When you’re the parent of a teenager, there is a balance you’re probably trying to manage and maybe not always successfully. You want your teen to feel independent and empowered, but at the same time, they still need guidance, and they aren’t yet adults.
This creates clashes, including in health care. A big discussion area right now is what rights teens have to confidential health care, including reproductive and sexual health care.
We often hear about varying types of confidentiality required between services providers and their clients or patients.
Along with doctor-patient confidentiality, for example, there’s also attorney-client privilege. In attorney-client privilege, attorneys must keep the information their clients share with them private, but as with anything, there are complexities.
The same is true in health care.
The following are some things that parents should know about teens, their healthcare, and the rights to privacy they may or may not have.
A Teen’s Rights to Confidentiality
Confidentiality between patients and physicians is important, but it becomes a much grayer area with the patient is a minor. Teens are less likely to be honest with their doctors if they believe what they say to their care provider will be disclosed to their parents.
Teens might be less likely to receive treatment for sexually transmitted infections or get contraception if their parents must participate in the appointment.
There was a survey of young people, and only around 20% of teens said they’d talk to their health care provider about sexually transmitted infections, birth control, or drug use if the doctor was required to report what they said to their parents.
Parents worry that they’re being kept in the dark, however, and that’s very much a real fear too.
While we tend to talk most about teens’ reproductive care as far as confidentiality in health care, mental health care is an increasing area of conversation, too, as is substance abuse treatment.
In some states, a physician can face significant disciplinary action when they reveal the confidential sexual information of a teen. In other states, physicians and health care providers have more liberty as far as their decisions and what’s in the best interest of a teen patient to share versus not sharing.
While laws do vary depending on the state, below, we detail what doctors can and can’t tell parents.
Sexual and Reproductive Health
Teens engaging in sexual activity are at greater risk for health risks sexually transmitted diseases. If a teen talks to their doctor honestly, they can receive medical advice and STD testing.
Teen pregnancy rates have been on the decline in the U.S. over the past two decades, and some experts attribute it to more access to birth control.
Twenty-one states and the District of Columbia allow minors to consent to services involving contraception. Parents don’t need to be informed if their minor child is given birth control in these states.
There are specific situations under which a minor can consent in some states. For example, a minor might consent depending on the state if a doctor determines there would be a serious health hazard without contraceptive services.
Under the majority of situations, a teen can get condoms, birth control pills, and emergency contraception without their parents knowing.
In most circumstances, a health care provider won’t tell a parent if a teen took a pregnancy test.
All states allow minors to consent to both testing and receiving treatment for sexually transmitted infections. If a teen thinks they may have been exposed to or contracted an STI, they can go to their doctor for an exam or test. Then, if that test shows they are infected, they can receive a prescribed medicine to treat it.
In 18 states, a doctor can inform parents if it’s in a teen’s best interest, but it doesn’t mean the health care provider has to.
Abortion laws and regulations for minors vary depending on the state. For example, in Connecticut, Maine, and the District of Columbia, minors can consent to an abortion without notifying a parent. In 21 states, at least one parent has to give their consent if a minor is getting an abortion.
In 12 states, at least one parent must be notified but doesn’t have to consent.
Some types of human papillomavirus are sexually transmitted. Certain types of HPV can ultimately lead to cervical cancer and other health effects, but other strains aren’t harmful.
There is an HPV vaccine that protects against the strains that cause genital warts and most cases of cervical cancer.
The recommendation of the American Academy of Pediatrics and the American Academy of Family Physicians is that all boys and girls get the vaccine at age 11 or 12.
Some parents don’t want their child to have the vaccine for varying reasons. A minor can still get the vaccine in some states even if a parent doesn’t want them to. In other states, parents must provide their consent before their child can get the vaccine.
If a teen is struggling with issues related to mental health, such as anxiety or depression, they may not feel comfortable talking about it with their parents.
Doctors again do have some leeway as far as deciding when they should keep a conversation with teens confidential and when they need to share information with parents.
If a teen is showing signs of dangerous behavior, then a doctor does have a duty to inform parents. If a teen, for example, could be at risk for suicide or could be a danger to themselves or the people around them, a doctor likely will speak to the parents.
In most cases, deciding whether or not to inform parents about things related to a teen’s health care is up to the doctor but is guided by state laws.