Every now and again, a story about young people and contraception hits the headlines. My ears always prick up when I hear the phrase "children as young as [insert teeny number] could be..." because I know that whilst it's important to focus on what the youngest and most vulnerable young people may need, these stories are often distorted to generate moral outrage. In the same way that an 11-year-old in a secondary school 'could be' set a maths GCSE paper, it would be fairly peculiar to do so unless there were unusual circumstances and, in fact, the GCSE paper would much more reasonably and sensibly be given to an older child.
Bearing this in mind, our starting point should be to acknowledge that most young people who are under the age of 16 are not having sex and do not require contraception. Furthermore, evidence shows that high quality sex and relationships education, provided by parents and at school, combined with access to free, confidential sexual health services, helps delay the age young people first have sex and means they are more likely to use contraception when they do. In other words, we do best for young people if we offer them a comprehensive set of information and services before they become sexually active.
Of course, we also need to make sure we are providing appropriate guidance, support, information and services to young people who are sexually active. Young people, both under and over 16, have a right, enshrined in law, to a confidential consultation with a health professional independently of their parent/carer. When asked, the vast majority of parents would much rather that their children had access to support from a trained healthcare professional, than being denied access to information and services that they need.
Just as we must trust maths teachers to deliver GCSE maths, we must also trust that, wherever it is delivered, contraceptive advice and treatment is provided by suitably qualified professionals working to strict professional and legal standards (including the Fraser guidelines). We are not talking here about dinner ladies popping in an implant during the lunch break. We are talking about the provision of services by doctors or nurses - the only people allowed to fit implants.
In order to provide services, the professional must be satisfied that the young person understands the decisions they are making and they are the young person's best interests. They will need to assess the young person's capacity to consent to the treatment and they will also usually encourage the young person to talk to their parents/carers. They will also be using their professional judgement to consider the young person's circumstances, the risk of harm they are exposed to, whether they are in a safe relationship, whether they are being exploited and their vulnerability to other dangers. All this as they encourage a young person to trust them enough to share their fears and needs.
In some cases, after that process has been gone through, the professional will judge that it's appropriate for a young person - even one who is 13 - to be fitted with an implant.
At Brook we know how important it is to trust young people, and for young people to trust us, in order to work effectively with them to be sure they are not being coerced into sex and are able to properly consent to sex and take responsibility for their sexual choices. We also know just how important it is to be able to trust the professionals responsible for these decisions and to recognise that they are often dealing with multiple risk factors and indicators of vulnerability when they make these important assessments.
I talk to sexual health professionals every day. All of them have a real desire to ensure that young people are protected and safe from harm, to help them to negotiate their relationships safely and to only have sex when they are genuinely ready. They do an amazing job, these professionals, and they need our support to do that.
No-one wants to undermine parents/carers but we need to accept the fact that young people have a right to seek confidential information and advice. It may be that some young people are not able to go safely to their parents/carers - another factor in their vulnerability. It is better that they are able get the support they need than to go without and make decisions which they may later regret or end up in risky situations.
I want young people to be safe and not to have sex too early or have relationships that will hurt them. Providing young people with a whole range of support, information, advice and services is vital to enable them to have healthy relationships. Not to do so, and not to support the professionals that do so, is simply wrong.
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