A FRIEND once received a panic call from a mother just as I was heading out to give a talk to middle-school students on growing up. As a paediatrician who deals with adolescent medicine, I give talks at schools to students about puberty — what changes occur physically, emotionally, and cognitively, what is normal and how to navigate the challenges of adolescence.

The mother was worried about what I would discuss with her seventh-grade daughter. My friend reassured her. This reaction, however, came from an educated parent of a student at an elite school, highlighting the reluctance to discuss reproductive health even among well-informed families.

One school shared that they had arranged a reproductive health session through an NGO but had to cancel due to parental objections. This underscores a critical issue: fear and misinformation prevent children from receiving essential education about their bodies. Many parents believe that avoiding discussions on reproductive health will prevent risky behaviour. However, research suggests otherwise. According to the WHO, sexual and reproductive health (SRH) education helps equip adolescents with accurate information in biological, psychological, and sociocultural contexts.

Adolescence is a time of rapid change, and if teenagers understand what is happening, why these changes occur, and how long this phase will last, they are better prepared to handle it. The real question is: where do they get their information from? Today, social media is the primary source for many. If parents are hesitant to talk about these topics due to cultural taboos, children turn to peers or unreliable sources. Ideally, parents, trained professionals, or educational institutions should be their primary guides. If parents choose silence, teenagers will still seek answers, often from inaccurate or unsafe sources.

If parents choose silence, teenagers will still seek answers.

Early adolescence (10-13) is a stage where children do not fully grasp the consequences of their actions. Friends become their greatest influence and being accepted by a peer group is paramount. When they smoke a cigarette, experiment with drugs, or engage in illicit activities, it is often to impress friends or gain entry into a desired social circle. Their brains are not yet mature enough to comprehend the negative consequences of their choices. What matters is appearing ‘cool’ to their peers.

By the time they reach middle or late adolescence, and their cognitive abilities develop enough to understand the long-term effects of their actions, it is often too late. This is why early intervention is crucial. Conversations about risky behaviour must take place before adolescents are exposed to these pressures.

Schools are perhaps the only place where adolescents can access accurate reproductive health education and life skills training. Providing such education early helps shape healthy attitudes, reducing the risk of harmful misconceptions and decisions later. Schools play a pivotal role in promoting safe and responsible practices. A common misconception is that reproductive health education encourages early sexual activity. However, global research shows that well-structured, skills-based programmes reduce such behaviour, as well as the incidence of sexually transmitted infections, reinforcing the importance of evidence-based education in shaping healthier futures.

Schools can provide consistent and evidence-based policies to create safe and enabling environments while integrating age-appropriate, skills-based SRH education. This includes preventing sexual harassment, gender-based violence, and aggressive behaviour and ad­­vocating for zero tolerance of such behaviour among staff and students. Providing evidence-based information on the benefits of SRH education and the dangers of ignorance at different developmental stages, facilitating teacher training, and advocating for counselling services and adolescent-friendly health services in schools or through collaboration with local healthcare providers ensures that teenagers have the knowledge and confidence to seek support when needed.

One of the biggest challenges in Pakistan is the taboo surrounding discussions on sexual and reproductive health. Many parents immediately shut down conversations on the topic out of discomfort. However, ignoring the topic does not prevent issues — it only leaves children uninformed and vulnerable.

By embracing reproductive health education, parents and schools can empower teenagers with the knowledge to protect themselves from harm, and navigate adolescence with confidence and awareness. The choice is simple: either we educate our children or let them learn from sources we cannot control.

The writer is a paediatrician at AKUH.

X: *@kishwarenam*

Published in Dawn, March 26th, 2025