Sexual Health

legal considerations

With an Adolescent Lens

Minor Consent and Confidentiality:

  • Many states allow minors to consent to STI testing/treatment, contraception, and sexual health counseling independently.

  • Confidential one-on-one time should be standard practice in every adolescent visit.

  • HIPAA defers to state law on parental access to adolescent health information.

  • Confidential services may still be visible to families via the patient portal or billing systems.

Explanation of Benefits (EOB) & Billing Risks:

  • EOBs can reveal test results, medications, or visit types to parents/guardians, even when care was confidential.

  • Counsel youth on potential disclosure through insurance billing.

  • Contact billing departments or insurers for confidential communications requests, where available.

Mandatory Reporting:

  • Providers are legally required to report suspected abuse, neglect, sexual exploitation, or trafficking.

  • Know your state’s reporting thresholds, timelines, and procedures.

  • Clarify these limits during the confidentiality explanation with adolescents.

  • Refer to your states legal guidelines for additional specifics and policy standards within your health system.

Navigating Parental Involvement:

  • Explain to parents: “We spend part of every adolescent visit privately to help them learn to manage their health.”

  • When minors consent to care independently, parents may not automatically access those records.

  • Review local clinic/EHR settings for proxy access and information release workflows.

Reproductive Rights and Pregnancy Options:

  • Access to abortion, contraception, and pregnancy care varies widely by state.

  • Some states require parental notification or consent, with judicial bypass as an exception process.

  • Support adolescents in locating accurate, safe, non-judgmental resources.

Telehealth & Digital Privacy/literacy:

  • Adolescents may not have a private space at home; confirm privacy before sensitive discussions.

  • Shared family devices or portals may compromise confidentiality.

  • Review safe contact methods (private phone, secure messaging, clinic follow-up).

Staying Legally Current:

  • Laws vary state-to-state and change frequently.

  • Use reliable legal summaries or institutional counsel to stay up to date.

  • Develop clinic policies and workflows that comply with current state law.