UCSF Pediatrics Professor Offers Advice to Parents on Talking About Sexual Behavior with Teens

Juliana Bunim on November 02, 2010

Bonnie Halpern-Felsher, PhD

Bonnie Halpern-Felsher, PhD, is a professor of pediatrics at UCSF and senior author of the study, “Predictive Relationship Between Adolescent Oral and Vaginal Sex” published online today in Archives of Pediatrics and Adolescent Medicine.

The survey was the first of its kind to follow teens’ sexual behavior over time to determine whether adolescents engaging in oral sex are more likely to engage in vaginal sex, or if it delays the onset of further sexual activity.

Data was collected every six months from the start of ninth grade to the end of 11th grade, between 2002 and 2005, at two northern California high schools. The results indicated that most sexually active adolescents engage in both vaginal and oral sex within the same six-month period, and half of teens who have oral sex during the ninth grade, will have intercourse by the end of the 11th grade.

The data yield important information about adolescent sexual development and the need to deliver more comprehensive sex education programs, according to the news release issued jointly by UCSF and UC Merced.

Halpern-Felsher spoke to UCSF Today about how parents can better prepare their teens, and themselves, when approaching the topic of sex.

Q: What kinds of strategies can parents employ when talking to their teens about sex?

A: I qualify all this by saying we don’t really know…Parents just need to be willing to talk to their children about sex, period. It is an important topic and conversation to be had. The other thing is, with regard to oral sex, is for parents to actually say the words “oral sex,” using the proper terms and explain what it means. While oral sex certainly is less risky, it’s not risk free.  And while oral sex is less risky when it comes to physical outcomes, it’s not less risky when it comes to emotional outcomes.

Once you have one form of sexual behavior, oral sex or any form of sexual behavior, it’s important to discuss what implication would that have on your willingness to have other forms of sex. Parents should address the idea that some teenagers may believe that you’re delaying having intercourse by having oral sex, because you may be more willing to open up to have another type of sex.

Q: The study indicates a couple key time periods for adolescents, namely the end of ninth grade, which represented the group with the highest risk of vaginal sex initiation during high school.  Should parents take timing into consideration when planning to broach the subject?

A: I’m somebody who believes we should start having those conversations about sexual behavior in the later years of elementary school. We don’t need to get into the details then, but talking about your body, menstruation, and puberty to get the topic going. In middle school we really need to talk to our sons and daughters about what types of social behaviors there are, options for protection, and delaying. I think we really need to start sex-education in middle school to be honest. By high school it’s almost too late, adolescents already think they know it all and are not listening.

Q: What do you think is the most important take-away parents can learn from your findings?

A: I think open communication about sexual behavior, for one. The other piece is to talk about oral sex. It’s prevalent in the younger teens and we definitely need to talk to teens about it. We need to be an open book about sexual behavior overall.

Q: How can health care providers better adapt their sex-education interventions?

A: Most of the sex-education guidelines tell providers to talk about sex, but doesn’t say talk about oral sex. But if you say to a teen that they should delay having sex, most teens will say, “well I’m having oral sex not sex.” That’s why it’s so important that providers address oral sex. They need to talk about oral sex, the potential risks associated with it including the potential relationships oral sex can have with other sexual behaviors.  And they need to start that education early.

Related Links


Having oral sex increases likelihood of intercourse among teens,
UCSF News Release, November 1, 2010

Should Teens be Denied Equal Access to Emergency Contraception? [PDF]

Guidelines for Teens: Thinking About Sexuality and Sexual Activity