“We make it a strict point to uphold their confidentiality,” says Dr. Marks, who stresses that this trust between doctor and patient makes it easier to discuss touchy, yet crucial, subjects and get truthful answers to tough questions. “It is a scary time, when your child is maturing, starts experiencing the outside world and, at the same time, becomes more private. At the first visit (often, at follow up visits), I tell my patients that what they share with me is completely confidential, except if the matter is very serious, in which case we will talk together about how to inform their parents. I assure patients that I will never call their parents behind their backs. At the end of the first visit, I have parents join the conversation, and repeat this policy and assure parents that they may call me, but should always tell their child first. My threshold for involving parents depends on the patient’s age, maturity, stability, and other factors. It usually works out fine.
“This way, the teen knows that the doctor and their parents may speak to each other, but only with the child’s knowledge. Likewise, parents know that they will be informed if something serious is going on.
Many times, these doctors can simply take the stigma out of awkward health issues for teens by explaining that they are a normal part of growing up, opening the door to future communication between the parent and child.
Embarrassment over certain health issues can lead to avoidance, and lack of care. A study conducted by the University of Rochester of more than 6,700 teenagers found that one third did not get the medical care they needed, often because they were afraid to tell their parents about health-related problems, such as depression, sexuality, or puberty-related concerns.
Getting the Care They Need
There are many situations where a teen wants care but won’t go because she’s embarrassed, she thinks her parents will be angry, or family issues are very complex and she fears the consequences. For example, a girl who has irregular menstrual periods may fear she is pregnant, but may be unwilling to ask for a doctor’s appointment because she fears her parents’ disapproval.
But it is crucial that young girls get regular medical care. Data from the Alan doctor Guttmacher Institute, a nonprofit organization focused on sexual and reproductive health research, shows that nearly 61 percent of all teenage girls have had sex by the time they turn eighteen, and that over one-fifth of all cases of STDs in the US are contracted by adolescents and young adults. Many STDs have no symptoms and, without proper medical diagnosis, can increase the risk of cervical cancer and fertility problems in the future.
Sex isn’t all that the experts worry about. A 2004 National Survey on Drug Use and Health showed that more young women than men started using marijuana, alcohol, and cigarettes in the previous two years. According to the National Center on Alcohol and Substance Abuse at Columbia University, male and female ninth graders are just as likely to drink (40 percent vs. 41 percent) and to binge drink (22 percent vs. 20 percent). More girls than boys start smoking cigarettes as teens, often believing it will help to control their weight. It is well known that the vast majority of those with debilitating eating disorders are adolescent girls.
