V

Case
A 16-year-old female comes to the clinic alone requesting contraception. She is sexually
active with one current partner and has been using condoms, but would like something
more reliable to prevent pregnancy. She has had one other partner, who she was last with
6 months ago. She has no medical problems and takes no medications. Her parents do not
know that she is sexually active, and she does not want them to know that she is using
contraception. How should you proceed?
Discussion
This patient has a right to make her own reproductive choices, which includes the
decision to take hormonal contraception. She does not require a pelvic exam or (in most
states) need parental consent. If you are not willing to prescribe her contraception or your
employer does not allow it for religious or cultural reasons, you should refer her without
judgment to a clinician who will. You should also discuss safe sex practices with her,
including recommending the continued use of condoms to prevent STIs. Finally, she
should be offered screening for gonorrhea and chlamydia if this hasn’t been done yet,
which is recommended as annual screening for sexually active people < 25.

Case
A 16-year-old female comes to the clinic alone requesting contraception. She is sexually
active with one current partner and has been using condoms, but would like something
more reliable to prevent pregnancy. She has had one other partner, who she was last with
6 months ago. She has no medical problems and takes no medications. Her parents do not
know that she is sexually active, and she does not want them to know that she is using
contraception. How should you proceed?
Discussion
This patient has a right to make her own reproductive choices, which includes the
decision to take hormonal contraception. She does not require a pelvic exam or (in most
states) need parental consent. If you are not willing to prescribe her contraception or your
employer does not allow it for religious or cultural reasons, you should refer her without
judgment to a clinician who will. You should also discuss safe sex practices with her,
including recommending the continued use of condoms to prevent STIs. Finally, she
should be offered screening for gonorrhea and chlamydia if this hasn’t been done yet,
which is recommended as annual screening for sexually active people < 25.

Case
A 16-year-old female comes to the clinic alone requesting contraception. She is sexually
active with one current partner and has been using condoms, but would like something
more reliable to prevent pregnancy. She has had one other partner, who she was last with
6 months ago. She has no medical problems and takes no medications. Her parents do not
know that she is sexually active, and she does not want them to know that she is using
contraception. How should you proceed?
Discussion
This patient has a right to make her own reproductive choices, which includes the
decision to take hormonal contraception. She does not require a pelvic exam or (in most
states) need parental consent. If you are not willing to prescribe her contraception or your
employer does not allow it for religious or cultural reasons, you should refer her without
judgment to a clinician who will. You should also discuss safe sex practices with her,
including recommending the continued use of condoms to prevent STIs. Finally, she
should be offered screening for gonorrhea and chlamydia if this hasn’t been done yet,
which is recommended as annual screening for sexually active people < 25.

Case
A 16-year-old female comes to the clinic alone requesting contraception. She is sexually
active with one current partner and has been using condoms, but would like something
more reliable to prevent pregnancy. She has had one other partner, who she was last with
6 months ago. She has no medical problems and takes no medications. Her parents do not
know that she is sexually active, and she does not want them to know that she is using
contraception. How should you proceed?
Discussion
This patient has a right to make her own reproductive choices, which includes the
decision to take hormonal contraception. She does not require a pelvic exam or (in most
states) need parental consent. If you are not willing to prescribe her contraception or your
employer does not allow it for religious or cultural reasons, you should refer her without
judgment to a clinician who will. You should also discuss safe sex practices with her,
including recommending the continued use of condoms to prevent STIs. Finally, she
should be offered screening for gonorrhea and chlamydia if this hasn’t been done yet,
which is recommended as annual screening for sexually active people < 25.

Case
A 16-year-old female comes to the clinic alone requesting contraception. She is sexually
active with one current partner and has been using condoms, but would like something
more reliable to prevent pregnancy. She has had one other partner, who she was last with
6 months ago. She has no medical problems and takes no medications. Her parents do not
know that she is sexually active, and she does not want them to know that she is using
contraception. How should you proceed?
Discussion
This patient has a right to make her own reproductive choices, which includes the
decision to take hormonal contraception. She does not require a pelvic exam or (in most
states) need parental consent. If you are not willing to prescribe her contraception or your
employer does not allow it for religious or cultural reasons, you should refer her without
judgment to a clinician who will. You should also discuss safe sex practices with her,
including recommending the continued use of condoms to prevent STIs. Finally, she
should be offered screening for gonorrhea and chlamydia if this hasn’t been done yet,
which is recommended as annual screening for sexually active people < 25.