Making Healthy Sexual Decisions

You may be thinking about what it means to be involved in a sexual relationship. As a young adult, it’s normal to think about sex, have sexual feelings, and have a desire to learn more about your own body. Deciding to have a sexual relationship is an important decision since it involves both your body and your emotions. You need to make sure that it’s the right decision for you. It’s always good to have a trusted adult to talk to.

What should I think about before I decide to have sex?

There are many things that are important to think about before you decide to have sex, including whether this is what you want and whether this is the right time in your life. You should also think about how you will feel afterwards. It should be a decision made without any pressure from your partner or friends.

You should never let others pressure you into having sex if you don’t want to.

• The decision to have sex for the first time (and every time after)is yours, not anyone else’s!
• Remember that it’s completely appropriate to wait to have sex.

What do I need to know if I’m sexually active or I’m thinking about becoming sexually active?

Teens have to make lots of decisions about sex, including whether to abstain (not have sex), or be sexually active.

If you are sexually active, you’ll also need to think about the:

• Kind of relationship you have with them
• Type of contraception (if you have a male partner) and sexually transmitted infection (STI) prevention methods you’ll use

Before you decide to have a sexual relationship, talk with your partner about whether having sex is what you both want.

1. Ask about their sexual history, including if they have  had any STIs.
2. Talk about what kinds of STI prevention methods you plan to use.
3. If you are in a heterosexual (straight) relationship, talk about birth control (condom, birth control pill, injection hormones, the “patch”, the “ring”, or IUD) if you would like to avoid an unintended pregnancy, and what you would do if it failed. If you feel that you can’t talk to your partner about these issues, then you should rethink whether or not you should be having a sexual relationship.
4. Be open and honest about whether you or your partner have been, or will be sexually involved with other people. Remember, the risk of getting an STI or a virus that can cause cancer or AIDS is increased if you or your partner(s) have sexual intercourse with other people. The more partners, the greater the risk!
5. Talk to your primary care provider about methods of birth control that are right for you, and about how to prevent STI’s.

Don’t forget that anyone born with female organs can get pregnant at ANY time if they have sex with someone who has male organs and don’t use a a condom, or if they are not using birth control correctly. To lessen the chance of pregnancy and STI’s, you should use a latex (female or male) condom every time you have sex, from start to finish. The only way to absolutely prevent getting pregnant or an STI is to not have sex.

Whom can I talk to about sex?

If you have questions about sex (whether or not you’re thinking about having a sexual relationship) you should talk to your parent(s)/guardian(s), a trusted adult such as a school counselor, someone from your religious center/youth group, or your health care provider. It’s a good idea to discuss all of your choices and any concerns you may have so that you can make healthy decisions. Deciding whether or not to have sex can be a difficult decision, so it’s always good to have someone to talk to.

How do I find a health care provider to discuss birth control and STI protection?

Many teens can talk to their moms, dads, or guardians about these issues, while others need confidential services. You can talk to your health care provider (HCP) about birth control or STI protection. You should feel comfortable with your provider, since it’s important to share personal information and any health problems with her/him. You need to find a provider who will listen to your concerns, answer your questions, and take the time to explain things clearly to you.

Ask your health care provider about the confidentiality policy. You should be able to talk privately about any health issues including your sexual choices and not feel judged.

Here are some sample questions you can ask your provider:

• What if I want to be tested for STIs such as gonorrhea, chlamydia, or HIV?
• Can you tell me what happens to my lab test results? Who do you call?
• Will the bill be sent to my house?
• If I’m covered by my parents’ insurance, will they find out about office visits and tests that are done on me?
• What if I need birth control? Will my parents find out?
• What if you find out that I have an STI? Who will you tell?
• What if you find out that I’m pregnant?
• Is there any information that you are required to tell my parents/guardians?
• What happens if I have a big problem and need help telling my parents/guardians?
• What should I know about emergency contraception?

What happens if I forget my birth control or the condom breaks?

If you forget your birth control or the condom breaks, you do have an option called emergency contraception, also known as the “morning-after pill”. Emergency contraception can prevent pregnancy up to 5 days after unprotected sex. The sooner you start the medicine after unprotected sex, the more effective the treatment is. Both females and males age 15 or older can buy it (Plan B One-Step™) at a pharmacy without a prescription. Call ahead to make sure they carry it and ask about the cost. If you’re 16 years old or younger OR you don’t want to buy emergency contraception yourself, you may be able to get it from your health care provider or a family planning clinic such as Planned Parenthood at a low cost.

For more information about EC, you can:

• Call Planned Parenthood at: 1-800-230-PLAN
• Visit The Emergency Contraception website

What if I’m not sure whether I’m gay, straight, bisexual, or transgender?

You may also be trying to figure out your gender identity (whether you identify as a woman, man, both, neither or something else) and your sexual orientation (who you are attracted to). If you feel like you want to talk to someone or you need more support, your health care provider can help you find a counselor or support group for gay, lesbian, bisexual, and transgender teens. If you don’t feel comfortable talking to your health care provider, you can speak with someone and get advice on where you can find a counselor or support group.

For more information, you can call the Gay, Lesbian, Bisexual, and Transgender National Hotline at: 1-888-843-4564. Services are confidential.

It’s important that having sex is a positive experience and YOUR decision regardless of whether your partner(s) are male, female, or both. If sex is painful, not pleasurable, not your choice, or makes you feel that it is the wrong decision for you, you should talk with a trusted adult.

Ask yourself the following questions to see if you’re ready to have a sexual relationship:

• Is your decision to have sex completely your own (you feel no pressure from others, including your partner)?
• Is your decision to have sex based on the right reasons? (It shouldn’t be based on peer pressure, a need to fit in or make your partner happy, or a belief that sex is the only way to make your relationship with your partner better, or closer. If you decide to have sex, it should be because you feel emotionally and physically ready. Your partner should be someone you trust.)
• Do you feel your partner would respect any decision you made about whether to have sex or not?
• Are you able to comfortably talk to your partner about sex and your partner’s sexual history?
• Have you and your partner talked about what both of you would do if you became pregnant or got an STI?
• Do you know how to prevent pregnancy and STIs?
• Are you and your partner willing to use contraception to prevent pregnancy and STIs?
• Do you really feel ready and completely comfortable with yourself and your partner to have sex?

If you answered NO to any of these questions, you are probably not ready to have sex. If you think you should have sexual intercourse because others want you to or you feel like you should since everyone else is doing it, you should rethink your decision to be sexually active. You should only have sex because you: trust your partner, feel comfortable with yourself and your decision, know how to protect yourself against STIs and unplanned pregnancies, and most importantly because you want to and you know that you’re ready!

Our health guides are developed through a systematic, rigorous process to ensure accuracy, reliability, and trustworthiness. Written and reviewed by experienced healthcare clinicians from Boston Children's Hospital, a Harvard Medical School teaching hospital and consistently ranked as a top hospital by Newsweek and U.S. News & World Report, these guides combine clinical expertise, specialized knowledge, and evidence-based medicine. We also incorporate research and best practices from authoritative sources such as the CDC, NIH, PubMed, top medical journals, and UpToDate.com. Clinical specialists and subject matter experts review and edit each guide, reinforcing our commitment to high-quality, factual, scientifically accurate health information for young people.