Let’s talk about Sex – teenagers and Sexual Health
As part of my work with the Connecting Care for Children Team at St Mary’s Hospital , I had the opportunity to take part in a teaching day at the local William Morris Sixth Form. The aim was to engage 16-19 year olds in conversations about healthy relationships and practising safe sex, and to provide education on Sexually Transmitted Infections.
The William Morris Sixth Form is a large and diverse school lying in the heart of the Hammersmith Area. It provides education for up to 900 students and offers foundation level, GCSEs and A levels.
The event was run by a small team of us including the school nurse, a representative from the local support group SASH (Support and Advice on Sexual Health), a charity member from MIND , myself and a medical colleague from the hospital.
As a new GP trainee and having worked for the majority of my career in the acute inpatient setting, this was a new and daunting experience for me. Perhaps the scariest aspect of the day was the idea of talking to a large group of 16-19 year olds about a topic as sensitive and embarrassing as sex. Having had little experience talking to teenagers before, it is fair to say that I went to the event with a number of preconceived ideas and expectations for the day. I knew this was an important topic and a valuable opportunity to educate, however, I was concerned that I would not be able to connect with this age group in a way that would enable them to engage in open conversation.
The day was structured around several talks that were given during assembly sessions followed by an open stall in the sixth form common room that gave students the opportunity to have follow up conversations, ask questions and get access to resources available to them both online and in their local area.
Perhaps the most rewarding and insightful part of the day was the informal discussions that took place around the sexual health stall. The atmosphere was more relaxed and less formal and I was surprised to see so many of the students wanting to talk about the subject – although perhaps the freebees had something to do with this!
What worked well:
• Small group conversations
Talking about sex can be both sensitive and emotional - particularly when talking to teenagers who are at such a vulnerable and impressionable stage of life. This is something that I realised was best done delicately and at times more privately. When doing the presentation in front of the assembly group it was difficult to engage students in dialogue perhaps because the conversations were taking place in front of their entire year group. Having the stall in the common room, however, was extremely effective and promoted more engagement and conversation about the worries and questions that students had.
As a healthcare professional, I found it was easy to get wrapped in the clinical aspects of the topic rather than the emotional side. Talking to the students on a more one-to-one basis, however, gave me a better appreciation for this and I realised that while it is important to educate teenagers about the various STIs and treatment required, it is also important to talk to them about having healthy relationships and open communication with their partner. I realised that this, in fact, is a key part of prevention.
• Inter-professional collaboration
What was amazing about the set-up of the day was the range of resources that were pooled together to provide a variety of viewpoints on the topic. The school nurse was an integral contact and link to the students and someone who the students trusted. This provided a good link for the doctors and charity members on the day.
Having representatives from local charities provided the students with contacts for the numerous local resources available to them and an independent third party they could contact for help and advice. Having the representative from MIND was especially important as it added an extra level to the complexity of the issue and addressed some of the psychological challenges that teenagers can face and the impact that sex and relationships can have on this.
Finally, as healthcare professionals we were able to provide some guidance regarding the screening, symptoms and management of common STIs as well as providing insight into the role of local walk-in clinics, and the GP.
What I learnt about talking to young people
• Engaging young people in sensitive conversation is often best done in less intimidating small groups or on a one-to-one basis where individuals can be encouraged to be more open.
• There can often be a barrier associated with talking to young people about sensitive topics for fear that they will not engage. Finding out what they are worried about and what matters to them is a good starting point to open up conversation and allow them to feel understood.
• You don’t need to become their best friend to get them to open up – having a professional approach I found worked well as it allowed the students to have confidence in the advice I was giving and see me as an independent point of contact that they could go to.
• Adolescence is a time of great change and vulnerability for many young people. When promoting safe sex, it is also important to address the emotional and psychological aspects of the issue
Conclusions
This experience was altogether unique and eye-opening. It highlighted the importance of sexual health education for young people and the challenges that lie in communicating with this age group. Going forward, I hope to be conscious in my clinical practice of how I engage with young people and to be mindful of what matters to them, rather than focusing on my own agenda. As GPs and healthcare professionals, we are a key source of contact with this age group and we have a great opportunity to educate and provide support. To be effective, sexual health education requires a multi-professional, multipronged approach and may be delivered in a number of settings including at school, in General Practice, local community centres and in secondary care.
CC4C has a key role introducing young doctors to the perspectives of children, young people and families. Here is another blog from a trainee who learnt about young people and their approach to sexual health
