Questions to ask teen partners of adult men
What is your approach when talking with an adolescent female patient who is involved in a relationship with a older man? Here are a few suggested questions to ask, offered by Linda Dominguez, RNC, OGNP, assistant medical director of Planned Parenthood of New Mexico in Albuquerque.
• How did you two meet?
Many teens meet their partners through friends. Others may come in contact with older men through less-desirable circumstances, such as at drinking parties.
• Does your mother know that you are seeing this man? What does she think of him?
By asking those questions, you can determine whether the relationship has been disclosed and what the consensus is concerning the partner.
• What does he do for a living?
Identify the partner’s socioeconomic status.
• Has he been married before? Does he have children?
If the answer is "yes" when it comes to children, ask if the children share the same mother. If the partner has children by more than one woman, it’s important to establish that fact when moving on to questions of contraception with the patient at hand.
• Have you talked with him about what would happen if you were to get pregnant accidentally?
Some counseling protocols may ask these questions in the form of "Are you trying to get pregnant?" No matter how it’s phrased, don’t be surprised if the response is, "He said he would take care of me."
Remember that in a young teen’s perspective, an older man already may have achieved important life skills, notes Dominguez. He may drive his own car, be independent of his parents, and have a job or some form of revenue stream that pays for a good proportion of the couple’s social life.
"This all goes back to that He’ll take care of me’ thing," she notes. "He has a car, he pays for the date, and he is more competent in life skills than the last boyfriend."
To help the teen focus on her need for contraception, ask about her life goals as well as her partner’s plans. Help her examine how she fits into her partner’s future. "Explain that by contracepting, the patient can help her partner achieve his goals," says Dominguez. "Of course, you are really helping the patient to avoid an early pregnancy. Young women in love tend to be selfless, so this approach may work with them."
Melanie Gold, DO, assistant professor of pediatrics at the University of Pittsburgh’s school of medicine, suggests having the older partner join the patient for her reproductive health visit if possible.
At this visit, ask the partner what he sees in their future as a couple and what his hopes are for his partner’s accomplishments in the future. Allowing adolescent girls to hear what their men say and then later reviewing if this is consistent with their own plans often helps them see any potential undiscussed conflicts, Gold says. Let the partner know during the visit that you are an advocate for the patient, she stresses.
"I make it clear the girl is my patient, and her needs and best interests come first, even if they conflict with his desires and plans," she says.
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