55.004 Adolescent Sexual Activity: (1) The role of the physician – Physicians who treat adolescents have a responsibility to address or refer a patient with concerns related to sexual identity and positive self image. Comprehensive health care for adolescents must address issues related to reproductive history and sexual activity. Physician offices should be welcoming to all adolescents, regardless of sexual orientation or gender identity.
Without being morally judgmental, the physician can help adolescents identify their own goals for safe and responsible sexual behavior. The physician’s nonjudgmental recognition of patients’ sexual orientations, sexual behaviors, and gender identities enhances the ability to render optimal patient care in health as well as in illness. In the case of lesbian, gay, bisexual, and transgender (LGBT) patients, this recognition is especially important to address the specific health care needs of people who are or may be LGBT.
Physicians who treat adolescents should provide counseling and treatment or a referral for adolescent patients with respect to sexual development, sexually transmitted disease, birth control, and pregnancy. Adolescents should have a confidential adolescent psychosocial history. Verbal histories and/or written questionnaires should use a gender-neutral approach. Screening and referral for depression, suicidality, other mood disorders, substance abuse, and eating disorders should be included.
(2) The role of the Texas Medical Association – TMA can contribute substantially to the promotion of adolescent health by (a) sponsoring continuing medical education for physicians and health care providers at annual sessions and preparing reports and facilitating formal presentations concerning adolescent sexual activity; (b) encouraging medical schools in the state to engage in research and training in all aspects of adolescent health, including adolescent sexuality; (c) promoting interdisciplinary dialogue and networking on public health and public affairs issues involving the promotion of improved care for adolescents and comprehensive health education; (d) utilizing Texas Medicine and other media as a forum for the promotion and discussion of all adolescent health issues including, but not exclusively concerned with, adolescent sexuality; (e) developing educational materials (i.e. anticipatory guidance/discussion with parents); (f) serving as a resource to public schools and agencies creating programs and strategies to educate our youth; (g) educating physicians on the current state of research in and knowledge of LGBT health and the need to elicit relevant gender and sexuality information from our patients; these efforts should start in medical school but must also be a part of continuing medical education; and (h) educating physicians on the health disparities that exist for sexual minority youth.
(3) Legislative initiatives – TMA should advocate for: (a) state adoption in statutory form of the “mature minor” doctrine and elimination of other statutory barriers to adolescents accessing health care; (b) the following principles regarding adolescent pregnancy when it is the subject of legislation: (1) access to early and accurate diagnosis of pregnancy; (2) professional counseling describing the gestational alternatives; and (3) support of already existing TMA guidelines regarding abortion, which base its performance on early and accurate diagnosis of pregnancy, informed and nonjudgmental counseling, prompt referral, skillful and understanding personnel working in a good facility, reasonable cost, and professional follow-up; (c) funding at the state and local levels to be established for student-oriented primary care clinics and/or school-linked comprehensive health care for adolescents; and (e) funding to be established for STD and AIDS research, treatment, and support services for adolescents. (Council on Public Health, p 76, I-91; amended Res. 304-, 305-, and 306-A-01; amended CCAH Rep. 4-A-10; amended CM-CAH & TF Rep. 4-A-17).