Content Warning: This article discusses sex, sexual health, puberty, STIs, body anxiety, death, dying, grief, hospice care, and end-of-life planning. Some readers may find portions emotionally difficult or personally triggering.

There are certain subjects Americans will joke about endlessly, but discuss honestly almost never.

Sex.

Death.

Dying.

Bodies.

Grief.

Fear.

Intimacy.

Disease.

Loss.

We market sex constantly while refusing to educate people about it honestly. We glorify youth while pretending aging and death are optional side quests that happen only to other families. We laugh at awkward questions instead of answering them. We turn discomfort into comedy because actual conversation requires vulnerability, maturity, and emotional courage.

Recently, ER physician and social media creator J Mack Slaughter Jr posted a reel responding to a parent whose child had asked what a “BJ” was. The post framed the interaction as an awkward and humorous parenting moment. To be clear, awkward parenting moments are real. Every parent, guardian, teacher, aunt, uncle, grandparent, older sibling, or exhausted adult has had that moment where a child asks a question so unexpected that the brain briefly exits the body.

That part is human.

But the reel struck a deeper nerve because it highlighted something many of us have spent years noticing: even highly educated adults, including medical professionals, often become visibly uncomfortable when sex enters the conversation in any direct way.

And that should concern all of us.

This is not an attack on Dr. Slaughter personally. He is clearly intelligent, accomplished, and successful at public engagement. Humor absolutely has a place in medicine and parenting. Humor often helps people survive stress, trauma, fear, and emotional exhaustion.

But the larger issue remains.

If a physician working in emergency medicine visibly struggles with discussing a basic sexual question publicly and educationally, what does that say about American culture as a whole?

Where exactly are people supposed to learn?

Pornography?

TikTok comments?

Locker room rumors?

Anonymous Reddit threads written by somebody named “420DragonWolf”?

The silence around sex and death is not harmless. It leaves people frightened, ashamed, medically uninformed, emotionally isolated, and completely unprepared for some of the most important experiences of their lives.

And we are paying for that silence every single day.

America’s Weird Relationship With Sex

America may be one of the only countries capable of simultaneously sexualizing literally everything while refusing to educate people about sex responsibly.

Beer commercials sell sex.

Perfume sells sex.

Music sells sex.

Movies sell sex.

Streaming platforms sell sex.

Influencers sell sex.

Advertising uses sex constantly.

Yet the second somebody asks an honest question about anatomy, pleasure, puberty, orientation, consent, or safer sex practices, entire rooms of adults suddenly begin acting like Victorian ghosts clutching pearls in a haunted mansion.

We laugh nervously.

We whisper.

We dodge.

We say things like:
“You are too young to ask that.”
“We will talk about that later.”
“Where did you hear that?”
“Oh my God.”
“Ask your mother.”
“Ask your father.”
“Do not say that word.”

And then we act surprised when young people end up deeply confused.

The Centers for Disease Control and Prevention states that comprehensive sexual health education helps reduce risky behaviors, improves health outcomes, increases condom use, and delays sexual activity among many adolescents.

That is public health data.

Not culture war propaganda.

Not moral collapse.

Public health.

But many Americans still approach sexual education as if information itself causes harm. The evidence says the opposite. Silence causes harm. Shame causes harm. Fear causes harm. Misinformation causes harm.

Information saves people.

The Child With the Itch

Let us discuss something that sounds funny until you remember there is a terrified kid sitting behind the experience.

A teenage boy shaves his pubic area for the first time.

Maybe he saw it online.

Maybe he thinks everyone does it.

Maybe he is curious.

Maybe he is embarrassed about body hair.

A few days later, the hair starts growing back. The itching begins. The skin feels irritated and strange.

Most adults reading this already know what happened.

The teenager may not.

That young person may immediately think:
“I have an STI.”
“I caught something.”
“I am disgusting.”
“My life is ruined.”
“I cannot tell anyone.”

Now imagine being fourteen, terrified, embarrassed, and too ashamed to ask an adult because society has taught you that questions involving genitals automatically become jokes.

That child may sit alone Googling symptoms at midnight.

That child may panic for days.

That child may avoid medical care.

That child may believe they are dirty or broken.

And all because adults refused to normalize conversations about bodies.

Yes, in hindsight, the situation sounds almost comedic to adults.

But it was not comedic to the child.

It was terrifying.

That is the piece adults often fail to understand. Young people do not possess decades of contextual experience. What seems obvious to an adult can feel catastrophic to a child or teenager.

The Office of Disease Prevention and Health Promotion recommends that parents discuss STIs openly with adolescents, including symptoms, prevention, and safer sexual practices.

That guidance exists because silence does not create safety.

Conversation creates safety.

A healthy adult response sounds something like this:

“Hair growing back after shaving can itch. That is normal. Bodies do weird things sometimes. STIs can also cause symptoms, so if something hurts, burns, smells unusual, or does not improve, we should check it out medically. You are not in trouble for asking.”

That response lowers panic.

It provides education.

It removes shame.

Most importantly, it keeps the communication door open.

Death: America’s Other Forbidden Conversation

The silence surrounding death may be even worse.

Most families avoid conversations about dying until they absolutely cannot avoid them anymore.

We avoid discussing hospice.

We avoid discussing advance directives.

We avoid discussing funeral preferences.

We avoid discussing quality of life.

We avoid discussing disability and decline.

We avoid discussing what people actually want near the end of life because talking about death feels emotionally dangerous.

Then the emergency happens.

A stroke.

Cancer progression.

A sudden accident.

A ventilator.

A brain injury.

A catastrophic diagnosis.

Suddenly the family is standing in an ICU hallway being asked impossible questions with no preparation whatsoever.

Did Dad want aggressive intervention?

Did Mom want to remain on life support?

Who has medical power of attorney?

Did they want burial or cremation?

Did they want hospice?

Did they want religious rituals?

Did they want no service at all?

Nobody knows.

Because nobody talked.

So grieving families are forced to guess.

And later they spend years wondering whether they got it wrong.

The National Institute on Aging explains that advance care planning helps people communicate medical wishes before they are unable to speak for themselves.

That conversation is not morbid.

It is compassionate.

It is an act of love.

One of the cruelest myths in American culture is the belief that discussing death somehow invites death closer. It does not.

Death already knows where we live.

The conversation is not for death.

The conversation is for the people left behind.

Why We Joke Instead of Teach

Humor is easier than vulnerability.

That is the truth beneath all of this.

A joke lets people escape discomfort quickly.

A real conversation requires emotional presence.

And to be fair, many adults were never taught how to have these conversations themselves. Entire generations were raised under systems that treated sexuality as shameful and death as taboo.

Many parents today are attempting to answer questions they themselves never received answers to.

That deserves empathy.

But empathy cannot become an excuse for avoidance forever.

At some point adults have to decide:
“Am I more committed to my own comfort or to another person’s understanding?”

That question matters in parenting.

It matters in medicine.

It matters in education.

It matters in relationships.

It matters in grief.

When children ask about sex, many adults panic because they confuse acknowledgment with encouragement.

Explaining oral sex to a teenager does not cause oral sex.

Explaining consent does not create promiscuity.

Explaining STIs does not increase infections.

Explaining condoms does not destroy morality.

The evidence repeatedly demonstrates the opposite.

The CDC has repeatedly found that comprehensive sexual education improves health outcomes and reduces risk behaviors.

Ignorance is not innocence.

Ignorance is vulnerability.

The Medical Community Cannot Afford This Silence Either

Healthcare workers occupy a unique position in society.

People trust them with their bodies, fears, secrets, symptoms, anxieties, traumas, and vulnerabilities.

That trust carries responsibility.

Again, this is not about humiliating J Mack Slaughter Jr specifically. Public criticism should never become cruelty. Physicians are human beings. They are allowed to experience awkwardness and imperfection.

But medical professionals helping normalize clear conversations about sex and death genuinely matters.

If doctors appear uncomfortable discussing basic sexual terminology, patients absorb that discomfort immediately.

Patients already hesitate to discuss:

• erectile dysfunction
• vaginal pain
• STI symptoms
• anal health
• libido
• sexual trauma
• orientation
• gender identity
• menstruation
• incontinence
• infertility
• aging
• hospice
• suicidal thoughts
• end-of-life fears

Many patients already walk into exam rooms carrying decades of shame.

Healthcare professionals who model calm, factual communication can literally change lives.

A patient who feels safe asking questions is more likely to:

• seek testing
• report symptoms
• disclose abuse
• discuss mental health
• address sexual dysfunction
• pursue preventative care
• ask about hospice and palliative options
• complete advance directives

Communication is healthcare.

Silence delays healthcare.

The Cost of Shame

Shame does not educate people.

Shame isolates them.

A teenager afraid to ask questions about sex may avoid medical care entirely.

A queer child afraid to discuss identity may spiral into depression or self-harm.

An adult embarrassed about STI symptoms may delay testing.

A family unwilling to discuss death may end up in devastating conflict during a medical crisis.

A patient ashamed of mental health struggles may avoid treatment until emergency intervention becomes necessary.

The silence surrounding sex and death intersects directly with stigma.

This connects deeply to the larger becoming project and years of advocacy surrounding mental health, disability, recovery, incarceration, queer identity, and social exclusion.

Stigma thrives wherever language disappears.

The second a subject becomes “too uncomfortable” to discuss honestly, misinformation fills the vacuum.

That vacuum kills people.

Sometimes literally.

What Honest Conversations Could Look Like

Adults often imagine these conversations must be perfect.

They do not.

They just need to exist.

A child asks:
“What is a BJ?”

A calm answer:
“That is a sexual term adults use involving oral contact with genitals. You do not need every detail right now, but I am glad you asked instead of guessing.”

A teenager asks:
“What if I think I have an STI?”

A calm answer:
“Then we get information and medical care. You are not dirty. You are not ruined. Bodies need healthcare sometimes.”

An aging parent says:
“I think we should discuss what happens if I become seriously ill.”

A calm answer:
“I hate imagining losing you, but I want to know what matters most to you.”

Those responses are not scandalous.

They are responsible.

The Silence Is Not Sophistication

Americans often confuse silence with maturity.

It is not mature to avoid difficult conversations.

It is avoidance.

Maturity means sitting in discomfort long enough to help another human being feel less alone.

That applies to sex.

That applies to death.

That applies to grief.

That applies to medicine.

That applies to parenting.

That applies to relationships.

Human beings deserve language for their experiences.

A young person deserves to ask questions about their body without feeling disgusting.

A dying person deserves to communicate their wishes without being silenced by other people’s fear.

Families deserve preparation.

Patients deserve clarity.

Children deserve honesty.

Adults deserve dignity.

And healthcare professionals, educators, parents, clergy, and public figures all play roles in shaping whether those conversations become safer or more shame-filled.

So Where Do We Go From Here?

Start small.

Talk to your children honestly at age-appropriate levels.

Teach body literacy without panic.

Normalize healthcare.

Discuss consent clearly.

Talk about STIs without treating them like moral failure.

Learn about hospice before you need hospice.

Complete advance directives.

Ask your loved ones what they want near the end of life.

Tell people what you want.

Stop treating death planning like surrender.

Stop treating sexual education like corruption.

Stop treating honest questions like comedy sketches first and educational moments second.

Laugh when appropriate. Humanity is absurd sometimes. Parenting is awkward. Bodies are strange. Puberty is chaotic. Aging is messy.

Humor belongs in these conversations.

But humor cannot replace them.

Because eventually every single one of us encounters sex, illness, aging, grief, mortality, vulnerability, and fear.

The question is whether we will keep stumbling through those experiences half-informed and ashamed because generations of adults refused to talk honestly.

Or whether we finally decide that discomfort is a small price to pay for clarity, compassion, preparedness, and truth.

The question was never the problem.

The silence was.