Tips for a First Gynecological Visit with an Adolescent

Are OBGYN visits only needed for sexually active teens? A teen does not need to be sexually active or heterosexual to seek gynecological care from an OBGYN. Doctors are assessing for sexual health concerns, reproductive health, breast and cervical cancer, tobacco or substance use, eating disorders, and other mental health needs. They’re also assessing for intimate partner violence and fertility/infertility concerns. In other words, these providers offer so much!

What’s the goal of the first visit? The goal for the first visit is to provide education, preventive health care, and problem-focused care. This often does not require a pelvic exam. If a pelvic exam is required, the adolescent should anticipate their caregiver and an additional health care chaperone in the room.

Do parents join? A standard of care is for your adolescent to meet with their doctor privately. This allows the doctor to build trust with your teen and to talk about issues they may not be comfortable discussing with you in the room. This is a very important part of the visit to ensure that your teen is getting accurate healthcare. Doctors offer counseling to help teens learn how to talk with their caregivers about their healthcare if they are not ready quite yet. 
But what if parents have questions? If you want or need to speak with your teen’s provider, please make sure to do so BEFORE the doctor meets with your teen. This helps to build better trust with the teen and reassures them that confidentiality is maintained.

Is it confidential? This visit and all visits after are confidential unless the adolescent is a danger to self or others. Medical doctors are under similar reporting laws to therapists. You can always ask your health care provider for details on what is and isn’t confidential.

Seeking trans or gender diverse/expansive specific health care? If your teen is seeking trans or gender diverse/expansive specific health care, it is important to do your due diligence when searching for a provider. Read OBGYN’s biographies to learn about their training and always ask questions. Do not be afraid to request the health care your teen needs.

What if your teen isn’t comfortable during the visit? Consent to treatment can be withdrawn at ANY TIME throughout the visit. This is important to review with your teen beforehand, ensuring them that they can ask to end or request a pause at any point in their appointment. Your teen has the right to feel safe and comfortable at their visit from the minute they walk in the door. This means no invasive questions by front desk staff, pronouns should not be assumed, staff should apologize and be gracious if they make mistakes. If these standards of care are not met, it is important to listen to your teen and honor their needs whatever that may be, including trying a new physician. There are physicians out there who can make this a comfortable experience; there is no reason to stay with a provider if your teen feels unsafe. 

Contraception, Hormones and Healthy Relationships 
Teens can access contraception options through their primary care provider or OBGYN.

* Title X clinics, like Planned Parenthood, offer reproductive and sexual health care for no or low cost. These clinics offer services regardless of insurance status. If a person does not feel comfortable with the primary insurance provider knowing that they are seeking reproductive or sexual health care, they qualify for Family Pact.
* Gender-affirming hormone therapy is not contraception.
* There are specific criteria for PMDD (premenstrual dysphoric disorder) versus MDD (major depressive disorder). Make sure to share with your doctor when you see symptoms occur for your teen; a timeline helps make a more accurate diagnosis.
* Some contraception can interact poorly with certain seizure and mood stabilizers; your teen should know the names or have pictures of the medications they are on when going to an appointment for contraception. 
Additional Resources
* CDC Contraception App– Information on contraception and interactions with certain medications or health conditions 
* Bedsider – Information on birth control, sexual health, and more
* Guttmacher Institute – Overview of current reproductive health policy Planned Parenthood – For information, services, and referrals
* The Center for Transyouth Health and Development Affirming care for transgender and gender diverse children, adolescents, young adults and their families at CHLA
* Los Angeles LGBT Center – Offering health and social services and more
* UCLA Gender Health Program – Offering health services and resources
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