Sexual health information
The Bichard enquiry has emphasised the need for professionals to consider the following points:
“The legal age for young people to consent to have sex is still 16, whether they are straight, gay or bisexual. Professionals need to consider whether there is any possibility of coercion, aggression or drug involvement if a young person under 16 is sexually active. The professional should note the age of the partner in their records and document in the notes the reasons this is felt to be a consensual relationship and not being referred to social services.”
Guidelines on providing contraceptive advice and treatment to under 16s were issued in 1985, as part of Lord Fraser’s judgement. The guidelines specifically refer to contraception, but the principles also apply to other medical interventions. They apply to professionals dealing with health issues in England and Wales.
Lord Fraser guidelines
A young person, under the age of 16, is competent to consent to contraceptive advice or treatment if the young person:
1. understands the choices and their consequences, including risks of treatment. Check on level of knowledge/previous sex education. Obtain feedback from patient to check understanding. Check literacy skills if giving leaflets
2. cannot be persuaded to inform his or her parents or allow the parents to be informed that he or she is seeking contraceptive advice. Can parents be involved in the decision? If not could another adult, eg sibling, aunt?
3. is very likely to begin to or continue having intercourse with or without contraceptive treatment. Is she/he under pressure from peers or partner? Is she/he happy about the relationship or are there doubts? If not yet sexually active discuss possibility of delaying onset of penetrative sex. Discuss implications of sexual activity including STIs, pregnancy, and emotional distress if relationship breaks down etc.
4. unless he or she receives contraceptive advice or treatment the young person’s physical or mental health, or both, are likely to suffer.
5. the young person’s best interests require the doctor to give contraceptive advice, treatment or both, without parental consent.
The young person who presents following sexual assault has needs that involve physical, psychological and legal issues.
- Ensure you have correct details for the young person.
- Acknowledge that this is a difficult time for the young person and explain your plan.
- Ask when this happened and who they have told.
- If the young person is under 16, the professional seeing that young person should follow the child protection route if necessary, and/or follow sexual assault guidelines. See the Sexual Offences Act document: Children and Families: Safer from Sexual Crime 2003.
- Action and support should be identified.
The age of consent
The legal age for young people to consent to have sex is still 16, whether they are straight, gay or bisexual. The aim of the law is to protect the rights and interests of young people, and make it easier to prosecute people who pressure or force others into having sex they don’t want.
Although the age of consent remains at 16, the law is not intended to prosecute mutually agreed teenage sexual activity between two young people of a similar age, unless it involves abuse or exploitation. Young people, including those under 13, will continue to have the right to confidential advice on contraception, condoms, pregnancy and abortion.
The guidance for professionals working with young people under 16 is clearly stated in Gateway ref no 3382 accessed from the Department of Health www.publications.doh.gov.uk and in the Sexual offences Act document Children and Families: Safer from Sexual Crime 2003 http://www.homeoffice.gov.uk/documents/children-safer-fr-sex-crime.