"It's important to remember that what we think is important in medicine is not necessarily what our patients think is important," said Dr. Wilkinson. Often times, doctors focus only on the effectiveness of a particular method, not how acceptable it is for a particular patient. When she speaks to teens, "I ask her, is it important for you to have a period every month," she said, "and whether your partner can see the method or knows you have birth control."
For some teenagers it may be important that they can stop the method at any time. The conversation must include a discussion of what would happen if a method were not used or failed, and the importance of being able to discuss all of these issues with your partner.
Pediatricians need to be comfortable with these conversations, said Dr. Wilkinson. "Data shows that young people transition into their sex lives during the time we are caring for them," she said. The dialogue should include discussions about when they are ready for this transition and how this reflects their personal values.
Even in medicine, some might have assumed that contraception wasn't a priority during a pandemic, she said, but that's not necessarily true. And the issue is even more important this fall as a whole cohort of young people are either returning to universities in exceptional conditions or not returning to their universities where they may be used to receiving medical care.
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As some college students return to campus, Dr. Lindberg: "The reaction and guidance from colleges and universities regarding safe behavior in Covid ignored the fact that young people are sexual beings."
"Instead, we see guidelines that say no guests are allowed into your room," she said. "Children will break this rule and then we'll be mad at them." The guidelines should highlight careful decision-making on both gender and Covid, and the guidelines should be set in relation to risk reduction and consent. "It can't be all or nothing because this model fails," she said.
"The topics keep repeating," said Dr. Lindberg. "You must have empowered them and given them the skills – how to make decisions, how to choose their actions carefully." She referred to the New York Department of Health's guidelines for sexual behavior, which start with advice that you are your safest sexual partner but go beyond that to address the specific risks of various behaviors.