Teens with ADHD

The Birds, the Bees & ADHD: Teaching Your Teen About Sex — Mindfully

Your teen is thinking about (and possibly engaging in) sex. Pretending otherwise only puts your child at risk — particularly if he or she has ADHD. Here’s how to talk to your teen about sex in a way that emphasizes health, happiness, and personal responsibility.

Teens with ADHD holding hands, thinking about sex

Parents, brace yourselves: By the age of 20, about 75 percent of American teens have had sexual intercourse. Still sitting down? That number is likely higher for teens with ADHD; numerous studies have linked attention deficit to a higher rate of teen pregnancy, promiscuity, and STIs.

This may sound scary — especially for parents of impulsive kids — but sex isn’t inherently bad or evil. In fact, sex can be fun and affirming when it’s treated with respect and responsibility. “Responsibility,” however, rarely comes naturally to teens with ADHD, a condition that brings with it impulsivity and the need for immediate gratification. In addition, children with ADHD typically trail behind their peers by three years in terms of social maturity. That’s why it’s important for parents to talk to their teens about their sexuality in a way that’s open, honest, and free of judgment. Here’s how to get started.

Teaching Mindful Sex

Smart sex education for teens with ADHD should focus, first and foremost, on mindfulness. This doesn’t mean your child must meditate before kissing his boyfriend for the first time! Rather, it means that before engaging in any sexual activity, your teen should ask himself: “Is this what I want to be doing? Am I making this decision for me, or because some outside force is influencing me? Will I look back on this positively five years from now?”

Teenagers with ADHD may struggle to stop and ask these questions because they’re accustomed to acting on impulse. Even when they’re capable of better judgment, they too often ignore it in favor of immediate sexual enjoyment and validation. To counter this ADHD tendency, parents should teach their children to view sex mindfully, and to make intentional choices that reflect their long-term goals. To achieve this, sex education should focus on three things:

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1. Health
This is the primary focus of most public sex-education programs — but it’s more than showing kids terrifying images of STIs. Scaring children will not prevent them from having sex, and can actually cause significant sexual issues down the road — particularly if comorbid anxiety is involved. But even if they have no anxiety, children with ADHD and/or ODD may interpret attempts to scare them as attempts to control them. They may rebel against these lessons as a form of defiance and independence.

The goal, then, is to teach children to have a healthy, complete view of sexuality. This includes educating them about the risks that come with sex. Telling your teen, “If you have sex, you WILL get an STI” is not the way to do it. Instead, present this important decision as a choice: She can choose to have sex, and if she does, there is a possibility she will get an STI or get pregnant.

Explain how she can take steps to prevent that — birth control, condom use, and regular STI testing, for starters — and what she can do if she does face a consequence for having sex. Giving her a complete view, including what may happen and how she can deal with consequences as they arise, will help her recognize that sex is not without serious perils.

2. Heart
Some children and adults with ADHD struggle with emotional intimacy. This may stem from social deficits that make empathy, connectedness, and focusing on others’ needs difficult — or it may stem from ADHD-driven impulsivity and an undying drive for stimulation. This is true for both girls and boys, though each may express it differently.

What seems like an exciting adventure at age 20, however, may easily become a future regret. It’s important that parents talk about sexual intercourse as a way to foster emotional connections and express love between willing partners. Encourage your teen to consider whether she’ll look back on her behavior in the future with pride or with regret. Doing this without imparting fear can be tricky, but it’s critical to try — people who make sexual choices that disregard connection and intimacy may encounter painful feelings (and in extreme cases, trauma) later in life.

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3. Ethics
We should all expect others to act with integrity in their sexual expression. People with ADHD should be especially mindful about treating themselves and their partners with moral and psychological integrity. This means emphasizing that enthusiastic consent from all partners is required — no means no, yes means yes — and also ensuring that your child is treating himself and his sexual choices with respect.

Some teens with ADHD suffer low self-esteem thanks to a lifetime of academic, social, and personal challenges. Sexual validation provides a temporary — though not necessarily genuine or healthy — self-esteem boost that teens with ADHD may turn to when they’re feeling down. When talking to your teen about sex, teach her that sexual impulses are completely normal, but sometimes we act on them for the wrong reasons. Teach her to be honest with herself and ethical about her intentions whenever she chooses to engage in sex.

Teaching sexual ethics also means taking the possibility of pregnancy seriously. Talk to your teen about using birth control regularly, if applicable to his or her sexual orientation, as well as the possible consequences of an errant pregnancy. Teens with ADHD may struggle with birth control methods that require executive function skills— remembering to take the pill every day, for instance — so be prepared to discuss other long-term options, like an IUD or an implant, if necessary.

Talking about sex in this manner can be deeply uncomfortable or even painful for parents, because they struggle with the fact that their child is growing up and may end up choosing to participate in risky sexual behaviors. But having sex — or not — is a choice that only the individual can make. Sometimes, your child will make choices that you don’t condone or agree with; that is part of growing up.

Modern “sex education” focuses on teaching kids to say no. Parents today — especially parents of teens with ADHD — need to accept that their child might say yes. Rather than hiding from or fighting that reality, prepare your child (and yourself) for the potential outcomes of that choice. Teaching your child to make smart decisions and reflect on what he really wants — in sex, in love, and in life — will allow him to live as his most authentic self. A mindful approach will be much more effective than “Just say no.”

ADHD and Sex Education: Next Steps

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