Kelsey Magnuson: Hi everyone, and welcome to HealthWorks here. I'm Kelsey Magnuson, community Benefits Manager at Emerson Health, And we are back for part two with Dr. Deborah Simon, a pediatrician, and Christina Howell, a licensed. Independent social worker from Acton Medical Associates. This conversation is gonna build on part one where we talked about how to have open and ongoing conversations with kids about body parts, puberty, And the basics of sex.

And this episode, we're continuing the conversation to focus more on intimacy and pornography. Welcome Dr. Simon and Christina.

Deborah Simon, MD: Thanks for having us.

Kristina Howell: Thank you so much, Kelsey.

Kelsey Magnuson: In part one, we really laid the foundation of why early and often conversations are better with kids. It creates comfort and trust for kids to be able to ask questions and seek parental guidance first before going to the internet or their friends. As kids get older and to middle school and early high school, they'll start having crushes and interest in romantic relationships.

How can parents approach this topic with their kids?

Deborah Simon, MD: Yeah. Thanks Kelsey. like you said in part one of the series, we spoke a lot about the positive impact of starting early with open conversations between parents and their children. We also recommended that parents should put aside their own discomfort and start to talk about relationships focusing primarily on the mutual respect and mutual consent between two people.

But now we're moving further And we have to accept that now it is a normal phase of child development that tweens and teens are starting to explore romantic and sexual feelings. So now we need to address that parents can proactively discuss the qualities of a healthy and strong relationship with their children.

through these discussions, parents can have a huge impact on the decisions their teens make. With regard to the romantic relationships, while at the same time weaving in their own parental values, again, it is so important to discuss boundaries And that adolescents have control over their own bodies. Just because two people are are in a close friendship, it does not mean they are consenting to touch or being touched or any other sexual acts.

Like we've said many times, no means no and having confidence in themselves and their own boundaries comes from maturity, which can be built by these open conversations that parents have with them. Parents need to proactively talk to their children about these. Hard topics because the children now are being exposed daily to unreliable sources like their friends, the internet, social media, tv, song lyrics, and now even ai.

the children are hearing so much misinformation through these sources And This misinformation has shown to increase the risk of poor decision-making And then subsequently risky behaviors in the areas of sexual activity and substance use.

Kristina Howell: So how can parents approach this topic with kids? be thoughtful. Be intentional. it's important, it's influential to your kids about sexuality and sex. but it's important to note that sexuality and sex aren't really the same thing and adolescents need to learn about both in order to launch and do a healthy adulthood.

so sexuality is more so defined as a broad range of issues that include a healthy regard. For our own bodies and respect for other's, control over their own body. healthy sexuality is interwoven with human relationships. On the other hand, sex is physical acts that when experienced thoughtfully at the right time with the right person can be a wonderful part of the human experie.

So not only is it important to make sure that our kids learn the correct facts about sexuality, but also how to make healthy and safer decisions about sex. research has showed that parents who talk openly about sexuality to their kids have way more influence over their child's sexual behaviors as they grow than if they don't attempt to have these conversations.

you might be fortunate enough for your tween or teen to come to you with questions, but if not, look for opportunities to talk about these sensitive subjects. You can utilize things like TV shows, movies, websites, books, as a springboard for educating your teen about sexuality. The storylines in that kind of media are about other people, which may make it more palatable and more accessible for your teenager to be comfortable talking to you about it.

so topics that you could easily find in those types of media are like where babies come from. romantic attraction. GBTQ, questioning and issues, dating, breakups, pregnancy, sexuality, all of the above could be utilized through books and media. as a support in your conversation with your kids.

Kelsey Magnuson: I love how you gave so. Many different examples of ways that we can approach the conversation and use as a springboard, that's a perfect word for, utilizing what is around us culturally and encouraging time spent with each other as well, to be able to understand what kids are watching and reading and, consuming across the board in all situations.

We've talked a lot about age-appropriate conversations, and I know I've gotten the question in the past. I've wondered myself, if I start talking about this with my kids, will it make them more interested or make them want to start experimenting with different sexual acts? So what are some age-appropriate ways to discuss sexual development and intimacy, and how can we reduce fear around introducing the topic?

Deborah Simon, MD: Well, age appropriateness is. Really important. So individualizing your conversation to the emotional stage of your child is the key. It may come to a surprise to many parents that children between the age of 10 and 13 already know about sex. This is the reality, so we need to start addressing these topics early on.

Kelsey. Recently, I had a parent of an 8-year-old boy ask me what to do because her son told her that he wants to have sex with a particular girl. I know. Take a deep breath. You can be shocked, but don't shut down if that happens to you. This is your chance to explore what your child means and do some teaching the parent at that point.

Could ask her child, what do you mean by that? See if they really mean the sexual act. Most likely he meant she's pretty, And that the comment had nothing to do with sex. The parent could ask questions to illustrate the importance of a strong relationship. Focus on what she is like, what does she like to do?

What are her friends like? Find out where he's at. This opens up the conversation on having relationships, focusing on the quality of the person, which is the most important aspect in a relationship. If the boy had meant a sexual act when talking about the girl, then addressing That is of course warranted.

If he says he wanted to kiss her, The parent could talk about mutual respect, consent, and boundaries. If he was describing a true sexual idea, the parent could talk about it being adult behavior. The parent could say something like, adults do this when they have a relationship care for each other and are in love.

They can also say Sex is a way to have children and open the door to talking about pregnancy So that the child learns that sex is adult behavior, One excellent opportunity in the younger teenage years is when leaving the pediatrician's office after they are discussing the human papillomavirus vaccine, which usually occurs around age nine to 13 in the physical exams.

You could as a parent when traveling back home. Ask the child if they understand what the HPV vaccine is for. You can discuss that it's a sexually transmitted disease, how it gets spread, discuss other STIs. And this can really open a discussion, about sexual activity, pregnancy avoidance, safe sex, et cetera.

So using these organic, opportunities. Will feel more natural in opening up these conversations.

Kelsey Magnuson: Thank you so much for giving those various examples And for helping us understand really how early kids are thinking about and, starting to talk about sex. Whether they actually mean it because they maybe just heard the word, or, if they are farther along in their maturity journey and ready to fully talk about it, And for parents to jump on.

That opportunity and continue to ask questions, which is so helpful. Christina, how do parents balance openness with their kids while maintaining their own values and beliefs?

Kristina Howell: Great question. Just as we talked about in the first episode, we need to begin talking with our kids early and keep that conversation ongoing. Even young kids need to learn about self-respect, appropriate touch, and regard for others' feelings. And when these topics are embedded in part of the values that you've routinely discuss within your family and with your child, it will be much easier to discuss them as the child ages enters puberty and sexual feelings that emerge.

One way of increasing your comfort level is just to know the facts. Younger kids need to learn the basic facts, And then in adolescence, they have to be prepared for the changes in their own bodies, the emotions and sexual feelings. there is a variety of well-regarded, accurate resources, particularly online, and it will teach you how to offer developmentally appropriate information to young people and your kids.

In different age stages. there's some things that books can't teach. And that, is your values, your community, if so, for with your child, your life experiences. that might mean your mistakes, your recoveries and all of that sort of thing. overall knowledge. Of sexual activity And the way things work does not equal permission to teenagers.

It equals preparedness. studies have shown that talking about romantic and sexual relationships do not lead to earlier sexual activity. And as a matter of fact, it's been shown to lead to less risky decision-making, that includes a later onset of first sexual experience. Less risk of date rape and sexting, and a lower incidence of sexually transmitted diseases.

And teen pregnancy knowledge equals preparedness and not permission. overall, there's three main don'ts and three main dos that I pulled together for our podcast today, on how to talk to your kids while maintaining your values and beliefs. so for the don'ts, don't assume that your kid knows it all or is heard it all.

When we assume they know too much, we deny them the basic knowledge that serves as the foundation of healthy sexuality. Don't assume that just because a question is asked that they're doing it. Plenty of teens may ask questions about sex, sexuality, contraception, and more simply because they're curious and it's important that they get the accurate information about those topics.

don't assume that your kids understand everything you've told them or that we understand everything they're trying to communicate to us. Ask your teen to repeat back what you said to them. if something seems unclear, okay to say. I may not know the answer to that question, but let me get back to you on that.

and either utilize the resources we already talked about, your pediatrician or other trusted adults to discuss how you may feel more comfortable talking to your kids. The do's are, begin talking with your children early. Keep the conversation going. Listen to what your tweens and teens have to say about sexuality.

listening to our teens is the key to getting them to talk to us. And the more they confide in us, the more we as parents will be able to guide them towards developmentally appropriate solutions regarding sex. And overall, do encourage them to talk. If they have a question, ask what they already know or have heard.

be nonjudgmental, be factual. Take notes of the reactions. And again, if you're unprepared to answer a question, it is okay to tell your child, I don't know, and find out the answer later and get back to them.

Kelsey Magnuson: Thank you for those great tips and breaking it down into the dos and don'ts of the conversation. I think that's really helpful for us all to have in approaching this topic. So now switching gears a little bit, wanna go into understanding the potential impacts of pornography on kids' expectations and understanding of sex.

Deborah Simon, MD: Yes, unfortunately, pornography exposure at younger ages is a reality that we have to face. The exposure to children. Is very concerning because it normalizes the unrealistic sexual behaviors as well as body images that are not realistic and should not be strived for. And the exposure also can portray aggressive and violent acts, which we do not wanna normalize.

Studies have shown that exposure at a young age increases the risk of earlier initiation of sexual activity, and more permissive sexual behaviors in children and tweens. Studies have shown that exposure to aggressive sex can normalize the aggressive sexual behaviors and even sexual harassment. And also early pornography has also been found to increase the likelihood of engaging in high-risk sexual behaviors such as unprotected sex, multiple partners, substance use during sex.

So the fact is that pornography distorts children and adolescents understanding of healthy relationships and sexuality. On the flip side, open communication by parents along with Parental monitoring of media exposure are associated with delayed sexual initiation and safer sex practices. So the parental monitoring really becomes a key component of protecting our children.

Kristina Howell: I wanted to add that teens, the social pressures And the unrealistic portrayals of sexual activity in pornography, and how it influences them. it's both their peers, pornography, media, all of the above. and studies have shown that. While influences such as peers in media may lead to maladaptive outcomes like risky sexual behavior, some youth are more susceptible to peer influence than other's.

The youth that may be more susceptible than other's are those who believe it could improve their social status to feel cool, to feel mature, gain respect of friends, become more popular, things like that. However, studies have also shown that there's a pretty big difference between boys and girls and their susceptibility for social pressures to engage in sexual activity.

the research showed that boys receive frequent messages of connecting sexual behavior to that higher social status idea. and they're taught that overly overt sexual behavior. Can lead to decreased social status, whereas girls tend to minimize or hide their sexual experiences to avoid the perception of promiscuity, particularly among their female peers.

so overall the perceived social rewards, adolescents who have higher sexual expectations in their social status, are more likely to engage in sexual activity, and increased susceptibility of youth in conforming to those risky sexual norms. So in addition to talking about the dangers and consequences of physical and sexual activity, it's also important to remember to talk about the positive aspects and feelings surrounding sexuality as well, you can discuss with your child the safety and emotional benefits of choosing to be abstinent while still discussing all the normal feelings around a developing awareness of one's sexuality.

Consider the emotional and social aspects too, like attraction and healthy, relationship formation, respect and consent and boundary setting. acknowledge that sexuality is a natural and pleasurable aspect of a healthy adult relationship. Our teens need to hear from us as their loving adults about the pleasures of sexuality so that they understand.

More appropriately, we need to teach them to appreciate the bodies they've been given and to be sure that they understand what their bodies can do and how to keep them healthy.

Kelsey Magnuson: Thank you so much for going through all of those tips and background. It's really helpful to understand what the research is saying and how to break it down and, ways to connect with kids on this. So it's really helpful to understand kind of the background of kids. Pornography use And what, impact it can have.

And many parents, it's hard to admit that kids are seeing it or, have seen it. So what do parents do if they find out their kids have accidentally seen it or if they catch their kids viewing it? and how to have that open conversation.

Kristina Howell: that's a great question. proactively try to use those tried and true resources, as a means to introduce consent and mutual respect to your teenager for any physical interaction, not just sexual interactions with other's. That includes holding hands. Kissing, intercourse, et cetera. And if they know what an appropriate understanding of healthy relationships and boundaries look like before they're exposed to pornography, they're less susceptible to the influences of that pornography, And the inaccurate portrayals of relationships, sex and sexuality that it often demonstrates.

One of those resources that can be really useful with your teenager is the fries model of consent by Planned Parenthood fries. outlines the ways that people can agree for the actions that they're going to do to be consensual and without consent. It's dating, abuse, assault, or rape. So going over the Fry's model F. The fries stands for freely given any physical activity.

Should never be forced coerced in any way, so no one feels pressured to do anything they don't feel comfortable doing. You teach your kids the RR means reversible or revocable. Anyone can change their mind to know. At any time for any kind of activity And the partner must respect that.

No, without question, the I in FRY stands for informed. All parties should be aware of any risks involved, so teacher kids that knowings TD status, birth control, status, and agreement upon what is being consented to between them and their partners. is important and enthusiastic. E for enthusiastic if it's not teach your kids that if you don't feel like it's an enthusiastic yes, it's a no.

for instance, a hesitant maybe is not the same as an enthusiastic yes and should be considered a no by both you and anyone you may be involved with. And finally, the S in fries stands for specific. essentially it gives consent for one activity. It does not give it consent for increased activity or recurring physical or sexual content.

So using the fries model of consent with your kids. It's just one of the many ways to talk about healthy relationships, boundaries, and consent. but overall, if they discover pornography, don't respond in crisis mode. Sit down, have a calm, private, safe conversation. do not blame, shame or scold. Rather approach the conversation with a curiosity and a willingness to hear your child's thoughts.

this would be a perfect opportunity to discuss that sexual activity is wonderful when it is in a loving, stable, and trusting relationship with two consensual people. Parents can ask if their kids are in a relationship or wish to be in a relationship, which further opens the door to more discussions.

Kelsey Magnuson: Thank you for such a great method that we can break down and, Always remember the fries And what it stands for. I'm so glad that we were able to bring this group back together to have this important conversation and continue to build on it. I wanna give each of you just one more opportunity for final tips and tricks for parents having these conversations.

Dr. Simon, we'll start with you.

Deborah Simon, MD: my final recommendation for parents is use any and every opportunity to have a short, non-judgmental conversation. Making general inquiries about your children's friends, instead of asking them directly about themselves, may be a little less threatening and more likely to open up the conversation. It can show that you're a cool parent to talk to and a safe parent to talk to.

Then hopefully you can morph the conversation to focus more on your child's. Views and thoughts about themselves and their activities or relationships. and one more thing. Well, it doesn't always seem like it. Teens actually want their parents to talk with them about relationships and sex. Think about what you would've liked your parents to do with you.

Wouldn't you have wanted your parents to be cool to talk to? Nonjudgmental? Wouldn't it have been nice to feel your parents were people you could ask private hard questions to? Rather than navigating these water secretly and wondering where to turn, be the parent that you would've wanted, you can do it.

And I. Would bet that when your adolescents are older, they will. Thank you.

Kelsey Magnuson: Awesome. That's great advice. Christina, what about you? What are your final closing thoughts on this?

Kristina Howell: My final closing thoughts are, use the resources available to you. Consider going to the websites for Planned Parenthood Federation of America, safe teens. they provide up-to-date clear, medically accurate information, helps, understand, adolescent sexual health. a lot of the websites also offer, articles and other suggestions on how to further these conversations with your kids in creative ways.

So overall, I would like to hit home that Teens say that their parents and not their friends actually influence their decisions about sex more than anyone else, but that's only if their parents talk to them. So as tough as it may seem at times, having these open and honest conversations about sexuality allows us to shape our teens into adults who will be better prepared for healthy and meaningful relationships.

Kelsey Magnuson: So great, and thank you both for your time in preparing for this conversation And for being here today. I know that parents will find it so valuable and I'm so glad that we were able to do this, with part one and now part two to really fully round out this conversation.

thank you all for listening to Emerson Health's HealthWorks here podcast. Make sure to catch the next episode by subscribing to HealthWorks Here podcast on Apple Podcast, Google Podcast, Spotify or wherever podcast can be heard. And visit Emerson health.org/podcast. To learn more or schedule an appointment with Dr. Simon or Christina, visit acton medical.com or call 9 7 8 6 3 5 8 7 0 0.