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Contraception

Methods to prevent pregnancy and STIs

Contraception – also known as birth control – is any method used to reduce the chances of unplanned pregnancy. Some forms of contraception also reduce the risk of sexually transmitted infections (STIs). Keep reading to learn about different types of birth control and how they work.

Need more info? Ask an Expert.

The different types of birth control

Some forms of contraception act as a physical barrier to prevent sperm from meeting an egg, while others use hormones to prevent pregnancy. To choose the right contraceptive for you, talk to your healthcare provider. You can see your primary care provider or visit your local health department or family planning clinic.

Contraceptives that don’t require a prescription include:

  • Abstinence: This means not engaging in oral, anal or vaginal sex. With abstinence, there is no risk of pregnancy or STIs. It can be hard to maintain. Abstinence provides 100% protection against pregnancy and STIs.
  • External condoms (use every time): An external condom is a barrier method that collects semen and other fluids, preventing them from entering a person’s vagina. It protects against pregnancy and STIs. They’re free at your local health department. Condoms must be used correctly every single time. Condoms break down over time, so pay attention to the expiration date. They’re 98% effective with perfect use and 85% effective with typical use. They’re available over the counter.
  • Internal condoms (use every time): An internal condom is a barrier type of contraception (material much like an external condom) that is inserted into the vagina or anus before sexual intercourse. They can be inserted up to eight hours before sexual contact, help prevent pregnancy and don’t require a prescription. Internal condoms may cause skin irritation around the genitals, you must remember to use them every single time and it only protects against some STIs. With perfect use, they’re 95% effective and 79% effective with typical use.
  • Withdrawal method (use every time): This is the removal of the penis before ejaculation occurs in the vagina. This method is free and more effective when using another birth control method, such as a condom. The cons are you may not be able to withdraw in time, pre-ejaculate may still contain sperm and this method doesn’t offer protection against STIs. With perfect use, it’s 96% effective and with typical use, it’s 78% effective.
  • Spermicide (use every time): Spermicide comes in creams, gels, foams, films and suppositories that have chemicals to stop sperm from reaching an egg to fertilize. It doesn’t protect against STIs, must stay in place for six hours after intercourse and may cause irritation to the genitals. Spermicide is 71% effective when used alone and 97% effective when used with a condom.

Birth control methods that require a prescription include:

  • Pill (take daily): This is a monthly pack of hormonal pills that must be taken once a day. It may help regulate the menstrual cycle and may be free or low-cost. The cons are you must take it at the same time every day, it may cause side effects (like headaches, nausea or weight gain) and doesn’t offer protection against STIs. With typical use, they’re 91% effective. With perfect use, they’re 99.7% effective.
  • Patch (replace weekly): A small patch placed on the body that releases hormones. It must be replaced weekly and you can still shower or swim normally with the patch on. The patch doesn’t protect against STIs and may cause skin irritation. With typical use, it’s 91% effective and with perfect use, it’s 99% effective.
  • Shot (get every 12 weeks): A short with hormones injected into the upper arm or buttocks every 12 weeks. It’s low-maintenance, can be injected at home after the first injection at the doctor’s office, and is effective one week after the first injection. It is usually not recommended for long-term use, doesn’t provide protection against STIs and may cause irregular periods. The effectiveness rate for perfect use is 99%.
  • Vaginal ring (replace monthly): A flexible ring that is inserted into the vagina and releases hormone. It provides nonstop protection against pregnancy if used correctly, may regulate menstrual cycles and reduce cramping, and is low-maintenance. It doesn’t offer protection against STIs and may cause vaginal discomfort, headaches or breast tenderness. It’s 91% effective with typical use and 99% effective with perfect use.
  • IUD (replace every three to 12 years): An intrauterine device is t-shaped and contains copper or progestin (hormone). It is inserted into the uterus by a healthcare provider. It provides long-term protection against pregnancy, is effective immediately and is comfortable. It may cause a slightly higher risk of infection during the first month of use, may fall out or puncture the uterus (rare) and doesn’t provide STI protection. They are more than 99% effective at preventing pregnancy.
  • Implant (replace every three to five years): A small, plastic-like rod is inserted under the skin of the upper arm that releases hormones. The implant provides long-term protection against pregnancy, can shorten or lighten periods and reduce cramps, and is low-maintenance. It may cause irregular periods, nausea headaches or weight gain. IT doesn’t protect against STIs. The implant is more than 99% effective.

Less common methods include:

  • Sponge (use every time): This is a small, round sponge that is made of soft, flexible plastic and contains spermicide. It can be inserted up to 24 hours before intercourse and is easily available. It must stay in place for six hours after intercourse, is less effective for women who have given birth and doesn’t protect against STIs. With typical use, it’s 80% effective and with perfect use, it’s 91% effective.
  • Diaphragm (use every time): A diaphragm is a dome-shaped silicone or latex cup with a flexible rim that’s inserted into the vagina before sexual contact. It can be inserted up to six hours before sexual contact, you can leave it in for up to 24 hours and multiple sexual encounters, and you can reuse it for up to a year. You must leave it in for six hours after intercourse, it may increase the risk of urinary tract infection or toxic shock syndrome, and doesn’t protect against STIs. It’s 88% effective with typical use and 94% effective with perfect use.
  • Cervical cap (use every time): A soft, dome-shaped silicone cup with a firm rim that can be used for up to 48 hours. You can use the same cap for up to a year with proper care between uses and can use it for up 48 hours. The cons are it may increase the risk of urinary tract infection and toxic shock syndrome, it’s less effective after giving birth, and it may move or shift during intercourse. The cap is 86% effective if a woman has never given birth and 71% effective if she has given birth.

Emergency contraception

The emergency contraception pill (sometimes called the “morning-after pill”) can reduce the chance of pregnancy after unprotected sex or if another method of birth control fails. Most options are available over the counter and don’t require a prescription. The pill must be taken within three to five days – the sooner it is taken, the more effective it is.

The copper IUD can also be used if inserted by a medical professional within five days of unprotected sex or birth control failure.

STI Prevention

The following methods are used to prevent STIs:

  • Abstinence
  • Condoms
  • Dental dams: A thin, flexible piece of latex that is placed over the genitals or anus before oral sex. It can easily be made by an unused condom and hard to find in stores.
  • PrEP, which stands for pre-exposure prophylaxis and is prescribed to people who are at risk for contracting HIV. This method only protects against HIV, not other STIs, and is best used with a barrier method. It must be taken daily.

Talk to your healthcare provider about which method is right for you.

Need more info? Ask an Expert.

Resources

For more information about staying in charge of your health and future, visit:

A Step Ahead: How to access free LARC methods in Tennessee

Centers for Disease Control and Prevention (CDC)

HHS Office of Population Affairs

Planned Parenthood

Home / Teen / Sex and Relationships

Gender, Sexuality, and Expression

What does LGBTQIA+ mean?

LGBTQIA+ stands for lesbian, gay, bisexual, transgender, queer or questioning, intersex, and asexual (or allies), plus other marginalized groups such as pansexual, heteroflexible, aromantic, etc. The term does not include everyone, but it’s a starting point for talking about different types of romantic attraction and gender identities.

 

Expressing Myself. My Way.

 

 

What is sexual orientation?

The following terms describe some people’s sexual orientations. Someone’s sexual orientation refers to the people that they are sexually attracted to.

 

      • Heterosexual (or straight) refers to a person who is sexually attracted to people of the opposite sex.
      • Homosexual (or gay) refers to someone who is sexually attracted to people of the same sex.
      • Lesbian refers specifically to a woman who is sexually attracted to other women.
      • Bisexual refers to a person who is sexually attracted to both men and women.
      • Pansexual refers to a person who is sexually attracted to people of any sex, gender or gender identity.
      • Asexual refers to a person with a lack of sexual or romantic attraction for anyone, or with low interest in sexual activity.
      • Aromantic refer to a person who has no interest in romantic relationships
      • Questioning is the process of exploring one’s own gender identity, gender expression, and/or sexual orientation.
      • Heteroflexibility is a form of a sexual orientation identified by minimal homosexual activity and being predominantly heterosexual (straight).
      • Queer is an umbrella term for sexual and/or gender minorities. Typically those who identify as queer do not consider themselves heterosexual and/or a part of the gender binary. (learn more in gender identity and gender expression sections)

 

Just like with differences in race, ethnicity, religion, or cultural background, it’s important to remember that just because someone is different than you doesn’t mean they’re weird, bad or wrong. Always treat everyone with respect and understanding no matter who they are or how they live their life.  If you don’t see yourself represented in the list above, click here to see a more complete list of sexual orientations.

 

What does biological sex mean?

Biological sex refers to the anatomy that defines us as male, female or intersex. This includes the internal and external sex organs in addition to chromosomes and hormones as well.

Here’s some important info to know about biological sex:

 

  • A person with two XX chromosomes is a biological female.
  • A person with XY chromosomes is a biological male.
  • Intersex refers to an individual who has a chromosome set different from biological males or females. This individual may develop sex or reproductive organs that are ambiguous or may develop sex characteristics of both males and females.

 

What does gender identity mean?

Gender identity refers to how people see themselves.  It is their own internal sense and personal experience of gender.  Just because someone is a biological male or female does not mean that they identify with that sex or gender identity. Gender markers are not determined by biological sex.  They are ideas that we assign to a person based on sex.  Here are some important terms to know regarding gender identity:

 

  • Cisgender refers to a person whose gender identity conforms with the gender that corresponds to their biological sex assigned at birth.
  • Genderqueer/Gender Non-Conforming refers to a person whose gender identity does not strictly conform to conventional gender distinctions but identifies with neither, both, or a combination of genders.
  • Transgender refers to a person whose gender identity does not correspond to their biological sex assigned at birth.
  • Non-binary refers to a spectrum of gender identities that are not exclusively masculine or feminine‍—‌identities that are outside the gender binary.

 

What is gender expression?

Gender expression includes all the ways a person communicates their gender based on societal factors such as gender norms and perceptions.  Gender expression is a person’s outward expression of their gender; like their clothes, haircut, makeup, etc.

 

It all exists on a spectrum

It is important to remember that gender identity, sexual orientation, biological sex, and gender expression are all on a spectrum. This means that some people aren’t always one thing or another – they can be somewhere in between.

 

  • A person who is transgender can identify as heterosexual, homosexual, bisexual or any other sexual orientation.
  • A person who identifies as a woman and is biologically female may choose to express their gender on the scale of masculine, feminine or androgynous.
  • A person whose biological sex is male can have a feminine gender expression.

Genderbread Person Poster

Trevor Project

Growing up LGBTQIA+

In 2012, the Human Rights Campaign did a report called, “Growing Up LGBT in America,” and surveyed more than 10,000 LGBTQIA+-identified youth ages 13 – 17.  It provided a stark picture of the difficulties they face.  Since, they surveyed more than 12,000 LGBTQIA+ youth ages 13-17 in the “2018 LGBTQ Youth Report.”  Both reports surveyed youth from all 50 states and the District of Columbia.  The results of the 2018 youth survey show continuing, serious challenges for LGBTQIA+ youth.

 

The 2018 youth survey shows 67% of LGBTQIA+ youth hear their families make negative comments about LGBTQIA+ people.  Similarly 48% of LGBTQIA+ youth who are out to their parents say that their families make them feel bad for being LGBTQIA+.

The Trevor Project’s 2019 National Survey on LGBTQ Mental Health surveyed over 34,000 youth, ages 13-24, with representation from all 50 states. Their key findings show:

 

  • 39% of LGBTQ youth seriously considered attempting suicide in the past twelve months, with more than half of transgender and non-binary youth having seriously considered
  • 71% of LGBTQ youth reported feeling sad or hopeless for at least two weeks in the past year
  • Less than half of LGBTQ respondents were out to an adult at school, with youth much less likely to disclose their gender identity than sexual orientation
  • 2 in 3 LGBTQ youth reported that someone tried to convince them to change their sexual orientation or gender identity, with youth who have undergone conversion therapy more than twice as likely to attempt suicide as those who did not
  • 71% of LGBTQ youth in our study reported discrimination due to either their sexual orientation or gender identity
  • 58% of transgender and non-binary youth reported being discouraged from using a bathroom that corresponds to their gender identity
  • 76% of LGBTQ youth felt that the recent political climate impacted their mental health or sense of self
  • 87% of LGBTQ youth said it was important to them to reach out to a crisis intervention organization that focuses on LGBTQ youth and 98% said a safe space social networking site for LGBTQ youth would be valuable to them

 

LGBTQIA+ Youth Rights

lgbtqia+ Youth Rights

If you are interested in laws specific to the state you live in, a good resource is: https://sexetc.org/action-center/sex-in-the-states/.

 

In recent years, many states have taken steps to protect LGBTQIA+ youth against bullying and discrimination.  22 states have anti-bullying laws geared to protect the LGBTQIA+ community, and 15 states have school non-discrimination laws and state-wide regulations to protect LGBTQIA+ students from discrimination in schools on the basis of sexual orientation and gender identity, including being unfairly denied access to facilities, sports teams, and clubs.  This information is up to date as of July 2019

 

LGBTQIA+ youth face lots of challenges and are often targeted by bullying and discrimination. School bullying is a big problem, which has garnered national attention and affects many LGBTQIA+ youth.  Results from the 2017 Youth Risk Behavior Survey show that, nationwide, more U.S. high school students who self-identify as lesbian, gay, or bisexual (LGB) report having been bullied on school property (33%) and cyberbullied (27.1%) in the past year, than their heterosexual peers (17.1% and 13.3%, respectively). Bullying puts youth at increased risk for depression, suicidal ideation, misuse of drugs and alcohol, risky sexual behavior, and can affect academics as well. For LGBTQIA+ youth, that risk is even higher.

 

 

There are many organizations that devote their time and money to fighting for the rights of the LGBTQIA+ community.  Their belief is that regardless of a person’s sexual orientation, gender identity, or gender expression; jobs, housing, government programs, service at restaurants and everything else should be equal.  If you would like to learn more about the fight for LGBTQIA+ rights, the American Civil Liberties Union (ACLU) and Humans Rights Campaign are good places to start.

 

How to be an ally

  1. Be a listener.
  2. Be open-minded.
  3. Be willing to talk.
  4. Be inclusive and invite LGBT friends to hang out with your friends and family.
  5. Don’t assume that all your friends and co-workers are straight. Someone close to you could be looking for support in their coming-out process. Not making assumptions will give them the space they need.
  6. Anti-LGBT comments and jokes are harmful. Let your friends, family and co-workers know that you find them offensive.
  7. Confront your own prejudices and bias, even if it is uncomfortable to do so.
  8. Defend your LGBT friends against discrimination.
  9. Believe that all people, regardless of gender identity and sexual orientation, should be treated with dignity and respect.
  10. If you see LGBT people being misrepresented in the media, contact GLAAD.org.

(https://www.glaad.org/resources/ally/2)

 

Frequently Asked Questions

 

How do I know if I’m part of the LGBTQIA+ community?

That’s a difficult question to answer because only you can decide.  You don’t need to decide right away.  As you learn about yourself, your identity may grow and change.  No matter how you decide to identify, you are valid and deserve happiness and acceptance.  Even if you identify as heterosexual you can still be an ally and support the LGBTQIA+ community!

 

How can I support my friend who has “come out of the closet?”

This could be a rough transition for them, try and make yourself available for them to chat with because they will need a good friend.  Coming out of the closet can be exciting and new but also scary because there is a lot of unknown.  You can learn about healthy positive relationships here.

 

How do I know what pronouns to use for a person?

Ask in a respectful way what pronouns they prefer.  The person will probably be happy that you care enough to use the correct pronouns.  Some pronoun examples include: he, him, his; she, her, hers; they, them.

 

Why do people say “that’s so gay”?

Typically when people use that phrase, they are using “gay” to mean something is bad, negative, stupid or less than desirable.  Using that term in that way can make a homosexual person feel that their sexual orientation is less than desirable or that they are not supported.  Using this phrase can be a habit for someone, even though they may not understand the weight of their words.  If you feel comfortable, you can ask that person not to use that phrase around you and explain to them why it’s offensive to you and others.

 

Someone called me homophobic, but I have a friend who is gay, so I can’t be, right?

Language matters.  Sometimes what we say, our body language, and how we talk to people can project a message that doesn’t match how we really feel.  The words that we use can be upsetting to some and not to others.  It’s important to listen to the person who you’ve hurt, be accountable and take responsibility for what you said, and then commit to do better.

 

I want to “come out” but I’m afraid that my parents/guardians won’t be accepting.

Deciding to come out is a brave decision.  Think ahead before you come out, get ready for a variety of reactions; good, bad, and super tough.  Your safety should be the first priority.  Being your authentic self is important but being safe is even more important. If you are worried that it may not be safe for you to come out, have a safety plan for yourself.  It may make you feel safer to have a back-up plan for housing, food, school and transportation in case your family is unsupportive.  And remember, even if they aren’t supportive initially, that doesn’t mean they won’t be in the future. The Trevor Project has an excellent guide to coming out on their website.

 

What should I do if I need help?

The Trevor Project also has a crisis line for LGBTQIA+ youth, where you can call 1-866-488-7386, use TrevorChat to instant message with a counselor, or use TrevorText by texting START to 678678.

 

Additional Information, Resources and Support:

Home / Teen / Sex and Relationships

Relationships

What is a relationship?

Dictionary.com defines a relationship as “noun: 1. a connection, association, or involvement. 2. Connection between persons by blood or marriage. 3. An emotional or other connection between people: the relationship between teachers and students. 4. A sexual involvement; affair.”

Types of Relationships info graphic

Red Flag vs. Green Flag

A Red Flag is something that someone does, or something that happens in a relationship which sends an intuitive signal saying something may be wrong.

A Green Flag is something that someone does, or something that happens in a relationship which makes you feel good about that person/relationship.

Healthy vs Unhealthy Relationships

How do I know if my relationship is unhealthy?

Healthy vs. UnHealthy amaze.org

If you are in a relationship that is harmful to your physical or psychological health, you are in an unhealthy relationship. In the graphic above there are some examples of what an unhealthy relationship might look like. This can be in a romantic relationship, a friendship, a family relationship, or any relationship. Just because you notice some of these red flags in your relationship, that does not make the relationship automatically unhealthy, unless it is some form of abuse. You may even notice them in yourself. Other than abuse, red flags can be a signal to either work on yourself or the relationship. However, if you are seeing red flags over and over again, and the relationship does not change, that relationship is unhealthy. Below are some definitions of different forms of abuse.

Physical- when someone hurts another person through bodily contact. Examples of this could be hitting, kicking, punching, slapping, burning, and other physical acts.

Emotional “any abusive behavior that isn’t physical, which may include verbal aggression, intimidation, manipulation, and humiliation, which most often unfolds as a pattern of behavior over time that aims to diminish another person’s sense of identity, dignity and self-worth, and which often results in anxiety, depression, suicidal thoughts or behaviors, and post-traumatic stress disorder (PTSD)” (joinonelove.org).

Domestic- occurs within one’s home. This could be between a parent and child, partners, or anyone within the home. If you or someone you know is a victim of domestic violence the Domestic hotline is available 24/7 at 1-800-799-7233.

Sexual“refers to sexual contact or behavior that occurs without explicit consent of the victim. Some forms of sexual assault include attempted rape, fondling or unwanted sexual touching, forcing a victim to perform sexual acts, such as oral sex or penetrating the perpetrator’s body, and penetration of the victim’s body, also known as rape” (rainn.org ). Resources for Sexual Assault victims can be found here.

 

There is a difference between an unhealthy relationship and an abusive relationship. An abusive relationship is not okay. If you are in an abusive relationship, it is not your fault. Find a trusted adult to help you create a safety plan. If you talk to an adult and they do not help you or do not believe you, find another adult you trust. Sometimes you may have to report to multiple people. If this has happened to you, it is not your fault. The National Domestic Hotline has a great resource if you are trying to figure out whether your relationship is healthy, unhealthy, abusive, or maybe somewhere in between. Find more about consent in relationships.

What can I do to work on my relationship?

If you are in a relationship that you believe may be unhealthy, talk to your partner about your concerns and how you can work to fix them together. Communication is an essential skill in any relationship. It is also very important to talk with your partner about boundaries. To learn more about boundaries and how they can help your relationship click here. Everyone learns to communicate based on how they have seen others around them communicate. When two people have different communication styles, it can be difficult for both to feel heard. Below are different communication styles and what they look like.

Passive– Those who communicate passively tend to hold back what they want to “keep the peace”. Passive communication often results in miscommunication and can result in the person feeling resentment. Body language of passive communication could look like someone is uncomfortable. They may not make eye contact and may have slouched posture. They may also feel like they cannot say “no”.

Aggressive– Those who communicate with an aggressive communication style know what they want and will do whatever is necessary to get it. Aggressive communication is normally loud and demanding. It can make others feel uncomfortable with their domineering presence.

Assertive– This type of communication is the most effective form of communication. Someone who communicates assertively knows how to communicate their thoughts and desires, while also understanding the other person’s thoughts and desires. With assertive communication, both parties can be heard and understood.

Love Languages can be a great tool for those who are looking to understand more about themselves and those they are around. Whether it’s a romantic relationship or a friendship, love languages can teach you how you like to receive love and how those around you like to receive love. You can take the love language quiz here.

 

How do I get out of an unhealthy relationship?

  • Tell someone. Talk to a trusted adult or close friend about your situation.
  • Plan your break up. If you decide to break up with this person, make sure you feel safe doing so. If you don’t feel safe breaking up in person, do it over the phone. If you do break up in person, do so in a public place. Bring family or friends along as back up if safety is a concern.
  • Do not try and explain your reasons for breaking up over and over. If your ex doesn’t understand or care the first few times, no answer is going to make them happy.
  • Understand that it’s normal to miss your ex – even if they were abusive, you still probably spent a lot of time with them. If you are struggling with this, create a list of reasons of why you broke up and review it to remind yourself of why you’re leaving this unhealthy relationship.
  • If your partner was controlling and jealous, it is likely that they made the majority of your decisions. It can be overwhelming to choose again. If you are feeling stressed out, talk to people in your support network such as your family and friends.
  • Let the people that care about you know about your break up. They can find ways to help you feel safer.
  • Save any threatening or harassing messages your ex sends. Set your profile to private on social networking sites and ask your friends to do the same. Block them if they harass and/or threaten you.
  • If your ex shows up at your home, school or workplace and tries to confront you, do not answer the door. Seek safety immediately.
  • Trust your instincts. If you feel afraid, you probably have a good reason.
  • If you feel like you are in immediate danger, call 911.

 

Resources:

Home / Teen / Sex and Relationships

Sexual Healthcare

Watch Accessing Healthcare for Minors from AMAZE.org

You can receive sexual healthcare at:

What can they do for me?

  • Pregnancy testing
  • STI testing and treatment
  • Contraception
  • Emergency Contraception (Plan B)
  • Physical Exams
  • Referral Services
  • Reproductive healthcare screening

What should I expect at my visit?

Take a look at a typical teen-friendly reproductive health visit here!
When you first arrive at the healthcare office or clinic:

  • You may be asked to fill out basic information (name, age, gender, medical history)
  • You may be asked to provide health insurance information (some clinics and health departments offer care for little or no cost)

At the beginning of the visit, your nurse or doctor may ask you about:

  • Your past and current sexual and reproductive history
  • Your protection/barrier methods if you are sexually active (including oral, anal and/or vaginal sex)
  • If you have ever been tested or screened for STIs
  • If you have ever been treated for an STI
  • If you’ve ever received the HPV vaccine
  • When your last period was and if they are irregular
  • If you have any medical problems or allergies to medications
  • If you smoke or drink alcohol
  • If you use drugs

During the visit, the nurse or doctor may:

  • Check your blood pressure and listen to your heart
  • Ask for a urine sample (pee in a cup)
  • Look at your genital area to make sure everything looks healthy
  • Perform a pelvic exam (if you have a vagina)
  • Give you a Pap test (if you have a cervix, but not usually done until you turn 21)
  • Examine or feel for signs of testicular cancer (if you have testicles)
  • Examine your breasts

What should I ask or talk with them about?

Be open and honest with your medical provider about any questions or concerns you have. Any physical or emotional changes or thoughts you may have are worth sharing. Your provider is there to answer your questions without judgment and to help guide your health in the direction you want. In order to get the most effective care from any treatment team, it is important for you to be honest with your provider.

Sexually Transmitted Infections (STIs)

  • What are the warning signs and symptoms of an STI?
  • Can I get tested for STIs? (If you are going for a routine checkup at your PCP, it is not common to be tested for STI’s unless you ask for it)
  • I think I may have been exposed to an STI, what should I do now?
  • What STI treatment options are available to me?
  • How can I protect myself from STI’s in the future? (You can get free condoms at most health departments and family planning clinics)
  • How do I tell my partner I have an STI?
  • How do I tell my friends/family I have an STI?
  • How often should I be tested for STIs?

Contraception

  • What contraception methods are available to me?
  • How effective are they?
  • What are the pros and cons of each method?
  • How will each method affect my menstrual cycle?
  • What are the side effects of each method?
  • Can I receive my method today?

Other things you should mention or discuss with your healthcare provider:

  • I think I may be pregnant. Can I get a pregnancy test?
  • I’m experiencing a lot of pain during my period.
  • I noticed a lump/lumps in my genital area or breast(s).
  • I am experiencing intense sadness or anxiety.
  • I think I have been sexually assaulted or raped.
  • I don’t feel safe at home. (Including experiences of any type of physical, sexual, domestic, or verbal abuse. Your healthcare provider will be able to help you or refer you to the needed resources.)

Will my info be private?

Due to HIPAA, your healthcare provider must keep your health information private. Most healthcare providers will not tell parents/guardians about your visit — even if you are a minor (under 18). Some states have laws that allow you to consent to care without parent/guardian permission. Every state is different, so it is best to ask your healthcare provider if they will keep your information private and whether or not you need permission from your parents/guardians to receive testing or prescriptions.

Please note: If you use any type of insurance at your healthcare visit, your care will be billed through your insurance, and the primary insurance holder (such as a parent) will get an explanation of benefits (EOB). This may show what was specifically paid for through the insurance such as:

  • an STI test
  • a pregnancy test
  • prescribed contraception

Healthcare rights for minors:

  • 25 states and the District of Columbia have laws or policies that explicitly give minors the authority to consent to contraceptive services.
  • 27 states and the District of Columbia have laws or policies that specifically authorize a pregnant minor to obtain prenatal care and delivery services without parental consent or notification.
  • All 50 states and the District of Columbia specifically allow minors to consent to testing and treatment for STIs, including HIV. (With respect to HIV, three states limit this authorization to testing only.)
  • 44 states and the District of Columbia have laws or policies that authorize a minor who abuses drugs or alcohol to consent to confidential counseling and medical care.
  • Laws in 20 states and the District of Columbia give minors the explicit authority to consent to outpatient mental health services.

(Minors and the Right to Consent to Healthcare)
 
Find out what laws or policies your state has on sexual health here!
 

What if I am uncomfortable at my visit?

It’s okay and normal if you feel awkward before getting a test or exam, or even talking about it. You are taking responsibility for your own sexual health and that is amazing! Besides, there is nothing that your nurse or doctor hasn’t seen or heard before. Don’t worry about it.

Plan ahead. Take a friend, partner, or family member with you. Depending on the circumstances of your visit, there may be restrictions on visitors; however, you should voice your level of discomfort with your provider. If you are alone with your medical team, let them know your concerns or anxieties; they are there to help take your treatment at a slower pace, meet your needs and provide care at your comfort level as much as possible.

You always have the right to ask questions. Ask your nurse or doctor why they need to do a certain exam or test. Remember, even doctors must ask for consent before touching you.

If you feel uncomfortable or do not like your nurse or doctor, it is okay to request to see someone else or to find a completely new place to get care. It is your right to receive healthcare without judgement

Getting Tested for STIs

STI testing may seem scary at first, but clinics can offer support and honor a patient’s privacy. Some individuals who are at a high risk for contracting and spreading STIs do not get tested for a number of reasons — a primary reason being the fear of the test coming back positive. Individuals who make the decision to not get tested based on this fear are doing themselves and their sexual partner(s) a disservice. While emotional pressures to avoid getting tested for STIs is understandable, not getting tested can prove harmful in some cases (Sex Info Online).

Watch “I Got STD Tested for the First Time” from health.com

 
Where do I start?

If you have had unprotected vaginal, anal, or oral sex, or you have a new partner, it is important to get tested for STIs before any further sexual activity. You can receive testing at:

  • Your family doctor or general physician’s office (the doctor you probably see for most of your check-ups)
  • A family planning clinic (free or reduced cost)
  • The local health department (free or reduced cost)

Find an STI testing location near you!

Once you find a place, it is a good idea to call ahead to see if you need to make an appointment.

Arriving at testing appointment:

So you’ve found a place to get tested and made an appointment…now what? Most locations will have you check in at a desk once you arrive. They may ask you a few questions or have you fill out a form with more information about yourself such as your medical history. Don’t panic if you do not know the answers to everything, just do your best!

In the exam room:

Once they call your name, someone will escort you back to a private room. They may ask you a few more questions in order to better understand your sexual health and history. It may be difficult and uncomfortable to talk about, but be honest! They are here to help you, not judge you. The more they know, the better they can help keep you as healthy as possible. These questions may include:

  • How many sexual partners have you had?
  • What type of sexual activity have you participated in?
  • How long have you been sexually active?
  • What type(s) of contraception/barrier methods do you use/have you used?
  • Have you ever been tested for an STI before?

 
 
How Do STI Tests Work?

There are a few different types of tests: blood tests, swabs of the mouth, throat or genitals, and urine samples. Sometimes doctors can do a visual diagnosis just by looking at the infected area. There are different tests for different STIs and not all tests are always at every clinic, so talk with the healthcare provider about what is available and which one(s) might be right for you. This is another reason why being clear about what type of sex you have had is important. If you have had oral or anal sex and they swab the vagina or penis, it may not be an accurate result. Below are the STIs and what type of tests can be used for each:

Swab of Mouth, Throat, or GenitalsBlood SampleUrine SampleVisual Exam
Chlamydia
Gonorrhea
HIV
Genital Herpes
Syphilis
Trichomoniasis
HIV
Genital Herpes
Syphilis
Hepatitis B
Chlamydia
Gonorrhea
 
Genital Herpes
Trichomoniasis
HPV (Genital Warts)

*For any concern about Cervical Cancer with HPV, starting at age 21, women should be tested with a Pap test, which looks for cervical cell changes associated with “high-risk” types of HPV associated with cervical cancer. Starting at age 30, women should get an HPV test as well. No test available for men for these types of HPV.

What does each test look or feel like?

Knowing what to expect for each type of test can help prepare you ahead of time. Most of them are over within seconds. Some may be slightly more uncomfortable than others, but just remember you are being tested by a medical professional and they do this sort of thing all day!

Swab of Genitals, Mouth, or Throat

For a vaginal swab, you will be asked to get undressed. They will give you a gown to wear and leave the room while you change. You will sit on a table with your legs in “stirrups”. They will insert a vaginal speculum (a tool used to open the vaginal walls) into the vagina. They will then take a clean swab (it looks like a big q-tip) and insert it into the vagina to swab the cervix (the opening to the uterus).

For a swab of the penis, you will be asked to pull down your pants just enough to access the penis. They will then take a clean swab and insert it slightly into the urethra (the hole on the tip of the penis).

For a swab of the anus, you will be asked to get undressed. They will give you a gown to wear and leave the room while you change. You typically will lay on the table on your side. They will insert a clean swab inside of the anus, rotate gently, and remove.

For an oral swab, they will take a clean swab to the back of the throat. To swab the throat, they will take a clean swab the back of the throat, across the tonsils and on any sore areas of the throat. This may cause momentary gagging, but is over in seconds.

Blood Test

For a blood test, a sample will be taken either from your arm or by pricking your finger. You may feel a little pinch, which will not last long.

Urine Test

To get a urine sample, you will either be handed a cup or there will be a cup provided in the bathroom for you. You will be asked to pee in the cup. Sometimes there is a specific place for you to leave it in the bathroom so it can be collected, or they may ask you to bring the sample back into the exam room.

How long do I have to wait for my results?

This may vary by clinic, but you can expect about 2 weeks for a blood test or about 4-7 days for a urine or a swab test. If you receive a rapid throat swab, results come back in 10-15 minutes. If your healthcare provider can visually diagnose you by your symptoms, they will be able to tell you right away.

Most clinics will call you with your results and tell you over the phone. Some use a “no news is good news” method where they will not call you if your tests come back negative. Before leaving your exam, they should tell you what to expect.

Learn more about STIs:

TeenHealthSource
IWannaKnow.org

Getting Contraception

Where can I get it?
Where you go to get contraception will depend on what method(s) you’d like to use. Learn more about what contraception options there are here.
You can receive most contraception methods at:

  • Local health department
  • Family planning clinic
  • Primary care physician (PCP)

Some types require a prescription, or need to be implanted into the body by a healthcare provider. Other types can be bought over the counter (without a prescription). External condoms (which do not require a prescription) can be purchased at convenience stores, or even given free at the health department or family planning clinics, like Planned Parenthood.

What should I expect and plan for at my appointment?

You and your healthcare provider will speak about your goals for contraception. Do you want something that is short term or long term? Do you want to use a hormonal or non-hormonal method?

You should expect your physician to ask you different questions about your body, health, and preference when it comes to contraception options. If they do not ask these questions, don’t be afraid to speak up and ask about what is available to you. If you choose a contraception method that requires implantation, ask your physician what to expect at that appointment.

Once you have decided the method(s) that will work best for you, your medical provider will either give you a prescription for your chosen method, tell you where to purchase your method over the counter (without a prescription), or schedule another appointment to implant the contraception if that is required.

LGBTQ Healthcare

As an LGBTQ person, going to a healthcare provider can be a stressful process.  If you’re concerned about your provider not being accepting of your identity or orientation, you can contact the office and ask if they are supportive of the LGBTQ community.  If you aren’t comfortable asking someone over the phone, you can seek out a LGBTQ friendly healthcare provider by:

Your doctor’s office or clinic should be a safe space to explain anything they need to know in order to take excellent care of you, including various aspects of your identity. When they ask what brought you in to see them, that’s a great time to lead with something like, “I have sex with other women, and I’m here for STI testing,” or “I’m dealing with some stress because I’m non-binary, and people at school refuse to use my proper pronouns.”

(https://www.self.com/story/find-lgbtq-ally-doctor)
You can tell a healthcare location or provider is LGBTQ supportive if:

  • They ask what your pronouns are — or if you tell them before they ask, they use the correct ones.
  • If they mess up your pronouns, they apologize.
  • They ask assumption-free questions such as, “Are you in a relationship?” rather than, “Do you have a boyfriend?”
  • They don’t assume things after you express your identity, such as thinking you’re there for STI testing just because you are bisexual.
  • If their body language and/or facial expression change when you mention your identity, it’s only in affirming ways, such as nodding and smiling.
  • They admit when they don’t have all the answers and ask for assistance when needed.

What should I ask about?
Ideas of what to discuss and ask your healthcare provider regarding your sexual health.
Talk about mental health
According to Yale School of Public Health, LGBTQ people disproportionately experience depression, anxiety, and substance use disorders as compared to heterosexual, cisgender individuals.  One source of these disparities is often assumed to be LGBTQ people’s greater social stress, such as threat-oriented social perceptions and behavioral avoidance.  Talk with your healthcare provider about your concerns and any issues you’re having.  If they can’t help, they can always refer you to another healthcare professional that can (https://medicine.yale.edu).

Home / Teen / Sex and Relationships

STIs / STDs

How to prevent sexually transmitted infections (STIs)

If you have a sexual encounter – whether that’s vaginal (penis-in-vagina) sex, oral sex or anal sex – you could be at risk for a sexually transmitted infection (STI). Some STIs (like herpes and HPV) can even be spread from skin-to-skin contact, meaning you don’t have to “go all the way” to get them.

STIs are also called sexually transmitted diseases (STDs).

While some STIs cause symptoms, others can live in your body without any signs. They can affect anyone, regardless of age, sex, race or sexual orientation. In 2018, there were 26 million new STIs in the United States. STIs are especially common in young people ages 15 to 24, accounting for nearly half of all new cases each year.

Keep reading to learn about the different STIs, how to prevent infection, symptoms to watch for and when to get tested. Need more info? Ask an Expert.

What are STIs?

Some STIs are curable; others are not. They can be caused by bacteria, parasites or viruses.

Curable STIs:

Bacterial and parasitic STIs can be cured with antibiotics. However, if left untreated, they can cause irreversible damage. These include:

  • Chlamydia
  • Gonorrhea (also known as “the clap”)
  • Syphilis
  • Pubic lice (also known as “crabs”)
  • Trichomoniasis (also known as “trich” or “trick”)

These infections can show symptoms, though many people may not experience any symptoms at all.

Incurable STIs:

Viral STIs cannot be cured with medication; however, these STIs are manageable through medication and treatment by a doctor. These include:

  • Human immunodeficiency virus (HIV)
  • Human papillomavirus (HPV)
  • Herpes
  • Hepatitis B

Signs of STIs

Some STIs cause no symptoms; others can cause:

  • Rashes, sores or bumps in the genital area (on or around the vagina or penis)
  • Pelvic, back or abdominal pain
  • Unusual discharge from the vagina or penis
  • Burning or frequent urination

Left untreated, even curable STIs can cause permanent damage to the body like:

  • Infertility
  • Ectopic pregnancy
  • Cancer of the cervix, anus, throat or penis
  • Blindness
  • Paralysis
  • Liver damage
  • Brain damage
  • Death

Having an STI also makes you more susceptible to contracting HIV.

How to prevent STIs

The only 100% effective way to prevent STIs is to not have vaginal, anal or oral sex. If you choose to be sexually active, you should stay as safe as possible by using protection. Learn more about how to protect yourself from STIs.

You can also lower your risk of STIs by:

  • Having fewer sexual partners
  • Getting tested with your partner before becoming sexually active
  • Using condoms or dental dams
  • Getting the HPV vaccine, which can guard against certain strains of the virus, some of which can cause cancer and genital warts
  • Getting the Hepatitis B vaccine
Video via Amaze.org

When to get tested for STIs

The only way to know if you have an STI is to get tested. Many people with STIs have mild or no symptoms. There’s no way to tell if someone has an STI just by looking at them. While some STIs can cause visible symptoms, others have no signs at all. Before you engage in sexual activity with someone, you should both get tested for STIs.

Your doctor’s office, local health department or a family planning clinic should offer STI testing. Visit the CDC’s website to find a free testing location near you.

Will your parents find out you got an STI test?

While all states give minors some control over keeping their sexual health confidential, the extent varies from state to state. To know your state’s laws, visit Sexetc.org or contact your doctor’s office or local health .

Need more info? Ask an Expert.

Resources

For more information about staying in charge of your health and future, visit:

Centerstone Sexual Healthcare

Centers for Disease Control and Prevention (CDC): Get Tested

CDC: Sexually Transmitted Diseases

Sex, Etc.

 

Home / Teen / Sex and Relationships

Teen Pregnancy

What you need to know about teen pregnancy

If you’re a teenager and are sexually active or thinking about having sex, you may be wondering how pregnancy happens and what you can do to prevent it. Or perhaps you think you or your partner may already be pregnant and you may feel scared, overwhelmed or worried about what to do. If so, you’re in the right place. Read on to learn how pregnancy occurs, how to prevent getting pregnant and what to do if you think you may be pregnant.

Need More info? Ask an Expert.

What causes pregnancy?

During vaginal sex (where the penis enters the vagina), it’s possible for pregnancy to occur. It’s also possible to get pregnant if semen gets on the vulva or near the vagina.

For pregnancy to happen, sperm must meet an egg. Here’s how that works:

  • In a biological male, sperm is made in the testicles and combines with other fluids to make semen, which is released from the penis during ejaculation.
  • Eggs live in the ovaries of biological females. Each month during a menstrual cycle, a mature egg is released from the ovaries (this process is called ovulation). The egg travels through the fallopian tube to the uterus.
  • If semen gets into the vagina, sperm can travel to the fallopian tubes and potentially fertilize the egg, which can lead to pregnancy.
  • Sperm can live in a uterus and fallopian tubes for up to six days after sex, so fertilization can occur up to six days after sex.
  • If the sperm fertilizes the egg, the fertilized egg will move into the uterus, where it divides into more cells and eventually attaches itself to the lining of the uterus. Once this happens, pregnancy officially starts.

If a fertilized egg implants itself in the uterus, this keeps the lining of the uterus from shedding, which is why periods stop while someone is pregnant.

Later in life, some adult couples may need some assistance from their medical team to have children on their own; there are still options for these couples. Doctors can help a pregnancy to occur via artificial insemination or in vitro fertilization (IVF).

How to prevent teen pregnancy

The only 100% effective way to prevent pregnancy is to not engage in vaginal sex. The only 100% effective way to prevent sexually transmitted infections (STIs) is to not participate in sexual activity that involves skin-to-skin touching with another person or where body fluids are involved.

If you plan to have sex, it’s important to protect yourself and your partner from pregnancy and STIs. Use a condom to reduce your risk of pregnancy and STIs and another method to prevent pregnancy (like the pill, patch or an IUD). Learn about your contraception options.

Early signs of pregnancy

If you’re worried you or your partner may be pregnant, here are the most common early signs of pregnancy:

  • Missing your period (some spotting could still occur and in rare cases, a menstrual cycle can continue during pregnancy)
  • Bloating
  • Feeling tired
  • Nausea or throwing up
  • Peeing more often than usual
  • Constipation
  • Swollen or tender breasts
  • Backaches
  • Headaches
  • Aversions to certain foods

Sometimes, these symptoms are caused by premenstrual syndrome (PMS). To know for sure if you’re pregnant, you can take a home pregnancy test (which you can buy at most pharmacies or grocery stores or your local health department or Planned Parenthood clinic) or see your doctor to get tested.

What to do if you think you may be pregnant

If you’re a teen and think you or your partner may be pregnant, you may be feeling scared and overwhelmed. First, know that you’re not alone. Many other teens have felt the way you do and have been in your shoes.

  • Seek support from an adult. Talk to a family member, teacher, school nurse, guidance counselor, coach or another trusted adult in your life.
  • Get tested. Next, it’s important to find out if you’re pregnant or not. You can take a home pregnancy test or get tested at your doctor’s office, health department or local Planned Parenthood clinic. Bring a support person with you if you can.
  • Be honest with your healthcare provider. You may feel awkward and that’s OK and totally normal. Your provider has seen and heard it all before, so feel free to ask questions and express your concerns.
  • Know your rights. If you feel uncomfortable with your doctor or nurse, it’s OK to ask to see someone else or find another place to get care. You have a right to receive healthcare without judgment.

If you’re pregnant, your healthcare provider will discuss your options with you. And if you aren’t pregnant, you can talk about birth control options to reduce your chances of pregnancy.

Need more info? Ask an Expert.

Resources

For more information about staying in charge of your health and future, visit:

Need more info? Ask An Expert