Welcome to my virtual therapy room!  I am Dr Lori Beth Bisbey and this is Sex Spoken Here. Today we are talking about how to talk to children about sex.  So many parents become anxious when the subject of sex comes up in relation to their children. It can feel incredibly awkward to try to explain to your child all aspects of the birds and the bees. How do you know what it is appropriate to say when?  If you leave it to the school to teach your child, how can you make sure that your child is learning all the facts that are important to you? Are your children learning from watching pornography?  In online chat rooms? On Snapchat? From other children whose knowledge is questionable? 

The best place for your children to learn about sex is at home. There are a variety of ways to teach your children about sex – from sitting them down and having ‘the talk’ and then being available for further talks to having a trusted blood or chosen family memberhave ‘the talk’ with them through to giving them age appropriate books, comics and videos and then answering questions.   

Children who learn about sex from the internet are at a higher risk of abuse or harassment. They are also under far more pressure to engage in a wide range of sexual activities far earlier. They have no way of filtering what they are seeing. Many of them are confused about the conflicting information they find. 

Peggy Orenstein published a book called Girls and Sex Navigating the Complicated Landscape. She interviewed 17 to 23 year olds about all aspects of sex. She reports that fully half the girls she interviewed experienced along the spectrum of coercion to rape. She highlighted the fact that girls still don’t talk about pleasure in relation to sex but rather talk about the pleasure they give to others. The girls she interviewed watched pornography to figure out how to act as they have so few trusted sources of information. 

Teenage pregnancy in the UK in 1998 was the highest in Europe. It has now dropped to the lowest level it has been at since 1961 when they first started keeping statistics.  And yet it is still the highest teen pregnancy and abortion rates in Western Europe as of 2010. This drop is the result of a clear strategy aimed at making sure that teenagers have the information they need achieve sexual health. Despite all of this great work, it still remains too high. 40,000 young women still become pregnant each year. Education at school is helpful.  Education through family doctors/ general practitioners is helpful.  Sexual health clinics for young people are essential. But none of this takes the place of education and a supportive environment at home. 

Sexually transmitted infections are highest in the under 25 year old group.   Information is patchy with many young people having inadequate knowledge to be able to prevent transmission of infections.

School based sexual education doesn’t always include topics like sexual orientation, gender and consent.  Suicide is the second leading cause of death between young people age 10 to 24. The rate is 4 times higher in LGBT youth and twice as high in youth who are questioning their identities. The figures rise further when these youth are in homes that are rejecting. Metro asked 7000 LGBT 24 year olds across the UK about their experiences. 42% had sought medical help for anxiety or depression. 44% have thought about suicide. 

If your kids can talk about their feelings and discuss their attractions no matter what gender they are attracted to, it is less likely that they will develop depression. If they are taught that all sexual orientations are valid and reassured that they are valued and have a safe place to bring feelings and questions, suicide and self-harm rates decrease.

So as a parent where do you start? I recommend learning about normal sexual development. Once you have a good understanding of what a child feels and thinks at different stages, you will find it easier to figure out how to approach the child at each stage. I now present a quick tour through sexual development.

We are sexual beings from birth. 

From birth to 18 months a child learns to feel negatively or positively towards his body. Through nurturing touch they learn to value themselves, they learn what it means to be loved.    

Research suggests that between birth and 18 months a baby begins to identify as either male or female. From birth to 18 months, children discover their genitals and will touch themselves for pleasure. They do not masturbate to orgasm at this age. 

Though you are not providing formal sexual education at this stage it is essential to remember that the child’s feelings about their own body are strongly influenced by how adults respond to masturbation. If parents express upset or disgust, this will impact upon the child’s view of himself as well. He will see himself as disgusting. Children touch themselves because it feels good and they will often do so when they are stressed because it relieves stress.  

The most important thing you can do at this stage is not react with negativity, rejection or disgust.

18 months – 3 years old.

Children learn the names for body parts at this stage. The most important sexual education you can provide as a parent here is giving them appropriate names for the sexual parts of the body. Often times children are not taught names for their genitals and when they are given names, they are usually silly names. If parents leave out names for genitals, the message they are giving the children is that these parts are unmentionable – or there is something hidden or wrong with them. When we give children silly names for genitals we further the message that these are unmentionable parts. If you want to normalise sex and sexuality for your child you start by giving him appropriate words to talk about his body. 

At three children start to notice the difference between men and women; boys and girls. Girls can worry that boys have something (a penis) and they have nothing. You can tell a girl that she has a vagina and that it is harder to see than the penis because it is tucked in. You can tell her she has a vulva. 

At three children should be taught that their bodies belong to themselves and that they can say no to unwanted touch.  You must start teaching them to trust their own sense of what is wanted and unwanted touch.

From 3 to 5 years old, children become more curious about their bodies and the bodies of others. They want to follow parents into the bathroom and may even want to touch their genitals. Though this is normal behaviour children need to learn about privacy and modesty at this time. The standards you choose will be individual to your family and your culture.

Between 3 and 5 is when children often first ask where did I come from. This is best answered honestly. There are lots of stories parents make up (like the stork delivered the baby). These are not helpful. When the child asks, first make it clear that you are happy to talk about this. So saying something like ‘That’s a good question’. Next you need to get an idea of what they are asking.  You could say ‘Can you guess?’ or ‘What do you know about that?’. Some children are looking for a very simple answer and others want more details. Make sure that you are clear about the messages you are giving along with your answer.

For example, you want your child to be comfortable asking you anything. You want your child to know that it is good to be curious. You want your child to know that there is nothing secret or forbidden or naughty about sex and procreation.

There are a variety of books aimed at this age group that you can read to your children that use age appropriate language. Or you can use them as a resource so that you find your own language to answer the questions.

At this age, they have no notion of adult sexuality so there is no need to give them the nitty gritty details. You can talk about sperm and egg without talking about daddy putting his penis in mummy’s vagina. Very bright children might keep asking questions until you give them more details. In that case, you can tell them more making sure to keep things straightforward. Children who have been born as a result of fertility treatments or using a surrogate should be told in simple terms how they came to be. 

Between ages 3 an 5 is when children begin to explore each other’s genitals, play at sex with dolls and with stuffed animals. Children may play ‘doctor’ or ‘house’. This is normal and another way for them to find out about their own bodies and the bodies of others.  There is no eroticism to this play. It is based purely on curiosity. I’m going to say that again: This is about curiosity. It is NOT sexualised behaviour. It is extremely important that adults don’t over react to this type of normal behaviour as doing so will send extremely negative messages to the child about sexuality. 

Even though it is normal for your child to engage in this type of exploration, it doesn’t mean you need to allow it to happen all the time.  If you were to walk in on your five year old son his four year old friend naked in the bathroom looking at each other’s genitals, you can gently distract the children by saying ‘I see you are both interested in looking at each other’s bodies. It is good to be interested but let’s find something else to do now.’ and then tell them to get dressed in a pleasant voice. You should let the parents of the other child know about the incident so that they don’t think you have been concealing something and they don’t make more out of it than it is. Have a talk with your son and tell him that it’s good to be curious but he should bring questions to you.  You might want to use an age appropriate book about bodies and sex to sate his curiosity. Most important is not to panic when you see this normal behaviour. There are behaviours that are not normal.  If your children are trying to actually have sex (a boy trying to insert his penis into another child’s mouth, vagina or anus) this needs investigating.  Panicking won’t help. A calm conversation with the children as to where they saw or learned these activities is the place to start.

Sexual development from 5 to 6 years old

Children at this age are creative and imaginative. Let’s pretend is often the preferred type of play. They also try to figure things out for themselves by listening to the adults and attempting logic to understand things that perplex them. The combination of these two things (imagination and trying to figure things out for themselves) can lead to some really strange misunderstandings about the body and how it works.  So it is important to give children clear and straightforward information about bodies and bodily functions. At this age, many children are clear about gender identity already and will often imitate the parent of the gender they identify as. Some children are more fluid in their gender identity. No issue should be made about this fluidity. Sometimes children will play out stereotyped gender roles despite parents’ best efforts not to present stereotypical roles.  Part of this is because at this age children see things as black and white and cannot really process shades of grey and the rest highlights what they are seeing in environments outside the home, in the wider culture and in the media they are exposed to.

At this age, it is really important to children to be able to see that their family is a ‘good’ family. If they come from a non-traditional family, they may have concerns that there is something wrong with their family or they may tell other children from more traditional family that there is something wrong with their families. I remember a child from a family I was working with being told by a friend in school that all families have a mummy and a daddy and she replied ‘Not true. Some families have two daddies and no mummy’. Another child told a friend that all families had to have a mummy because ‘you can’t have a baby without a uterus’. 

At this age masturbation is very common though children are still not masturbating to orgasm as a rule. Giving children negative messages about masturbation increases the likelihood of sexual problems later in life. Children in this age group should already know that masturbation is something done in private. 

Sexual development from 6 – 9 years old

This is the time when children have developed enough cognitively so that they can understand the basic facts about pregnancy, sex and birth. Even so, they don’t understand the erotic part of sexuality or the emotional bits. Even when they understand the process, they may not believe their parents have had sex or may believe they have had sex only as many times as the number of children they have. 

Normality becomes important at this age and most children will try to conform to their peers. It is important that they are exposed to gender roles that are not stereotypical at this point so that they are able to see these as normal as well (which they are). Their understanding of and feelings about gender become more complex at this point.

This is the time of sexual jokes and potty humour. Sex play continues as does masturbation. Questions are more complex and it is important to give them more details but to recognise that they don’t understand the emotional and erotic content.  

Puberty can start at 8 or 9 for some girls. They need age appropriate information about the changes their bodies are going through. This initial information is best given to them by their mum or a female relative.  In lots of cultures, the arrival of menstruation is both a sad event and something to be celebrated. Most girls would prefer not to have this event broadcast to family and friends.    

Sexual development from 9-14 years old

For most children, puberty begins during this time.  It is at this time that it is essential your children have good information about the changes their bodies are going through, sex and relationships.

Average age for puberty to begin for girls between 8 and 13, for boys between 10 and 15.  It takes between 3 and 5 years to progress through puberty.    There is huge variation as to when puberty begins and when it ends so it’s hard to know if you are normal. This is an issue that causes kids in this age range lots of stress. 

The idea that talking to kids about sex, gender, sexual orientation, birth control and sexually transmitted diseases will encourage more sex is completely wrong. The only thing not telling kids what they need to know to be responsible and protect themselves accomplishes is higher rates of STDs and higher rates of unwanted/unplanned pregnancy. Children in this age group need to know that everyone develops differently and that they will get through puberty.   

Biggest anxieties:

• For boys: penis size, height, unwanted erections
• For girls: breast size, sudden periods, mood swings. 

Body image becomes an even bigger issue during this time when children compare their developing bodies with the bodies of models, actors, and other famous people. They pore over magazines that tell them how they should look and what they can do if they don’t have the ideal body. 

Despite how much it embarrasses them, you need to bring up the subject of sex with your teen and make sure that they have accurate unbiased information.  Most teens prefer this talk to be done by the same sex parent but sometimes the preference is the opposite sex parent (if there is one). 

This is the point at which children will masturbate to orgasm. The message you give your child about this can have a big impact upon self-esteem and sexual relationships then and later in life. Take care not to shame or humiliate your child by drawing attention. Make sure to knock and wait for an answer before entering a room. 

Sexual orientation can become more of an issue at this stage.  Answer questions in an honest and straight forward manner so that your child can feel secure in their orientation. It is good for children this age to be exposed to role models of all orientations so that they can see that there are homosexual, bisexual and heterosexual people who are well adjusted and in happy relationships. If you don’t feel confident about giving this type of positive message,  you should find someone else to help you with this part of your child’s sex education and make sure that you are not telling your child that there is something wrong with them if they are bisexual or homosexual. 

This is the time to start talking to your children about consent in relationships.  The cup of tea video has been done in clean versions (with no swearing) and not so clean versions and is an easily understood straight forward analogy that brings humour into the discussion. Your children need to learn that consent is more complex than just asking someone quickly if they want to be involved in a sexual activity and that consent can be withdrawn at any time and if it is, the person needs to stop what they are doing rather than pressuring the person who has said no. 

This is also the time when you may find your child has been accessing pornography on the internet. If you have not been monitoring their access (and discussing the things they are accessing with them) up to this point, you need to do so now.   Not so that you can shame them or punish them for their viewing but so that you know what messages they are being given and you can make sure to give them healthy messages.  

Sexual development 14 years – 18 years

This is the time your children will need to learn a deeper understanding of consent, sexual orientation and relationships. Kids in this age group are notoriously impulsive so it is essential that they have easily accessed information on STD’s and birth control and that they know parents will answer any questions in a non-judgemental way.

You need to be clear when you speak with them about these issues and help them to learn to think through sexual behaviour and relationships prior to acting. Teen agers have the same drives towards different types of sexual behaviour (like kinky behaviour) as adults. They don’t need to see or be taught about dominance and submission to feel a desire to be controlled or ‘forced’ or to be in control. If you avoid talking about these topics, you run the risk that the information they get will be from fiction (pornography primarily) where the actors are portraying fantasy not reality. If they imitate the fiction they see, they can find themselves in relationships where they are being disrespectful to their partner (or disrespected by their partner), injured (or doing the injuring) or at risk from adults who prey on adolescents and young adults. They need good non-judgemental information in order to protect themselves and make good choices.

Rejection is one of the more upsetting experiences that most teens will have and they may need help to deal with it in an appropriate way. They need to learn to take responsibility for their choices.Sexting, taking erotic movies and pictures and placing them on social media all become issues during this time. They need to be helped to consider the long term implications of their choices.

Pressure to have sex before they are emotionally ready is another feature of this time period. Teens need support to be able to stand up for themselves and wait until they feel ready. Parents can facilitate teens learning the difference between biological sex roles and the gender roles that are socially assigned....