Wes: I thought we’d made great strides in reducing teen pregnancy, but research and clinical experience say otherwise. According to the Centers for Disease Control, a third of girls will get pregnant before age 20. The teen birth rate actually rose by 3 percent between 2005 and 2006, after dropping 34 percent over the last decade. Kids used to come to my office well-prepared on topics of birth control and disease prevention, ready instead to consider the emotional and psychological aspects of their decisions. Some still come in that way, but far too many do not.

I can’t account for this. Despite lots of made-up controversy about abstinence versus sex education, the availability of information and professional services for young people has steadily increased. As unreliable as the Internet can be for educating kids on sexuality, all one need do is Google “birth control” to get 12.2 million citations, the first hundred of which appear quite legit. So I’m not buying the argument that kids lack the info to make educated choices.

What’s still lacking for many kids is good homegrown guidance. I see numerous families who not only believe their teens aren’t sexually active, but don’t even see it as a major risk factor. This is especially jaw-dropping when it comes to boys. At the risk of sounding terribly sexist, I would expect most parents of boys to be aware that their sons have at least a passing interest in sex and would therefore open regular discussion of the issue. Yet I see a lot of young men who’ve had even less of this dialogue than their female peers.

If we consider the issue at all, we seem to saddle girls with all the responsibility for birth control. Perhaps this is because there’s no “male pill.” Maybe it’s the reality that early pregnancy not only happens to teenage girls physically, but emotionally and economically. It takes two people to make a baby, but getting young men to cover their half of the obligation is a problem our society faces across every age and socioeconomic group. You only have to do a head count to realize how many more young single moms are taking care of kids than single dads.

When I take my kids to the City Museum in St. Louis, I suggest that as they climb through the many tunnels and caverns they simply assume that at any given moment they were about to raise up and smack their heads on something. I’d offer the same advice to parents of boys (and girls). Assume your kid is in a situation that calls for constant, reasonable caution, and spend some time from age 3 forward talking about how to be cautious. Few words of advice will go further to make a difference in your boy’s life.

Samantha: Wes is right. Contraception often ends up being the responsibility of the girl. We’re willing to accept HALF of that responsibility. The rest goes to the guys and, before them, their parents.

I would like to thank every parent who has talked to his/her child about protection. As a teen, I can tell you it is just as awkward for us as it is for you. We, too, would rather be sitting outside in parkas, scarves and gloves on a 105-degree day than talk with you about sex. However, your input really means something to us.

Having a “use protection” talk is hard enough in a close and open mother-daughter relationship. I can only imagine how hard it would be to broach the topic with a son. If you’re a parent who has given up on talking to your child about contraception, rethink your excuses. If you’re a teenager and you are sexually active but you aren’t using contraception, your excuses are no better. Let me see if I can bust through some common ones.

The Evolutionary Excuse: Males are programmed to want sex all the time. In the heat of the moment, they can’t possibly think about contraception. When we say guys “just can’t control themselves,” we reduce the intelligence of a male to that of an animal. That’s ridiculous. Men and women are born with brains to reason through the consequences of their actions. Teenage boys are capable of thinking to use birth control, so we can expect them to do so.

The Religious Excuse: I have a lot of respect for religious guys (and girls) who swear they will not have sex before marriage. However, pretending you are not going to have sex and then having it on the spur of the moment without a condom doesn’t make the sex any less sinful.

The Enabling Excuse: You may worry that thinking about protection makes teenagers more interested in sex. As far as I can tell, guys are thinking about sex all the time anyway. If a guy isn’t planning to have sex, great. But he should be prepared just in case.

The “What’s In It for Him?” Excuse: While a guy SHOULD care about the possibility of dismantling a girl’s life by getting her pregnant, the sad truth is that some guys don’t. While we can’t force ethics down their throats, we do have other weapons of choice. For guys who sleep around, the chance of catching an STD is a good enough reason to use contraception. For monogamous guys, the answer lies in two words: child support. With a minimum-wage job, a teenage boy will have little money left for anything else. For 18 years, even when he settles down and starts a real family, he will have that responsibility looming over him. Guys can find at least one reason to use birth control.

For parents, it’s never too late to bring up contraception. There is no right time or convenient segue way to lead you to the conversation. Just do it. For boys, step up and take responsibility. Condoms are cheaper than babies.

Next week: A mother asks what to do about a daughter who lies – even to her therapist.