Your Son's First Health Exam
When it comes to sexual health for teens, it's quite easy for girls to find information on their first gynecological exam, but that same information is nearly nonexistent for guys. Just for you and your son, here's what he can expect during his first sexual health exam and how you can help.
During the adolescent years when hormones are raging and teens become more and more curious about sex, sexual health screenings can mean the difference between life and death. As soon as you start to see signs of sexual experimentation in your son, talk with him about scheduling an appointment. If you don't know for sure whether he's sexually active, let him know you're not accusing him but think he's at the right age to start having these exams.
What You Can Expect
Be prepared to hear him say he doesn't need one because he knows he doesn't have a sexually transmitted disease (STD) or because his girlfriend goes to the gynecologist and handles all of that. One out of four teens contracts an STD each year, and guys can't depend on girlfriends, friends or whoever to tell them when something's wrong. Sometimes the other people involved don't know or are too embarrassed to tell. That's why sexual health exams are important. Whether you have to talk your son into it, schedule him an appointment, or if he takes the initiative to schedule his own, be supportive. Taking care of himself sexually is one of the first steps in becoming a responsible young man.
Often times, getting your son to schedule an appointment or allow you to do so is the easy part. It's the time between the call and the actual appointment that allows him to become a nervous wreck. Not knowing what to expect can cause a guy to have second thoughts and skip out on his appointment. You can prevent this by talking to him about what will happen. Here's a rundown on what he can expect:
A Little Chat
One of the most important parts of a good sexual health exam is "the talk," a pre-exam interview where the doctor, urologist or nurse practitioner will ask your son about his lifestyle. Some of the questions that may be asked may make him a little apprehensive, but Dr. Charles Wibbelsman, chief of Kaiser Permanente's teen clinic in San Francisco, warns that the doctor isn't just being nosy. "The only reason the doctor is asking these questions is because he wants to help the young man," he says. "It's a very normal part of the interview of an adolescent and something that all physicians should be doing to really identify those adolescents who are at risk." The answers to the questions help him decide what areas are of concern, what kind of tests the patient may need and more, so it's very important that your son answer them truthfully.
According to Dr. Joan Adler, an adolescent doctor at Temple University Children's Medical Center in Philadelphia, some of the questions your teen may be asked are:
- Do you smoke or drink?
- Do you use drugs?
- Have you ever had sex?
- How many sexual partners have you had?
- Were they male, female or both?
- Do you have oral and/or anal sex?
- Do you use condoms?
The interview isn't going to be just a session with the physician firing off questions. It's also your son's time to address any questions or concerns he may have.
After the interview, your son will have to remove his clothing and put on a drape sheet. The doctor will do a testicular exam, where he checks the testicles for signs of testicular cancer, which is most common in older adolescents and young adults. The penis and scrotum will then be checked for warts, bumps, lumps, sores and unusual discharge. Then comes what's commonly referred to as the "turn your head and cough" portion of the exam. Here, as the name suggests, your son will turn his head and cough to be checked for hernias. (Dr. Wibbelsman says a rectal exam isn't part of the routine physical exam.) None of these things should be painful to your son. If they are, he should tell the doctor because it could signify a problem.
The final step of the exam is getting tested for sexually transmitted diseases. When you or your son schedules the appointment, you should specifically ask for STD screening because often times doctors won't do this automatically. During the physical exam, STDs like pubic lice and genital warts are detectable, but other tests will be needed to check for other infections. Urine samples are tested for chlamydia and gonorrhea. Samples of blood may be drawn to test for HIV, herpes or hepatitis. Any unusual discharge gathered during the swab test can be checked for gonorrhea, herpes or syphilis. Your son can expect to receive test results in about a week.
Calming His Fears
Despite knowing exactly what can be expected at the exam, your son will probably still be nervous about certain things. Here's a look at those things and how he can beat those fears:
Will the swab test hurt? Mark, 17, says he heard about the swab test, and it freaked him out. "I couldn't imagine anything going up there, so it kind of turned me off to the whole idea of going," he says. For many guys, hearing about the penile swab is enough to make them stay far away from the doctor. But as Mark learned when he finally went for his exam, "it's not really painful, more like a slight pinch." And according to Dr. Wibbelsman, not all clinics use the penile swab, because urine and blood samples are sufficient enough to screen for STDs.
Is the doctor a man or a woman? Just as some girls prefer a same-sex physician, guys sometimes have a preference as to which gender they want conducting the exam. For some, they couldn't imagine allowing another man to examine their genital region. For others, having a woman perform the exam and talking to him about sexual health is too embarrassing. If your son frets about his doctor being one sex or the other, let him know he can breathe easy. "I think that it's very common for someone to want to see a doctor or nurse practitioner of one sex or the other," says Dr. Adler. At Temple Children's, like many other offices, they have both a male and female who conducts exams, and Dr. Adler says, "If someone prefers one over the other, they can just make the appointment with whichever one they want."
What about erections? "It's very normal, especially in young males, to get an erection for any reason," says Dr. Wibbelsman. Let your son know that this is a common occurrence, doctors see it all the time and don't think twice about it.
Are secrets safe? Josh Tyler, now 19, says he put off getting checked because he thought the clinic would send his parents a "report card" of his sex life. That thought kept him out of the doctor's office and unaware of his STD status. Don't let it be the same for your son. Assure him that the things that happen and are said during his visit are strictly confidential, kept between him and the doctor, and no information is going to be relayed to you without his permission. If your word isn't enough assurance, have him ask the doctor about the clinic's confidentiality agreement.
It doesn't matter if he's anxious to get it done or if you have to drag him in kicking and screaming, do whatever you have to do to get your son to his first sexual health exam. In the end, he'll thank you for it, and it could ultimately save his life.