Health Professionals: The Gatekeepers In Youth Health Care

Young people deserve respectful, culturally competent care when accessing basic health care services. But some find a trip to the doctor winds up more like a stint in the principal's office.

At 19, Angela found herself in a monogamous relationship with a partner she had been with for 2 years. Making, what she felt was, a responsible decision she went to her family doctor to ask about birth control. Instead of being informed and educated, what she encountered was a physician who took it upon herself to levy a moral judgement. Angela's doctor told her that she was too young to be having sex, and to leave her office immediately and never come back for such a request, unless she wanted her parents to become informed of her "activities".

Unfortunately this situation is all too common with youth, where they are told they are too young to make a decision for themselves about sex, and have another's judgment imposed. Fortunately for Angela, she knew that she could go to another clinic, another physician who would help her access contraception. But what of those who are not able to make this choice? Youth in small towns across Canada who often have access to only one physician, or one health care facility, are in danger of becoming a statistic in teen pregnancy and/or sexually transmitted infections. In my previous blogpost I focused on the barriers that young women face when trying to access safe abortion care. More broadly, what about youth and sexual health?

Sexual health clinics, Planned Parenthood offices, and even the internet can provide unbiased, scientifically based information. However, not all youth can access these services. That is why it is imperative that all health professionals are trained properly in dealing with youth sexual health issues. When we talk about health professionals, we are not referring only to physicians, but nurses, hospital and clinic staff, and pharmacists. Over the past five years a popular chorus amongst anti-choice people has emerged — that all individuals have the right to object to giving out contraception, or even information, based on their personal religious beliefs. This is true. However, it is the duty of every health care professional despite the position that they hold, to refer a client to an individual or facility that will give them the information they are looking for, and not to impose judgement. In Canada, pharmacists and pharmacies can choose not to stock or give out emergency contraception (EC) (due to the misconception that EC is an abortion pill). In these cases they should (Note: they are not required to by law) refer the customer to another pharmacy that does carry EC.

So why aren't youth being allowed to make their own choices? Mainly because the attitude that youth are not capable or informed enough to make their own choices still exists. But I ask how can youth become informed and educated if they are not given the chance to do so? With gatekeepers imposing their own morality and ethics, youth are not even given the chance to ask questions. Even worse it is anecdotes such as the one above that discourage youth from accessing services because they become afraid that their privacy and their choices will not be accepted which can lead to engaging in risky sexual behaviour. In Angela's case her doctor could have given her information on contraception and STIs, so that she would be educated enough to make an informed decision. Health professionals should always attempt to give scientific and unbiased information. If they can't, then they have a duty to refer their client to someone who can.