Your Teen's Right to Confidential Reproductive and Sexual Health Care

Teen talking to doctor about sexual health
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In a perfect world, teens would talk to their parents about their sexual decisions. They’d approach their parents with questions about their reproductive health or hold honest conversations about their plans to become sexually active. And in turn, parents would offer education about reproductive and sexual health care.

Unfortunately, many of those conversations never happen. Whether a teen worries his parents will be disappointed in his decisions or he’s embarrassed to bring up questions about sex, many teens don’t feel comfortable going to their parents.

But many teens do feel comfortable talking to their doctors about their sexual decisions and reproductive concerns. To the surprise of some parents, a teen may get tested for pregnancy or treated for genital warts without parental consent.

While state laws vary on the details, your teen has a right to confidential reproductive and sexual healthcare. But most parents aren’t sure exactly what that means. They wonder things like:

  • Could my teen have an abortion without me knowing?
  • If a doctor learns my teen has a sexually transmitted infection, will the doctor tell me?
  • If my daughter becomes pregnant, can I insist she gave the baby up for adoption?
  • Could a doctor give my daughter the HPV vaccine even if I don’t want her to have it?

Your Teen’s Rights to Confidential Reproductive Healthcare

Confidentiality between a physician and a patient—even when that patient is a minor—is essential for good health.

Many teens wouldn’t be honest with their doctors if they thought their health information was disclosed to their parents.

Additionally, many teens wouldn’t seek contraception or treatment for sexually transmitted infections if their parents had to be involved in the appointments.  In a regional survey of adolescents, only 20 percent of teens said they would talk to a physician about birth control, drug use, and sexually transmitted infections if the doctor was mandated to report the information to their parents.

Confidential sexual and reproductive healthcare for teens isn’t meant to keep parents in the dark. It is, however, meant to give teens access to vital healthcare. Without it, many sexually transmitted infections may go untreated and many teens may lack access to birth control.

Confidentiality extends beyond reproductive health for minors. Teens also have a right to confidential mental health and substance abuse treatment.

In some states, physicians may experience serious disciplinary action for revealing a minor’s confidential sexual information. In other states, physicians have a little more liberty in deciding when it may be in the best interest of the minor for the parent to be informed.

Contraception and Family Planning

Teen pregnancy rates have been on the decline in the United States over the past two decades and experts believe this is partly due to increased access to birth control. Over the past 30 years, states have increased minors’ ability to gain access to contraception without parental consent.

Currently, 21 states and the District of Columbia explicitly allow minors to consent to contraceptive services. Parents do not need to be informed if a minor is given birth control.

Some states only allow minors to consent under certain conditions, such as:

  • If a physician determines the minor would face a health hazard in the absence of contraceptive services
  • If a minor is pregnant or has previously been pregnant
  • If a minor has already graduated high school or reached a certain minimum age
  • If a minor demonstrates “maturity “
  • If a professional, such as another physician or member of the clergy, refers a minor for services

Under most conditions, teens can get birth control pills, condoms, emergency contraception and other contraceptives without their parents’ knowledge.

HPV Vaccine

Some types of human papillomavirus are sexually transmitted.

While some forms of HPV can lead to cervical cancer, others may lead to genital warts. Some strains seem to have no harmful effects at all.

The HPV vaccine protects against the types of HPV that cause most cases of cervical cancer and genital warts. The American Academy of Pediatrics and the American Academy of Family Physicians recommend that all boys and girls get the HPV vaccine at age 11 or 12.

Many parents, however, have concerns about the vaccine and don’t want their child to have it. But in some cases, minors want the vaccine, even though their parents are opposed.

In some states, minors can still get the vaccine, regardless of their parents’ opposition. In other states, however, parents must give consent before the vaccine can be given.

Pregnancy Testing and Counseling

Teens can purchase over-the-counter pregnancy tests at the store without parental knowledge. They can also seek pregnancy testing and counseling from a physician without a parent’s consent.

Under most circumstances, a doctor won’t reveal to you that your child took a pregnancy test. Instead, the doctor will talk to your teen about her options and inform her of her rights in your state.

Prenatal Care

Thirty-two states and the District of Columbia have laws that explicitly state minors can consent to prenatal care. Some states allow a doctor to provide prenatal care, but allow for the physician to tell the parents when it’s in a minor’s best interest.

Testing and Treatment for Sexually Transmitted Infections

All states allow minors to consent to testing and treatment for sexually transmitted infections. So a teen who suspects he may have contracted an STI can ask his doctor for an exam and test. Then, he may be prescribed medication or undergo a procedure to treat an infection.

Eighteen states allow a physician to inform a parent when it’s in the best interest of a teen. But, that doesn’t mean a doctor is obligated to contact the parents.

Many states have separate laws covering HIV testing and treatment. While some states allow minors to consent to treatment, other states mandate that a physician must tell a parent if a minor tests positive.

Abortion

Despite the decline in teenagers giving birth, around 250,000 teenage girls still get pregnant every year. Studies estimate 75 percent of those pregnancies are unintended.

Among 15 to 19-year-olds in 2011, about 60 percent of pregnancies ended in births. About 26 percent of teens had abortions.

Abortion regulations for minors vary from state to state. Connecticut, Maine, and the District of Columbia allow minors to consent to an abortion without parental notification.

Twenty-one states require at least one parent consent to a minor’s abortion. But, 12 states require at least one parent is notified of the abortion, but that parent doesn’t need to give consent.

Some states require an adult give consent, but the adult doesn’t have to be a parent. A grandparent or aunt, for example, may be able to give permission.

Other states allow minors to bypass parents by gaining court approval. A judge may excuse a minor from notifying a parent under certain conditions, like when a parent doesn’t play an active role in a teen’s life or when there is evidence of abuse.

Adoption

Most states allow a minor to place a baby up for adoption without permission from their parents. Ten states require an adult be involved in the adoption process.

Four states require a teen’s parents to consent before she can place a baby up for adoption. Pennsylvania requires parents to be notified, but they don’t necessarily need to give consent.

Some states require minors be at least 16 years old before they are allowed to give consent. Other states allow parental consent to be waived if a minor is “sufficiently mature and well informed.”

Finally, a few states provide court-appointed legal counsel to represent a minor in court. Legal counsel assists with adoption hearings.

Consent to Medical Care for an Infant

If a 16-year-old has a baby, and the baby needs surgery, can the 16-year-old give consent? In some states, the answer is yes.

Almost all states allow a minor who is a parent to consent to the baby’s healthcare. But, not all states allow a minor to consent to surgery.

Mandated Reporting

Physicians are mandated reporters of abuse and neglect. So under some circumstances, a doctor may be required by law to report information to child protective services.

If a 14-year-old teen reveals she’s sexually active with a 35-year-old man, for example, the doctor may be required to notify the authorities that she’s being sexually abused. A doctor may also inform parents if a teen has been sexually assaulted.

Ways You Might Accidentally Learn About Your Teen's Health Care

Of course, just because your teen doesn’t tell you—and the doctor doesn’t disclose it—doesn’t mean you won’t find out. If your teen uses your health insurance, you might get the explanation of benefits in the mail. But, your teen may also ask the doctor not to bill your insurance.

Many clinics provide free and low-cost services for teens. So, your teen may be able to pay for his treatment on his own, or he may not have to pay anything at all. 

You also might receive the reminder that your teen has a doctor’s appointment on your phone if your teen doesn’t ask the office not to call. Or, you might happen to see a text message from the pharmacy reminding your teen to pick up her prescription. 

Encourage Your Teen to Come to You

No parent wants to be left in the dark about their teen’s health. Holding open and honest conversations about sex with your teen is key to encouraging your teen to come to you.

It’s also important to let your teen talk to a doctor privately. If you attend your teen’s appointments, offer to excuse yourself for a few minutes so your teen can ask questions or reveal information that he might not feel comfortable talking about with you present.

Sources

Guttmacher Institute: An Overview of Abortion Laws

Guttmacher Institute: An Overview of Minors’ Consent Law

HealthyChildren.org: Information for Teens: What You Need to know About Privacy

New York Civil Liberties Union: Reference Card: Minors’ Rights to Confidential Reproductive and Sexual Health Care in New York

Office of Adolescent Health: Trends in Teen Pregnancy and Childbearing

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