Aug 182017

Last week, a boy contacted me through our Facebook page and said that he and a friend believed they had tulo or gonorrhea. He said his friend got it from a bakla (gay person) and that he got it from a girl. He was worried because pus and blood had started coming out of their penises. He refused to go to a doctor and was hesitant to come to our office. He said they felt ashamed and he kept peppering me with questions about various medicines that he’d heard could cure tulo. He also asked if it was true that when blood comes out of your penis, that you must have AIDS. I explained as much as I could over messenger and kept urging him and his friend to access services from our clinic.

The two boys finally came to our office. We facilitated a referral to a doctor who diagnosed them both with gonorrhea after taking samples of their discharge. The doctor prescribed them each a dose of antibiotics in order to treat the infections. They are 17 and 13 years old.
Doctors are bound to the Hippocratic oath which includes the directive to “do no harm”. Doctors can give proxy consent for minors accessing healthcare when denying them treatment would lead to harm and serious repercussions. In some HIV testing centers, doctors also give proxy consent for a minor to be tested for HIV if the minor believes he or she has been exposed to the virus. Denying a minor access to a test that could then connect them to lifesaving medicine would do harm. Thus the proxy consent. It is not clear to me if only doctors and social workers have this privilege or if nurses and midwives can do the same.
Why is this necessary?

When the Supreme Court upheld the constitutionality of the Reproductive Health Law, it did so only after removing the right of minors to access reproductive health services without informing their parents. The Supreme Court held that parents had the right to consent to their children’s reproductive health activities and thus require parental consent for minors for access to contraception and to HIV testing.

I am a parent. I think in theory requiring parental consent is great. I hope that my kids consult me before making important and potentially risky decisions, such as starting sexual relationships.In reality though, when young people start having sex, they do not usually confide in their parents and will not ask them for permission to use contraception. This too often results in unplanned teen pregnancy, and in sexually transmitted infections like gonorrhea, chlamydia and HIV. There is no law prohibiting young people from having sex after all.

In the Philippines, 23% of teens begin having sex before age 18*. Here in Puerto Princesa there are a few cases of girls as young as 13 getting pregnant. Current parental consent laws leave boys and girls unprotected by contraception and unable to access life-saving tests like the HIV test for years. It is no surprise that 20% of our pregnancies are to teens and that 95% of People Living with HIV in Palawan are categorized as young people.
I’m not sure how I feel exactly about parental consent. On the one hand I see the need for protections like this because children need their parents to care for them, and parents have a right to make important decisions for their kids. But on the other hand, when it comes to health, I see the harm in requiring parental consent for things like contraception and HIV testing. If kids are exhibiting health-seeking behavior and they are trying to be more responsible by protecting themselves when having sex, or are trying to find out if they have a deadly disease, do they really need their parents to first approve? I wish that not having access to contraception would stop people from having sex but that is not the reality. When kids are having sex and there are barriers to contraception, they simply go without.

I hope that my kids will not start engaging in sex early. I don’t want them to be exposed to potential infections, unwanted pregnancy and the myriad emotional and mental issues that come with sex. But if they do start having sex early, I want them to protect themselves and if they felt they couldn’t talk to me about it, I hope another adult would give them the consent they’d need to access contraception and STI testing and protect their health.

What do you think? If you support parental consent for contraception and HIV testing, what do you think some ways are to address the fact that these laws leave sexually active young people vulnerable? I’d love to hear your thoughts!

*Young Adult Fertility and Sexuality Study in the Philippines. 2013


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