CLEVELAND – The answer used to surprise the pediatrician.

Not anymore.

When Dr. Phil Fragassi asks his teen patients, “Do you enjoy having sex?” most all the girls answer the same way: No.

Doctor Phil, as he’s called, is an inner-city pediatrician. He is the medical director of both the Juvenile Detention Center and New Directions adolescent drug and alcohol treatment center.

Working with high-risk adolescents, he’s seen it all:

Girls who got pregnant by their mothers’ boyfriends even after the girls had told their moms about the sexual abuse.

A 17-year-old boy who had gotten three girls pregnant.

A 15-year-old heroin addict who turned to prostitution.

And dozens who bring him hope. Girls who say, “No more.” Boys who are willing to wait.

But at least half the boys he sees tell him they want to have a child. About a fourth of them already have one.

“It’s cool,” they tell him.

The guys have nothing else to brag about – no jobs, no good grades. So they boast: “I got a girl pregnant.”

He estimates that 90 percent of the teenage boys he sees are having sex. They laugh about how they prefer virgins. They know they can get sexually transmitted diseases but tell Doctor Phil they don’t wear a condom. It’s too uncomfortable.

“It doesn’t feel very good when you’re peeing fire either,” he tells them bluntly.

Every child at the detention center is screened for sexually transmitted diseases. Nearly 20 percent of all the kids there have one. Doctor Phil worries for the girls with STDs who risk serious infections and infertility.

When a patient confided that she wasn’t sure if the boy wore a condom, Doctor Phil told her, “Look at his penis. Boys lie.”

He works to dispel the myths:

“Everybody is having sex.” (No, they’re not.)

“I can’t get pregnant because I had sex once without a condom and didn’t get pregnant.” (That doesn’t mean you’re infertile. It means you were lucky.) “If the boy pulls out, I can’t get pregnant.” (Doctor Phil has met plenty of “pull-out” babies.)

He believes the cure for teen pregnancy is education. He’s right. We’ve got to empower girls at an early age to respect and understand their bodies and teach boys to stop and think about consequences before having sex.

He asks the girls: Is this your choice to have sex or somebody else’s? Is this guy meeting any of your needs? If not, this is a choice you don’t have to make.

Teens who are having sex need to know where to get birth control. (Here it’s available at the Free Clinic, MetroHealth Medical Center and Planned Parenthood.)

Doctor Phil tells parents to tell their kids the truth, don’t be judgmental, and applaud kids who make healthy choices.

One girl told him, “I don’t know what’s right or wrong. Nobody ever taught me.” Doctor Phil tells kids who have no fully engaged parent, “Decide what you want and fight for it. Sometimes there’s nobody else fighting for you.”

For those kids, the rest of us need to join the fight. When it comes to reducing teen pregnancy, every teacher, coach, aunt, uncle and grandparent has a role.

What’s yours?