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The Birds and the Bees, Please! Normalizing Sexual Health Conversations for Teens and Young Adults

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Released: November 11, 2026

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In my experience, conversations about sexual health, HIV, and PrEP become easy to engage in when you make them part of a regular visit. The key is remembering that young people are growing and developing, and that thoughts of sex, regardless of whether they are engaging in it or not, are a natural part of growing up. Here, I discuss 2 practical strategies for normalizing conversations about sexual health with teens and young adults, and why it is so important to have these conversations on a regular basis.

Samantha V. Hill
Samantha V. Hill, MD, MPH, FAAP
Normalizing Sexual Health Conversations for Adolescents

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In my experience, conversations about sexual health, HIV, and HIV pre-exposure prophylaxis (PrEP) become easy to engage in when you make them part of a regular visit. At some point, I ask every teen and young adult about their sexual health. With younger people, that starts with friendships, safe and healthy relationships, or even a question like, “Is anybody cute?” Just knowing and planning to ask those questions before going into the exam room makes it easier.

Initiating the Conversation
Each conversation and each patient is different, but I always ask the same question to initiate the discussion: What do you want to be in life? I find it easier to initiate these conversations if I can link sexual health to one of their goals, hopes, or dreams.

For instance, if they are playing a sport and hope to be team captain or to win a championship, or if they want to become president of a club, I could ask them how their sexual health could affect those goals. I might ask, “What would it mean for you if you accidentally got pregnant or if you accidentally got someone pregnant? What would it look like if you had an STI? How would that affect your thought process?”

Once I’ve engaged them, I can transition to discussing how sexual healthcare is a form of empowerment, of taking control over their bodies. I tell them that I am here to help teach them how to care for their bodies, and they should feel empowered to ask questions.

I also ask their permission to continue discussing sexual health at this point. I ask something like, “Are you interested in learning some tips and tricks that could help you be even more empowered in your relationships and sexual health?” If they say yes, which most of the time they do, then I can help educate them on birth control, emergency contraception, PrEP, PEP, doxyPEP, routine STI testing, and having conversations with their partners, about sexual health.

I find that asking these questions and initiating these conversations in this way gives my patients the opportunity to decide what matters to them in the moment. They can see there are many options for taking charge of their sexual well-being.

Having these conversations regularly makes it easier for patients to bring up new concerns or bring up interest in things like PrEP; they won’t feel like they are bringing it up out of the blue. Rather than feeling stigmatized, they know that PrEP and STI prevention are normal health concerns because they have heard me talk about it, and the only difference now is that their interest in the topic has changed.

I also remember and remind myself that I was once a teen, and that I wished my providers had asked me these questions.

Discussions Without Assumptions
Another way to initiate sexual health conversations, particularly if you do not already discuss sexual health regularly and want to avoid making patients feel like they are being singled out for engaging in sexual activity, is to ask a knowledge question.

A good question could be: “Do you know what STIs are, and can you name some?”

Most teens can name a couple. Even middle schoolers have usually learned about them in health class. I find that initiating the conversation this way is a great lead-in because they give you what they know and what they don’t know. This approach also reassures parents that you’re discussing sexual health, not teaching their child how to have sex. Then, you can get into ways that people can protect themselves from getting an STI.

Framing the conversation as education helps avoid any stigmatizing assumptions about whether the patient is sexually active. As HCPs, we are taught to be systematic when doing physical exams to ensure we are not missing any organs or body parts. It is the same thing for sexual health conversations. Although every topic may not apply to every individual, being comprehensive and systematic prevents missed opportunities for sexual health screening and prevention.

The key is to figure out how it becomes systematic for you and to keep practicing it.

Systematic Doesn’t Mean Slow
Another common barrier to sexual healthcare discussions is the perceived time constraint on the HCP’s behalf. Often, we only get about 15 minutes with each patient, and time is already being taken up to address other, more acute concerns. However, limited time is not justification for avoiding conversations about sexual health. When needed, these conversations can be initiated quite quickly.

Personally, although I make it a point to at least mention many sexual health topics, I do not go into detail about any of them unless prompted to by the patient. As I list the different aspects of sexual wellness, I am carefully gauging their attention to determine if they are displaying any interest in a particular topic. These conversations can be done in a very short time, with the option of elaborating on things that you feel the patient needs or things that the patient asks you about.

The key is remembering that young people are growing and developing, and part of that process is becoming sexual beings. Thoughts of sex and curiosity about it, regardless of whether they are engaging in it or not, are a natural part of developing and growing up. I think most parents would love for teenagers or young adults to get the information they need from a trusted source, such as a healthcare professional. Being cognizant of that is what helps me initiate these conversations.

Your Thoughts
How do you initiate conversations about sexual health with your patients? How does your approach differ between adolescents and young adults? Leave a comment to join the discussion!

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