Most parents expect teens to slowly pull away and keep some details of their lives private, but it may come as 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 that allow youths age 12 and older to make some health decisions independently, without the consent of a parent or guardian.
“Part of becoming older is [an adolescent] developing their own self-care and health-related skills,” says UCLA Health medicine-pediatrics physician Susan Duan, MD. “Your health care provider will encourage your child to get more involved with their care.”
As children grow into adolescence, many things begin to change physically and socially — changes that often affect a teen’s relationships with parents and peers, Dr. Duan notes. Annual exams for tweens and teens reflect those changes. Screenings, education and wellness discussions may begin to focus more on:
- Alcohol and drug use
- Gender identity
- Mental health
- Sex and dating
- Sexually transmitted diseases
While parents may assume they will be involved in their child’s health affairs until they turn 18 and officially reach adulthood, California has laws that allow teens, beginning at age 12, to advocate for some of their own health care. “California’s laws protect the health status of preteens and teens,” says UCLA Health medicine-pediatrics physician Janet Ma, MD. “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 age 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 if someone is in danger.
“As health concerns shift for teens, we want to build their independence and help them feel comfortable and confident speaking to a physician on their own,” Dr. Duan adds.
“As health concerns shift for teens, we want to build their independence and help them feel comfortable and confident speaking to a physician on their own.”
While parents may be uncomfortable with the idea of their children having access to confidential medical services, Drs. Duan and Ma respond that not being able to do so may cause many teens to avoid getting necessary care out of fear that their parents or other people may find 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.”
There are, however, instances when a child’s confidentiality may be broken. “Safety is always our first concern,” Dr. Ma says. “Privacy rules may be broken if information suggests that the safety of the patient or other people is in jeopardy.”
Physicians are mandatory reporters and required by law to 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 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.”
Drs. Duan and Ma encourage parents to talk to their teens before an appointment so they have time to prepare. “Let them know that the doctor will speak to them one-on-one,” Dr. Ma says. “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.”
“They may have questions about the services they can access on their own,” Dr. Duan adds. “It also opens the line of communication between you and your teen.”
The physicians also want parents to keep in mind that their teen will eventually transition to adult care, and their 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.”