WebMD Live Events Transcript

Barbara Huberman will discuss when to talk to your children about the 'birds and bees' and how open conversations about sex will help your child make the right choices.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Moderator: Welcome to WebMD Live. Today we will be discussing "Age Appropriate Sexuality Education: What To Tell Your Children and When" with Barbara Huberman.

Barbara Kemp Huberman was the founder and president of the nationally recognized Adolescent Pregnancy Prevention Coalition of North Carolina from 1985-1995 and has been actively involved in human sexuality education and adolescent sexuality issues for over 30 years. Huberman is an expert consultant on adolescent pregnancy prevention and sexuality education and is currently the national director of Training and Sexuality Education for Advocates for Youth, formerly the Center for Population Options, based in Washington, D.C.

Barbara, welcome to WebMD Live.

If you'd like to ask Barbara a question, type /ask followed by your question (e.g. "/ask How are you?")

Huberman: Good evening.

Moderator: Describe some of the principles of effective communication about sexual health for parents to know.

Huberman: When we choose to become parents, there are many things we take on in terms of helping our children grow into mature, responsible, respectful human beings. And for every parent, one of those roles we take on is helping our children to understand who they are as sexual people, what kind of behaviors are appropriate, what values they will have as they grow up, the relationships that they engage in and, ultimately, their own self-worth about themselves as a sexual person. So, some basic things that are helpful for all parents, regardless of the age of their children, are to recognize that while children receive information and are influenced by many other sources as they grow up, for instance, the media, their peers, sex education at school, parents are still the best and primary sex educators for children. When we ask young people, over and over they say I wish my parents could talk to me more and I wish we could have better discussions as I grow up, as my body changes, as relationships change and as I grow into being an adult. The second principle for adults is that there are many times and events in helping your child learn to be a sexual person. Being a sexual educator is not just one event, the birds and bees talk, but many, many teachable moments. These are opportunities that parents get from birth until their children are grown to help them understand, gain information and knowledge and explore who they are as sexual beings. It can be a TV show, it can be an event in the family, such as a new baby or a pregnancy, it can be an article in a newspaper, it can happen in a car pool, not necessarily a class room. And, it certainly happens from the moment children are born.

Another important principle is that when we asked parents, tell us more about how you talk to your children about sex, they frequently say I feel uncomfortable, my parents didn't talk to me. Where do I begin, how do I do this? So, if you're a parent who feels like, perhaps, you've not had these conversations, it's never, never too late to begin. And, it's okay to say to your child, no matter what their age...my folks didn't talk to me about this, but it's really important, and as uncomfortable as I am, I want to talk to you and I want you to feel comfortable coming to me with your questions and concerns any time. Parents also need to know that being a sexuality educator of your children is not just about facts, biology, body parts, it's about values and beliefs and feelings, hurts and joys. And, because parents talk to their children, what we know from research is that in families where there is positive healthy communication, and children feel that they can go to their parents, these children generally delay the initiation of sexual relationship until they're older. And, when and if they do become sexually active, they are more likely to use contraception and protection against STDs (sexually transmitted diseases).

And, the last principle for parents is, listen, listen, listen. There is an old proverb that says the reason God gave us two ears and one mouth is so we can listen twice as much as we talk. And if we give our children opportunities where they can talk and they can share and we just listen without judgment, without criticism, without fear that if a child asks us a question or talks about a sexuality issue that they're automatically doing it, then children are much more likely to grow up to be healthy sexual humans.

Moderator: What are the important concepts parents need to talk about with very young children under age 5?

Huberman: With very young children, this is the beginning of the relationship between parent and child. And, at first, it begins with many nonverbal communications. The way a parent touches an infant, the way children are picked up and hugged, cuddled, responded to when they need something but don't have language to tell us. From these things, our children learn about some of the basics of our sexuality. And, that's learning to trust, a high sense of "I am worthwhile", someone comes to me when I need them, and a sense of mastery over their body and being able to express themselves to other people. In these very early years, some things that parents can do to foster a child's healthy sexual development are giving lots of physical attention to a child. This is not spoiling, this is saying, I love you, I care about you, I'm here for you. And that, in turn, makes the child feel valued, worthwhile and capable. This is the time, also, when children are very young, to start using the proper words for body parts and body functions so that children respect their bodies and know how their bodies function, and they aren't embarrassed as they get older when their peers or their playmates look at them and say, why do you call your breasts that name or why do you call your penis that name? That's not the right name.

It's also extremely important in these early years that parents help their child to understand that their body is their body and they have a right to say no to unwanted touch. And that, if anyone ever touches their body and they don't like it or it doesn't feel good or they know that that's not okay, then they should come to you and tell you and you will protect them. Young children, before they get to school, generally don't have a sense of shame about their body. And, it's important in the early years to teach them about privacy. That it's okay to touch your body yourself, especially around your genitals, but that's done in privacy. Most children in this age group, especially from 0-3 years old, masturbate openly. And they do it because it feels good and they've discovered that. And, this is a time that's very important for parents to share with their children that this is something that you recognize does give them pleasure, but it's something that's private. This is also a time when children begin to learn about bathroom functions and the fact that, generally, these are private too in our culture.

Some questions that young children generally ask are "where do babies come from?", "how does the baby get in or out of its mother?", "why do I have breasts?", "will my brother have breasts?", or, "How come daddy doesn't have them?" They're usually pretty simple questions in the infancy to pre-school years. And, because they're very small children, for a parent who does have some uncomfortableness, this is a wonderful time to go ahead and answer questions easily.

Moderator: What are the important concepts parents need to talk about with children between ages 5 to 10?

Huberman: The school years certainly bring about much more interaction with friends, their peer group, and family members. Language development makes very complex questions possible for children as they learn more and they have the skills to understand more. Children in the school years are very interested, usually, in roles. What do mommies do and daddies do? What do girls do and boys do? And, while they were certainly learning when they were young about roles, this is the time where there is heavy influence from school, from peers, from play groups, from activities that they engage in like scouts or ballet classes, about what actually being female and male means in our culture. It's also a time when children are much more capable of taking care of themselves personally. Taking care of their bodies personally. And so, for a parent, this means reinforcing some of the early lessons about cleanliness, about taking care of your body to make sure that you're healthy, and, again, reinforcing the messages about good touch and bad touch. This is also a time when young children, school age children, are very interested in what's "normal" or "not normal". And so, a lot of their questions will have to do with, "is this okay?" And, it's important for parents, during this time, to reassure their children that their body IS normal, no matter what it looks like, what size it is, so that they can feel, as they move into the teen years and begin to experience the changes of puberty, a sense of pride about their bodies.

Moderator: What age does someone discover their sexuality?

Huberman: That begins, really, in conception where children begin to experience pleasure while in the mother's uterus. There is evidence that children masturbate while in the uterus. So, we certainly don't know if they're experiencing pleasure from that activity, but it certainly offers them some kind of comfort. And, if we look at sexuality as much, much more than a sexual relationship, we can understand that the other parts of our sexuality, our body image, whether we like the way our body looks, our values and beliefs about sexual relationship and about sexual behavior. Our sex roles, how do we see ourselves in terms of our sex roles and our interactions with other people. These are all critical parts of our sexuality. Our sexuality for all of us as human beings is changing constantly. From birth to death, we are sexual beings and it changes all the time as our life and our experiences change and our circumstances change in our lives. And, certainly, the greatest amount of change physically, at least, occurs for children in the years around puberty.

Moderator: What are the important concepts parents need to talk about with adolescents between ages 11 to 19?

Huberman: An interesting thing that's helpful for parents to know is that the age in which bodies start to mature and grow into adult status has been dropping for the last century. So, for girls today, when they begin to experience the physical changes of puberty, the average is now 11-1/2, which means, for many young girls, those changes are occurring, if that's the average, at ages 8 and 9. For boys, it's about one to two years later. That's why when you look at, let's say, a sixth grade class of young people, the girls, many of them appear to be physically mature. And, if they dress, wear make-up and look like adults, the young boys in that class, most of whom will be one to two years behind them in starting puberty, still look like little kids. The danger in that, as the age of puberty for girls has dropped, is that they aren't attractive really to 12-year-old boys, they're attractive because their bodies are physically mature to much older young men or men Because their bodies are mature, however, doesn't mean that socially and emotionally and cognitively, their ability to think about themselves and their situations, is mature as well. That, itself, is a long process as well. And, for most of us, the majority of that certainly isn't complete until well into our 20s.

During adolescence, there are some keys for parents. Number one, be honest. Be honest, tell the truth. If you don't know the answer to a question, instead of brushing your child off and say "go ask your mom" or "go ask your dad", admit that you don't know it and find some way to help your child get the answer. You get on the Internet, you go to the library, you go to a book store and buy books. You realize that perhaps you need some help and you go take a class. And, if you find it really tough to answer these questions, then place your child with someone who will answer them for you in the way you want them answered. That can be a relative, another family member. That can be a friend, a minister or clergy person. It can be a trusted teacher or youth worker, a grandparent. As teenagers separate from their parents, though, and move into adulthood, one of the tasks that they have to do is to be independent. And, what that means is, there may be times that they can't talk to you. You may have been open, you may have given them every opportunity to talk, but for a variety of reasons, they just can't talk to you perhaps at this time. And, it's really important that you give your child someone else to go to. You have this conversation in which you say, "I love you. I always want you to come to me if you can. You should never go through anything major in your life where you have fear or concern or you're upset alone. Here's two people that you can go to who I believe share our values and would help you. And, if you want, would help you come to me and tell me. What you're feeling, what your problem is, what you need help with." But the important thing, as we look at some of the events over the last few years of young people committing violence and suicide and getting HIV, etc. the important thing is that they never go through it alone. They should have some adult who will be there and talk to them.

Another thing that is so important thing to share with adolescents is your values. Most adolescents will get some form of sexuality education. What we call, generally, the plumbing courses. The body parts, how it works. But, what parents need to share over and over again are the values that are important in their family. For many parents, this will be based on their religion or their culture. But, making sure that your children know what your standards are, what your expectations are, but also as a parent, understanding that, more than likely, when your child makes that decision about being involved with someone in an intimate sexual relationship, you are not going to be there and you can't hold their hand or pull them back so they don't get hurt or they don't suffer consequences. Your young person is going to make that decision. And, as the parent, your role is to prepare them for that so that when they do decide that they feel good about that decision, that they are not being coerced, they're not being used, and that they are protecting themselves against pregnancies and STDs.

Moderator: What do I do when my kids ask me questions about what I did (sexual behavior)?

Huberman: That's probably one of the most frequent questions in parent-child communication seminars or workshops that comes up. And, there is no easy answer to this one. And, nobody can tell you what's right or wrong or what's the best or the not best thing to do. But, the guideline is that you have a right to your privacy and it's okay to say to your child, that's not something right now that I'd like to share with you. You're at an age right now, in the next few years you may be making that decision yourself and I want you to make it on your own, feeling good that you know very well what your values are and what your own standards for your behavior are. Other parents feel very comfortable saying to their child, I'm glad you asked that question. Yes, I did have an intimate relationship when I was a teenager. And the parent may choose to say, I did have an intimate relationship and I felt good about it. We really cared about each other, we protected ourselves against pregnancies and STDs. Or, a parent might say, I did have an intimate relationship and I wish I hadn't and this is why. The important thing here is being honest with your child, but also understanding that they are going to make that decision for themselves and you can preach all you want to, but the fact is, that over 80% of the young people in this country have had at least one sexual relationship before they're 20. And, while we may want them to live by the value of waiting for marriage, 90% of the marriages in this country are not virginal marriages. So, while that may be a value of some denominations or individuals, it's not a public value that's overwhelmingly held in our country. I said before that parents have a right to their privacy. But, I think what that also carries with it is that parents respect and also give their children a right to privacy and understand that as they move from childhood into young adulthood that they do have a desire for some things, as they work out who they are as an adult, to be private and perhaps to not share them.

Moderator: How has sexuality changed from the past generations?

Huberman: When we look back in history, we look at cultures and how they've changed around sexuality and sexual behavior, we see cycles of more openness and acceptance. And then there will be a cycle when the pendulum swings back to much more control, much more restriction, much more closed kind of atmosphere that discourages open conversation about sexuality. I think what has changed it incredibly in just the last couple of years is the Internet. And, the possibilities or the potential that any individual has now for learning about sexuality and becoming perhaps more comfortable and knowledgeable about sexuality is unlimited. In past cultures we didn't have that ability to instantaneously access information. Before books were printed, information about sexuality had to be transferred from person to person and it really was much more open in the societies. There was much more of a naturalness and comfort with sexuality.

I was just in New Mexico and had the opportunity to talk to some Native Americans about the celebration that is a part of tribal customs when a young girl starts her first menstrual period. And it truly is a celebration, a party with wonderful food and all the relatives. And, everyone at that party imparts to that young girl a sense of, you're a woman physically now, you're wonderful. But, there is also a part of those ritual customs and the celebration in which the elders, the older women, the older men share stories from centuries ago that relate to a young woman what her responsibilities are and will be in the future. Most parents today think their children are getting a comprehensive sexuality education in school. And so, they feel like, well, maybe I don't have to do it. Maybe I don't have to talk about it. But, unfortunately, nothing could be further from the truth.

Moderator: Where do kids get most of their information about sex?

Huberman: In survey after survey there's been some dramatic changes in the last 50 years certainly. We've seen a reversal from parents and churches being at the top of the list of where children get their information to now TV, movies and peer groups being at the top. For young girls, the growth of magazines and printed sources of information has been astounding in the last 10 years. For young boys, when you look at the list of their sources for information it's mostly their peers. And unfortunately when we go back, we know that much of the information that we learned from our peers was inaccurate and in many cases inappropriate and certainly unhealthy.

Moderator: What problems are linked to children not having enough or correct information about sexuality?

Huberman: Well, one of the most severe problems is that one out of ten young people in this country, one out of ten young women has a pregnancy in their teens. That's 13 times higher than young women 15-19 in the Netherlands. That's 9 times higher than young women in Germany. We know that one out of four young women in this country experiences some type of sexual abuse or harassment during their teen years. We know that one out of four cases of STDs, sexually transmitted diseases, occur to teenagers in our country. These are certainly physical consequences that we've seen, but there are others as well. For young people who become parents at very young ages, their whole potential and their future changes. The road that they might have been on for many of them to self-sufficiency, completion of an education, and the ability to parent is severely diminished. We know that many of the children who are born to teen mothers will not have a father in their lives. Almost 80% of teen pregnancies are out-of-wedlock pregnancies. And, a great majority of those will have no relationship with the father.

Moderator: Does America differ from other countries in terms of parents and communications with their children about sexuality?

Huberman: You see a totally different picture in Northern European countries. I've been studying France, Germany, the Netherlands and the Scandinavian countries for the past five years. We've been meeting with experts in those countries who are looking at relationships between young people and families and their communications. What we find is that parents generally feel very comfortable to answer questions. Parents, in general, accept, in the European countries, that the older adolescents, it's a normal part of growing up to become close to someone and to become sexually intimate with that person. What parents in those countries say to their young people is not, don't have sex, but don't ever have sex without protecting yourselves from pregnancies and STDs. In those countries, in most families, young girls go to their family doctor when they're 16 years old and receive some type of birth control When we stopped young people on the streets or sat and talked with them in coffee shops, over and over again every single one of them said, I always carry condoms. Perhaps not for me, but so that I have it for a friend. Condoms, because of AIDS and HIV primarily, not because of pregnancy prevention, are easily available in the European countries. And the public in general supports the government's role in providing family planning services to all people. There is no doubt that in these countries with national health care insurance, that a teenager's ability to access reproductive health services is much easier and can be done because everyone has the national health insurance, this can be done confidentially. But, in most families, the parents are very aware that their young person is involved in a relationship that is sexually intimate. And, the message overall is not one of "you shouldn't be doing this" , but, "if you are doing it, you're protecting yourself."

Moderator: Do you feel there is enough interest in educating children about sex, and what role should the government have?

Huberman: Well, in the past several years there has been tremendous interest in this country on the part of the government especially. Until three years ago, the federal government had invested no dollars in sexuality education. And, as a part of welfare reform in 1996, appropriated $250 million for sexuality education. But, they placed severe restrictions on that money that was divided among the states. The money could only be used for programs in which young people were told that they could not have sex until they were married. And, if they did, one of the other restrictions you had to tell young people was that if you did have sex before marriage you would suffer physical and emotional damage.

Moderator: What is your opinion of sex education in public schools?

Huberman: Only about one out of ten schools in the country offers comprehensive, medically accurate, developmentally appropriate sexuality education taught by a competent, trained sexuality educator. So, what that means is about 90% of our kids may get a plumbing lecture in the 7th grade - this body part does that or this tube connects to that organ - but they are virtually deserted after junior high school in terms of sexuality education, a time which is the most likely time for them to be involved with someone and risk the consequences of unprotected intercourse.

Moderator: What has interested you in educating people about sexuality?

Huberman: A variety of things. I think, certainly the first, just to help people feel good about themselves and about their relationship. And, especially my work in adolescent reproductive health, to empower young people to make wise, safe, responsible decisions about their sexual health. I worked in a maternity home many years ago for pregnant, unwed mothers and it was so tragic to me. There was no good answer once a teenager was pregnant. Abortion? Adoption? Teenage parenting? They all had life-changing consequences. I think my personal motivation is one in which to help families communicate about sexuality in a positive, healthy way so that parents feel good about how they've raised their children and children feel good about the way they've been raised. And, if they begin their own families can look back in future generations and say wow, you never know that some of the things you tried to do so differently from your parents that you've done them. I have two grown children and when my daughter had her first child and was changing a diaper, she was doing the usual, this is your nose, these are your eyes, these are your fingers, and then she turned around and said, Madeline, your grandmother would like for me to tell you that these are your breasts and this is your vagina.

Moderator: Do you have any last comment for those parents going off to talk with their children?

Huberman: It's never, ever too late. and, it's one of the most important things that you can do as a parent to help your children grow up with healthy feelings about who they are, about their relationship, to understand the joy and the passion, the love and the comfort and the intimacy that healthy sexuality can provide.

Moderator: Barbara, thank you for joining us. Please join us every Friday at 9 p.m. here in the Sexual Health Auditorium. Next week, we will discuss Multiple Orgasms, with Felice Dunas, Ph.D.

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