Sorry, Mom, no praise for getting your 12 year old the Pill.

The Pill

No one likes unsolicited advice. It doesn’t matter if it’s good advice and it doesn’t matter if it’s well meant. Patients are no exception, even though part of the provider’s job is to counsel patients about their lifestyle choices. Smokers don’t want to be told not to smoke; overweight people don’t want to be told about the risks to their health.

That’s why I always tried to confine myself to the unadorned facts, and carefully excise any value judgments from my comments. Every now and then, though, I couldn’t help myself.

Any gynecologist is depressingly familiar with sexually active young teens and preteens, and the dreadful consequences. I often saw these girls in the Emergency Room in the middle of the night, unaccompanied or accompanied only by teenage friends. Certainly, no one came in with her mother. Perhaps that’s why I was not expecting a discussion of birth control when an affluent mother brought her 12 year old to the office for a consultation.

Improbably, the mother was beaming. Very few people are beaming at their gynecology appointment.

“We’re here for the Pill,” she announced cheerfully.

“The Pill,” I was shocked and it must have showed. “Who’s here for the Pill?”

The mother plowed ahead. “I brought my daughter to get the Pill. She’s sexually active.”

I turned to the daughter. She nodded her head slightly in affirmation.

“I’ve explained,” the mother continued, “that when you are sexually active, you always have to use protection, and the Pill is the best protection there is. That’s why I brought her myself.”

“Well,” I started tentatively, “the Pill is the best protection against pregnancy, but it doesn’t offer any protection against sexually transmitted diseases. Before we get to that, though, I’d like to talk a little more about sexual activity. I turned to the daughter again. “What grade are you in?”

“Seventh.”

“How old is your boyfriend and what grade is he in?”

“He’s 17 and he’s a senior in high school.”

“Yes,” the mother confirmed proudly, “she’s dating a senior.”

“Have you considered,” I ventured, “that might not be such a good thing?”

“What do you mean?” The mother was clearly annoyed.

“I mean,” I said, “that 5 years is a big age gap. There’s a big difference between a seventh grader and a high school senior.”

“So?”

“So, the needs and desires of a 17 year old boy are very different from the needs and desires of a seventh grader. A sexual relationship might seem like a good idea for a 17 year old, but it’s inevitably a bad idea for a 12 year old.”

“But she wants to date him,” the mother responded.

“Yes, she may want to date him, but that doesn’t mean that there might not be an element of coercion involved. Let’s think about this for a minute; what kind of 17 year old boy dates a 12 year old? It’s usually someone who has no success with girls his own age, and has to reach down to much younger children to have a sexual relationship.”

The mother was clearly growing angry. “But I thought you’d be impressed that I brought my daughter in for birth control,” she said, “My mother wouldn’t have done anything like this. She didn’t even tell me the facts about sex.”

“Sorry, I’m not impressed that you brought your sexually active 12 year old in for the Pill. I’m worried that someone is taking advantage of her.”

I kept looking in the direction of the daughter, but she made no response.

“We didn’t come here for your dating advice,” the mother replied heatedly. “Are you telling me that you won’t give her a prescription for the Pill?”

“No, that’s not what I’m saying. If her exam is normal, and she has no risk factors, I’m certainly going to give her a prescription. She’s sexually active and she needs to be protected from pregnancy. And I’m going to talk about condoms, too, since the Pill does not protect against sexually transmitted diseases.”

The mother was not mollified. She sat stonily through the rest of the interview and exam. When I finally wrote the prescription for birth control pills, she snatched it from my hand.

“Thank you,” she said coldly. “That’s what we came for. And by the way, the next time we want your opinion, we’ll ask for it.”

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  • AlisonCummins

    A friend of mine started both his daughters on the pill as soon as they started their periods. His reasoning was that they should develop the habit of taking it whether they happened to be sexually active at that particular time or not. That way they’d already be protected against pregnancy when they did eventually start having sex and wouldn’t have the impulse to immediately stop taking it after a breakup.

    How common is this?

    • toni

      Well I for one think that is creepy as heck.

      • AlisonCummins

        Yeah, that was my first thought! But then I thought it was smart. They didn’t actually start having sex until much later, but this way it keeps the parents out of it which is smart if your goal is to prevent pregnancy.

        Just wondering how common it is. Apparently the GP had no issue.

        • toni

          Hm, still creeped out. Did his daughters have any say in the matter? They just weren’t allowed to experience any normal cycles because their dad thought it his business to train them to take their bc pills like good little girls? I know it’s unfashionable but I think if you act like you expect your children to start having sex as soon as they think they’re in love they are more likely to do so. And anyway though I have no personal experience of contraceptives I’ve flipped through the booklet at the gynae office and looks like there are better options than the pill these days perhaps they would have preferred a vaginal ring or something for when they actually chose to begin a sexual relationship (maybe you have to be a certain age for the other methods idk) I’m a bit surprised a GP would prescribe birth control to a (I’m guessing about) 13 year old unless they said they were planning on becoming sexually active soon or had problems with their periods. Like a paed. doctor prescribing antibiotics to make the parents feel better but the child doesn’t really need them.

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