The nation’s largest pediatrics group says that it’s time for doctors to start counseling parents who have children who face possible infertility or sexual dysfunction.
The American Academy of Pediatrics is for the first time recommending that doctors, including mental health providers, talk to parents as early as their children’s infancy about the difficulties their children will face, or that they bring it up when they begin to notice that a child may be affected. Doctors should talk with both the parents and children together, and also with the children alone, once they become teenagers.
Children can become infertile or have sexual dysfunction as a result of surgery, radiation, chemotherapy, or taking hormones as part of a gender transition. Others have genetic conditions or developmental issues that will create these issues.
Most discussions about sexual health with children or teens at the doctor’s office tend to focus on discussions about avoiding sexually transmitted infections or an unintended pregnancy. The AAP says that it’s time to expand beyond that, noting that people who have infertility become distressed or have anxiety, and that it can affect their romantic relationships.
Doctors may use treatment for the conditions if they have evidence that they work, the group advised, but families must be told about the risks involved. For instance, sometimes it may be possible for medical procedures to preserve eggs or sperm that a person could use to reproduce later in life.
Doctors should be talking to their patients about what they will experience and should not avoid the topic altogether, the group said. It cited examples such as telling children that there are several ways to start a family, or by asking them how they feel about their bodies.
“We want children to feel safe asking questions, as a lack of information can lead to inaccurate beliefs or distress over time, through young adulthood,” said Dr. Leena Nahata, the lead author of the report. “Early on, in some situations, there may also be opportunities to preserve a patient’s future fertility or sexual function that can be addressed.”
