Most parents expect teens to slowly pull away and keep some details of their lives private. But it may be a shock that after age 12, parents and guardians can also be shut out of some of their child’s health care — and it’s not necessarily a bad thing.
California has laws about confidentiality and minor consent. They allow youth 12 and older to make some health decisions independently, without the consent of a parent or guardian.
To better understand the law and what parents can expect at their teen’s medical exams, we turned to Janet Ma, MD, and Susan Duan, MD, UCLA Health pediatricians who practice at Santa Monica 16th Street Internal Medicine and Pediatrics.
Dr. Ma and Dr. Duan answered some frequently asked questions about teen health exams:
What new health concerns arise for tweens and teens?
Once a child reaches the age of 12, many things begin to change physically and socially, often affecting a teen’s relationships with parents and peers. Annual exams for tweens and teens reflect those changes. Screenings, education and wellness discussions may begin to focus more on:
- Alcohol and drug use
- Contraception
- Gender identity
- Menstruation
- Mental health
- Puberty
- Sex and dating
- Sexually transmitted diseases (STDs)
“Part of becoming older is developing their own self-care and health-related skills,” Dr. Duan says. “Your health care provider will encourage your child to get more involved with their care.”
How does minor patient confidentiality change at age 12 in California?
Most parents assume they’ll be involved in their child’s health affairs until they turn 18 and officially reach adulthood. But in states like California, teens can advocate for some of their health care at 12.
“In California, there are laws that protect the health status of our preteens and teens,” Dr. Ma says. “Minor patients can seek some health care for certain delicate matters on their own, without the consent of a parent or guardian.”
Physicians typically ask to speak privately to patients 12 or older. That way, they can talk about confidential health topics that most teens don’t want to share in front of their parents. The information discussed in those confidential conversations is only shared if the teen says it’s okay or someone is in danger.
“As health concerns shift for teens,” Dr. Duan adds, “we want to build their independence and help them feel comfortable and confident speaking to a physician on their own.”
What health services can my teen request and receive without my knowledge and consent?
Teens can undergo visits, screenings and services related to:
- Pregnancy
- Birth control or abortion
- Sexually transmitted diseases (STDs)
- Drug and alcohol use
- Mental health
“If your child screens positive for something, we’ll ask if they are comfortable involving their parent or guardian in the discussion,” Dr. Duan says. “They’ll also have the option to get care on their own.”
Many health services still require a parent or guardian’s consent and are not considered confidential, including:
- Physical check-ups and vaccinations
- Treatment for a cold, virus or flu
- Treatment for injuries
Why is it good for my teen to have access to confidential medical services?
Teens can experience private health issues that make them nervous. They may not seek care for their issue out of fear of their parents or other people finding out.
“The confidentiality laws exist to protect your teen,” Dr. Ma explains. “It lets them know they can seek the care they need confidentially and helps them build trust with their health care provider. They see that we are looking out for their best interests.”
Are there instances when my child’s confidentiality will be broken?
Confidentiality laws exist to protect patients and the people around them. But sometimes, the best protection involves breaking that confidentiality. “Safety is always our first concern,” says Dr. Ma. “And those rules may get broken if new information jeopardizes the safety of the patient or other people.”
Physicians are mandatory reporters and must report:
- Physical or sexual abuse
- Thoughts or plans to hurt themselves or someone else
- Sexual intercourse with someone 14 or older (if the patient is younger than 14)
- Sexual intercourse with someone 21 or older (if the patient is younger than 16)
“Our goal is always to involve the parents, especially if we have a concern about unsafe behavior,” Dr. Duan says. “But we want to do that in a way that makes the teen feel safe and supported.”
Should I talk to my 12-year-old about the confidentiality rules? What should I say?
Your teen will have a more positive experience if they know what to expect during their exam.
“Let them know that the doctor will speak to them one-on-one,” says Dr. Ma. “Encourage your child to take that opportunity to ask questions about their health or feelings. Assure them that whatever they discuss with the physician is private and that you are okay with that.”
Talk to your teen before the appointment so they have time to prepare, adds Dr. Duan. They may have questions about the services they can access on their own. It also opens the line of communication between you and your teen.
How can I best support my teen’s health and wellness?
Your teen will eventually transition to taking care of their own health. Your role as a parent or guardian is to pave the way for that transition.
“As much as we counsel in the clinic, the real work is done at home,” Dr. Duan says. “If parents don’t allow their teens to practice self-care skills, it can be jarring when they go off to college or out on their own.”
Some ways you can support your teen’s health include:
- Allow independence: Let your teens participate in doctor’s appointments alone — with you nearby in the waiting room. Help them set up their own MyChart account and teach them how to use it. Older teens can start picking up their prescriptions and making their appointments.
- Be truthful: If your teen asks for information about their health, be honest. If you don’t know the answer, guide them to someone who does.
- Establish trust: Let your teen know their health is your priority, and you’ll support them without judgment.
- Talk about tough subjects: Don’t ignore topics such as sex, drugs, puberty and peer pressure. Ask many questions and encourage your teen to talk to you about these things.
