A 17-Year-Old Girl Comes to the Office for a Routine

A 17-year-old girl comes to the office for a routine maintenance evaluation.  The patient is thinking about having sex for the first time.  She has been in a relationship for 6 months and would like to have a "physical connection" with her boyfriend.  The patient has not felt pressured by him and feels comfortable and safe in the relationship.  She has fantasies often about having sex with her boyfriend and masturbates 4 or 5 times a week.  The patient has no history of partnered sexual activity.  Which of the following is the most appropriate response by the physician at this time?

A) "Deciding when to have sex is up to you, but we should talk about ways to protect yourself from sexually transmitted infections."
B) "Having sex for the first time is a big decision; have you thought about discussing it with your parents?"
C) "It sounds like you may decide to have sex with your boyfriend soon; have you thought about how to prevent an unintended pregnancy?"
D) "It's normal for teenagers to experiment with sexual activities; but do you think you're ready to have sex?"
E) "Wondering about when to have sex is very normal; what questions do you have about sex and your body?"