Sex & the Law: The Fraser guidelines

Despite the fact it isn’t legal to have sex until you are 16, young people can still access sexual health services at any age. So for example there is nothing to stop a young person visiting their doctor, or a sexual health service to ask to be put on the pill or to get a bag of condoms, or even just to have a chat if they fancied. They have the right to do all these things, they can even access emergency contraception or have an abortion without their parent’s knowledge or consent if they wished.

Personally, the thought that my daughter could have an abortion without me knowing not only scares me, but also makes me feel very sad – however as a sexual health professional I am proud of the fact, as it is one of the most important rights young people have in regards making choices for themselves and taking control of their own lives. Whilst it may be scary from a parent’s point of view, if you think about it, it all makes sense.

It may be illegal to have sex when under the age of consent, however, if we turned away a young person who was brave and mature enough to walk in to a sexual health service and ask for condoms in order to take responsibility for their sexual health and their partners, it would just be stupid. If anything we should pat them on the back and say well done. To be honest, this is what we want – we want young people who can step up and take responsibility for themselves and make their own informed choices. Even if you are rocking up to say, ”hey, I made a mistake last night and I need help to sort out the consequences”, you are still taking responsibility for what has happened and that can only be a good thing.

Now if a young person wants to access a sexual health service the workers there have to see if they are what we call Fraser competent. This basically means that they understand the advice that they are given and able to make informed decisions for themselves.

In the mid 80s there was a famous court ruling by a judge called Lord Fraser and this is where the guidelines come from. Basically, what happened was that a mother called Mrs. Victoria Gillick, took her local health authority to court in 1985. She was upset when she found out her daughter had been put on the contraceptive pill by her doctor without her knowledge.

As a mother she felt it was her right to know what her child was up to and if she was using contraception. She claimed that the doctor and the health authority had acted inappropriately, as her daughter was under 16 at the time.

Fortunately, the House of Lords’ ruled against Mrs. Gillick, as they thought it was in the best interest for young people to be able to seek confidential advice and treatment, rather than having sex without using precautions, just because they thought they would get in trouble or their parent’s might find out.  As a result Lord Fraser set out the following criteria for giving contraceptive advice for young people, these are commonly known as the Fraser Guidelines:

• the young person can understand the health professional’s advice;

• the health professional cannot persuade the young person to inform his or her parent;

• the young person is very likely to begin or continue having intercourse with or without contraceptive treatment;

• unless he or she receives contraceptive advice or treatment, the young person’s physical or mental health or both are likely to suffer;

• the young person’s best interests require the health professional to give contraceptive advice, treatment or both without parental consent.

Simply put these guidelines mean young people have the right to access sexual health advice and treatment without their parent’s knowledge or consent. It is completely confidential, so the doctor isn’t allowed to then phone to young person’s folks and tell them what you’ve been in for the second they leave the room. However, most decent health professionals will encourage a young person to try to talk to their parent’s about their relationships, or encourage you to find someone you can confide in, as having a good chat is the most important protective factor for a person’s emotional health.

The only time a professional should ever break confidentiality with is if they are worried that a young person is at risk of harm or risk of harming another person. So for example if they suspected a young person was being abused. As professionals we have a duty of care to make sure all young people are safe. Usually, it is good practice for the health professional to explain to the young person that they were planning on breaking confidentiality before they do so. Having and keeping young people’s trust is essential so we never break confidentiality lightly – otherwise young people would never come and talk to us.

However, most services have a cut-off point at 13yrs old –  sex with a young person below the age of 13 is seen as far more server in the eyes of the law and most services would see a sexually active under 13 as an automatic concern for child protection procedures.

That being said: seeking advice, having a chat or being nosey is not a case child protection. Asking for a bag of free condoms does not mean a young person is at risk of harm – in fact most professional think the sooner you play with condoms, even if they are merely blowing them up or sticking them on your head the better!  Oh, and just because a young person is having sex underage does not necessarily mean that they are at risk of harm.

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