Working with doctors Working for patients

0-18 years guidance: Sexual activity

64. A confidential sexual health service is essential for the welfare of children and young people. Concern about confidentiality is the biggest deterrent to young people asking for sexual health advice.32 That in turn presents dangers to young people’s own health and to that of the community, particularly other young people.

65. You can disclose relevant information when this is in the public interest (see paragraphs 47 to 50). If a child or young person is involved in abusive or seriously harmful sexual activity, you must protect them by sharing relevant information with appropriate people or agencies, such as the police or social services, quickly and professionally.

66. You should consider each case on its merits and take into account young people’s behaviour, living circumstances, maturity, serious learning disabilities, and any other factors that might make them particularly vulnerable.

67. You should usually share information about sexual activity involving children under 13, who are considered in law to be unable to consent.33 You should discuss a decision not to disclose with a named or designated doctor for child protection and record your decision and the reasons for it.

68. You should usually share information about abusive or seriously harmful sexual activity involving any child or young person, including that which involves:

a. a young person too immature to understand or consent

b. big differences in age, maturity or power between sexual partners

c. a young person’s sexual partner having a position of trust

d. force or the threat of force, emotional or psychological pressure, bribery or payment, either to engage in sexual activity or to keep it secret

e. drugs or alcohol used to influence a young person to engage in sexual activity when they otherwise would not

f. a person known to the police or child protection agencies as having had abusive relationships with children or young people.34

69. You may not be able to judge if a relationship is abusive without knowing the identity of a young person’s sexual partner, which the young person might not want to reveal. If you are concerned that a relationship is abusive, you should carefully balance the benefits of knowing a sexual partner’s identity against the potential loss of trust in asking for or sharing such information.