Confidentiality: how it works for minors and conversations with the doctor.

Every medical certification association (the American Academy of Pediatrics, the American Academy of Family Physicians and the American Medical Association) as well as the Centers for Disease Control and Prevention (CDC) understand and support private conversations with a teenager and their doctor without a parent present. There are certain topics — including sex, substance use, gender identity, sexual orientation, relationships, bullying, mental health and family dynamics — that are best suited for this confidential arrangement when the timing is appropriate (usually after age 13 or 14, though the concept can be addressed earlier to prepare families for this “alone time”).

If the doctor sees many teenagers they may be more comfortable bringing up this private time. However, some doctors who don’t regularly see teens or don’t feel that the teen seems comfortable with a private conversation may not even bring it up. It then is up to the patient or parent to bring it up — but this can be tricky. The CDC has a handout for parents on why this alone time is so important for their young adult. There are a few other ways the teen can bring up the concept prior to the doctor’s appointment as well.

Regarding confidentiality, the doctor should keep everything private UNLESS it concerns safety of the teenager (suicidal thoughts, abuse) or someone else (wanting to hurt someone). However, when it comes to issues of mental health, gender identity or sexual orientation, it’s beneficial for the doctor to work with the patient toward open discussions with their family, as family support can be incredibly helpful when facing tough situations.