to talk about sex than their male counterparts. About half the teens answered with yes or no responses, and only 4 percent of teens had prolonged conversations with their doctors. None of the adolescents initiated discussions on sex, reinforcing the need for physicians to start the conversation.
Longer visits and confidentiality both raised the chances that sex was mentioned. Only 31 percent of visits included a confidential discussion— that is, without a parent present—but when they did, sex was four times more likely to come up.