Helping Teens Understand Unhealthy Dating Relationships

heartsickness-428103_1280Most adults would agree that the teen years can be a vulnerable period.  Teens juggle the mastery of many tasks during this phase.  One of the most important is developing the tools needed to form healthy partner relationships.  Unfortunately, for many teens, an introduction to unhealthy relationships occurs during this time.  According to the CDC, 1 in 4 teens say they’ve been verbally, physically, emotionally or sexually abused by a dating partner.  And, about 10% of teen students say they’ve been physically hurt by a partner in the past year.  A high percentage of teens experiencing these behaviors do not tell their parents or other significant adults in their lives.

The effects of teen dating violence can be quite severe.  The CDC reports that its victims are more likely to experience eating disorders and depression, do poorly in school, be involved with drug and alcohol use and continue being involved in unhealthy intimate relationships into adulthood.  And, teen girls who suffer from dating violence are more like to have an unintended pregnancy.

Parents, health care providers, and teachers are among those in critical positions to help teens understand what unhealthy relationships look like.  What’s the best approach?  As with any problem, there are many ways to be proactive.  However, making sure teens know what to look out for is an important first step.  Some examples of unhealthy dating behaviors highlighted by the advocacy group, Futures Without Violence, are presented below.  The health and safety of any teen experiencing these behaviors may be in jeopardy.

  • Being hit, slapped, pushed, or kicked
  • Called insulting names or being overly criticized
  • Prevented from engaging with family and friends
  • Being humiliated, either in person or online
  • Experiencing control over where they go, what they wear or what they do
  • Feeling pressured to do participate in sexual acts

There are many measures that adults can take to support teens in developing healthy partner relationships and avoiding unhealthy, potentially harmful ones.  Parents, in particular, are on the front line in addressing this issue with their teens.  Some “common sense” guidelines include:

  • Modeling healthy behaviors in your own partner relationships
  • Promoting the importance of self-respect
  • Communicating to teens that abuse, in any form, is never acceptable
  • Looking for changes in behavior such as moodiness or increased irritability that  teens suffering from an unhealthy partner relationship may exhibit
  • Observing for signs of unhealthy behaviors in a teen’s dating partner and speaking up about your concerns
  • Pointing out examples of unhealthy partner relationship on tv, in the movies, and on social media outlets

If you are concerned that a teen you know is at risk of or is possibly in an unhealthy dating relationship, seeking guidance from a school counselor, health care provider or spiritual advisor can be an important first step.  Online assistance can be obtained from several organizations including Futures Without Violence (  and Love is Respect (  Concerted and proactive efforts are needed to ensure that every young person understands what constitutes an unhealthy dating relationship, feels empowered to resist being in one, and is able to reach out for guidance if they are ever a victim.



Teens, Sex, and Pesky Birth Control Myths


Roughly half of teens who became pregnant hadn’t used birth control, according to a CDC report. Why? Numerous explanations exist, but the fact that many teens believe in myths about birth control and sex is definitely one of them.


Teens, who experience many changes during the transition from childhood to adulthood, may be more likely to believe in myths or misinformation than adults.  Research tells us that the teen brain is not fully developed.  In fact, brain development and maturation aren’t fully realized until about age 25.  This concept helps to explain why the ability of teens to make sound decisions and exercise high degrees of reasoning in their decision-making is often compromised.

As an OB/GYN physician, I understand the challenges of educating sexually active teens about birth control while also confronting prevailing myths that can be dangerous. This article sheds light on five popular myths and offers straight facts that adults can use to educate their teens.

Myth #1:  You won’t get pregnant the first time you have sex.

Fact:  There’s no such thing as a pass for beginners. If a teen girl has unprotected sex near the time she ovulates (releases an egg from her ovary), she can easily become pregnant. It’s possible to become pregnant a few days before, during, and after ovulation. Effective birth control and condom use should always be used to protect against pregnancy and STDs (dual contraception).

Myth #2:  Pregnancy won’t occur if the male partner “pulls out” or withdraws prior to ejaculation or orgasm.

Fact:  Withdrawal is a common birth control method among teens, but is not highly effective. In fact, the failure rate of withdrawal is more than 25%, according to some reports. Pre-ejaculation fluid may contain sperm. And, withdrawal requires a certain amount of self-discipline, which is likely more difficult for teen males than adults.  While withdrawal is better than nothing, its use should be discouraged in favor of dual contraception (effective hormonal or non-hormonal birth control and a condom).

Myth #3:  A girl won’t get pregnant if she has sex during her period.

Fact:  It’s easy to understand why this myth prevails, and it’s true that it’s unlikely for a girl to become pregnant when she’s on her period. Usually ovulation occurs about two weeks prior to the start of a period. However, in some cases bleeding may occur in the absence of ovulation. If a girl has sex during this bleeding and ovulates soon afterward, she could potentially get pregnant since sperm can live in her body for several days. It’s never worth taking a chance that ovulation won’t occur during a bleeding episode.

Myth #4:  The hormones in birth control make you gain weight

Fact: Teens are very image-conscious and it can be difficult to persuade them to use birth control that they think causes weight gain.  Several studies have been done on birth control pills.  While some teens may experience a small increase in weight, most studies show that birth control pills do not cause weight gain when compared to women taking placebo pills (tablets with no medication in them). Nonetheless, concerns about the pill and weight gain are common from my teen patients and adults as well.


The most effective methods of birth control are the IUD (intra-uterine device) and the implant (small rod placed under the skin in the arm).  They are also known as LARCs (Long-Acting Reversible Contraceptives).  Weight gain is very unlikely in IUD users and reported to occur in only 6-12% of implant users.  These points are well worth stressing to teens.

Myth #5:  Birth control causes cancer

Fact:  It is important for teens to know that the birth control pill is actually associated with protection against ovarian, uterine and colorectal (large intestine and rectum) cancers. The progestin containing IUD is also associated with a decrease in uterine cancer and may even be prescribed as a risk reduction measure in very obese young females. Uterine cancer risk is also decreased in females who use the depo-provera shot.  Informing teens of these facts can ease their concerns and reluctance to use birth control because they believe the cancer myths.

This article is adapted from Before It’s Too Late, A Parent’s Guide to Teens, Sex, and Sanity by Sheila Overton, M.D., FACOG



5 Ways to Become an Approachable Parent: Positive Parenting for Teen Sexual Health

family-photo-827763_1920One of the top questions I’ve encountered from parents as an OB/GYN and health educator is: “How can I get my teen to come to me with questions and concerns about sex?”



While some parents and teens may have that near-perfect, open relationship that allows them to discuss sensitive issues like sex easily, my experience is that most don’t. There are many things that parents can do to create an environment in which their teen feels comfortable coming to them with questions about sex.

One of the most important traits a parent can possess is that of an “Approachable Parent.” This is a parent who encourages their teen to feel safe and comfortable bringing up sensitive concerns. The top five traits of an approachable parent listed below are based on the feedback I’ve received from parents and teens during seminar presentations since 1998 and in my clinical work.

1. A Nonjudgmental Outlook
If you find out your 14-year-old teen has been having sex, how are you supposed to react? Being nonjudgmental doesn’t mean that you don’t get to have an opinion or to be upset. What it means is that you don’t react externally by condemning or berating your teen. In this instance, you might choose to say something like “This is upsetting, let’s talk.” A judgmental response might sound something like, “How could you let this happen? That’s really stupid on your part!” A nonjudgmental response is more likely to leave your teen feeling that she/he can really talk to you about the situation.

2. A Listening Ear
This means really being attentive and listening actively, nodding your head or saying “yes” or “um hmm” to show that you are very interested in what’s being said. It also means using good eye contact with your teen and not interrupting. It’s a good idea to ask your teen how she/he feels about the situation being discussed.

3. Open-mindedness
When concerns arise, flexibility and the willingness to consider several options are needed. I strongly urge parents to be open to their teens talking to another close relative or an adult who is a close family friend about sex-related questions. I’ve seen parents react with hurt or anger at the thought of their teen turning to someone else. However, remember that the primary goal is that your teen be able to talk to a responsible adult who can give accurate information, not for you to always be in charge.

4. A Calm Demeanor
A calm demeanor will help you and your teen deal with what’s really important and to take more logical and meaningful steps in handling any situation.
For instance, if your 16-year-old-daughter told you she had an STI (sexually transmitted infection), a calm response might sound like this: “This is difficult news for me to hear. First of all, how are you feeling? I’m going to need a few moments to gather my thoughts together before we talk.”

5. Lightheartedness
As they say, “Laughter is the best medicine.” Maintaining a sense of humor, especially during the teen years, might seem difficult. The truth is that while early teen sex, teen pregnancy, and STIs are serious issues, there is room for humor when it comes to parenting, teen dating, and relationships. Many parents will appreciate Arnold Glasgow’s remark, “Telling a teenager the facts of life is like giving a fish a bath.”

What these five traits highlight is the concept that being an approachable parent means being the type of parent you wanted as a teen. It’s really that simple!

This article was first published by Healthy Teen Network in “Under the Currents”, January, 2012

How to Decrease the High Rate of STDs Among Black Youth

biohazard-549303_1280Parents want the best for their children. They want them to grow up to achieve their full potential and to be free from physical and psychological harm.  However, we know that sometimes, despite parent’s best efforts, their children may be exposed to and even succumb to harmful life events and situations.

For example, Americans are all too familiar with statistics depicting Black children and youth as being at higher risk of harm due to gun violence.  Because of community concerns, programs and awareness campaigns to end gun violence have formed across the country.

Much less media coverage and attention has been given to a serious health problem that affects Black youth at alarmingly high rates.  Data from the Centers for Disease Control and Prevention (CDC) reveals that Blacks are often at higher risk of STDs than youth in other racial groups.  While STD infections aren’t always associated with the risk of serious illness or death, they can cause complications that threaten or take the lives of young people.

Chlamydia is the most common bacterial infection among youth.   Figures from 2013 show that rates of chlamydia are five times higher among 15-19 year old Black females than their white counterparts.  And, among 15-19 year old males, Blacks have rates of chlamydia that are more than nine times higher than in Whites.

Like most STDs, chlamydia often causes no symptoms and therefore an infected person may not seek treatment.  Females who do not receive treatment for chlamydia in a timely fashion may experience serious complications, such as an overwhelming pelvic infection.  If this occurs, pelvic organs that include the uterus, ovaries and fallopian tubes may be significantly damaged and require surgical removal.  Damage to the female pelvic organs can also lead to a condition where a pregnancy grows outside of the uterus (ectopic pregnancy).  When this happens, life threatening hemorrhage and rarely, even death, may occur.

Gonorrhea is the second most common bacterial infection among youth. Reports show that Black females, ages 15-19, have rates of gonorrhea that are thirteen times higher than their White female counterparts.  Among males ages 15-19, rates of gonorrhea in Blacks are over twenty one times higher than in White males. The potential complications that may result from an infection due to gonorrhea are most serious in females and are similar to those associated with chlamydia infections.

HIV remains the most serious and feared STD.  When the CDC reports HIV rates among youth, they refer to young people between the ages of 13-24.  Approximately 64,000 youth were living with HIV by the end of 2012.  Of those diagnosed with AIDS (Acquired Immune Deficiency Syndrome), a result of HIV infection, 156 died of this condition in 2012.  Black young males are at highest risk of acquiring HIV.  Estimates suggest that new infections among Black males are more than two times higher than among White or Hispanic males.  Gay and bisexual male youth generate most new HIV infections in this age group.

The reasons for the increased risk of STDs among Black youth are multifold.  No doubt, higher rates of socioeconomic disadvantage and less access to health care play a role.

The first step in fighting any problem involves creating awareness.  More parents, school health educators, health professionals, and community leaders must become educated about the potentially life-threatening STD risks youth, and Black youth in particular, face.

While governmental health agencies must do more to combat this problem, there are some simple and straightforward measures that all of us can take to help reduce the incidence of STDs among youth.  These include discouraging early sexual activity, strongly encouraging condom use for all who are sexually active, encouraging comprehensive sex education at the middle and high school levels, and sending a clear message to our elected officials that all youth must have access to affordable reproductive health care services, including STD counseling, testing and treatment.

This article was featured in the Afro-American Newspaper


6 Things Parents Should Avoid When Guiding Teens About Sex


traffic-signs-674623_1280As an OB/GYN and an advocate for teen pregnancy and STD prevention, I’ve had plenty of opportunities to interact with parents on the topic of teen sexual health.  Often, parents allow misperceptions and worries about what to say to their kids about sex become obstacles to effective communication.  As a parent, you want to be able to provide the very best guidance to your kids. The more knowledge you have, the more empowered you will feel.

The following points will help you to avoid sentiments that can interfere with your efforts to proactively and confidently parent your teen about sex.  Positive advice is given to replace unhelpful or even negative thinking and actions.  By changing your mind-set, you can become a more assured and capable parent.  That’s my goal and I know it’s your goal too.

1.  Don’t delay talking with your teens about sex, unintended pregnancy and STDs.    The time is now and you don’t have to feel daunted by the task.  Become an informed parent, while keeping an open mind and a sense of humor.  Also, remember your own teen years to help keep things in perspective.

2.  Don’t worry that you’ll say the wrong thing, or say too little or too much.               Trust your instincts and remember that you’ll have several opportunities to get your point across.  If you say something that you later regret, find the time to let your teen know what you really meant to get across.

3.  Don’t expect perfection or lose confidence in your ability                              Remember that you have already helped your child learn how to do all kinds of things, from using the potty to riding a bicycle to saying “please” and “thank you.” Communicating about sexual behavior and what your values are is another one of these important tasks—you can do it.

4.  Don’t underestimate the influence you have on your teen’s sexual behavior.    Parents often worry about the effect of peer pressure, but surveys by the National Campaign to Prevent Teen and Unplanned Pregnancy reveal that parents have more influence on teen sexual behavior than their friends do.  This feeling was echoed by teens in the Pregnancy and STD Prevention Program that I led in Los Angeles.

5.  Don’t hesitate to use social networking sites and media to your advantage.                 Song lyrics, movies, and TV episodes often provide teachable moments. You can have a thoughtful conversation with your teen about sexuality, respect, commitment, and self-esteem based on things you’ve seen or heard in the media.  Facebook and Twitter posts can also offer a foundation for conversations with your teen about values and how he or she can best navigate the sexual landscape that they encounter growing up.

6.  Don’t assume you know what your teen is doing or whom they’re with.          The odds are you weren’t a perfect teen, so expecting perfection in your teen isn’t realistic.  Sometimes, parents assume that their kid is not having sex and are shocked when they learn that’s not the case.  You can simply ask your teen if they’ve thought about having sex.  This may allow you to pick up on possible reasons for concern.  And, never hesitate to pick up the phone and call to verify that an adult will be present at a friend’s house party.  Supervision, especially for very young teens, is an essential prevention measure against all types of risky behavior.

Teen Pregnancy: No Time For Complacency

pregnant absTeen pregnancy and birth rates in the U.S. have reached historic lows, so it might be tempting for parents, healthcare providers, community leaders and others to think, “problem solved!” and move on to another really important teen issue.  But here is the reality:  The most recent data, according to the Guttmacher Institute, still show approximately 625,000 teen pregnancies still occur annually in the U.S.  That’s roughly equal to the population of a city like Baltimore.  And, the U.S. has higher teen pregnancy rates than other comparable industrialized countries.

The term “teen pregnancy” doesn’t begin to convey the cascade of public health and social problems that occur when teen girls get pregnant and give birth.  Statistics from the National Campaign to Prevent Teen and Unplanned Pregnancy show that teen pregnancy is a significant cause educational and economic hardship.  Only about 38% of girls giving birth before age 18 obtain a high school diploma by age 22.  Sadly, just a fraction of teen moms will obtain a college degree by the age of 30.  This educational disadvantage is one of the reasons that teen pregnancy is a leading cause of poverty. Data from 2010 shows that roughly half of teen mothers, not staying with their parents, were living in poverty by the time their child turned three.  A lack of education and economic hardship, too often propel teen moms and their children to lives of unfulfilled potential.

In 1997, I co-founded and chaired a Teen Pregnancy and STD Prevention Program at my hospital in Los Angeles.  A key goal of this program and my continued work in this area is to educate parents and to facilitate their ability to guide their teens towards healthy, smart, and values-based decisions about sexual health.  After all, parents should be the primary sex educators of their children, but often they report feeling unprepared, or even clumsy, about this very important parenting task.  The following Pearls of Wisdom are excerpts from Before It’s Too Late:  What Parents Need to Know About Teen Pregnancy and STD Prevention:

  1. Be an empowered parent—education is the key.  Staying abreast of current information about teen pregnancy and prevention issues will help you feel more confident in talking to your teen.
  2. Keep talking—and please avoid that one time, awkward moment, called “The Talk”.  You’ll want to have many conversations with your child about the wide spectrum issues related to sexual health.  Some may be more formal, but teens prefer more impromptu, casual, and brief talks.
  3. Emphasize your values and morals—if you don’t, the vacuum will be filled with the highly sexualized information abundant in today’s media.
  4. Partner with health care providers—you don’t have to go it alone.  Choose a health care provider for your child who is tween/teen friendly, has an interest in promoting sexual health, and is really willing to listen.

Photo courtesy of J. K. Califf