Navigating Teen Sexual Health: Trends Every Parent Should Know

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Learn how to better navigate the mental and physical health of your tween teen or young adult through proven expert advice. Here's your host, Leanne Castellino.

What is trending when it comes to teens and their sex lives? And why are some of those trends a growing concern? Welcome to Where Parents Talk. My name is Lianne Castelino.

Our guest today is a professor at York University in the Faculty of Environmental and urban change. Dr. Sarah Flicker is also a York Research Chair in community based participatory research.

Her areas of focus include adolescent sexual and reproductive health. Dr. Flicker is also a mother of two and she joins us today from from Toronto. Thank you so much for taking the time.

It is my pleasure. Thanks for having me.

Tell us, Dr. Flicker, first of all, if you could paint a picture for us as to what the current landscape generally looks like in Canada when we're talking about teenagers and their sex lives.

Such a big and important question.

I think when we're talking about teenagers and their sex lives, we're seeing a generation of teenagers who are empowered online, know a lot about sexuality and sex from what they're doing online, whether that's social media or accessing pornography or chatting with their friends, and who are making, you know, choices about how to enact those in their real lives in different kinds of ways than certainly we saw youth from a generation ago, and we are certainly seeing a spike in sexually transmitted infections among teenagers. We're seeing changes in how they're approaching or thinking about condom use.

And we're seeing a generation of teenagers who may have missed really important sex education opportunities because of the pandemic.

So let's unpack each of those elements if we could. First of all, your point about where they're accessing information online, social media, etc.

Can you characterize what that looks like in terms of also the disinformation and misinformation also being included in there?

Sure.

We actually know from lots of research happening across North America that teens are accessing pornography much earlier, much more often with greater ease than a generation ago.

And of course, pornography comes in a whole array of genres and some of it is far more informed or offers far more healthy depictions of sexuality and promoting healthy sexuality than other forms of pornography certainly is out there.

And I think a lot of the misinformation or disinformation might be accessing from kind of sensationalized depictions of sexuality and or from peer Networks that may or may not have, like, the best possible information.

So we're, you know, we're seeing youth who are getting their information from TikTok or from, you know, Instagram reels, which sometimes can be really informative, but oftentimes can also be full of misinformation.

And so I think it is really important that we think about how youth are getting their information, what they have access to, and offer counterpoints to them from trusted adults and professionals in their lives who can answer questions in a way that fits with best possible evidence and fits with best, you know, values approach that a young person might have in their family and their community and their schools.

And I think weighing those, you know, like, all sources of good information can be good, but we need some media literacy and we need to be encouraging our young people to sort of think twice before believing everything they see on the Internet.

On that note, despite many parents and their best efforts to kind of know what their kids are looking at online, you know, it's impossible to stay on top of that, especially as they become teens and deeper into adolescence.

So along the lines of that disinformation and misinformation and where the information is coming from, the sources, what would you suggest then to parents about how they can ensure that their kids are getting accurate information when it comes to sex education?

Sure. So one of the things I've done with my own kids is encourage them to check out sites that I believe are offering factual information.

So, you know, I, I know that they're going to access all kinds of things because I just know that that's the reality of being a teenage boy. And I don't want to shame them or make them feel bad about whatever it is they may or may not be accessing.

But I have said to them, look, hey, come to me with questions. I'm really happy to answer them.

And if you don't want to talk to me about them, check out Planned Parenthood's website, Check out the Public Health Agency of Canada, Check out the Canadian foundation for AIDS Research has a great website called Sex Fluent. Here are websites that I know to be factual, that I know to provide, you know, really thoughtful, well vetted information.

And please be skeptical of information that you might get from non vetted sources. So you want to look like, is it an NGO that you know about? Have you heard of this NGO before? Is it a government website? Or is it some YouTuber who.

Or some influencer who may or may not have all the facts and give them a little bit of literacy And I think this is important not just for sex education, but for all education when you're interested in the news. Like the difference between going to a YouTube influencer versus the New York Times or the Globe and Mail. Right.

I want, I want my kids to have that understanding that information comes from all kinds of sources and it's not always true just because you saw it somewhere.

And I think sort of offering those, like pre vetted resources can be really helpful for youth who are learning to navigate and trying to figure out, like, what's true, who am I? And if you don't feel like you can answer those questions directly, you can sort of direct them to places that might be able to do that.

You also mentioned at the beginning there, in terms of trends, condom usage or lack thereof, can you take us through what that looks like in terms of statistics and what that trend entails?

Yeah.

And so when we start to see like, you know, those numbers dropping, we wonder why, like, what is going on that fewer youth are using condoms?

Because as we know, condoms are not only a really reliable form of birth control, they're also one of our best strategies for preventing the spread of sexually transmitted infections and hiv. So you know that that's one of the reports that has come out really recently that's very, very concerning when you look at this.

Yeah. When you look at that statistic, I mean, it's stark, certainly. And if you're looking at root causes, what.

I'm sure there's a confluence of factors, but are there any that rise to the top there?

Yeah, I think there's a few and there are a few really important ones to think about.

And that's for a variety of reasons.

Lots of teachers told us they were uncomfortable sort of having Those conversations with teens when it was sort of broadcast in their living rooms and they had no idea who else was around and kids were uncomfortable like having those conversations, you know, online when who knows who else was around.

So we know that there was kind of this period and of course it looked a little bit different in different parts of Canada where kids missed really critical information.

So that, that I would say is like one big explanation, potential explanatory factor. The other is we are seeing major shifts in HIV treatment and care, and particularly around young men who have sex with men who we are seeing.

HIV has moved from sort of this idea of a death sentence to a disease that is well managed and people are living quite a long time with hiv and people are able to get their viral load down to zero. And when we talk about the importance of that, when we have an undetectable viral load, our HIV is untransmissible.

And so we have taken in, in many communities, folks who are actively on treatment, or what we call prep, which is a pre treatment, are engaging in unprotected sex because the risk of transmitting HIV is so low to almost non existent when they are actively taking those steps.

And we would see more and more young men who have sex with men who are either engaged in relationships where their partners are on prep, or they, they themselves are on prep. That has changed the landscape a little bit there.

Yeah, no, and you know, it's a really interesting point in the sense that when we think about what our areas of focus were, many parents during the pandemic, it was basically reading, writing and arithmetic and let's make sure that our kids aren't falling behind there. But you make an excellent point about sex ed.

And you know, how much of that fell through the cracks and then what is the ensuing impact of that if they didn't get the proper education or any at all? So then how does that void get filled optimally in your estimation?

Like, how can this be addressed for those kids who maybe missed out or who are now again getting their information from other less viable sources?

I think that's such a great and important question. I have always been an advocate for sex education and healthy sexuality education to happen early and often throughout the school.

I almost think it's like a topic that should be covered every year. And of course, different provinces have different approaches to it. And of course it needs to be done in a very developmentally appropriate way.

You know, a curriculum based in kindergarten all through grade 12. But it seems to me a real shame that if you miss this window, like, it's gone and you. And you never see it again.

So I think, number one, our schools can and should and hopefully could be doing kind of catch up.

So if they know that kids miss that window, like, make sure before you graduate high school that that that information is there and is shared in a meaningful way by, you know, professional teachers and, or the folks that they bring in, like public health nurses or health promoters to kind of deliver that information.

So I think one, one big answer to that is like, how can we support our schools to do this work in a really important way and always in addition to in school? I really think it's really important.

It's important for families and communities to also share that responsibility because we know that sexuality happens in community contexts and different people have different values around it.

So I always think it's really important for parents to at least open the conversation with their kids about, you know, thinking about sexuality, thinking about making important choices around their bodies and their autonomy to be engaged as sexual beings and providing those kinds of resources, as I mentioned, like, whether it's by buying a book or going to the library and taking out a book, or saying, you know, hey, there are these great websites I checked out. Maybe you want to check them out too, and we can either do it together or you can come to me with questions after.

Or you know what, maybe if you don't want to talk to me because I'm your mom and that's super embarrassing.

Auntie so and so is also a really good resource, like nudging or pointing them in the direction of trusted adults, whether that's in your family or in your community or in your wider network that you know will have answers that you feel like will resonate with your kid as well as with you in terms of your values and your community.

So I know, like, for instance, lots of my son's friends ask me questions because they know I will answer them and their parents have told them, yeah, she's a good person to ask. And I'm really comfortable having those conversations. I love having those conversations with kids.

So find the, the folks in your community who you think, ah, like, that person's going to be one. And sometimes it's not even a professional.

Sometimes it's an older sibling, maybe it's an aunt, maybe it's a friend, but someone you know and trust who's going to be able to either provide that information or find the answers if they don't have it. And then lastly, of course, there's the health professionals.

So making sure that your teens have access to a trusted health professional and giving them maybe some of that privacy at their next checkup to say, you know what, I think my kid might have a few questions about their body and I'm going to step out of the room so they can ask you, you know, and that can also be a really good time and place for young people to get questions answered or vetted or, you know, get prescribed perhaps or treated for, you know, any concerns that they might have, or access to birth control, like just even opening that space up a little bit and showing your kid that you trust them, you believe in them, you care about them, and sexuality is a part of health, like every other part of health that needs to be attended to and taken care of.

Would you say, Dr. Flicker, that where we are today in society, given sort of the backdrop that you outline for us with, you know, the sources of information, the social media, et cetera, et cetera, that it's not a question of an option to talk about sex ed at home, but it's an obligation just because of, again, where we are and also where we're trending.

You know, I, I hesitate to say it's an obligation for all families in all ways. Right. Because every family is different, our constellations of family are different, every parent, child relationship is different.

And in some families that conversation is safer to have than in others.

So I would never say, I would never want to say, like it's your obligation to do so, especially if that puts you or your child in an unsafe situation in relationship to a family or a wider community. But I would say it's great to open up lines of communication and lines of dialogue.

And I think these are important around all aspects of teenage life. You know, peer pressure, friend group, drug use, career decisions, sexuality.

Like I lump sexuality in with all of these other really important life decisions because I don't think it's that different.

And I think the more we kind of keep open lines of non judgmental communication open with our teenagers about one aspect of their life, the more they're willing to share about others. And so again, I hesitate with the obligation, but I do lean into those conversations and want to really encourage those conversations.

And they don't necessarily have to be about, you know, where particular body parts go and get aligned and, you know, deep conversations about how to really pleasure your partner. Like, maybe it's just about, like, how do you know when you're ready, what feels good to you? How do you.

How do you tell someone, I'm uncomfortable with this?

Like, how can you build those negotiation skills, those healthy relationship skills, those just like, basic kind of open communication skills that then translate into their sexual lives in ways that sort of feel comfortable and not embarrassing for everybody at the table?

When we talk about some of the other numbers and the trends currently going on, we talked about condom usage going down among teens in Canada. Any other trends that are worrisome?

Yeah, we are seeing big spikes in sexually transmitted infections across Canada, particularly in the north, particularly with indigenous youth.

But the rates of sort of, certainly chlamydia, syphilis and gonorrhea have gone up in Canada among teenagers, and quite substantially so that is a real concern. Again, thinking about what role condom use might have in sort of changing these trends is really important conversation.

Another sort of strategy that I've seen lots of parents use is just to say to their teens, you know what? I bought a box of condoms. I put them in the bathroom. You or your friends, when they come over, want to take them.

I'm just going to keep an eye and refill them.

I'm not going to ask questions about who's using them or how often, but I just want you to know, like, in our bathroom, there's a space to get them, you know? You know, so again, not if, if it's too embarrassing to have, like, the conversation of how do you put it on? Or.

Or maybe like, here's a video where you can learn how to use them if you don't already know and just tell your friends, you know, so, finding access points for helping youth access condoms, getting information about how to use them, building the skills on how to negotiate around them, even. You know, my son told me that in his sex ed class, he watched a very funny video about, like, how much tea do you want to drink?

Like, and, like, the pressure tactics that were used. Like, you said you wanted tea and now you don't want tea. Like, you know, and they made it kind of funny.

And I think the more we can use humor, the more we can use metaphor, the more we can use, like, ways of opening up the conversation that aren't so potentially embarrassing look, the better so that when. So that we're ready to talk about condoms if and when we're ready to.

Talk about sex now. Part of your research is focused on youth HIV prevention.

You alluded to some of the sort of the landscape earlier, but is there anything else that parents need to be aware of as it relates to HIV and teens?

Yeah, so the, I think for me, I, a lot of times we talk about, or in the past, people sort of talked about HIV as like, this, the worst thing that can happen to you in relation, you know, like it's the death sentence. And I think obviously that has changed so much in terms of our treatment of hiv. We need to reduce stigma around hiv.

It's not the worst thing that can happen. It is, it is a, a bad outcome. It's like not an outcome we want.

But I, I like to frame sexuality in terms of what do you, what do you hope for, what do you want, what's going to feel good in your body and what are we trying to prevent?

And you know, maybe it's, and not sort of framing it as like, HIV is the, the ultimate thing we're trying to prevent, but we're trying to prevent anything that makes us feel unwell or anything that's going to make us have to take pills forever in our life or any, you know, so thinking about all STIs and HIV as part of that conglomeration, how do we prevent all of these? And like, condoms are great for preventing all of them. Right? So it's great we have this technology that can actually run the gamut of protection.

So in terms of kind of thinking about, you know, how can we promote conversations where young people know that it's okay to be sexual beings, it's okay to be interested in, in sexuality, and it's also okay to have boundaries about it and have concerns about it.

And, and each individual is going to have to decide if and when and how they're ready to pleasure themselves or pleasure others or be pleasured and, and find that balance that is comfortable for them and safe.

And we also know the other really worrying trend that we're seeing is around sexual violence and the number of young people who experience unwanted sexual attention, sexual touching, rape, sexual assault. Again, this, this is not new.

Lots of people have been victims of sexual violence for a very long time, but it continues to be a concern and it continues to be something really important that I think we have to talk to our kids about really explicitly.

Like if someone says no, or if someone is unconscious or if someone is not, is too intoxicated to say yes, like these are all really big important red flags to pay attention to, and that violence has no role or should ought to have, like, no role in coercive sexual relationships. So it's something I. Sure. I talked to my son about. It's something I talked to my daughter about so that they.

They've known from a very young age about autonomy and boundaries and respecting themselves and respecting others. Autonomy and boundaries.

And that's also, I think, a conversation that can and should be had with our young people really early and often, but especially when they're dating.

Yeah, for sure. So along those lines, I was just going to pick up on your point to say, ultimately, we're talking about, you know, what does consent look like?

What is the understanding of consent by tweens, teens, young adults, and also, how do we define healthy relationships? So if we're going to take those two concepts, Dr. Flicker, like, what would you say to parents about how to frame and have these conversations?

Because let's face it, there are plenty of examples out there currently in the world, all over the place that go counter to what these. These concepts actually are meant to stand for. So how do you, you know, turn that tide?

Yeah, you know, it's. It's such a. It's such a good question. It's such an important question. We've been.

We were funded a few years ago to develop a healthy relationship curriculum that sort of fits with the Ontario mandate through the Public Health Agency of Canada. And we spent a lot of time thinking about, like, how do we teach the skill? How do we get.

Equip young people with the tools and strategies to negotiate these skills? And I think one of the first, most important pieces of building blocks of thinking about how do we think about healthy relationships is how do we.

How do we give young people the skills for open, honest communication, assertive communication? How do we help them clarify for themselves what their own boundaries are, what their own values are? Because I think you're right.

Healthy relationships mean different things for different people, and healthy relationships mean different things at different stages of our lives. And so there isn't one right answer. Like, this is what healthy looks like. This is what unhealthy looks like. But it's about checking in with yourself.

Like, what does healthy mean to me? What do I want out of relationship? How do I want to feel in that relationship?

And when I start to not feel great, how do I negotiate around that before it escalates into physical violence? How do I stand up for myself? How do I say, hey, I didn't like that?

And here's going forward, how I would like this to go better and really building those sort of assertive communication skills, those conflict resolution skills, and also the confidence to go seek help when you need it. So you don't have to do this alone.

Especially when you're like 13, 14, 15, it's your first time dating someone and you like them so much and you care about, like, how do you. How.

Do you learn those negotiation skills, but also how do you learn to rely on your community of your friends and other adults in your life to sort of advocate when you don't feel strong enough to do that yourself? And so really kind of building that piece by piece, it doesn't happen overnight. I don't think it could be covered in one lesson or in just one chat.

But I think the more we can model healthy relationships for our kids with them, or help them navigate healthy communication with their siblings, with their friends, with other folks in their life, the easier it will be for them to translate those skills into their romantic relationships. So those are all strategies to kind of think about scaffolding.

Certainly incredibly important points.

And if we move it further down the line with respect to consent and sort of violence in relationships, you know, we're looking at and talking about intimate partner violence epidemic proportions in different parts and different communities. So the importance of having those conversations early on, certainly to address the. Down the line or prevent it from happening in the first place.

So, Dr.

Flicker, what among all these trends and you shared so many, and so many of them are certainly cause for concern, what concerns you most about the trajectory and where it's heading?

Oh, my gosh. I spend all my time thinking they all concern me.

I, I think one of the things that concerns me most, again I sort of go back to this, is the ways that social media so influences the way we interact with each other, the way we spend our time, and the ways that we develop our ideas about who we are as humans and sort of seeing how this impacts not only our sex lives, but our mental health and our peer groups and our friendship groups and really giving young people the, the skills and the tools to develop a, a critical literacy on what it is they're seeing and doing online, B, how to take, like, breaks from it and build some resilience around some of the peer pressure they might be seeing online or some of the trends. And then three, how to talk about it and how to say, look, I saw this online. Do we want to try this? Don't we want to try this?

You know, and, and being open to having like, a conversation, real life. Because as we all know, like, what we see online doesn't necessarily mimic most people's responses in real life.

And so much of the portrayals of sexuality we find online do not really mimic what pleasure looks like in female bodies. What, you know, people want, how they negotiate, how awkward it can be to talk about condom use or sex or touch another person for the first time.

Right. Like, it's all sort of slick online.

It looks so easy, but we need to talk about the awkwardness and the messiness, and it's okay if it doesn't feel just how you thought it would the first time, and that practicing and communication makes things better.

So I think, again, the more we can openly have conversations with our young people so that they can have conversations with each other, I think the, the better chance we'll have of opening up new possibilities.

As somebody who is on the front lines of this topic from a research perspective and through different lenses as well, how can we go about making sex education more relevant, more intentional, and how it's taught and more engaging for young people?

Such great questions. I spend, you know, lots of my time thinking about it. So I have a couple of research projects right now where we're. We're really leaning into this.

I have one great project with a group called Sexed Sex Education by Theater, where we're working with teenagers, mainly newcomer teenagers, to develop plays, skits, parodies that talk about sex and sexuality from. And the youth themselves are developing the material and then performing for other youth to kind of open up dialogue and conversation.

That has been so effective and so impactful, and we just got some funding to sort of roll that out further, and that project is brilliant.

I do a lot of work using films and video and having sort of youth create almost counter narratives to the, to the stuff they consume, and they become the producers. So what, what, what, what would that look like?

How, how can you talk to you through video, through social media, to create material that resonates from their realities?

I've done work using all kinds of different art forms, hip hop, music, murals, theater, you know, so I'm really interested in how can we engage young people in conversations in and with and through the medias that they're already interested in engaging with to create new stuff that we can then use to spark even more new stuff. And we've seen it.

We've seen, number one, that kids tend to really like it because it's fun, because it's not like Shamey Blamey, but much more interested in, like, what do you already know? What can you Teach other people how can we debunk myths together and make it fun and funny?

And it gives them the skills and the confidence to then translate those newfound knowledges into their own relationships when they're ready. So, you know, that's. That's one of the big areas of my research that I. I love to. To do and to talk about and to create with young people.

We're almost out of time, but I did want to end by asking you, you know, one piece of advice that you would. Could share parents of tweens and teens about how to support their children's sex lives.

Talk about it, normalize it. Just talk about how weird and wonderful bodies are. You know, what they do, how they work. Read books together, have.

Have material kind of lying around the house. Again, point to websites or go see movies. And when you see things that don't resonate, like, talk about it.

Hey, in that movie, when you saw that happen, do you think that was normal? Do you think that was weird? You know, use. Use what you have and what you see every day.

And when you see other people's relationships that you're like, I don't like what I'm seeing. Like, talk about it with your kid so that they can see that you are.

Are thinking about it, that you are a sexual being, that you are a being in relation to other people, and that you're a safe person to talk to when they do have questions or comments or want more information.

Lots of really critical food for thought. Dr. Sarah Flicker, professor at York University with a focus on adolescent sexual and reproductive health.

We really appreciate your time and your perspective today. Thank you so much.

My absolute pleasure. Thank you for doing this. It was great.

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