We read the above article with interest as we recently carried out a survey of parents regarding similar issues at the Cystic Fibrosis (CF) Outpatient Department at Great Ormond Street Hospital for Children.
Infertility can be a very emotive and difficult subject for some parents to talk to their sons about. It can raise feelings of failure and lack of masculinity, and take away plans for the future. It is inappropriate for adolescent boys to hear about infertility "through the grape vine." We, therefore, wanted to elicit parental views on the ideal age that reproductive and sexual health issues should be discussed with their sons, who should be responsible for this, and where the discussion should take place.
Ninety-one parents took part in the survey (67 mothers). The mean ideal age at which parents thought that discussion of reproductive and sexual health issues should take place was 13.5 years (range, 10-18 years); this was similar to the above report. Twenty (22%) parents said that there was no right age for this discussion, and that it should be when the child was mature enough. However, 9 parents felt strongly that this discussion should not take place until their son was over age 16 years. Again, similar to the above report, we found that 71 (78%) parents felt that it was the joint responsibility of both the CF team and the parents to carry out this discussion, and only 16 (18%) parents felt that it was their sole responsibility. The majority of parents (62%) felt that these discussions should take place during an outpatient visit, and only 24% were not sure; no parent felt strongly that this discussion should take place at home.
We have found that parents recognize their need for support when tackling this often sensitive subject and appreciate the input of the CF team. This survey showed that the CF team should balance the majority view with individual needs when planning educational sessions. However, it is important to remember that we must work together with the families. Consideration and careful preparation before discussion will ensure that adolescent boys are made aware of all the issues surrounding reproduction and sexual health before transfer to adult care.