“What good could possibly come out of going to the kind of doctor only your mom and maybe an older sister sees especially when as far as you can tell you feel fine?!”
This is probably the thought that goes through most young adolescents’ minds if the subject comes up. I imagine most teenagers can almost convince their parents that this is indeed an unnecessary endeavor. But there is so much that can be accomplished by bringing your young daughters to the gynecologist.
I personally love talking with adolescents in the office setting. They are so bright and have so much to teach adults by showing us the world through their eyes. Our children of course are our future and it is our job to teach them how to stay healthy and safe. Something that may help ease your child’s discomfort about coming to this type of visit is knowing that the discussions we will have are confidential. We always have the option of speaking with them one on one to allow them a safe space to ask questions that otherwise might embarrass them in front of their parent or guardian. But we also encourage the parent to be present for some or all of the visit, depending on the type of visit and comfort level of the child, for many reasons – they often contribute so much to the conversation and it is imperative that they play an active role in helping their children access appropriate resources.
One of the first things I like to talk with adolescents and their parents about is the role of the gynecologist in their reproductive years including when certain types of exams are appropriate or recommended. For example I often like to let it be known early in the discussion that a screening pelvic exam for a Pap smear is not done before age 21. Usually I get an audible sigh of relief from most patients when that is said and the rest of the discussion feels much more relaxed. I feel it is important to normalize the pelvic exam and gynecologic visits in general to reduce fear and improve communication. This also increases the likelihood the teenager will utilize her gynecologist in the future as a health care resource.
Along with relationship building some of the topics we address at that first visit are painful, heavy, or irregular periods, contraception, safe sex practices and STD screening, and Gardasil vaccination. In addition to counseling about reproductive and general health, the visit may also include a discussion about healthy relationships. The American College of Obstetricians and Gynecologists (ACOG) advises, “the initial reproductive health visit recommended for girls ages 13-15 years provides an opportunity for obstetrician-gynecologists to educate the adolescent and accompanying parent or guardian on numerous age appropriate health issues. Because middle school is a time when some adolescents may develop their first romantic or sexual relationships, it is an ideal time frame for obstetrician-gynecologists and other health care providers, parents, and guardians to play a role in anticipatory guidance.” This visit provides an opportunity to begin to provide sexuality education which should continue ideally through a person’s lifespan. ACOG also stresses that “adolescence is the time frame of psychosocial, cognitive, and physical development when young people make the transition from dependent child to independent adult. Although explorations of gender identity, sexuality, relationships, and intimacy occur throughout a lifespan, adolescence is a critical developmental period. Adolescence is a time to prepare for future relationships by learning healthy skills such as compromise, negotiation, conflict resolution, setting healthy boundaries, and other potentially protective behavior.”
Dr. Garbarino and I like to think of ourselves as part of your child’s team. Our goal would be to build a relationship with your child so that she can utilize us as a resource during the challenging period of adolescence and beyond. If you are unsure if bringing your child to see us for that first appointment is appropriate do not hesitate to call our office to talk with one of our nurses or just ask us at one of your visits.
Grace G Evins MD