According to the Alan Guttmacher Institute, a nonprofit organization focused on sexual and reproductive health research, about 50% to 60% of adolescents under the age of 18 have had sex.
In 2001, an estimated 917,000 girls younger than 18 visited federally funded family planning clinics. Clinics that receive certain types of federal funding are required to provide confidential contraceptive and sexually transmitted disease (STD) services to minors. But some lawmakers would like to make parental notification mandatory for minors trying to get prescription birth control.
Those who support parental notification contend that the legislation would discourage many teenagers from having sex. Opponents suggest that it would simply deter teenagers from seeking medical services for contraceptives or STDs. Little is known about how many parents are already aware that their children are seeking sexual health services, or about how teenagers would respond to laws making parental notification mandatory.
In a study published in the January 19, 2005 issue of the
Journal of the American Medical Association
, scientists surveyed a national sample of teenage girls who were obtaining sexual health services from publicly funded family planning clinics. They found that more than half of the adolescents’ parents knew that they were visiting the clinic, and why. Most of the young women said they would continue to use the services of that clinic even if parental notification was mandatory. However, almost one-fifth of the adolescents said they would engage in risky sexual behavior, such as no contraception or the withdrawal method, if parental notification were required for prescription birth control.
About the Study
Researchers from the Alan Guttmacher Institute distributed confidential questionnaires to female patients younger than 18 years of age seeking sexual health services at publicly funded family planning clinics across the United States. They analyzed data from 1526 completed surveys.
The questionnaires asked whether a parent or legal guardian knew that the patient was visiting the clinic for birth control or other sexual health services. The adolescent girls were also asked how they would react if their parents had to be notified in writing in order to receive prescription birth control.
The researchers found that 60% of the patients’ parents knew that they used the clinic for sexual health services. Fifty-nine percent of the girls said they would continue to use the clinic for prescription birth control even if parental notification was required. This response was significantly more common (79% versus 29.5%) for girls whose parents already knew they were visiting the clinic. On the flip side, 70% of the adolescents whose parents did not currently know they were visiting the clinic said they would not come to the clinic for prescription birth control if their parents had to be told.
Forty-six percent of the girls said they would use an over-the-counter method of birth control, such as condoms, if parental notification was required. Patients whose parents did not know they were visiting a family planning clinic were significantly more likely to have this response.
Patients were allowed to give more than one answer to each survey question, and more than one-third did so. For example, 7% of the girls said they would stop having sex if parental notification was mandatory, but only 1% said this would be their only response.
If parental notification was mandatory, 18% of surveyed teenage girls said they would practice unsafe sex, including no contraception or the withdrawal method. Finally, 5% of the girls said they would not seek STD testing or treatment if parental notification was required for prescription birth control.
This study was limited by the possibility of inaccurate responses; for example, adolescents may have falsely stated that their parents knew of their visits because they mistakenly thought they needed to say this in order to continue receiving confidential sexual health services. In addition, it is impossible to know how well the teenagers’ expected reactions predict how they would actually respond if parental notification was mandatory.
How Does This Affect You?
Mandatory parental notification of sexual health services for minors is a controversial issue. Parents have a legal say in most medical decisions involving their children, yet almost half of the states in the US allow contraceptive services for minors without parental notification.
This study suggests that mandatory parental notification would do little to prevent minors from having sex, and would likely increase the chances of minors practicing unsafe sex. The vast majority of teenage girls who said they would use family planning clinics if parental notification was mandatory were girls whose parents already knew that they were using the clinic.
This study raises as many questions as it answers. Are girls who can discuss their sexual behavior with their parents more likely to have sex, or just more likely to have safe sex? Are teenagers who obtain prescriptions for birth control less likely to use a condom and thus put themselves at greater risk for STDs?
Conversations about sex should be more than a discussion of contraceptive options. Parents should initiate these conversations and use them to communicate their values while encouraging their children to freely express their thoughts, emotions, and fears.
Jones RK et al. Adolescents’ reports of parental knowledge of adolescents’ use of sexual health services and their reactions to mandated parental notification for prescription contraception.
. 2005; 293:340-348.
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