How do you discuss sexual health with pediatric patients transitioning to adult rheumatology care when the patient is accompanied by parents or caregiver?

One of the most important aspects of transition is taking the time alone with the patient to ask questions confidentially. Best practice in pediatric rheumatology care is to have part of the clinic visit conducted with the patient alone- often, this is the opportunity to ask age relevant questions (and people will screen teen behaviors through the acronym- HEADDSS: home, education, alcohol-use, drug-use, depression, sexual health, and suicidality). Framing this time alone as part of the transition process and an expectation of independence makes this more normalized and routine especially when they transfer their care to an adult provider, and parents/caregivers do appreciate when it happens. If a patient is on a potentially teratogenic med...