LARC? What the heck is that??

LONG ACTING REVERSIBLE CONTRACEPTIVES!!!! So what does THAT mean?  It refers to birth control methods that last a long time (for YEARS) but are not permanent.  Meaning, once they are removed a woman can get pregnant!

What birth control methods are considered LARC?  The IUD (the Mirena & Paragard) and the Implanon/Nexplanon.

Although I have already written about the awesomeness of the IUD and the Implanon/Nexplanon why not hear from women who are actually using (and loving) them?  And yup, that’s me there in the video talking about why I LOVE my IUD.

Didn’t catch those articles? Just click here to read about the IUD and click here to read about the Implanon/Nexplanon.

Let me know what YOU think about these methods for a chance to win $25 to Old Navy.  You can tell me what you’ve heard about them, why you think people should or shouldn’t use them, or anything else you think is worth while to share about the IUD or Implanon/Nexplanon.  I love hearing what y’all have to say!

In happiness & health,


Meet the Faces of New Generation Health Center: Part 2

Last month I posted bios of our current volunteers and interns and told ya I would be introducing more peeps every few weeks so as promised, here they are!

This week I want to introduce you to the clinical staff.  If you have ever been a patient here before, you may recognize some of these faces.  They are also the ones who review the medical accuracy of my posts.  New Gen is so lucky to have some of the most experienced clinical staff around.  They have all been working with teens and young adults before some of you were even born!  They also train many, many future clinicians including doctors, nurses, and midwives.  If you are interested in becoming a clinician, feel free to ask them questions.

KoharKohar Der Simonian, MD – I am an assistant clinical professor in the UCSF Department of Family and Community Medicine and the department of Obstetrics, Gynecology and Reproductive Sciences, and am the new medical director at New Generation Health Center.

During my training in family medicine, I became especially interested in caring for teens and young adults especially in the area of reproductive health services.  I wanted to be able to empower my patients to make the best family planning choices for them and to educate young men and women about preventing pregnancies and sexually transmitted infections.  I also saw that even in this age of information overload, patients are often still embarrassed to talk about sex and their sexual health!  New Gen is the perfect place for me to work because we get to promote safe sex choices every day!

I received my medical degree from the University of Vermont and did my family medicine residency at UCSF/San Francisco General Hospital, with a special emphasis in urban under-served medicine.  I completed a fellowship in reproductive health at Beth Israel in NYC.   Before starting medical school, I was living in Yerevan, Armenia and spent a year as an Armenian Volunteer Corps member.  My experience abroad made me committed to serving disadvantaged populations and promoting education about reproductive options because I got to see first hand how young women’s lives were affected every day when they didn’t have any birth control options available to them.

In my free time I am an avid reader and runner and enjoy cooking and baking, and spending time with my friends and family.


Hey, I’m Dr. Tonya Chafee.  I’m from SF originally and have worked in many places in the Bay Area.  I’ve worked at New Gen since 2004, but have also been at the UCSF Teen Clinic, Kaiser Teen Clinic (3 different sites), Stanford Children’s Hospital Teen Clinic, Daly City Youth Clinic, Mission Neighborhood Teen Clinic, and am Director of San Francisco General Hospital’s Teen and Young Adult Health Center.  When I am not working, I like to run, watch/listen/read the news, run, go wine tasting, run, and walk my dog.  I am drawn to working with teen reproductive health because I enjoy being able to help young people make one of the most important decisions regarding their health and future.

Reproductive health was way different when I was a teen in the 80’s.  The only birth control methods were, I think, the pill and condoms, and HIV was all you heard about because it was taking its toll in the US.  The only message we heard was that sex could kill you.  I’m very glad things have changed, particularly as young people are being better about being safe, talking to each other more about what they want sexually, and having HEALTHIER relationships!

AndreaI’m Andrea Raider and I am a nurse practitioner who has always been drawn to working with young adults.  I focused my studies at the UCSF nursing program on Adolescent Health.  I feels spectacularly lucky to have my dream job, working with youth at New Gen and have been here since its inception in 1997.  I was born in Sri Lanka and traveled around the world in my early years; living in Turkey and Portugal.  I love to travel when possible and I speak Spanish. My other interests include jogging, camping, quilting, floating in an inner tube, playing lacrosse with my son, snorkeling with my daughter, and enjoying my husband’s yummy cooking.


Hi, I’m Debbie Davidson and I’m a nurse practitioner.  I’ve been at New Gen since 1997, when we first opened.  I love working here!  When you’re a teen and just starting to have sex, there is a lot to learn about having a good relationship, keeping your body healthy, and making decisions about pregnancy.  I like working in a clinic where the whole staff is dedicated to helping our clients with their questions and problems.  And our clients are amazing – curious, looking for answers, many facing hardships in their lives with great strength.

When I was a teenager, abortion was illegal.  The pill was about the only method to use for birth control besides condoms, foam, or the diaphragm.  If you didn’t want to have a baby, there weren’t many choices.   Although I was terrified of getting pregnant, I was clueless about STD’s – no one ever told me about them, and I did nothing to protect myself.

I was a single mom, raised 2 wonderful sons in San Francisco.  They’re grown up now – and I’m looking forward to being a grandma.  When I’m not working, you might find me in my backyard in my vegetable and flower garden, baking pies in the kitchen, reading a good novel, or hiking on the beautiful trails in the bay area.

WhitneyMiskellThere is one other clinician on staff here at NGHC but unfortunately we do not have bio for her yet!  But I will say that Whitney Miskell, NP is an amazing clinician who is extremely dedicated to providing reproductive health care.  When she is not at New Gen, she is working at the Women’s Option Center at SFGH.  When not being a super hero in  the field of reproductive health, Whitney is kicking butt in boot camp, running, swimming or biking.  Maybe next month I can get Whitney to tell ya’ll a little bit more about her awesomeness.

Again, when you see these lovely clinicians don’t hesitate to ask them questions whether it be about your own health or about their journey in medicine.  They are truly an amazing bunch and I am so fortunate to work with them every day!

In happiness & health,


Does Your Relationship Sound Like a Taylor Swift Song??? Then You Should Read This!

Hey Shawna,

My partner and I get into fight after fight.  Every time I try to talk to them about a problem in our relationship, I get nervous and shut down or I blow up and forget what started the fight.  How can we make it better? I know we can make it work if we talk it out.  I just don’t know how.



That is a very common question!  Fortunately, I know just the person to ask! Mei-Lani began at New Gen as an AmeriCorps member (super cool program you should check out by clicking here) and when her term ended she so graciously offered to continue here as a volunteer (we are very lucky).  Mei-Lani not only has tons of training but she also has counseled hundreds and hundreds of patients and answered this question many times.  There are so many knowledgeable people here at New Gen and I think it’s important to share them with you.  So without further adieu, here is Mei-Lani’s answer.

Hey there,

You know what?  You just asked one of the most common relationship questions we hear in the clinic.  Communication is very important for relationships.  It builds trust, understanding, and lets a relationship grow.  But it can still be very difficult for people.  That’s because there are many ways to communicate (with your words, with your body, with your phone…and many more) and many styles that people use to express their feelings (passive, aggressive, assertive, and many more!)

No matter how you are communicating or what you are talking about, there are some basic steps you can follow to make talking to your partner about the tough stuff easier.  Many of these tips are adapted from the sex educators at San Francisco Sex Information, but I’ve broken them down into three parts: plan it, do it, and follow up.


Plan with your partner to make the conversation happen:  Many times people will want to wait for the right time to bring something up, but when the time comes, the place isn’t right.  The perfect time and place don’t just fall into your lap.  You might have to make it happen.  Plan this conversation with your partner.  Let them know the issue.  Let them have the time they need to think about things before the talk comes up.  Think about the times when you have had a big talk sprung onto you out of the blue.  It can suck.

Planning can be as easy as
“I have been feeling upset about ____this____.  Let’s plan a time when we can talk about it.”

Set the stage:  This means pick a good time and place to talk.  Make sure there’s enough time so no one gets rushed.  And try to pick a place that allows both people be comfortable and honest.  Talking right before class ends or before getting off the bus cuts the conversation short.  Plus being around a lot of other people can put pressure to act a certain way.

Think before you speak:  Now that you both have the time to think before the big talk comes up, make sure your own thoughts are clear.  What is really the problem? Think about what you truly want to come out of the conversation.  Do you want change?  Do you want support?  Do you want trust?  How will you know if the talk went well?  How will you feel? How will things change?  Asking yourself these questions before hand makes sure that if your partner asks you them, you already know how to say what you think.

PART TWO: Do it.

I know, easier said than done.  But… you have already thought about things and made the time and space to make this talk happen.  So go for it!

Use I-Statements:  Saying “I feel… when you….” “I think… because of….”  This lets you say what you think and feel without attacking the person you’re talking to.  Rather than  making assumptions for your partner with “You think, you feel, you do,” you can speak truth about what you know and feel.

Try it out and see how different these statements make you feel.
“You are always texting other girls.  Why can’t I have guy friends?.”
“I feel disrespected when there seems to be different rules for you than me.”

Listen:  Look at your partner.  Check your understanding by repeating some of the things they say back to them.  For example, you could say, “So I hear that you feel ____ because of __this and that___.”  If you are having a hard time understanding what your partner is saying, ask yourself why?  Are you already thinking of what to say next or making judgments?  Are you agreeing with everything they say before they say it or putting words and ideas into their mouth?

Pay attention to the non-words:  65% of communication is in our tone of voice and body language.  Make sure you aren’t speaking in Imagean angry tone when trying to say something nice.  Read your partner’s body language – are their arms crossed and are they facing away from you when they say “everything is okay.”  See if their body is speaking a whole different language than their words.

Ask questions:  If you don’t understand what your partner just said, ask!

Meet in the middle:  Relationships are about give and take.  Likely, you both will come up with some ideas to change your own behavior or things you want your partner to do differently.  Try to find ways to make changes that leave both people happy.  You might not come up with something that leaves you both happy.  That’s okay – you both at least said what you were feeling.  Sit with that and see where it takes you in a few days.

PART THREE: Follow up.

Bet you didn’t think there was more, right?  This conversation just brought up a lot.  You both shared how you felt.  You probably had some emotions come up and you both probably want to change some things.

Before you wrap up this conversation, make another date to check in.  This could be something like “okay, boo, we just said a lot.  I appreciate that we both could be honest.  I think this was good for us to talk, but I wanna make sure things are going right for us later on.  In a couple of weeks, let’s get some food and go for a walk and check in about this again.”

And speaking of wrapping things up, I have gone on way too long about talking.  I hope these tips are helpful for you.  It might seem like a lot of work, but start slowly.  You don’t have to try everything all at once.  Try one tip and see if it helps out.  If you have any questions, write me back at


Volunteer Health Educator

Not Everybody is Doing “It”


So often sex educators (myself included) get caught up in teaching about birth control methods, STD prevention and generally being sex positive (the idea that sex is a totally normal part of life) that we forget about abstinence.  Sometimes we get so caught up in fighting back against “abstinence only education” (education in schools that only teach students about NOT having sex) in favor of comprehensive sex education (education in schools that teaches about all kinds of things related to sex and sexual health) that we let the idea of abstinence slip right by us (or only briefly acknowledge it). Comprehensive sex education is supposed to be comprehensive, meaning it should include a real discussion about all things related to sex and sexuality, including abstinence.


So what is abstinence?  Abstinence is the practice of refraining from some or all aspects of sexual activity for various reasons.  Meaning, it is a fairly flexible term.  Some people engage in all kinds of sexual behaviors other than penetrative sex (penis in vagina or butt) and consider themselves abstinent.  Others don’t engage in any kind of sexual activity (touching, rubbing, oral sex, etc.).  And the reasons behind why people chose what they do, also vary.  Some people want to avoid pregnancy or STDs (considering it is the ONLY way to prevent pregnancy 100% & depending on the behavior, may protect against STDs 100% too).  Others are abstinent for religious or cultural reasons.  Some want to wait until they feel ready (which is different for everyone).  Really, there are many reasons and they vary from person to person.

Also, anyone can be abstinent.  Just because someone has had sex or engaged in any kind of sexual behavior in the past doesn’t mean they have to continue doing so – even if they are still with the partner they had previously engaged in those behaviors with.

Whatever reasons someone has for being abstinent; here at New Gen we completely support you.  That means we can help you figure out what you are and are not okay with or how to talk to partners about your decision.  You don’t have to be engaging in any kind of sex or sexual activity to come to New Gen to talk to a health educator or clinician about sex related stuff.  Not only do we do the medical stuff like STD testing and birth control but we also do a lot of education about sex related subjects.  Including Abstinence.  So come talk to us!

And I have to thank a very awesome young person for reminding me that abstinence is equally important in the conversation about sex.  Precious Listana is a sophomore in high school and has written this wonderful poem about abstinence.

Virginity Unbroken

It’s been 2 years, 6 months and 10 days.
I am just a teen, I’m not ready.
“It’s just another phase baby come and lie with me already”
He tells me, and I wonder
“Is this my relationship?
What choice do I prefer?”
He stares; starts to unzip his clothes.
I whimper.
He stops and listens
Everything stirs around me.
“Please don’t do this!”
He puts his clothes on and yawns.
We sleep.

In happiness & health,


P.S. If you are interested in submitting a poem, article, story, artwork or whatever else about reproductive health for this blog I most definitely encourage you to do so. If featured, you could win a $25 gift card to Old Navy!  As always, if you have any questions about this or anything else, email