Dr. Kaufman and Dr. Spitzer reply

摘要

To the Editor:The editorial that was paired with Silva's article on pregnancy outcomes in juvenile SLE was meant to generate discussion about adolescent issues, and Drs. Bidwell, Bolt, and McDonagh have continued the conversation in a well documented response. Raising awareness about adolescent sexuality is just a first step. As the writers point out, it is essential that rheumatol-ogists and all pediatric practitioners continue to polish their skills in interacting with adolescents in a developmentally appropriate manner. This isimportant not only in the area of sexuality but also in discussing adherence, pain, vocational issues, and transition to adult care.While rheumatologists need not be experts in contraception, sexual behavior, or sexually transmitted infections, they must be able to relate to their patients and probe relevant health issues in such a way that young people will disclose the need for more information or intervention about these topics. There are growing numbers of clinicians who are experts in these and other adolescent issues and who are keenly interested and available to manage medically challenging adolescents with contraceptive and sexual health needs, but these individuals still rely on their colleagues to have the skills to identify and refer the appropriate patients.