Discussing “sexting” with teens during routine exams

These days it is very common to walk into a patient exam room and find a woman texting or talking on her cell phone. This is particularly true of my adolescent patients who will often hold onto their cell phone throughout the visit, occasionally typing quickly when they think I’m not looking.  

I often tease the teenagers, asking if they really need to share the intimate details of their pelvic exam with a Facebook status update. But kidding aside, I’ve learned to use this opportunity to segue into discussing the all-too common phenomenon of young people “sexting” — sending sexually explicit messages or photographs with cell phones via text message.

Risky, impulsive and provocative behavior among teenagers is not a new problem.  However in today’s high tech, ultra-connected society, it is much easier to share intimacies once reserved for the bedroom. 

The problem is that all too often a private photo or message meant for a paramour gets shared with others and can spread quickly.  Whether the sexts are shared as a boast from a current girlfriend or boyfriend or by a revenge-seeking ex, the consequences can be humiliating and widespread. 

There can be legal ramifications to sexting as well. In many states, posting or sending naked photos of teenagers qualifies as child pornography. Increasingly there are stories in the news about young people facing prosecution and even some who are charged with prison time for sharing nude photographs online or in a text message.  

Most teens laugh when I bring up sexting during a visit, but I encourage them to think about the future ramifications of sending naughty photos.  Many adolescents do not realize that colleges and employers often use Google and search Facebook accounts to evaluate applicants. I remind them that it is difficult and often impossible to remove something once it is on the Internet. 

Clinicians should be aware of sexting and should speak with their adolescent patients about it. Unfamiliarity with technology cannot be an excuse to ignore this growing problem.