Sexuality, Mental Health, & Teens

Being a parent seems to be one of the most difficult experiences in life. Being a child and adolescent therapist, almost gets close to being a parent. I can’t count how many times I have had to have the “sex talk” with many of my adolescent clients, primarily girls. I often question why I’ve chosen to work with teens! I suppose the allure of watching these “mini adults” rethink their lives and what they admire in order to lead healthier lives is what keeps me entangled with this group. Even more, our teens today face a multitude of challenges ranging from mental health problems (diagnosed and undiagnosed), behavioral problems such as defiance, ADHD, or oppositional behaviors, to AIDS/HIV, relationship difficulties and poor parent-child interactions. Our kids are burdened by modern day bullying, violence, substance abuse, peer pressure, and parental goals and aspirations for their lives. 

Despite all of this, one issue remains the least spoken about at home, in mental health settings, and schools, which is sexual health. As a mental health therapist I have no training in sexual and reproductive health, but I’ve had the talk many times and would like to make a few points about our youths today:

  1. Our youths are very uneducated: A client came to a session and asked me how she could abort a baby without having an abortion. Knowing my values about this, she refrained from having the abortion. But she expressed that many of her family members and friends told her she could:
      • Sit on top of a moving washing machine for 2hrs
      • Engage in multiple splits
      • Drink multiple cups of alcohol

It became apparent to me that not only is my client highly uneducated about sexual health, but so too is her family, friends and many other teens.

2.  Mental health problems make sexual health difficult: What I mean by this is that many kids with mental health diagnoses such as depression, anxiety, and ADHD often engage in sexual experiences on impulse or to “self-sooth” or “self-medicate.” Youngsters with severe depression who often feel “numb” or experience anhedonia (a loss of interest in activities) will engage sexually in order to finally feel something. You may have heard that teens who self-harm (cut themselves) do it because they need to “feel” something. The same is true with sexual experiences in some cases.

3. Chronically sexually active teens are not normal: Of course we would all like to think that teens are hypersexual beings who are constantly trying to understand themselves and others in this way. But the reality is that there is a level of abnormality involved in desiring and engaging in sex at certain frequencies. Sadly, many of our teens are sexually active in today’s world. We must keep in mind and try to understand that a hypersexual teen could be acting out for help. Teens who suffer from low self-esteem, depression, anxiety, interpersonal conflicts within the home, are bullied, or are going through a family divorce may resort to sex for comfort and begin to “crave” it like one would crave a drug. In other words, sex addiction is likely to occur among our teens if we are not aware of why, when, and how often they are engaging.


It’s a difficult discussion all the way around, but our youths need us to help them make smarter decisions, keep themselves safe, and educated about their bodies. There are multiple online videos, articles, and activities to help you discuss this topic with teens. Discussing sexual health with teens struggling with mental health conditions is ten times more important because symptoms themselves can lead teens into negative sexual experiences or consequences such as pregnancy.

As always, stay informed!