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Contraception

What is contraception?

Contraception (also known as birth control) lowers the chances of unplanned pregnancy by preventing the sperm from meeting the egg, resulting in pregnancy. Some forms of contraception/birth control also help protect against sexually transmitted infections (STIs).

Contraception will block sperm and an egg from meeting and a pregnancy occurring. Some contraception uses hormones to do this while others are just barrier methods.

For teens, this is especially important.

According to the Centers for Disease Control and Prevention, pregnancy and birth commonly lead to increased high school dropout rates among girls. Only about 50% of teen mothers receive a high school diploma by 22 years of age, whereas approximately 90% of women who do not give birth during adolescence graduate from high school.

In fact, only 61% of working teen dads obtain a high school diploma by the age of 26 compared to 97% of their counterparts.

How does pregnancy happen?

In order for a pregnancy to happen, a sperm cell must fertilize an egg – most commonly through vaginal intercourse.

Once the sperm has been released in the vagina, they will travel through the cervix into the uterus and eventually to the fallopian tube where an individual sperm can fertilize an egg. Following fertilization, the egg will travel into the uterus and embed itself into the uterine lining.

Choosing contraception that’s right for you means talking with your health care provider. Just remember to always protect yourself in the event you become sexually active. Knowledge prepares you to make healthy decisions for the future. For more information on teen pregnancy and reproduction click here.

Check out this Amaze.org video called Pregnancy and Reproduction Explained:

https://www.youtube.com/watch?v=OejdOS4IqeE&list=PLwKLUKhFLWhYoU638Q_oJz4SVOuhQT8JH&index=10&t=0s

Types of contraception:

There are different types of birth control to choose from. Remember, because there are multiple options, you want to choose what is best for you!

Check out this Amaze.org video called Birth Control: The Final Frontier

https://www.youtube.com/watch?v=QUCe1xrm7OU

 

Over the counter (no prescription required):

This type of contraception does not require an appointment with a health care provider or prescription to purchase. Over-the-counter contraceptives can be found in drug stores, convenience stores and health departments/clinics.

The prices of these contraceptives can vary by state, so check your local store or health department for pricing. Most health departments provide forms of contraceptives for free. For a full list of health departments near you, visit The National Association of County and City Health Officials.

External Condoms (Use every time):

This form of contraception provides a barrier method of protection made of latex (rubber), polyisoprene or polyurethane. It covers the penis and collects semen and other fluids, preventing them from entering a person’s vagina.  An external condom should be used for oral, anal and vaginal sex. When used correctly and consistently from beginning to end, condoms protect against both pregnancy and STIs, including HIV.

Condoms can leak or break if not used correctly. Oil-based lubricants (like Vaseline or massage oil) should not be used due to possibly breaking down the latex on the condom. You should always use water or silicone based lubricants with external condoms.

On average, condoms last about five years after their manufacturing date. This expiration date is printed on the condom label. Always be sure to check this expiration date before using a condom.

A condom’s material degrades over time. Also, things like lubricant or spermicide can dry up which means that an expired condom is more likely to break during use.

It is super important to check a condom prior to its use. If the condom is expired, has no air in its packaging or appears dry/brittle when removed from the package — use a different condom! If no other condoms are available, an expired condom can still help reduce your risk, but it will not be as effective or safe as an unexpired condom.

The effectiveness rate for external condoms is 85% with typical use but 98% if used perfectly every time.

Here is a link for a short video on proper instructions to use a condom every single time: https://www.youtube.com/watch?v=rrW-0wam5QY

Internal Condoms (Use every time):

The internal condom, prevents sperm from entering a person’s uterus. You can also use internal condoms for anal sex by inserting into the anus. This form of contraception comes packaged with a lubricant and may be obtained in most drug stores and family planning clinics.

The internal condom can be inserted up to eight hours before sexual intercourse so you are able to plan ahead with this type of contraception.

The CDC recommends not using an internal condom with an external condom because it can cause tearing.

As a note: internal condoms may cause irritation of skin surrounding the genitals and does require commitment. In other words, this form of birth control must be used consistently and correctly to be effective every time.

The effectiveness rate for an internal condom for perfect use is 95% but typical use is 79%.

Withdrawal Method (Use every time):

The withdrawal method is also known as the pull out method. This is when a person removes the penis from the vagina before ejaculation occurs. This is most effective when using another type of birth control method, such as a condom since this provides no protection against STIs by itself.

When done correctly every time the effectiveness rate for typical use is 78%. There is something called pre-ejaculate which comes out of the penis before it’s time to ejaculate and that contains enough sperm to start a pregnancy, which is why it’s important to use another form of birth control with the withdrawal method. If done perfectly, while using other types on contraception the effectiveness rate is 96%.

Spermicide (Use every time):

Spermicide has chemicals that stop sperm from reaching an egg to fertilize. This will come in different types of creams, gels, foams, film and suppositories. A person will insert this into the vagina right before sex. This works by blocking the cervix and stopping the sperm from being able to move. Spermicide may irritate the vagina. This method works best with using a barrier method such as an external condom.

Spermicide does not provide protection for STIs. When used correctly this has a 71% effective rate for preventing pregnancy if used alone. If used with a condom it has an effective rate of 97%.

The Sponge (Use every time):

The sponge is a small round sponge that is made out of soft flexible plastic. The sponge contains spermicide. The sponge will cover the cervix; this will prevent sperm from being able to enter the cervix and the spermicide in the sponge will make the sperm unable to move. Once the sponge is in it can be used multiple times, for up to 24 hours. It’s small and easily carried around.

This is unsafe to use while on your period. It may irritate the vagina and increase your risk of contracting an STI.

The sponge only provides protection from pregnancy and not from STIs. The effectiveness rate for typical use for a sponge is 80% but for perfect use it’s 91%.

Dental Dam (Use every time):

A dental dam is a flexible, thin piece of latex that is laid over the vulva or anus during oral sex. Dental dams are only to protect against STIs and should not be used for contraception/to prevent pregancy.

If you don’t have access to a dental dam, you can cut an external condom and make one to use. Always check the expiration date on the outside of the package before use.

Abstinence (Free):

Abstinence is defined as not engaging in any type of sex (oral, anal or vaginal).

It can feel difficult to wait sometimes, but waiting until you are mature enough to handle the outcomes of sex is your safest option when trying to prevent unplanned pregnancy and STIs. Abstinence is the only method that offers 100% protection against pregnancy and STIs, assuming no sexual contact of any kind has occurred (including genital touching).

Abstinence can be hard to maintain, so make sure you’re always communicating with your partner about your boundaries.

Prescribed (Requires a prescription from a medical professional):

Birth Control Pill (On a schedule):

Commonly referred to as “birth control” for a person with a uterus, the contraceptive pill can be provided by a health care provider. Like all hormonal methods, the pill releases hormones that prevent ovulation and thicken the cervical mucus. If taken correctly, the pill provides non-stop protection from pregnancy; it can make periods more regular, reduce cramps and shorten/lighten a menstrual cycle. The pill is most effective when taken at the same time every day.

Birth control pills offer no protection against STIs. Each type of pill is different, so check with your doctor to learn more and figure out what is best for you.

When starting a birth control pill it is not immediately effective. For the first month at least, you would need to still use an alternate form of birth control such as a condom to protect yourself from pregnancy. The birth control pill may cause side effects such as weigh gain, headaches, nausea, etc. If these symptoms occur, talk to your medical provider.

The effectiveness rate of the birth control pill for typical use is 91% in preventing pregnancy but for perfect use it’s 99.7%.

The Patch (On a schedule):

The patch helps prevent pregnancy but offers no protection against STIs. To use the patch, you will put it on once a week on the same day every week for three weeks and then take a week off; so it’s not a form of contraception that you have to remember every day or every use. Some people have skin reactions, nausea, headaches and breast discomfort. The small adhesive patch is available through a prescription from a health care provider.

The effectiveness rate for the birth control patch for typical use is 91% for preventing pregnancy but for perfect use it’s 99%.

The Shot (On a schedule):

The shot, also known as the Depo shot, needs to be administered by a medical provider the first time you receive it. You will need to get the shot again every three months, roughly every 12 weeks, but this can be done at a medical provider’s office or at your house if prescribed. Unlike the birth control pill, the shot becomes effective one week after receiving it, so you would still need to use other types of protection such as a condom during this time to prevent pregnancy. If administered on time in the future, it is always effective after that first week.

Some side effects of the shot are irregular periods or no periods at all, headaches, depression, acne, weight gain, etc. Ask your medical provider for a full list of side effects.

The shot (Depo shot) has an effectiveness rate for typical use of 94% for preventing pregnancy.(This may be if people miss a shot or do not get their shots on time). The effectiveness rate for perfect use is 99%.

Diaphragm (Use every time):

Diaphragms are dome-shaped silicone or latex cups with a flexible rim and can be obtained through a prescription from a health care provider. It won’t effectively protect against STIs including HIV. It can increase the risk of urinary tract infections and toxic shock syndrome if not cleaned/left in too long. It can be inserted into the vagina six hours prior to sexual activity and must be left in for six hours after. It can be left it in up to 24 hours and you can have intercourse multiple times with same use. You can reuse the same diaphragm for up to a year.

The diaphragm is 88% effective against preventing pregnancy for typical use and has a 94% effectiveness rate for perfect use.

The Cap (Use every time):

This device, made of silicone, can be obtained through a prescription from a health care provider. A person with a uterus uses spermicide to coat the inside of the cap, then inserts it into the back of the vagina so that it covers the cervix to block sperm from entering. It won’t effectively protect against STIs. There is an increased risk of urinary tract infections and toxic shock syndrome (if it’s not cleaned properly/left in too long). You can use the same cap for up to a year with proper care in between use. You can insert it up to six hours prior to having sex and leave it in for up to 48 hours after sex.

The Cap is 71-86% effective depending on usage to prevent pregnancy depending on if you have previously given birth or not. If you have never given birth, it has a higher effectiveness rate.

The Ring (On a schedule):

A person with a uterus can place the vaginal ring (NuvaRing) in the vagina for three weeks, followed by a ring-free week. It releases hormones to prevent ovulation and thickens the cervical mucous. If used correctly, the ring provides non-stop protection from pregnancy. It can make menstrual cycles more regular, reduce cramps and shorten or lighten a menstrual cycle period. The ring only needs to be changed once a month.

It offers no protection against STIs. Some people experience vaginal discomfort, nausea, headaches and breast tenderness.

The ring has a 91% effectiveness rate for preventing pregnancy with typical use and an effectiveness rate of 99% for perfect use.

IUD (Low maintenance):

IUD stands for intrauterine device, a long acting reversible contraceptive (LARC). There are two kinds of IUDs, one that contains copper and one that releases the hormone progestin. A health care provider inserts this t-shaped device into the uterus to provide effective pregnancy protection. A copper IUD can stay in place for up to 12 years, and a progestin IUD lasts 3-6 years depending on brand.

Some possible side effects of IUDs are headaches, acne, irregular bleeding (this normally improves after six months of use), mood changes, cramping and pelvic pain.

While IUDs offer no protection against STIs, they are more than 99% effective at preventing pregnancy.

The Implant (Low maintenance):

A health care provider inserts a small plastic-like rod under the upper arm skin of the person with a uterus. This long acting reversible contraceptive (LARC) device can protect against pregnancy for up to three years, can shorten or lighten a menstrual cycle and reduce cramps.

It may cause irregular periods, nausea, headaches and weight gain. Some people may be able to see the rod under the skin.

While the implant offers no protection against STIs, it is more than 99% effective at preventing pregnancy.

PrEP (Taken Daily):

PrEP stands for Pre-exposure prophylaxis. According to the Centers for Disease Control and Prevention, PrEP is for people who are at risk of contracting HIV. A person would take PrEP every day at the same time for it to be most effective at preventing HIV.

“Studies have shown that PrEP reduces the risk of getting HIV from sex by about 99% when taken daily. Among people who inject drugs, PrEP reduces the risk of getting HIV by at least 74% when taken daily.”(CDC)

PrEP will become effective anywhere from 7-21 days after first taking it. Currently no long term side effectives have been known. Some people experience headaches while taking PrEP but report they have gone away after using for a period of time.

PrEP only helps protect against HIV, this method does not help prevent pregnancy or other STIs. It is best used with a barrier method.

For more information specifically on PrEP and where to find PrEP in your area click

Emergency Contraception (Used after sex):

Check out this video from Amaze.org called: What should you do if you’ve had unprotected sex?

https://www.youtube.com/watch?v=48zdZ6x3SK4

The emergency contraception pill (sometimes known as the morning after pill) can reduce the chance that a person with a uterus will get pregnant if they have unprotected sex or if another method of protection failed. It must be taken within 3-5 days; the sooner the pill is taken, the higher its effectiveness. Some brands are less effective depending on a person’s weight. Most of these options are available over the counter (Do NOT require a prescription).

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

The emergency contraception pill doesn’t protect against STIs and may cause nausea and/or breast tenderness. If a person does not get their period within three weeks, they should take a pregnancy test.

Depending on different factors the effectiveness rate for this is anywhere from 75-99%.

What method of birth control or contraception should I use?

When deciding on which method of contraception fits you best, it’s a good idea to talk to someone you trust. It could be a parent, a friend, a doctor or even a counselor.

It’s okay to ask questions. Have you ever heard “There’s no such thing as a stupid question?” Guess what? When it comes to contraception, not knowing is understandable. However, when we seek answers and educate ourselves, studies show that we’re more likely to make informed decisions.

For more information visit the Centerstone sexual healthcare section.

Frequently Asked Questions:

  1. Is tracking my period an effective way to prevent pregnancy?
    1. It can be if you menstruate on a regular cycle. Not everyone menstruates on a regular cycle (especially teens). So this is not a reliable way to prevent pregnancy without using another form of protection.
  2. If I have sex during my period does that prevent pregnancy?
    1. No, sperm can live in the female reproductive system for up to five days so if you have sex during your period, sperm can still be present when you ovulate.
  3. If I use two condoms will it better protect myself from STIs and unplanned pregnancies?
    1. No, using more than one condom at a time actually lessens your protection; it can cause friction and possibly cause the condom to break.
  4. Can I use plastic wrap or a balloon if I don’t have condoms?
    1. Plastic wrap or balloons aren’t a good idea to use because these do not fit around the penis well and are more likely to come off during sex or tear, leading to a chance of pregnancy and STI transmission.

Key takeaways:

  1. To reduce the risk of unwanted pregnancy and STIs, choose the most effective methods to lower your risk.
  2. A condom is the only birth control method that also reduces the risk of spreading/contracting STIs including HIV.
  3. Abstinence, or not having sex, offers 100% protection against the spread of STIs and can prevent a pregnancy.
  4. Sperm can stay alive inside the female reproductive system for up to five days.

Additional resources

Did you know health departments offer free forms of contraception?

The National Association of County and City Health Officials created a tool to help you search for local health departments in your area.

Want to learn more about sexually transmitted infections? Get the facts by visiting our page on STDs and STIs.

The statistics surrounding teen pregnancy are interesting. Learn more on our prevention page where we take a closer look at teen pregnancy prevention.

Additional resources:

https://www.hhs.gov/opa/pregnancy-prevention/birth-control-methods/index.html

https://www.plannedparenthood.org/learn/birth-control

https://www.cdc.gov/reproductivehealth/contraception/index.htm

 

Birth Control & Emergency Contraception via online/telehealth/apps:

NURX https://www.nurx.com/

PP Direct https://plannedparenthooddirect.org/

Pill Club https://thepillclub.com/

Ella- Emergency contraception (Rx) for people 165lbs+ https://www.prjktruby.com/products/ella/

 

Minor’s access to birth control and sexual/reproductive health rights by state:

https://www.guttmacher.org/state-policy/explore/minors-access-contraceptive-services

Bedsider- Birth control methods info, locators, reminders https://www.bedsider.org/

A Step Ahead- How to access free LARC methods in TN https://www.astepaheadmiddletn.org/

 

What if I need birth control help?

Contact your medical provider or local health department if you have any questions about the different types of contraception.

Refer to resources listed above.

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

What are sexually transmitted infections?
Contracting a sexually transmitted infection (STI) is possible through any type of sex (oral, anal and vaginal) with a person who carries the STI. The infection can live in the body most often without showing symptoms. Sometimes STI’s are referred to as STDs which means “Sexually Transmitted Disease.” They mean the same thing and the terms are sometimes used interchangeably.

Check out this video “STD Prevention Beyond Condoms” from Amaze.org

For information on how to receive STI and HIV testing, contact your local health department.
What kinds of STIs are there?
Curable:
Bacterial & 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. Common symptoms include:

  • rashes, bumps or sores around the genital area
  • pelvic, abdominal or back pain
  • unusual discharge from the penis or vagina
  • burning or frequent urination

Incurable:
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

 
What are the possible outcomes for an untreated STI?
STIs can affect anyone, of any race, class, age or sexual orientation.
According to the Center for Disease Control:

  • Of the 20 million newly diagnosed cases every year, half are found in youth ages 15-24. (2015)
  • The highest age-specific rates of reported cases of chlamydia in 2018 were among those aged 15–19 years (2018)
  • Young people aged 15-24 account for 70% of all gonorrhea infections and 63% of chlamydia infections. (2013)
  • Even though young people account for half of new STI cases, a recent survey showed only about 12% were tested for STIs in the last year. (Cuffe, 2016)

How can I protect myself?

  • The best way for someone to protect themselves against an STI is to avoid vaginal, anal, and oral sex.
  • If a person engages in sexual activity, they should stay as safe as possible by using protection. For more information about how to protect yourself, read about contraception and accessing healthcare.

The lowdown info graphic
Even STIs that have a cure can cause permanent damage to the body if left untreated. Some of this damage can include:

  • Infertility
  • Pelvic Inflammatory Disease
  • Ectopic Pregnancy
  • Cancer of the cervix, vagina, penis, anus, or throat
  • Blindness, paralysis, liver damage, brain damage, or even death

 
Frequently asked questions
How do I know if I have an STI?
The only way to know if you have an STI is to get tested by a doctor. Most individuals will not experience any symptoms or symptoms so mild they go unnoticed. If someone does experience symptoms they may include rashes, bumps, or sores around the genital area, pelvic, abdominal, or back pain, burning or frequent urination, and an unusual discharge from the penis or vagina. For more information about getting tested click here.
 
How do I know if someone else has an STI?
You cannot tell just by looking at someone if they have an STI. While some STIs cause observable symptoms, many people with STIs show no symptoms at all. Before you engage in sexual activity with someone, ask them to get tested by a doctor so you can both be as safe as possible.
 
How do I get tested for STIs?
Family planning clinics often offer reduced or no-cost STI testing. Your county health department is also an excellent resource for finding affordable STI testing. Visit cdc.gov to find a testing location near you. The site allows you to filter your search results by what type of test you want/need. You can even filter results by free/low cost testing! Visit the Healthcare page to learn more about getting tested.
 
If I get an STI test, will my parents find out?
All states give minors some control over keeping their sexual health confidential, but the extent varies from state to state. Some states allow minors to confidentially access testing for all STIs except for HIV, and some leave confidentiality completely up to the discretion of the minor’s physician. Many offer access to confidential sexual health screening, while others restrict it by age. For specific information on policies in your area, contact your doctor or local health department. You can also visit Sexetc.org to look up what the laws on for your state. For more information about insurance and privacy please visit our Healthcare page.
 
How do I avoid getting an STI?
The only 100% effective way to protect yourself against an STI is to not have vaginal, anal, or oral sex. However, if you do engage in sexual activity, it is important to use a condom or dental dam during sex, as they can both provide protection  against certain STIs.
 
Does HIV only effect the LGBTQ  community?
No! HIV can effect anyone who participates in certain behaviors like unprotected sex or sharing needles for drugs and/or tattoos or piercings. Someone can even be born with HIV or contract HIV through breast milk if their birth mother has HIV. In the past, HIV was more commonly associated with MSM (men who have sex with men) but with our knowledge now, we know it can effect anyone! Visit the cdc.gov to learn more about this.
 
I heard that there’s a vaccine that protects you against STI’s. Is this true?
There are vaccines available for Hepatitis B and HPV. Most people are vaccinated for Hepatitis B when they are infants. There are two vaccines that offer protection against certain strains of HPV. HPV is a viral STI that has many different strains, some of which can cause cancer and genital warts. Cervarex protects against the two most common cancer causing strains, and Guardasil protects against both the cancer causing strains and the genital warts causing strains. Most doctors now recommend that their patients receive an HPV vaccine before becoming sexually active and many schools now require it.
If you’re unsure if you’ve been vaccinated for Hepatitis B or HPV, talk to your doctor about your medical history.
 
Additional Resources:
Want to learn in more detail about STIs? Click here!
Have questions about the where, when and how of STI testing? Click here!
Find a STI Testing center near you:
 
Resources

  • Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2018. Atlanta: U.S. Department of Health and Human Services; 2019
  • Cuffe, Kendra M. et al. Sexually Transmitted Infection Testing Among Adolescents and Young Adults in the United States Journal of Adolescent Health 2016, 58(5), 512-519
  • Saltz, Gail, et al. “STD Prevention Beyond Condoms.” Amaze.org.
  •  “The Lowdown on How to Prevent STDs.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, www.cdc.gov/std/prevention/lowdown/
  • “Get Tested.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, gettested.cdc.gov.
  • Sex in the States, sexetc.org/action-center/sex-in-the-states.
  • “HIV and Gay and Bisexual Men.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 12 Nov. 2019, www.cdc.gov/hiv/group/msm/index.html.
Home / Teen / Sex and Relationships

Teen Pregnancy and Reproductive Health

Puberty is a normal part of adolescence! Many teens will begin going through the process of puberty on average between age 9-13, although some people may start earlier or later. Everyone will start puberty at the time that is best for their own body. This section will help you navigate some of the changes to expect during this time. You will also learn more about how pregnancy occurs, the effects of teen pregnancy, and you will be directed to information on how to lower the risks of pregnancy by using contraception.

What should I expect during puberty?
Puberty is the transition from the body of a child to the body of an adult. During this time, a person becomes physically capable of reproducing. During puberty, people experience both physical and emotional changes—all of which are completely normal! Check out the links below to learn more about what to expect while going through puberty.

Puberty for Biological Females (Amaze.org)

Puberty for Biological Males (Amaze.org)

To learn more about how to embrace these physical changes and for information on body image and appearance, check out our section on body image here.

I hear a lot about hormones during puberty. What are they?
Hormones are chemicals in the brain that can play a role in human reproduction and sexual growth. While people have hormones in their body system from the time they are born, sex hormones, which do things like determine biological sex, are released for the first time during puberty. Hormones can cause physical, emotional, and sexual changes to the body. It is normal for people to start feeling sexual feelings for the first time during puberty. Everyone feels, expresses, and responds to sexual feelings differently. Learn more about gender, sexuality and expression.

What is PMS and what does it have to do with the period?
Premenstrual syndrome, or PMS, is a condition that a person with a uterus may experience 1-2 weeks before their period. Periods are a normal part of the menstrual cycle, and there are physical and emotional symptoms of both PMS and the period. To learn more about why periods occur, what to expect during PMS, and how to manage symptoms, click here (Amaze.org).

How do I take care of hygiene once I start my period?
Learning how to establish proper hygiene routines is an important part of puberty. People who experience periods will also learn how to practice hygiene during their cycle. There are many options including pads, tampons, and menstrual cups. All options are suitable in managing hygiene, and finding the best option for you depends on your own comfortability with each product. It is important to read the directions for each product to make sure it is being used correctly, safely, and comfortably. Learn more about which period hygiene product may be best for you (Amaze).

Vaginal Hygiene

Aside from periods, vaginal health and hygiene is still import, and surprisingly simpler than some may expect. The American Sexual Health Association (ASHA) provides some helpful “do’s” and “don’ts” surrounding vaginal health. ASHA recommends that people with vaginas DO NOT douche; while douche products market cleaner, healthier vaginas, these products are actually more prone to causing vaginal infections (2020). ASHA recommends that people with vaginas DO: wash the vagina and vulva with a plain unscented soap, wipe from the vagina to anus from front to back to help prevent spread of germs, and try to stay as dry as possible (this can be done by wearing looser and more breathable clothing) (ASHA, 2020). For more information on how to maintain vaginal health, please visit ASHA Vaginal Health.

Penile Hygiene

A person with a penis can clean their penis and genitals with a regular soap while bathing. Some people may have a circumcised penis, which means the foreskin of their penis has been surgically removed. Others may have an uncircumcised penis, which means the foreskin of their penis is still intact. Both are normal! A person with an uncircumcised penis should take a few extra steps during their hygiene routine to keep the area clean and healthy. The Nationwide Children’s Organization provides steps to clean this area: very gently pull the foreskin away from the tip of the penis, rinse the tip of the penis as well as the inside of the foreskin with regular soap and water, and gently return the foreskin back over the penis (Nationwide Children’s, 2020). For more information on how to care for an uncircumcised penis, please visit here (Nationwidechildrens.org)

Other than physical changes, is there anything else I should expect during puberty?
While biological males and biological females go through different physical changes during puberty, everyone experiences some of the same emotional changes. Teens may feel frustrated, overwhelmed, sad, confused, and sometimes even depressed. The best thing to do when you experience these feelings is to remind yourself that this is a normal part of puberty caused by an increase of new hormones to our body. It is important to understand, though, that just because it is normal to experience these feelings does not mean that you have to go through this time alone. Never be afraid to reach out to a trusted adult when you are feeling sad, depressed, or lonely.

Feelings and Emotions (Amaze)

How does a pregnancy occur?

In order for a pregnancy to happen, a sperm cell must fertilize an egg – most commonly through vaginal intercourse.

Once the sperm has been released in the vagina, they will travel through the cervix into the uterus and eventually to the fallopian tube, where an individual sperm can fertilize an egg. Following fertilization, the egg will travel into the uterus and embed itself into the uterine lining.
how does pregnancy occur
Later in life, some adult couples may need some assistance from their medical team in order 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.

Effects of teen pregnancy on teen parents:

The effects of raising a child are much more difficult for teens than other age groups.

  • 75% of pregnancies for people 15-19 years old are unplanned (Guttmacher Institute, 2019)
  • In 2017, a total of 194,377 babies were born to women aged 15–19 years (CDC, 2017)
  • Only 50% of teen moms are able to finish high school by age 22, compared to the 90% of young women who are not teen moms (CDC, 2017)

How can someone avoid pregnancy?
There are many different types of contraception that sexually active individuals can use to reduce the risk of pregnancy. These forms of contraception and/or barrier methods should be used each sexual experience to reduce the chance of pregnancy, and are often available for free or reduced cost at local health departments and family planning offices. The only 100% effective way to prevent teen pregnancy (and STI) is to not engage in P&V (penis and vagina) sex.

What should I do if I think I’m pregnant, or if my partner thinks they’re pregnant?
If you or your partner think you may be pregnant, your wellness is of utmost importance. Home pregnancy tests are available for purchase at local convenience stores and drug stores, and may be available for free at your local health department or Planned Parenthood office. In order for a pregnancy test to provide an accurate reading, the person taking the test should carefully follow the instructions on the package. It is also important for the person taking the test to continue to monitor their period after taking the test, and follow up with a doctor if their period does not resume. Check out our Sexual Healthcare section to learn more about how to find a clinic or take a pregnancy test.

If I have sex in a swimming pool, can I still get pregnant?

While there is a common myth that having sex in a swimming pool or body of water will not lead to pregnancy, this is not true. There is no 100% guaranteed safe time, place or situation to have penis and vagina sex and not risk an unplanned pregnancy. According to the Center for Disease Control and Prevention, almost one-third of teen moms report that they had no idea they could get pregnant at the time they had sex (2017).

Although the chance of fertilization depends on the stage of the menstrual cycle, a person with a uterus can get pregnant any day of the month if engaging in sex with a person with a penis. Because ovulation (releasing an egg) happens roughly two weeks before the period begins, even someone who hasn’t started their period can become pregnant.

Contraception can help lower the risk of pregnancy.

Can you get pregnant the first time you have sex?

It is possible for a pregnancy to occur during your first time having sex. Remember, a pregnancy can occur around the time of ovulation (when an egg is released from the ovaries). If an egg has been released, and is fertilized by a sperm cell, a pregnancy can occur.

Everyone chooses to have sex for the first time when it is right for them. For some, this may be after someone has ovulated for the first time, while for others it may not. It is important to note that a person with a uterus/ovaries ovulates roughly two weeks before having a period. Therefore, it is possible that a person has already ovulated and released an egg even if they have not had her first period yet. It is always important to use contraception/barrier method to lower the risk of pregnancy and STI.

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