The shift in medical privacy rights for teenagers upon reaching the age of 13

13 and Growing: Navigating Your Teen's Medical Freedom in Washington

As a parent, you might find yourself navigating uncharted waters when your child turns thirteen. Suddenly, their once open book can feel like a mystery, and you might wonder about the services they can access without your permission. Well, buckle up, because we're about to help you demystify your teen's medical privacy and the services they can access without your consent.

(Insight: Minors in Washington can access services such as birth control, abortion, STI treatment, mental health treatment, and substance abuse treatment without parental consent. They can also receive emergency care.)

In Washington, the government safeguards your teen's medical privacy to ensure they can discuss sensitive issues without fear of judgement or interference. This is particularly important for reproductive health, mental health, and substance abuse issues, where studies show that youth are more likely to seek care and receive services when parental notification is not required[1][2].

(Insight: Minors can access reproductive, mental health, and substance abuse services without parental consent, and this allows them to feel more comfortable discussing these issues with healthcare professionals.)

Confidentiality Kicks in at 13 for a Reason

When your child turns thirteen, your access to certain parts of their medical records will be restricted. This can be a tough adjustment for families who are used to easily accessing that information. But rest assured, the state's laws on minors and healthcare access are designed to protect confidentiality between teens and their healthcare team, ensuring they get the care they need regardless of their family situation.

"The laws recognize a right to privacy and autonomy around mental and reproductive health for teens, and we want to follow the law and provide the best care for our patients," says Dr. Julian Davies, a pediatrician at the Pediatric Care Center at UW Medical Center - Roosevelt and a UW School of Medicine clinical professor of general pediatrics.

Now let's get down to brass tacks: Here are some of the services that minors can access without your consent in Washington:

At age thirteen, minors can make decisions about inpatient and outpatient mental health services, seek either outpatient or inpatient substance abuse services, and, in some cases, get consultations related to gender identity without an authorized adult's consent[2].
At age fourteen, minors can make decisions about receiving STD tests and treatment[2].
At any age, minors can get birth control, have access to abortion-related services or receive prenatal care[2].

(Insight: Minors can make decisions regarding their mental health, substance abuse, STD tests, treatment, birth control, and gender identity without parental consent in some cases.)

Keep in mind that, while minors generally have autonomy over the services listed above, certain services still require parental consent for patients under the age of 18. For example, gender-affirming medical treatments like puberty blockers and hormone therapy usually require parental consent[2].

## Changing Access to Online Medical Information

When it comes to digital access to your teen's medical history, you will still have "proxy access" to their account when they turn thirteen, which means you will still be able to message their care team, view, schedule, or cancel upcoming appointments, refill medications, view immunization records, and update insurance information[2].

However, proxy access won't allow you to view healthcare information related to the kinds of care that Washington allows teens to access without parental consent, such as reproductive and sexual healthcare, mental health care, and substance use care[2].

Parents can still request copies of notes and labs via MyChart messaging, and clinicians will determine what they can share or if they need to redact sensitive information[2].

When the Rules Change

There are a few exceptions to the standard rules for parental access to minors' medical records. These include:

Cognitively Disabled Minors: In some cases, caregivers of cognitively disabled adolescents can have full access to their medical records[1].
Emancipated Minors: Children who are emancipated have full control of their medical records[1].
Married Minors: Minors who are married to a legal adult can receive healthcare services without an authorized adult's consent[1].
Mature Minors: In some cases, teens can be determined to be mature minors, which allows them full control of their healthcare decisions without parental consent[1].

Embracing the Change for the Best

It's natural for parents to feel anxious about the changes that come when their kids turn thirteen, but there's no need to panic. Instead, view this as an opportunity for your teen to develop independence and make their own decisions.

"It's great for teens to develop a more independent relationship with their care team as they approach adulthood," says Dr. Davies, adding that "they will soon be responsible for all aspects of their health."

Remember, your teen's care providers are obligated to break confidentiality if they believe your teen is in imminent danger or at risk of harm. In such instances, they will discuss the limitations of confidentiality with your teen before disclosing any information[1].

Balancing the needs of both parents and teens can be a delicate task, but your pediatrician wants to keep you involved in your teen's care.

"We welcome parents to share their concerns directly with us, even if our replies are constrained by confidentiality," says Davies. "We prefer shared decision-making with teens and their parents around mental and reproductive health when possible and safe."

Don't be afraid to ask questions and partner with your teen's pediatrician during this transition period. Embrace the change and help your teen learn to advocate for themselves, because soon enough they'll be taking charge of their own health.

(Insight: Parents can help their teen navigate the transition by asking questions, supporting their relationship with their doctor, and understanding the limits of confidentiality.)

(Sources: [1] HealthColor [2] UW Medical Center - Roosevelt)

During the teen years, your child may seek confidential healthcare services for reproductive health, mental health, and substance abuse without your consent, as safeguarded by Washington state laws to ensure teens can discuss sensitive issues freely.
When your child turns thirteen, they can make decisions about inpatient and outpatient mental health services, seek substance abuse services, receive STD tests and treatment, access birth control, and have conversations about gender identity without an authorized adult's consent.
Mental and reproductive health services are important areas where minors are more likely to seek care and receive services when parental notification is not required, according to studies in the health-and-wellness and mental-health fields.
As a parent, understanding the new access to your teen's medical records can help you navigate services your teen can access without your consent and collaborate with their healthcare team in a supportive manner, adhering to the principles of confidentiality and shared decision-making.