Talking Sex In Therapy With Teens

Teen Therapy: Teens Can Get Over Their Heads With Sex

In our therapy with teens, we often notice that the rhetoric out there is that teenagers can make bad decisions about sex (among other things) because adolescent brains are a mess. Maybe. But we think there’s more going on.

First, teens are new to this sex stuff. Sex is tricky. The assertion that sex is something we innately know how to do–wow, is that wrong! Procreation, maybe, but avoiding procreation–not to mention experiencing pleasure, emotions, avoiding hurt feelings, avoiding hurting physically–isn’t so easy. Secondly, often nobody has given teens much direction on how to have sex, how to think about being safe, having fun, attending to feelings, etc.

Sex Isn’t Just Intercourse

Teens have sex or want to have sex. Way too often the conversation about sex with teens, if had at all, is focused solely on the object of preventing pregnancy and STD’s. While important stuff, there is so much more for teens to navigate–dating, holding hands, joking about sex over text, not joking about sex over text, sending sexy pictures, flirting, sexting, making out, phone sex, oral sex, intimacy, breaking up, masturbation, abstinence, talking with friends about sex, wearing bright red lipstick and a revealing top, etc.

As with all our patients of all ages in our therapy practice, we believe sex is fun or should be. There’s a lot of evidence connecting a happy sex life with a safer sex life–obviously, safe sex is more fun, but it turns out that fun sex is also safer. People who enjoy sex are more likely to feel confident around sex, and with and in their bodies. This doesn’t mean, however, that we push teens into sex or that the function of parents or therapists ought to be to help improve the enjoyment of sex for teen children.

Parents, Talk To Your Teens About Sex (And When You Can’t, Get Help)

Parents have to grow up in their own relationship with sex in order to be able to be of value in talking to their teen children about sex. Shame, in particular, is a killer and it sets teens up for risky sex, sexual assault and abuse, coercive relationships and unfulfilling sex lives. Shame rarely produces safe behavior and nearly always produces, well, shame! Shame is sometimes conscious and intended. Other times, it’s the net result of having unfair judgments or a parent that's really uncomfortable about sex themselves.

For parents, it’s important to know your depths. Most teens we talk to about sex are more comfortable talking about sex than their parents, by a large margin. It’s better to say, “I’m uncomfortable with this. I’m sorry. I don’t want you to feel like there’s something wrong with what you’re doing. It’s me. I need to grow.”

Maybe you’re comfortable about talking to your teen about everything that sex involves. Maybe you’re not. We’d like you to–and we’re willing to help–but maybe you can’t. It’s important when you can’t talk to your teen about sex to figure out how to make those conversations available like through therapy. Teens need more than just a few people to talk to about sex anyway. And they need to learn to be more comfortable talking about it so they can get good help, talk to their healthcare providers, speak up when they’re in a situation that doesn’t feel cool, talk about it with their partners and eventually (you guessed it), talk about it with their own children.

The Decision Not To Have Sex

In our therapy practice, talking through a decision not to have sex is also a conversation we have surprisingly often with teens. Plenty of teens aren’t ready for sex and know it. But, talking about not having sex with partners and friends can be tricky. In our teen therapy practice, we often enter into conversations with teens on the assumption that our agenda (that they wait until their ready or have safe sex) is at odds with theirs.

Not having sex is a decision that takes some backbone for teens. A romantic partner might be disappointed or lose interest. Is it worth it? Similarly, friends might make assumptions about what this means: Is a guy a real guy? Is a young woman a prude? These are real issues and in our practice, we’ve learned it doesn’t work just to tell teens not to care. As adults, you have to help them figure that out.

What Feels Right: Speaking With Teens Of All Genders About Consent

As a parent of a young child, it is key that you teach your children that “no means no” and about “bad touch" to prevent sexual abuse. As a parent of teens–no matter what gender, it’s equally important to talk about consent. No still means no. While girls certainly need to learn to respect limits and boys of all ages can be victims, the conversation is still necessarily gendered to a degree. When in doubt, err on the side of checking in. Recognize that coercion is just as much a violation of consent as physical force.

We find the best way to approach conversations on consent is in the language of moral philosophy–What feels right and fair? What feels wrong? Pose real scenarios (in the form of “what if’s”). For example, ask: “What if you’re making out and she starts to tense up?” or “What if you’ve had sex before but this time, you’re drinking?”

Some questions have legitimate gray areas, but others don’t. Make your values clear. Let teens know that people get hurt when there’s a lack of respect around sex. Ask them to think about the kind of partner they want to be. Talk to them about these issues before you think they’re ready for sex. Why? For one, odds are they’re more ready than you think, or at least, their peers are. And second? It’s better to have a chance to think about where you stand and what feels safe and right before the time

What Should A Teen’s Boundaries Be Around Porn?

Teens have a lot of exposure to sex and no, you, as their parent, can’t control that. Boundaries should be enforced only in regards to issues of safety and severe consequences. Teens need to understand and have boundaries around whom they communicate with online and it shouldn’t be okay for them to steal online content or view illegal material. But, once teens learn about pornography, they are opening a massive pipeline of data into their lives. In our experience, establishing a hard rule against porn is unlikely to work.

It also eliminates any chance of a conversation about helping teens decide about their tolerance for violent images and different kinds of sex, including same-gender sex and kink. How do they make sense of what’s out there and of what turns them on (or off) at a given moment? How do they make sense of the relationship between porn and one’s own sex life? And of course, as with a decision not to have sex, what is needed to support a young person who isn’t into porn or otherwise decides he or she doesn’t want it in his or her life?

Sexual Identity And Same-Sex Attraction

In our practice, we’re aware that teens these days are less hung up on labels and categories–being attracted to others of the same gender doesn’t necessarily have the kind of meaning relative to identity that parents and other adults may assume it does. That’s not to say in a given instance, a teen wouldn’t find a label meaningful. What’s critical is to be open-minded, genuinely curious and check your assumptions at the door, which includes, even, the very assumption that same-sex attraction is a problem for a given teen. Being aware of the risk isn’t the same thing as assuming risk.

At the same time, teens may be vulnerable in ways they aren’t aware. Biases and discrimination are often hidden. Just because a teen’s peers are ho-hum about sexuality and same-sex attraction, doesn’t mean the same goes for kids at a party or adults on the subway. A challenge for parents is to respect a teen’s own assessment of his or her risk level, while thoughtfully helping them be aware of the ways they may be mistreated in the world.

We haven’t nearly solved the high level of risk for kids when it comes to same-sex attraction. As we’ve said, discrimination can linger in dark corners. For boys attracted to other boys or girls attracted to other girls, to consider identifying as gay or bisexual can be loaded with shame and stigma–both from within and without. It’s imperative to make your support crystal clear and let your kid know you’re with them no matter what.

If I, As A Parent, Haven’t Succeeded In Talking About Sex to My Teen, What Makes You Think You Will?

For one, we’re not you. Relationships between parents and kids are complicated–there’s a ton of history. There may have been a few false starts in the past. There’s also fear of judgment and embarrassment. While these fears can emerge in any context, a fresh relationship–without any baggage–gives us a leg up.

We also bring some skill to the game. Because we talk to teenagers all the time, we’ve learned some things about what works and what doesn’t. We also have kill in talking to folks of all ages about sex (along with lots of other potentially embarrassing subjects).

So much of the time, if we don’t pry, but rather extend an offer, eventually, teens open up. Why? Because their interests–learning about sex and getting support with the ways it’s tough–lead them there. They see us as offering information and help they need. Ultimately, it’s the same reason anyone opens up about anything in therapy–they develop trust, see value in what the therapist has to give and ask for more.