Health rights of teens are important for every parent to understand. A major task during the teen years is to navigate the balance between autonomy and parental support. Developmentally, teenagers are going through the process of maturing: they shift from concrete to more abstract thinking, they question boundaries, and they start to take responsibility for their own health.
This time can be amazingly fun and extremely challenging at the same time. When it comes to health, teens may seek medical care less often, but when they go, they’ll often be accompanied by parents. The question I hear from teens and parents alike is “How old do I need to be to consent for my own health care? Do I need to be 18?” My answer is “It depends.”
Minor consent laws vary by state, but all states and the District of Columbia have laws that allow teens to consent for special circumstances, such as for mental health care or substance use treatment, without the consent of their parents or legal guardian. The ages vary by state, but I’ll outline to laws for Washington State. It’s important to note that even though the law allows teens to consent for their own care, medical providers almost always encourage them to involve a supportive adult. Our medical system is complicated and decisions about your body and health can be very serious. As providers we balance keeping our teenage patient’s trust with acknowledging their developmental stage and knowing when a parent’s input and support is needed.
- Let’s start with marriage. Anyone who is married can consent for their own health care. A person who is legally married (even if they are 17) is no longer a minor in terms of the law.
- Mental Health: A minor who is 13 years or older can consent for inpatient and outpatient mental health treatment without a parent or guardian.
- Substance Use: Anyone age 13 or older can consent for inpatient or outpatient substance use treatment.
- Sexually transmitted infection (STI) and HIV screening and treatment: Minors age 14 and older can be treated for STI’s without parent consent. This diagnosis and treatment remains confidential.
- Reproductive Health (contraception, pregnancy termination): There is no legal age limit to consent for reproductive health services.
Some or all of these laws may make some parents uncomfortable, but they are in place to protect the rights of teens. Medical providers consider each encounter with a teen on a case by case basis. We consider the patient’s maturity and ability to make rational decisions. If it seems appropriate, we will encourage the teen to talk with parents or bring the parents into the discussion. For example, if a very young teen comes in for mental health concerns and ends up needing to schedule multiple follow up visits and possibly start a medication, we will bring the parents into the discussion in order to get their input and help coordinate a complicated care plan. In certain circumstances (such as a suicidal patient or one who admits to being abused) we always involve the legal guardian.
I encourage all parents to know the laws in their home state. Have open communication with your teen about substance use, mental health/mood, and sexuality. Discuss your family values early and often. When you take your teen in for a yearly or sports physical, tell your concerns, then offer to step out of the room for a few minutes to give your teen a chance to speak with their medical provider alone, then come back in for a summary of the visit. This small act encourages teens to take some responsibity for their own health.