With young children, parents often provide moral support and literal hand-holding during doctor’s visits — taking notes, answering questions, making decisions. And after years of this, we’re often shocked when we’re eventually asked to step outside so a doctor and teen can talk privately.
What’s being discussed? How do we navigate this new dynamic? Will we be frozen from future conversations? Don’t worry — the prognosis is good.
“We still really, really want to include parents, because they’re the ones interacting with the child 24/7,” says Dr. Darla Klokeid-Foulston, a family medicine provider at The Polyclinic. “It’s just important that teens become comfortable advocating for themselves and forming opinions. It’s an opportunity to ask questions and isn’t necessarily a conversation about something dire.”
All 50 states have some form of teen consent laws, those that allow minors to make specific health decisions without parental involvement. Among the legal parameters for teen consent in Washington state:
- There is no minimum age for receiving reproductive health services, such as contraception.
- Teens 13 years and older can seek inpatient or outpatient treatment for substance abuse.
- Kids 13 years and older can consent to inpatient and outpatient mental health treatment.
- Adolescents 14 years and older can receive testing and treatment for sexually transmitted infections.
- Anyone who is legally married, even those younger than 18, is no longer considered a minor and is responsible for all health decisions.
“The most prominent myth with parents is that these laws encourage bad behavior, that kids will automatically start sneaking around doing things they’re not supposed to,” says Dr. José Mendoza of Pediatrics Northwest. “I argue against that. These laws protect teenagers and facilitate their good health and ability to seek help.”
More than a number
If your teen can seek his own medical care, it’s normal to worry that you’ll be cut from the conversation. In reality, many experts consider teen-led medical discussions to be an opportunity to establish more mature communication for the whole family.
“From a neuro-developmental standpoint, [teenagers] are at an age when they start differentiating from their parents and developing their own values and opinions,” says Klokeid-Foulston. “Cognitively, they’re doing more abstract thinking, asking more questions and having more complex conversations.”
Adolescence also presents more opportunities for risky behavior — sex, drugs, alcohol. A teen may not feel comfortable discussing those issues with a parent, so a trusted physician can provide some much-needed objectivity and a wealth of information.
It’s not always sex and drugs. Sometimes it’s a benign question about ‘Why am I sweating more?’ or ‘Is it normal to be growing hair in these places?’
“Even in the best situation, there is an inherent power imbalance between parent and child, since the parent provides feedback on behavior,” says Klokeid-Foulston. “I won’t be judgmental and can just be a resource.”
While it’s easy to assume a private consultation automatically means your teen is in trouble, in truth, young adults are like all patients. Sometimes they just need privacy.
“It’s not always sex and drugs. Sometimes it’s a benign question about ‘Why am I sweating more?’ or ‘Is it normal to be growing hair in these places?’” Klokeid-Foulston says. “I want to help them to have the space to develop self-confidence to ask a provider questions.”
Perhaps the most important benefit of giving teens more autonomy is that soon, you won’t have a choice.
“A lot of these kids will leave the nest shortly after turning 18 and they’ll be expected to make adult decisions,” says Dr. Emily Diana Kerins Ruedinger, an adolescent medicine specialist at Seattle Children’s Hospital. “If they go straight from no decision making to [making decisions about] everything, that’s really hard and an unfair expectation.” Consider the teen years as practice, she says.
Laying the groundwork
So, where to begin? First, start talking. Drawing on his own experience with his teenage daughter, Mendoza recommends engaging your teen in conversation about health care. This makes the transition to independent doctor visits easier for both parents and young adults.
“At first, I think she was a little shy to speak up [with the doctor], but we really facilitated her feeling comfortable,” says Mendoza. “She appreciates that trust and recognizing that she is no longer a little girl.”
Also, don’t be surprised if your doctor takes the lead.
“I ask parents to step out for a short time during almost every visit with a teen to normalize the experience,” says Ruedinger. “By the time they’re 15 years old, they’ve practiced the skill of not needing to look at Mom or Dad to prompt them on what to say.”
Regarding topics such as sex, introduce age-appropriate conversations years in advance regarding values, expectations and healthy decision making. This establishes a foundation for having more candid discussions when kids get older.
As a parent, I’d rather my daughter feel comfortable with her doctor and seek help on her own.
“It’s more complex than one day telling a kid, ‘Oh yeah, you can talk to me about anything,’” says Mendoza. “Encourage them to share in other areas of their life: school, friends, the dinner they made. When you reach more difficult subjects, like puberty and reproductive health, talking will come easier to both you and them.”
According to Ruedinger, providers actively encourage transparency between teens and parents. For the most part, Ruedinger finds from her own experiences that most teens don’t want to keep secrets or navigate health care by themselves. They want support within the framework of some independence.
“Generally,” she says, “teens just ultimately want to feel they have some control over their own lives and decisions.”
Mendoza agrees. He encourages parents wary of ceding any oversight to consider the more important issue: their teen’s health.
“As a parent, I’d rather my daughter feel comfortable with her doctor and seek help on her own,” he says. That, he adds, is far better than the alternative: a teen not doing anything.
