• Leah Jewett

Hot topics to tackle – parent advice from the Global Teens doctor


Raised in America by South Asian immigrants, having 2 sons with a German husband and working in Holland, China and the US as a paediatrician specialising in teen health, Dr Anisha Abraham has all the personal and professional credentials to write Raising Global Teens: A Practical Handbook For Parenting In The 21st Century. It’s clear, concise and universally applicable, covering topics like puberty, vaping, stress, sex and relationships.


Here she talks to Outspoken about the questions kids ask her, how to role play around sexting and why talking about sex ed is like making lasagne…




ON BELONGING AND IDENTITY


It is important to ask teens the following questions about identity:

  • Who is your tribe? Who do you identify with and why?

  • How many circles or groups are you in?

  • Ask yourself: who do I feel comfortable with? Where do I feel I belong most?

– From Raising Global Teens



We all have our story. As we’re helping teenagers to become adults we want them to feel comfortable in what their story is and in their cultural, gender, sexual and physical identities.


In a survey that I did of 361 teens and parents from around the world, nearly 70% of kids had never talked with an adult about identity and belonging. So check in with your child.


Increasingly, teens are diverse and many identify as cross-cultural – they might have moved among communities or countries or have parents from different backgrounds.


But this book is also relevant to teens from a monoculture, if that even exists anymore, because it covers the hot topics all young people are experiencing like social media and sexual health.



ON THE TEENAGE BRAIN


The developing teenage brain is like a new computer. It takes a little time and work to be fully set up and operational. Parents can be the tech support



The teen brain develops until the early 20s. A lot of what teens are doing is trying and testing things out. What I tell teens is that if they’re doing something crazy, they can tell their parents it’s because their brain is a work in progress so they’re not always thinking about the consequences.


Regular alcohol use, binge drinking, restricted eating and stress can cause little changes in the immature brain that could potentially be irreversible.


Helping young people make smart decisions is a lot of what I do in my work, so I always tell them: “You only have one brain, so how can we protect it as much as possible? An immature brain, where all the connections are not fully made, is vulnerable. So if you start smoking or drinking at 14 or 15 you’re more likely to not be able to stop as you get later into adulthood. If there’s any way to delay some of these behaviours until your brain is a bit more mature, it’s a lot easier in terms of protecting it and preventing things like addiction from occurring.”



ON BODY IMAGE AND APPEARANCE PRESSURES


In most cultures and countries by the time girls are 10 years old, they have been taught that their main asset is their physical appearance


It is important for teens to be critical of stereotypical images and messages they receive from social media, their peers and their community



Young people who use social media frequently, constantly check how many likes they’re getting and compare themselves to their peers can be at higher risk of body-image issues and not feeling satisfied with themselves. Also there can be pressure from their peer group or subtle messages from their parents about how they should look or how their parents feel about their own body image. There’s a lot of input they’re receiving and it’s our goal to make them feel good from the inside.

I ask teens: “What do you feel is your strength – arts, music, technology? Everyone has that unique strength.” That’s where they can build value and self-esteem, as opposed to what they’re seeing on the outside.


We can get young people to be more critical of the images they see. Show them Dove’s photoshopping Evolution video. It’s astounding for kids to realise that they’re sometimes viewing very altered images or to know that sometimes models achieve those physiques at considerable cost to themselves, such as an eating disorder.


You want kids to become critical users of media. If they’re watching, say, Victoria’s Secret videos, it’s a great opportunity to talk about what they’re viewing and how it’s affecting their self-esteem. You can tell them: “Victoria’s Secret has good marketing but those models are not what the average woman looks like. It’s unattainable. When you look in the mirror after seeing that, how do you feel? Victoria’s Secret makes it seem like it’s all about what’s on the outside – but I think it’s important for a young woman to think about what’s inside.”



ON SEX AND HEALTHY RELATIONSHIPS


Adults need to encourage young people to be open about their feelings, stick to their values, create boundaries and build intimacy gradually



So much of what I’ve learned about sexual health I experienced in Holland – it’s the gold standard of how to approach sexual heath. They start sex ed at age 4. It’s developmentally appropriate. They talk about consent and having the ability to say no. The focus isn’t on not having sex but on having a positive sexual relationship at some point when you’re older.


Being able to have an open conversation with kids about issues related to: “How do you get to the point of having a positive relationship?” is important. Certainly as a parent talk about your own morals and why you might think that holding off for a period of time makes sense.

Have objective conversations. With anatomical parts I always say: “Call your penis your penis and your vagina your vagina.” Take away that mystery. So many times parents are afraid to have those conversations – they make it mysterious and they make it something they’re not comfortable talking about.


When kids are 12 to 14 and starting to be curious, a thoughtful way to present the idea of sex is: “If you become sexually active there are responsibilities: you want to make sure that you’re protected, that you don’t get pregnant, that it’s a good loving relationship. If you’re not ready for those responsibilities it’s always OK to wait.”



ON SEXTING


Sexting for some adolescents may be a way to explore their attraction to someone. They may sext to flirt, be romantically involved or to show intimacy


Sexting is another thorny topic that parents need to broach with their teenagers



My approach to sexting is like my approach to sexual intercourse: if you tell kids not to, they’ll do it anyway because they’re curious, there’s lots of pressure and lots of kids do it.


You can say: “A lot of responsibilities come along with sexting. For example, if you send an image of a body part to someone you consider your boyfriend, then if you break up this person will have some information that puts you in a very vulnerable position and they could use it against you. And if your parents, grandparents, teacher or classmates see it, how devastating would that be? In many places if you request a sext it’s illegal because sending information between 2 people under age 18 could be considered child pornography. Some schools have strict policies, and you could get in trouble. Is this really where you want to be in terms of letting that information out?”


Planting that seed and getting kids to think about what all this might mean for them is better than just telling them not to sext.


I also think it’s important, with sexual intercourse too, to ask kids if they feel they’re getting pressure to do it. I like to ask: “Have your friends being sexting? Do you know of anyone else in school that’s received, sent or even seen a sext? Have you? What would you do if someone were to do that?”


Role play is a great way to put kids in the hot seat. If you feel comfortable, it’s one of the things you can build into your toolkit to support your child. Ask a hypothetical question like: “What will you do if you receive a sext? How will you handle it? Just delete it? Or bring it to an adult, because it’s better that you don’t respond right away? Sometimes the nature of being a teenager is that you’re impulsive. This is a time when you wait, and you hold, and you don’t do anything.”


As a clinician I love using role play to get kids thinking about how to figure out better decisions. I’ll say: “You’re with this good-looking guy at a party and you’ve both had a few drinks. He wants to take it further and be sexually active and have oral sex or intercourse, but he doesn’t have protection. How will you handle that?” They might say: “Ooh wow, I don’t know.” So I say: “You’re going to say: ‘Maybe we need to wait. I’ve been drinking – I don’t know if it’s the right decision now. I’m going to hold off because I need to have protection.’”



ON QUESTIONS FROM KIDS


I’ve had teens tell me that they have an issue with their “chuchewawa” or “that thing down there”. I’ve had to remind them there is a proper name for the body part such as their vagina or their penis. I also tell kids that they should be comfortable seeing or touching their own body and genital region so they know what’s normal


I’ve also been asked: “Do girls really like sex, or do they do it for their boyfriends?”



It’s valuable for parents to know what their kids are asking about so they can provide them with that information.


Some of the other questions kids ask me are: “How big should my penis be?”, “Is it OK to masturbate?” and “How much masturbating is too much?” Boys think they’ll lose all their sperm – they’re terrified. Of course we should also have these conversations with girls and let them know that a normal part of being an adolescent is being able to touch yourself – it’s normal to explore.


Another common question is: “When is the right time to have sex?” Teens think everyone else is having sex, so it’s good to remind them that other kids aren’t and it’s OK to defer it.



ON HOT TOPICS IN SEXUAL HEALTH


It’s important to be aware of the basics of current hot topics such as having a healthy relationship or protecting against pregnancy and sexually transmitted infections



Parents should know there are issues related to teenage sexual health that are currently big issues, such as consent related to alcohol use. It’s important to educate young people so they know that when they’re drinking, particularly binge drinking, they’re at higher risk of being either a victim of sexual violence or a perpetrator, and that drinking changes their ability to consent and make decisions. Tell them: “You need to have a buddy with you.”


Porn is another hot topic. Young boys come to me with real curiosity. They ask: “Is it OK to watch?” So try to have nuanced discussions. You can say: “A lot of kids watch porn and you’re curious, but watching it can affect you because it’s not the most positive way to think about sexual relationships. You’ll see stylised ways of interacting that aren’t the norm.”




ON TALKING OPENLY


There is excellent evidence that young people whose parents discuss sex and sexual identity openly and honestly with them are more likely to delay having sex, avoid early pregnancy, have fewer partners and have more positive relationships


When with school-age kids, for example, if you see a pregnant woman talk about how a baby grows inside a mother’s body. With a preteen, if a couple is dating, talk about healthy relationships and falling in love. With teens, if you watch a movie with a racy or sexualised scene, talk about the importance of building intimacy slowly


Let’s get the conversation started!



It’s parents’ ultimate responsibility to be talking to their kids about sexual health and imparting their own morals and values. But many young people tell me that they just don’t have discussions with their parents about sex.


Most parents I’ve talked to didn’t have these conversations with their own parents – there was stigma, shame and taboo – so they can’t tap into what they did when they were a teen.


If you don’t feel comfortable, use the “global village” – another adult, a friend or health provider – to start the conversation. Then you need to come back and build on it.


Two tips related to starting the conversation: ask about what their friends and peer group are doing. Also don’t look directly in their eyes – do it in parallel, whether you’re walking or driving or they’re in bed so it’s a little less intimidating.


The sex ed discussion shouldn’t be one talk – it’s more of a layered approach with concepts sprinkled into everyday life. Start early and build it over time.


Think of it as your own sex ed lasagne! There are many ways to make a lasagne, but they’re all based on layers. It can be a little time consuming to do it from scratch, but it creates a very substantial meal over time.



Watch Demystifying Teens – the 13-minute TEDx talk by Dr Anisha Abraham. Raising Global Teens: A Practical Handbook For Parenting In The 21st Century is out now


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