Parents who want to know when the right time is to have "the talk" with their kids probably are asking the wrong question, health experts say.
They may also be asking it too late.
When it comes to the birds and the bees, "it shouldn't just be one discussion - THE discussion," said Dr. Jodi Brady-Olympia, assistant professor of pediatrics at Penn State College of Medicine.
Experts recommend an "early and often" approach to talking to their kids about matters relating to sexual health.
"Parents need to be starting these talks early," said Megan Beckett, a behavioral and social scientist at the RAND Corp. "And have these talks frequently and in small doses … because sometimes, kids don't hear it the first time."
Beckett was a lead researcher in a study just published in the journal of the American Academy of Pediatrics.
The study found that parents discussed sexual health topics with their teenagers too late, or not at all. And parents were found to be particularly lagging when it came to talking to their sons, who tend to report having sex at an earlier age than girls.
The study surveyed 141 parents and their adolescents, ages 13 to 17, over a year. The teens and their well-educated parents, who came from households with a median income of $90,000, were participating in a program called Talking Parents, Healthy Teens.
The study found that more than half of the children had engaged in sexual touching before their parents had talked to them about issues such as birth control or how to resist pressure to have sex.
Forty percent of the children had intercourse before any discussion about the symptoms of sexually transmitted diseases, choosing birth control, condom use, or what to do if a partner refuses to use a condom.
Most of the boys said they had engaged in sexual touching before they discussed with their parents how to ask for a date, or before parents talked to them about the importance of not pressuring others for sex. Nearly two-thirds of the boys surveyed said they had intercourse before their parents talked to them about how to use a condom.
Beckett said she doesn't have a magic age at which kids "need to have all the information, but it should be early - earlier than many believe."
Beckett said that other studies have shown that parents try to time sexual health topics to where they think their children are, but parents are "simply not judging what's happening to their adolescents accurately."
Parents not eager
So what does early mean, exactly? Few parents are eager to broach the subject with their kids, and may wrestle with when to start talking about sex.
"Sometimes, parents are still stuck in thinking about the first time they had sex, and think it's OK to wait [to talk to their kids] until that age," said Jayme Trogus, coordinator of Millersville University's Wellness and Women's Center.
But these days, "kids are exploring their sexuality earlier," Trogus said.
Because parents tend to underestimate their children's sexual activity, they may think they have more time to prepare their kids than they really do.
"We don't want to think of our babies as sexual beings. Believe me, they don't want to think of us that way either," said Dr. Christine Stabler, deputy director of family medicine residency at Lancaster General Health. "Too often we think if we avoid the idea it won't happen, but that is [a] myth with serious consequences."
One doctor told U.S. News & World Report that if "parents think they should broach the topic at X age, they should subtract two years and do it at that age instead."
Stabler said that if kids "ask the question," they're probably "ready to hear the answer."
Trogus agreed, but added that parents shouldn't always wait for their kids to start asking questions. And they should not assume that if a child isn't asking questions, he isn't ready to discuss sexual matters.
"You're supposed to try to catch them ahead of time," Trogus said, adding, "You also want to make sure the child is emotionally mature enough to handle the information you're providing them."
A parent may be able to get away with delaying a birds-and-bees talk until the late middle-school years if, perhaps, a child is in a cloistered home-schooling environment, sheltered from television and the Internet, Stabler said.
"But that's not practical for most families," Stabler said. "The external influences are going to get there first. You want your kids to be given the kind of information and education that makes sense to you. Parents have to step up and take charge."
If a child asks about sex, and "you turn them away, they're going to think it's something forbidden," Stabler said. "Kids are curious. They're going to find some other way. ... You want them to have the message you want them to have."
Parents should convey their values, and emphasize self-respect, healthy decision-making and the connections between actions and responsibility, Stabler said.
Beckett said that adolescents cite the media and their peers as prime sources of information. "If that's your competition, it seems like if you're a parent, you're going to want to get in there early, and adequately, and convey your values," Beckett said.
Teens want talk
Studies have shown that teens value their parents' opinions, and want information about sexual health to come from their parents.
And research has shown that children who are able to talk openly to their parents about sex have better outcomes - they delay intercourse, and when they have sex, they practice safe sex, Beckett said.
"I can talk to my mom about anything, like birth control, or whatever," said one Millersville University student, who is a peer health educator at that university.
This student, who asked to be identified by her first name, Lizzy, said her mom always has been open about issues relating to sexuality.
Lizzy said her mom started talking to her about sex before she had sex education in the fifth grade.
She said she feels a little sad for her peers who are unable to talk to their parents about sex. "It just seems like there's a disconnect somehow," she said. "It's not like these people are not having sex."
Lizzy said she knows her mom wanted to offer her perspective early, that "you don't have sex with somebody unless you love them, and you're probably married."
And that perspective, she said, is now her own. But it's not the view of sex that's often conveyed in the media, and it's not the view of sex that some young people get from their peers, she said.
Kids who rely on their peers for information about sex may "have the misconception that all kids are sexually active," and they may get the impression that they are expected - even obligated - to have sex, Brady-Olympia said.
They may get similar impressions from television shows such as "The Secret Life of the American Teenager," which airs on ABC Family.
A parent needs to convey to an adolescent that having sex is about making a commitment to someone you love, and that it should be delayed until you can handle the emotional, as well as possible medical, consequences, Brady-Olympia said.
And kids need to learn "to advocate for themselves, especially at the age when they're so influenced by peer pressure," Brady-Olympia said.
She and other health experts interviewed for this story agreed: Parents should open the lines of communication with their kids when the kids are very young.
Even very young children should be taught the correct anatomical terms for their body parts. "We don't call a nose a puffy," Stabler said. "Why make up names?"
Brady-Olympia agreed, noting that when parents use the correct language when talking about bodies they signal to their kids that "this isn't a taboo subject. This is healthy. This is normal ... and you need to learn respect for your body."
When kids are very young, parents should be talking to them about good touch vs. bad touch, about body responsibility and self-control, Stabler said.
And if a very young child asks where babies come from, you can explain, in age-appropriate language, that "babies grow inside mommies' bellies," Stabler said.
"Puberty is a perfect time to begin to talk about body functioning," the Lancaster General physician said.
She said that most children start learning about puberty at school in the fifth grade. Stabler said parents should call their child's school, and ask what's going to be taught, and "introduce it your own way first."
Most kids should know about the basic mechanics of intercourse by the time they're in the sixth grade, she said.
And parents should discuss issues such as condom use, and other forms of birth control, sexually transmitted diseases, and the right of every individual to refuse sex, before their kids leave middle school, Stabler said.
"By the end of middle school, [kids] need to have heard it all," Stabler said, noting that if parents don't discuss these issues with their kids by then, it's probably too late.
What not to do
She cautioned parents against a "hit and run" approach to talking about sex. "If you ambush them at the dinner table with armfuls of books, they're not going to like it," Stabler said.
Stabler also warned against parents delivering a "fire-and-brimstone threat talk. The kids will turn you off."
"The parents will need to give their children information AND reasons to delay sex," Stabler said, noting that parents can talk to their kids about alternative ways to express themselves, while building on a consistent message framed by their family's values.
Doing your homework on these issues is a good idea, health experts agreed. "Parents really need to be up on things, and they need to do research," Trogus said, adding a caveat: "The books used when they were teens probably aren't good now."
Parents sometimes are wary of getting into specifics with their kids, fearing that if they discuss oral sex, for instance, they'll be introducing new ideas to their kids.
"You're not going to be putting ideas in their heads," Brady-Olympia said. "They're already thinking about a lot of this stuff."
Physicians have to be very specific these days when asking adolescents if they're sexually active, said Brady-Olympia, a pediatrician in Penn State Hershey's adolescent medicine practice.
Some adolescents engage in oral sex, considering it to be "not a big deal," and not even counting it as real sex, Brady-Olympia said.
But this form of sexual activity carries its own risks, and parents should let their kids know this, she said.
Stabler said parents should examine their own attitudes, beliefs and values about sex, and work through their discomfort, so they don't give vague, mumbling answers to important questions.
It's OK for a parent to acknowledge that sex is a stressful subject to talk about, Brady-Olympia said.
"It's kind of overwhelming for both parties, and it's a little embarrassing," said one Lancaster mother, who has a 16-year-old stepdaughter. "But it goes a lot better when you're honest."
Brady-Olympia said that some specifics may be "a little uncomfortable to talk about, but better they hear it from you."
Stabler said it's vital that parents let their kids know, at all stages of development, that they're there for them, and open to continual discussion. When it comes to talking to your kids about sex, "There's no stop to the education," she said.
Suzanne Cassidy is a staff writer for the Sunday News. Her e-mail address is email@example.com.