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Let's say a 16 year old girl manages to speak to her doctor in private during a regular appointment and requests birth control. She is afraid her parents would respond poorly to knowing she is considering sexual intercourse, and so requests the doctor make up some other excuse for prescribing the medicine, such as to regulate or manage her periods.

I assume the doctor has the right to decline to make up an excuse for the prescription, and in absence of doctor being willing to justify it a minor may not request the prescription since their parents may guess on the reason for it.

Aside from that though I'm more wondering can the doctor inform her parents of her request, and that she is considering sexual activity? Legally does she have a legal right to demand her request be kept private from her legal guardians?

Assume the minor is living with her parents and hasn't been emancipated.

Ryan M
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dsollen
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  • I think there is already an answer on this point and will see if I can find it. – ohwilleke Mar 23 '22 at 20:47
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    @ohwilleke I found a question asking if a minor legally could consent to various things with a doctor, but it didn't cover rather the minor's privacy was protected. That answer also said the answer was effectively yes if emancipated, but I'm asking specifically if the minor is still a dependent of their parents. – dsollen Mar 23 '22 at 20:52
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    I think we would need the state to give an accurate answer. – mkennedy Mar 23 '22 at 23:05
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    Birth control is prescribed for many reasons beyond prevention of pregnancy during intercourse: https://www.plannedparenthood.org/learn/birth-control/birth-control-pill/what-are-the-benefits-of-the-birth-control-pill – casperOne Mar 24 '22 at 19:57
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    A general note: There are two independent questions involved here - whether the minor may consent to the treatment (the prescription, in this case), and whether they may ask for privacy. The rules for these two areas are sometimes different. If the prescription requires parental consent, the question of privacy is rather moot... – sleske Mar 25 '22 at 08:23
  • Just to clarify... is the minor going to be using the parents' insurance to cover the doctor visit and/or prescription? Or will all this be out of pocket? – Bardicer Mar 25 '22 at 14:49
  • @casperOne birth control is also prescribed to male sex offenders in return for lenient sentences. The meds used for chemical castration is actually birth control meds – Neil Meyer Mar 25 '22 at 15:36
  • @Bardicer This is more theoretical, but from the minor perspective the ideal outcome would be using parent's insurance but tell the parents the medication was for regulating periods or some cause other than for birth control. Rather or not a doctor can even do that would depend on state, but my real question is rather it's safe to ask. Ie even if the doctor can't get the minor a prescription can the minor at least know their parents won't find out what they wanted. – dsollen Mar 25 '22 at 20:16
  • @dsollen I don't think the minor would be able to use the parents' insurance without them finding out, as the insurance would send them an explanation of benefits of what the insurance covered, and what the out of pocket expenses would be. Would definitely recommend just paying cash if the minor did not want a paper trail. – Bardicer Mar 28 '22 at 02:17
  • @Bardicer but doctors have a long history of perscribing medication for a stated reason that is different then the actual reason, usually because insurance agency will only support medication for certain reasons. since most birth control can also be prescribed to regulate a period and similar issues a doctor could give the insurance agency, and thus the parents, an excuse reason for the BC that they would accept without giving the truth way if they were comfortable doing that. Though that's mostly mute as my main question was one about privacy not logistics of getting the meds. – dsollen Mar 29 '22 at 13:14

5 Answers5

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In the US, it depends on the consent-to-treat laws of the state. In Washington, under RCW 9.02.100, everybody has a right to reproductive privacy (be it contraceptives or abortions). Under the federal HIPAA privacy rule, the minor requesting contraceptives would therefore be "the individual", which means that disclosure to others requires consent from the patient. Given the supremacy clause, that's all she wrote for Washington. The majority of states similarly allow 16 year olds to request contraceptives. Texas Family Code §32.003 spells out the conditions where a minor can consent to their own medical treatment, which does not include the situation you describe, therefore parental consent would be required (which clearly implies parental notification). Furthermore, that law also says

(d) A licensed physician, dentist, or psychologist may, with or without the consent of a child who is a patient, advise the parents, managing conservator, or guardian of the child of the treatment given to or needed by the child.

Therefore in Texas there is no prohibition against informing the parent(s). (Note that in the Texas Family Code, "child" is a synonym for "minor", so this also applies to teenagers, not just small children.)

Carey v. Population Services Int'l, 431 U.S. 678 is an important ruling regarding the rights of minors to make their own decisions regarding contraception, but it does not go so far as to declare that minors have a constitutional right to give consent to the requisite medical examination.

sleske
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user6726
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    Thank you, that mostly answers my question. However, I was asking about the right of privacy. Is privacy to not tell parents of a request guaranteed even if the child cannot get contraceptives without parental consent? I'm not including a state because I actually would like to know if it's safe to advice anyone in the US that there is no harm from asking a doctor for contraceptives, so if there is even one state where their privacy is not guaranteed that would make my assertion false. – dsollen Mar 24 '22 at 13:25
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    Actually section D of child consent in the Texas law you linked explicitly says that minors aren't guaranteed privacy so I suppose that already answers my question. I'll be happy to select this answer if you updated it to explicitly call out that privacy is also not guaranteed in all states, so as to fully answer the question as asked. – dsollen Mar 24 '22 at 13:33
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    @dsollen Because the citizens of the state of Texas hold other values and norms than you do not make Texas stupid. – paulj Mar 24 '22 at 19:57
  • The use of "child" in the cited law is a bit confusing, as it is unclear whether "child" also covers teenagers. I edited to clarify, hope that's ok. – sleske Mar 25 '22 at 08:26
  • The words "of the treatment given to or needed by the child" do not include treatments "not given and not needed" aka birth control not prescribed. Therefore, your argument seems to have a hole or at least, the letter of the law does not support your conclusion. – DonQuiKong Mar 25 '22 at 08:29
  • Actually, imho, information about a request made is not covered by that clause as long as it's not relevant medical information, which I assume it is not. – DonQuiKong Mar 25 '22 at 08:32
  • @DonQuiKong it says treatment needed by the child. If a child states they want birth control because their planning to be sexually active then it sounds like birth control is a service the child has clearly stated is 'needed' and as such something that the doctor could discus with parents. Yeah it's a little grey, but given Texas conservative bent and history I suspect a medical professional making such a claim to back up speaking with parents about a birth control request would likely be supported by the courts. – dsollen Mar 25 '22 at 20:11
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A 16 year old is not considered, for these purposes, a minor so she can legally engage in consentual sexual activity (with certain exemptions not relevant here).

A child under 16 can get professional advice from a medical practitioner about birth control without their parents' knowledge or consent - and have it prescribed - as long as they satisfy the Fraser Guidelines1:

  • He/she has sufficient maturity and intelligence to understand the nature and implications of the proposed treatment

  • He/she cannot be persuaded to tell her parents or to allow the doctor to tell them

  • He/she is very likely to begin or continue having sexual intercourse with or without contraceptive treatment

  • His/her physical or mental health is likely to suffer unless he/she received the advice or treatment

  • The advice or treatment is in the young person’s best interests.

1These guidelines stem from the House of Lords judgement in Gillick v West Norfolk et al which was primarily concerned with determining a child’s capacity to consent to medical treatment.

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    Excuse my ignorance, but howcome wikipedia states the age of majority in Wales to be 18, not 16? (https://en.m.wikipedia.org/wiki/Age_of_majority) - Or is the age for consensual sex handled separately from the age of majority ...? Am confused – csstudent1418 Mar 24 '22 at 12:48
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    @csstudent1418 Yes, it is, is some situations, it's different. I can't speak for Wales, but in Australia, the age of consent is certainly not the same as age of majority. For instance, in Victoria, Australia, there is a hard age of consent of 12 years old. Between the ages of 13 and 15 you must be within 2 years of them. And then regular rules apply after 16. But the age of majority is 18. – Gregory Currie Mar 24 '22 at 12:54
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    @csstudent1418 There are different age requirements for different activities. e.g. Legally to have sex or drink a beer in a pub (with an adult and as a part of a meal) it's 16 whereas one has to be 18 to vote, buy cigarettes etc. and 21 to adopt a child. –  Mar 24 '22 at 12:59
  • In Australia, medical records are hidden by default from parents at 14 years. Before that you cannot have access to your child's medical records unless they are on your medicare card or you both visit a General Practitioner. It is a major worry where vaccinations are required for school and benefits. Also in many countries you are considered to be an adult at marriage. To simplify income support and drafting of legislation, Australia generally does not allow celebrants to marry persons under 18 within the country. This does not preclude you traveling to NZ or SKN. – mckenzm Mar 24 '22 at 17:55
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Parental consent is normally needed for any intervention made on a minor but two topics are exception, in which they incur secrecy and never needing parental consent, birth control and IVG (Voluntary Abortion)

As per article L5134-1 of the Code de santé publique (Law for public health)

I.-Le consentement des titulaires de l'autorité parentale ou, le cas échéant, du représentant légal n'est pas requis pour la prescription, la délivrance ou l'administration de contraceptifs aux personnes mineures.

La délivrance de contraceptifs, la réalisation d'examens de biologie médicale en vue d'une prescription contraceptive, la prescription de ces examens ou d'un contraceptif, ainsi que leur prise en charge, sont protégées par le secret pour les personnes mineures.

Translation and emphasis mine

I.-The consent of the holders of parental authority, or, if applicable, the legal representative is not needed for the prescription, issuance or administration of birth control for minors

The issuance of birth control methods, lab exams for the prescription of birth control, prescription of these exams or birth control and the covering of care costs are protected by medical secret for minors

Nicolas Formichella
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  • Out of curiousity, what is different for patients over 26? Or is the medical privacy an exception for that younger age range specifically when related to the topic of birth control? – fyrepenguin Mar 24 '22 at 10:41
  • Practitioners are required to ask parental consent for all acts they provide on minors, except for birth control and IVG (abortion) where full secrecy is maintained. I didn't explain that 26yo mark because it is for coverage of the fees (all acts related to birth control and most medications are free for 26yo and younger), which is out of topic in this question – Nicolas Formichella Mar 24 '22 at 10:47
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    @fyrepenguin I have removed the part and reworded my answer – Nicolas Formichella Mar 24 '22 at 10:57
  • "Interruption" is an interesting word. Can it be resumed? – Andrew Leach Mar 24 '22 at 11:52
  • No, it's a litteral translation of french's Interruption Volontaire de Grossesse = Voluntary Abortion, you're right that that can be confusing, I'll touch that word up – Nicolas Formichella Mar 24 '22 at 13:09
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In South Africa a girl can request birth control without the need to have permission from parents at the age of 13.

This is not a right specifically given to girls. A boy can also request to be circumsised without a parents permission at age 13.

In general a person's right to choose over his or her body is not predicated on a parent's opinion.

This conduct is regulated by the HPCSA (Health Professions Council of South Africa). The statutory body dealing with the various medical professions.

Although if she tries to obtain birth control from a private facility they may refuse her access to the drugs if she cannot pay for them. If she goes to a government clinic there is no such problem.

David Siegel
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Neil Meyer
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  • This answer raises questions like: (1) Why does the first sentence specifically say “girl”? (2) What does circumcision have to do with birth control? Also, this answer is about consent, but the question was about privacy. – Brian Drake Mar 26 '22 at 09:26
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tl;dr:

Generally, yes. The doctor may not inform the parents against the patient's wishes, as long as the doctor considers the patient to be "sufficiently mature", which is generally accepted for patients aged 14 and older.

Details:

In Germany (as in most other countries), medical professionals are generally required to respect a patient's privacy. Violating a patient's privacy is punishable with up to one year of imprisonment (Strafgesetzbuch §203).

In principle, this applices even if the patient is a minor. However, the parents or legal guardians may be informed and must consent to treatment if the patient lacks the maturity (Einsichts- und Urteilsvermögen - literally ability for comprehension and judgement) to make an informed decision (see e.g. Bei jungen Patienten lauern juristische Fallstricke).

In practice, the medical professional must make an individual judgement whether the patient posesses the required maturity. If they do, patients may take decisions alone, both on what treatment they want and who may be informed about it. This is a difficult area for the professional, because there are no fixed rules for assessing maturity. However, it is generally recognized that patients 14 years and older usually are sufficiently mature.

The standard is also different depending on the seriousness of the decision in question. For example, if a major intervention is planned, the legal guardians may have be informed even if the patient is considered mature - on the other hand, medically minor interventions may be performed without the consent or knowledge of the parents. Prescription of birth control pills would probably not be considered a major intervention, since it is a widely practiced treatment where serious side effects are rare.

sleske
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