Challenging Conversations

It’s Everywhere Online, But Nobody is Talking About It

Delaney Ruston, MD
August 16, 2022
hand scrolling on pink phone

Yes, I’m talking about the topic of sex.

Part of being a doctor involves, at times, asking patients about their “sexual history.” I generally start by asking, ”Are you sexually active?” If they say yes, I ask, “Is this with males, females, or both?”

Taking a sexual history in my clinic has become second nature to me. Yet, what I find interesting is that it is one thing to be a trained physician who talks with thousands of patients over the years, but it is quite another trying to talk about sex with my own two kids. 

Raising topics around sexuality is, to varying degrees, uncomfortable. Yet, I believe our digital age makes having uncomfortable conversations paramount. In my films, Screenagers and Screenagers Next Chapter, audiences have seen me struggle with uncomfortable discussions with my kids. 

I know that not giving up and continuing to raise uncomfortable topics with my kids over the years has paid off. When I bring up issues repeatedly over time, I signal to them that I can handle talking about these things. They know they can come to me with questions and concerns about personal issues, including intimate relations. 

Talking for years with teens about sexuality in my clinic, I know that many teens do not have someone with whom they feel comfortable discussing these issues.

Boys in particular, including my son, have shared with me how uncomfortable they would feel talking with a friend about any sexuality-related issues, whether it’s about something going on with a current partner, a one-night stand, or a crush. 

It’s a gift to kids of all ages when we calmly and non-judgmentally raise topics related to sexuality and let them know we care and are here for them.  

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Today, I offer four topics to raise with your child or older teen.

Some will be appropriate for both age groups, and some will just make sense for those who are a bit older. 

1. There is a teenager-friendly book published this summer titled Queer Ducks (and Other Animals) by Eliot Schrefer. The book explores something I did not know much about the fact that many animal species engage in same-sex sexual activity. 

Take bighorn sheep, for example. Male sheep predominantly hang together, and female sheep stay together, except when both genders get together to procreate. However, this doesn’t happen often. It turns out that the male bighorn sheep have sex with each other quite regularly. Researchers believe this may be a way that animals are creating more cohesion among the group. Check out this video of Schrefer on the Daily Show to learn more.  

Bringing up this book and video are wonderful ways to normalize same-sex relationships and practices among animals, including humans. 

2. This summer, I was talking with an older teen who told me why he limits his consumption of pornography. He explained that he avoids watching a lot of pornography because he knows it can negatively impact his ability to have an erection during sex. He said he heard about how porn can impact male arousal from a variety of sources. 

While studies that look at the intersection between pornography, masturbation, and erectile dysfunction are few and far between, some data shows at least somewhat of a link between porn over-consumption and erectile dysfunction (almost all the data is regarding males 18 and older). The reported prevalence of ED (erectile dysfunction) in young men has increased enormously over the last decades, from 2 percent to 5 percent from 1999 to 2002 to more recent studies that report a rate of 20% to 30%. 

This can be a tricky thing to bring up, but sharing some of this data might be interesting to your teen. Sharing data makes room for you to bring up important information without directly implicating your teen and sometimes allows for more vulnerability in following conversations. 

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3. Many sitcoms have loads of sexual references throughout. Examples of such shows include How I Met Your Mother, New Girl, The Office, Gossip Girl, and even Friends.  

Consider having a conversation with your child about the types of jokes frequently made in their favorite TV shows. 

The interesting thing is kids often don’t notice the multitude of sexual references, but if you watch an episode with them after mentioning the issue of how often sex is referenced, very quickly everyone in the room realizes how often these references are made. 

Through the jokes and the little remarks scattered through mainstream shows, viewers are subtly taught how to act and feel about sex. No one likes to think they are influenced by what they see and hear, but the fact is we are influenced.This can ignite a larger conversation about sex in our society and what might be contributing to what we think about things. 

4. Talking about sexuality on TikTok (along with Instagram Reels, music videos, and so on) is important since most teens spend a lot of time on these platforms. Ask your kids how some of the dance videos on TikTok make them feel and if they’ve ever noticed any subtle reactions they or their friends have while watching some of these dance videos. For sure, there can be loads of videos involving dancing that have no impact, but then one, for whatever reason, may suddenly cause a reaction. 

With TikTok’s massive popularity, dancing is more pervasive in the media than ever.

You might ask your kid: “I’ve been thinking about dance videos — even if they are not trying to be really sexy, the truth is, they can be. Given this is happening on a mass scale, what do you think the implications are?”  

Kudos to all of us who step into these challenging conversations. It is NOT easy, but as I said, sex is everywhere online. So let’s help our kids out and learn how to get comfortable with these uncomfortable topics. 

Questions to get the conversation started:

  1. Given the popularity of TikTok dances, what do you think about the dances and sexuality? 
  2. Did you know that many animals are sexually active with the same sex?
  3. What sitcoms have you seen that seem to include a lot of sex references?
  4. Have you ever heard about how pornography can (not frequently, though) affect a guy’s ability to have an erection?

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Challenging Conversations

It’s Everywhere Online, But Nobody is Talking About It

Delaney Ruston, MD
August 16, 2022
hand scrolling on pink phone

Yes, I’m talking about the topic of sex.

Part of being a doctor involves, at times, asking patients about their “sexual history.” I generally start by asking, ”Are you sexually active?” If they say yes, I ask, “Is this with males, females, or both?”

Taking a sexual history in my clinic has become second nature to me. Yet, what I find interesting is that it is one thing to be a trained physician who talks with thousands of patients over the years, but it is quite another trying to talk about sex with my own two kids. 

Raising topics around sexuality is, to varying degrees, uncomfortable. Yet, I believe our digital age makes having uncomfortable conversations paramount. In my films, Screenagers and Screenagers Next Chapter, audiences have seen me struggle with uncomfortable discussions with my kids. 

I know that not giving up and continuing to raise uncomfortable topics with my kids over the years has paid off. When I bring up issues repeatedly over time, I signal to them that I can handle talking about these things. They know they can come to me with questions and concerns about personal issues, including intimate relations. 

Talking for years with teens about sexuality in my clinic, I know that many teens do not have someone with whom they feel comfortable discussing these issues.

Boys in particular, including my son, have shared with me how uncomfortable they would feel talking with a friend about any sexuality-related issues, whether it’s about something going on with a current partner, a one-night stand, or a crush. 

It’s a gift to kids of all ages when we calmly and non-judgmentally raise topics related to sexuality and let them know we care and are here for them.  

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