Does this seem a bit wack? Medical privacy for children from parents?

[Roland of Gilead]

We don't have kids, and old enough now that we won't be having any but I just got this email:

"Policy Update – Patients 13 and Older Will Establish Their Own Portal Accounts

Effective April 5, 2021

Beginning April 5, 2021, parents will no longer have access to Protected Health Information (PHI) belonging to children 13 and older, in accordance with Washington state privacy laws. The result is that upon turning 13, your child will have sole access to test results and to chart notes produced in the practice or during a hospital stay. Your current access to your child’spatient portal will be disabled on April 5; your 13-year-old may reestablish their portal account using their own email address. "


Does this seem a bit too far?   What if a kid is diagnosed with something that a 13 year old is incapable of mentally handling on their own?  Are not parents supposed to help council their kids?   

What if a kid has mental health issues which could endanger other kids (school shootings don't happen though right?).   I would think a parent should be able to access the medical records of someone who they are legally responsible to care for.

Thoughts?  Could just be yet another case of the state of Washington being bat shit crazy...

[Morning Glory]

This is normal. It's meant to allow kids to get birth control and mental health treatment without having to tell their parents. Imagine if your kid needed an std test but was too afraid to tell you that they'd had sex. You would still want them to get the test, right? They can give you permission to see their records, or parts of them.

 The shitty thing is that the insurance eob still goes to the parent who carries the insurance, even after the child is 18. This law doesn't close that loophole, it only prohibits access to the chart

Providers are legally obligated to report patients who are a danger to themselves or others. I would think not being treated for mental health issues would be a bigger concern.

[Sid Hoffman]

How could this ever go wrong? When I was 13 years old I was way smarter than my parents. They're idiots, after all. It took until I was 25 before my parents started making any sense and I was 40 before my parents caught up to me in intelligence. Surely leaving 13 year olds to manage all their own medical care is a fantastic idea and will never result in doctors running up thousands of dollars of bills that the parents and their insurance are on the hook to pay by using scare tactics guaranteed to work on young teenagers who don't know any better. Oh sorry, I mean teenagers who should have honorary PhDs because adults are all idiots and kids are so smart they can manage their care without adult supervision in a for-profit medical system designed to extract the maximum dollars from every patient.

So no, this will never result in any problems. Kids should never have adult supervision when making life or death decisions or signing off on $15,000 elective medical procedures. No problems here!

[Paul der Krake]

Yeah that's whack and silly.

"You went to the doctor?"
"Yeah but I'm not going to tell you why."
"Oh sorry, I didn't mean to invade your privacy. Dinner is in 30 minutes."

[Sibley]

I understand the desire to ensure that teens are able to get birth control and mental health treatment, despite potential parental opposition. Not to mention vaccines, STD testing, etc. I get it. But the system overall is not designed in such a way for this to work.

People be dumb :(

[Morning Glory]

How could this ever go wrong? When I was 13 years old I was way smarter than my parents. They're idiots, after all. It took until I was 25 before my parents started making any sense and I was 40 before my parents caught up to me in intelligence. Surely leaving 13 year olds to manage all their own medical care is a fantastic idea and will never result in doctors running up thousands of dollars of bills that the parents and their insurance are on the hook to pay by using scare tactics guaranteed to work on young teenagers who don't know any better. Oh sorry, I mean teenagers who should have honorary PhDs because adults are all idiots and kids are so smart they can manage their care without adult supervision in a for-profit medical system designed to extract the maximum dollars from every patient.

So no, this will never result in any problems. Kids should never have adult supervision when making life or death decisions or signing off on $15,000 elective medical procedures. No problems here!

The parent is still required to sign off on any procedure requiring informed consent (surgery etc) until the child is eighteen, with the exception of certain ones pertaining to pregnancy, abortion, and std treatment. The list varies by state.  The conservative outrage machine must have left that out.

Also most medical professionals are ethical and aren't out there to do unnecessary procedures and extract dollars. Jeez. The provider is also still allowed to talk to the parent except for a couple of situations already mentioned (reproductive health, some mental health, etc). The law only pertains to electronic records.

The risk of teens being dishonest with health providers about things like drug use is much greater if they are afraid that the parent will read the chart.

As little as ten years ago, depending on location, these electronic charts weren't available to anyone. You had to go to the records office and pay for a copy and it would often take weeks to obtain. Your doctor's office had to call you with test results. Nobody ever saw the chart. We all had to become a little more tactful in our note-writing once the portals became commonplace.

Calm down.

[Zamboni]

Yeah, while the easy access to electronic records is sure handy sometimes, I wish all of my medical info wasn't out there on the interwebs so easy to hack into. I have no confidence that those charts containing my private information are properly secure.

The irony of all of this stuff with kids and their electronic charts is that, due to some big recent lawsuit payouts involving molestation, teenagers of driving age are often not able to even sign themselves in for appointments with big medical system providers. I had to go check my son in for every single one of his ankle PT appointments. So, I couldn't see his online chart (which I'm fine with not seeing), but I did have to drive over to the PT office every Tuesday and Thursday at 3pm to meet my son there (because he drove himself straight there from school) just so I could show my ID to the receptionist. And then I promptly left, because there's really no reason for me to sit there watching him rehab his ankle injury.

And, yes, I did complain and complain about this waste of my time and gasoline, over and over, and tell them that it was stupid that I was having to show my parental ID for them to check in someone with a full beard who is legally allowed to operate heavy machinery. Eventually they said there was some sort of waiver I could sign, but they never were able to come up with their required waiver form for me to sign, and eventually the point became moot.

[GuitarStv]

Yeah that's whack and silly.

"You went to the doctor?"
"Yeah but I'm not going to tell you why."
"Oh sorry, I didn't mean to invade your privacy. Dinner is in 30 minutes."

Alternately  . . . in my house


"You went to the doctor?"
"Yeah, but I'm not going to tell you why."
"Then you're not going to eat.  I bet you'll tell me within the week."
"Have you ever wondered if a hotwheels would fit up your butt?  Turns out it goes in OK, but has trouble reversing."
"Now I wish I didn't know.  Pull up a seat at the table.  If you can."

:P


I can't really see this rule preventing a parent from finding out exactly what's going on with their kid.

[ericrugiero]

How can they require people to pay for medical procedures they didn't know about?  That's going to be tough for parents to swallow and for hospitals to collect.   

[Roland of Gilead]

How can they require people to pay for medical procedures they didn't know about?  That's going to be tough for parents to swallow and for hospitals to collect.   

I never thought about it from that aspect.   Maybe hospitals don't charge children for tests and such?

[OtherJen]

Teens are too frequently abused or kicked out of their homes because of reproductive health/sexual issues (happened to my cousin), or parents may refuse to take a child to a clinic to have such issues treated.

I know someone who is dealing with the repercussions of what was likely untreated endometriosis (based on what sound like awful symptoms and later fertility problems) in her teenage years. Her family of origin is very religious and conservative, so her mother wouldn’t even entertain the thought of a gynecological consult when she was under 18.

I also had horrible periods (9 days long, migraines and vomiting the first 2 days) when I was in high school but would never have dreamed of asking to see a gynecologist because that would have been interpreted as “she’s having sex,” even though I wasn’t allowed to date or even attend parties unless my parents could drive me and go inside to meet the other parents. When I found a lump in my breast, the pediatrician dealt with that. I had my first gyno exam at the university clinic when I was an 18-year-old college freshman, went on the pill, and had “normal” periods (5 days long, manageable symptoms) for the first time in 6 years.

But yes, the issue of confidentiality is moot if the parents will be notified by health insurance companies.

[Laserjet3051]

How can they require people to pay for medical procedures they didn't know about?  That's going to be tough for parents to swallow and for hospitals to collect.   

I never thought about it from that aspect.   Maybe hospitals don't charge children for tests and such?

Not sure this is entirely true. Phalloplasty has got to come with a pretty heavy price tag.

[Morning Glory]

How can they require people to pay for medical procedures they didn't know about?  That's going to be tough for parents to swallow and for hospitals to collect.   

I never thought about it from that aspect.   Maybe hospitals don't charge children for tests and such?

They do. Each child has their own little deductible and oop max, even newborns). For a  child under 18 the parent still has to give permission for medical procedures, with the exception of emergencies and certain scenarios mentioned above. For young adults 18-26 who are still on the parent's insurance, the parent is still the "guarantor" and is responsible for paying for the care, even though they may know nothing about it until months later.  There is no way to set it up to have someone on your insurance but they receive the bills for copays, deductibles, etc.  It is no different than having your spouse on your insurance.

The parent also receives the EOB: there was a big lawsuit about that in (Indiana?) recently. Daughter was 22 and had a miscarriage and didn't want to tell the family she was pregnant and they found out because she was on their insurance. This law doesn't appear to address that issue at all.

If we had single-payer this would all be a non-issue.

[Metalcat]

Nothing there is specifying that parents can't get information about their child's health.

I would be curious what the actual laws are on that front.

If my teen patient asked me to keep their medical information from their parents, I was absolutely obliged to do so unless I, in my medical judgement, felt the parents needed to be informed. This is basically no different.

I'm assuming that the doctors involved are still obliged to contact the parents for anything that they deem the parents should be involved in, the parents just aren't getting default access to their teens medical records, so they can't access on demand every detail without having a reason to know it.

If that's how the law is set up, then it seems completely reasonable to me.

I frequently had parents push me to tell them about what their teens said in appointments, and I was very happy to be legally allowed not to share personal information with them if their teen didn't want it shared and they didn't need to be involved. Many teens will not disclose concerns if they fear their parents will find out. It's a huge issue, we need to be able to give them the appropriate degree of privacy, and at a certain point, that decision is one that should be determined by the teen and their healthcare professional, not their parents.

I have absolutely shared information with parents that teens didn't want shared, because it was a case where the parents needed to be informed. Such as the kid who let me know that he had seriously relapsed in his drug use and was engaging in life threatening behaviour. He begged me not to tell his parents, but I knew his parents were very supportive and wouldn't harm him as a result of this disclosure. He wanted me to keep it secret so that he could keep using.

The 16 year old Muslim girl who contracted oral herpes and had a meltdown about her family finding out? Yeah, I never said a word and was happy to legally be able to protect her privacy and give her some valtrex.

[scantee]

When this came up last year for my now 13-year old it was actually a good teaching moment about health and data privacy. I explained the reasoning behind why the rule exists and who it is there to protect. Then I talked through how it would be helpful for me to be able to see his records and asked if he agreed. He signed without issue and I made it clear he was free to change his mind.

For families with strong relationships this is a non-issue. For families without strong relationships it is meant to protect the kid. It seems like you have your undies in a bundle for no reason.

[Davnasty]

How could this ever go wrong? When I was 13 years old I was way smarter than my parents. They're idiots, after all. It took until I was 25 before my parents started making any sense and I was 40 before my parents caught up to me in intelligence. Surely leaving 13 year olds to manage all their own medical care is a fantastic idea and will never result in doctors running up thousands of dollars of bills that the parents and their insurance are on the hook to pay by using scare tactics guaranteed to work on young teenagers who don't know any better. Oh sorry, I mean teenagers who should have honorary PhDs because adults are all idiots and kids are so smart they can manage their care without adult supervision in a for-profit medical system designed to extract the maximum dollars from every patient.

So no, this will never result in any problems. Kids should never have adult supervision when making life or death decisions or signing off on $15,000 elective medical procedures. No problems here!

The parent is still required to sign off on any procedure requiring informed consent (surgery etc) until the child is eighteen, with the exception of certain ones pertaining to pregnancy, abortion, and std treatment. The list varies by state.  The conservative outrage machine must have left that out.

Also most medical professionals are ethical and aren't out there to do unnecessary procedures and extract dollars. Jeez. The provider is also still allowed to talk to the parent except for a couple of situations already mentioned (reproductive health, some mental health, etc). The law only pertains to electronic records.

The risk of teens being dishonest with health providers about things like drug use is much greater if they are afraid that the parent will read the chart.

As little as ten years ago, depending on location, these electronic charts weren't available to anyone. You had to go to the records office and pay for a copy and it would often take weeks to obtain. Your doctor's office had to call you with test results. Nobody ever saw the chart. We all had to become a little more tactful in our note-writing once the portals became commonplace.

Calm down.

Thanks for providing some context. When policy sounds outrageous, occasionally it really is, but more often it just sounds that way due to missing details. This is a good reminder to dig a little deeper before getting emotionally invested in something I don't understand.

[iris lily]

How can they require people to pay for medical procedures they didn't know about?  That's going to be tough for parents to swallow and for hospitals to collect.   

I never thought about it from that aspect.   Maybe hospitals don't charge children for tests and such?

Not sure this is entirely true. Phalloplasty has got to come with a pretty heavy price tag.

The years of 13 to 18 are so problematic with health and other issues.

But it sure gives me pause to know that 13 year olds can  get body changing hormones, testosterone and etc, with little to no therapeutic intervention or requirement in some places. These hormones do permanent damage and are not reversible when the teen decides to “de transition.”

[Kris]

How can they require people to pay for medical procedures they didn't know about?  That's going to be tough for parents to swallow and for hospitals to collect.   

I never thought about it from that aspect.   Maybe hospitals don't charge children for tests and such?

Not sure this is entirely true. Phalloplasty has got to come with a pretty heavy price tag.

The years of 13 to 18 are so problematic with health and other issues.

But it sure gives me pause to know that 13 year olds can  get body changing hormones, testosterone and etc, with little to no therapeutic intervention or requirement in some places. These hormones do permanent damage and are not reversible when the teen decides to “de transition.”

Can you please post information about how, when and where that occurs? Because as far as I can see, generally what happens for minors who are trans is, they are put on hormone blockers to arrest puberty. And hormone blockers do not do permanent damage. If one decides to stop taking them, puberty simply continues as before.

[CodingHare]

Does this seem a bit too far?   What if a kid is diagnosed with something that a 13 year old is incapable of mentally handling on their own?  Are not parents supposed to help council their kids?   

What if a kid has mental health issues which could endanger other kids (school shootings don't happen though right?).   I would think a parent should be able to access the medical records of someone who they are legally responsible to care for.

Thoughts?  Could just be yet another case of the state of Washington being bat shit crazy...

I also live in Washington State, and I was so happy when I got this email.  My mother didn't believe in "extreme and unnecessary medicine"-- by which she meant birth control exclusively.  It was literally being prescribed to me as a noninvasive way to control my acne, which my mother refuse to believe was hormone driven.    But no, it would give me "permission" to have sex*, so I got to enjoy heavy acne well through my college years until I finally got a job and my own insurance.  Wouldn't you know the acne cleared up right after I started BC?

* The permission to have sex thing was doubly hilarious since I was homeschooled and I literally had zero social life.

All parents believe they are being responsible, but the system is not well setup to protect kids who want (a) to protect their reproductive health while being born female, (b) are LGBTQ+ with bigoted parents who refuse to understand their medical treatment (see people in this very thread claiming this will let minors get gender reassignment surgery and not hormone blockers), or (c) have anti vax parents endangering their lives with their anti-science bullshit out of "love."  Laws like this give kids who are in the position I was in better health outcomes.  That's what we all want in the end, right?

[Kris]

Does this seem a bit too far?   What if a kid is diagnosed with something that a 13 year old is incapable of mentally handling on their own?  Are not parents supposed to help council their kids?   

What if a kid has mental health issues which could endanger other kids (school shootings don't happen though right?).   I would think a parent should be able to access the medical records of someone who they are legally responsible to care for.

Thoughts?  Could just be yet another case of the state of Washington being bat shit crazy...

I also live in Washington State, and I was so happy when I got this email.  My mother didn't believe in "extreme and unnecessary medicine"-- by which she meant birth control exclusively.  It was literally being prescribed to me as a noninvasive way to control my acne, which my mother refuse to believe was hormone driven.    But no, it would give me "permission" to have sex*, so I got to enjoy heavy acne well through my college years until I finally got a job and my own insurance.  Wouldn't you know the acne cleared up right after I started BC?

* The permission to have sex thing was doubly hilarious since I was homeschooled and I literally had zero social life.

All parents believe they are being responsible, but the system is not well setup to protect kids who want (a) to protect their reproductive health while being born female, (b) are LGBTQ+ with bigoted parents who refuse to understand their medical treatment (see people in this very thread claiming this will let minors get gender reassignment surgery and not hormone blockers), or (c) have anti vax parents endangering their lives with their anti-science bullshit out of "love."  Laws like this give kids who are in the position I was in better health outcomes.  That's what we all want in the end, right?

d) or have parents who are straight-up abusive.

Agreed. Laws like this give kids better mental and physical health outcomes.

[GuitarStv]

How can they require people to pay for medical procedures they didn't know about?  That's going to be tough for parents to swallow and for hospitals to collect.   

I never thought about it from that aspect.   Maybe hospitals don't charge children for tests and such?

Not sure this is entirely true. Phalloplasty has got to come with a pretty heavy price tag.

The years of 13 to 18 are so problematic with health and other issues.

But it sure gives me pause to know that 13 year olds can  get body changing hormones, testosterone and etc, with little to no therapeutic intervention or requirement in some places. These hormones do permanent damage and are not reversible when the teen decides to “de transition.”

Can you please post information about how, when and where that occurs? Because as far as I can see, generally what happens for minors who are trans is, they are put on hormone blockers to arrest puberty. And hormone blockers do not do permanent damage. If one decides to stop taking them, puberty simply continues as before.

Is there a large group of young people transitioning to another gender?

The last study I read (which was Canadian) indicated that less than a quarter of one percent of the general population identified as trans.  The one trans person I knew in my entire time going through elementary and high school (at four different schools in four different cities) took an awful lot of shit from other students and occasionally teachers.  Enough that she certainly had to be VERY certain of what she was doing.

[iris lily]

How can they require people to pay for medical procedures they didn't know about?  That's going to be tough for parents to swallow and for hospitals to collect.   

I never thought about it from that aspect.   Maybe hospitals don't charge children for tests and such?

Not sure this is entirely true. Phalloplasty has got to come with a pretty heavy price tag.

The years of 13 to 18 are so problematic with health and other issues.

But it sure gives me pause to know that 13 year olds can  get body changing hormones, testosterone and etc, with little to no therapeutic intervention or requirement in some places. These hormones do permanent damage and are not reversible when the teen decides to “de transition.”

Can you please post information about how, when and where that occurs? Because as far as I can see, generally what happens for minors who are trans is, they are put on hormone blockers to arrest puberty. And hormone blockers do not do permanent damage. If one decides to stop taking them, puberty simply continues as before.

Is there a large group of young people transitioning to another gender?

The last study I read (which was Canadian) indicated that less than a quarter of one percent of the general population identified as trans.  The one trans person I knew in my entire time going through elementary and high school (at four different schools in four different cities) took an awful lot of shit from other students and occasionally teachers.  Enough that she certainly had to be VERY certain of what she was doing.

To answer both questions:

The book Irreversible damage: The Transgender Craze Seducing our Daughters by Abigail Shrier talks about, to Kris’s point, varied use of “T” in girls including minors. It may not be the norm but they are getting it.  From page 167 “In 2007, there was one gender clinic in the United States. Today, there are well over 50; Planned Parenthood, Kaiser, and Mayo all disperse testosterone, too. Many do so on a first visit on a ‘informed consent’ “basis with no referral or therapy required. The age of medical consent varies by state. In Oregon it is 15. “

And I suppose some of them get it in the black market.

As for puberty blockers being entirely harmless, not sure that is true. They slow (change) brain and bone development. That seems just ugh to me.
 
To GuitarStev: this book is based on research that came about when the researcher found a sudden explosion of female to male transitions  taking place among adolescent girls. There  is a cultural current to some of this. Dr. lisa Littmann did the original research which points out the sudden increase in numbers, the clumping aspect of trans kids in peer groups, the overall social phenomena.

[Metalcat]

How can they require people to pay for medical procedures they didn't know about?  That's going to be tough for parents to swallow and for hospitals to collect.   

I never thought about it from that aspect.   Maybe hospitals don't charge children for tests and such?

Not sure this is entirely true. Phalloplasty has got to come with a pretty heavy price tag.

The years of 13 to 18 are so problematic with health and other issues.

But it sure gives me pause to know that 13 year olds can  get body changing hormones, testosterone and etc, with little to no therapeutic intervention or requirement in some places. These hormones do permanent damage and are not reversible when the teen decides to “de transition.”

Can you please post information about how, when and where that occurs? Because as far as I can see, generally what happens for minors who are trans is, they are put on hormone blockers to arrest puberty. And hormone blockers do not do permanent damage. If one decides to stop taking them, puberty simply continues as before.

Is there a large group of young people transitioning to another gender?

The last study I read (which was Canadian) indicated that less than a quarter of one percent of the general population identified as trans.  The one trans person I knew in my entire time going through elementary and high school (at four different schools in four different cities) took an awful lot of shit from other students and occasionally teachers.  Enough that she certainly had to be VERY certain of what she was doing.

To answer both questions:

The book Irreversible damage: The Transgender Craze Seducing our Daughters by Abigail Shrier talks about, to Kris’s point, varied use of “T” in girls including minors. It may not be the norm but they are getting it.  From page 167 “In 2007, there was one gender clinic in the United States. Today, there are well over 50; Planned Parenthood, Kaiser, and Mayo all disperse testosterone, too. Many do so on a first visit on a ‘informed consent’ “basis with no referral or therapy required. The age of medical consent varies by state. In Oregon it is 15. “

And I suppose some of them get it in the black market.

As for puberty blockers being entirely harmless, not sure that is true. They slow (change) brain and bone development. That seems just ugh to me.
 
To GuitarStev: this book is based on research that came about when the researcher found a sudden explosion of female to male transitions  taking place among adolescent girls. There  is a cultural current to some of this. Dr. lisa Littmann did the original research which points out the sudden increase in numbers, the clumping aspect of trans kids in peer groups, the overall social phenomena.

This is a largely separate issue.

Whether or not medical records should be private for teens vs whether or not transitioning counts as a procedure that should require parental consent.

The vast, overwhelming majority of kids that this law will affect are kids who don't want their parents knowing they're sexually active, using birth control, drinking alcohol, smoking, etc, etc.

You can debate legitimately if you think teens should be able to transition without their parents' consent and what kind of safeguards should be in place for kids, such as mandatory ongoing counselling, family counselling, whatever. That's not the main effect of this rule though.

This law makes kids safer. Lots and lots and lots of kids who have never and will never have anything to do with gender transition.

The law doesn't just make kids safer from parents who might cause them harm, it makes ALL kids safer because they will be more willing to disclose things to their medical professionals. Which is a HUGE ISSUE in treating teenagers.

[CodingHare]

To answer both questions:

The book Irreversible damage: The Transgender Craze Seducing our Daughters by Abigail Shrier talks about, to Kris’s point, varied use of “T” in girls including minors. It may not be the norm but they are getting it.  From page 167 “In 2007, there was one gender clinic in the United States. Today, there are well over 50; Planned Parenthood, Kaiser, and Mayo all disperse testosterone, too. Many do so on a first visit on a ‘informed consent’ “basis with no referral or therapy required. The age of medical consent varies by state. In Oregon it is 15. “

And I suppose some of them get it in the black market.

As for puberty blockers being entirely harmless, not sure that is true. They slow (change) brain and bone development. That seems just ugh to me.
 
To GuitarStev: this book is based on research that came about when the researcher found a sudden explosion of female to male transitions  taking place among adolescent girls. There  is a cultural current to some of this. Dr. lisa Littmann did the original research which points out the sudden increase in numbers, the clumping aspect of trans kids in peer groups, the overall social phenomena.

Uh, wow.  That book definitely has an agenda and is not a neutral source.  Abigail Shrier is not a doctor, she is an investigative journalist with a definite conservative agenda.  Do you have sources that actually come from the medical community or just hitpieces?

As for increases in numbers: it is finally becoming much more social acceptable to be Trans.  So of course more people are going to be willing to claim that title if it no longer comes with the baggage of being denied healthcare/thrown out of your house by your family/ostracized from the job market.   The internet also makes it a lot easier to connect with other folks who are experiencing the same medical issues as you are.  We should be happy that we are enabling people to explore their gender identities safely--and lowering the amount of suicides due to gender dysphoria.

[iris lily]

To answer both questions:

The book Irreversible damage: The Transgender Craze Seducing our Daughters by Abigail Shrier talks about, to Kris’s point, varied use of “T” in girls including minors. It may not be the norm but they are getting it.  From page 167 “In 2007, there was one gender clinic in the United States. Today, there are well over 50; Planned Parenthood, Kaiser, and Mayo all disperse testosterone, too. Many do so on a first visit on a ‘informed consent’ “basis with no referral or therapy required. The age of medical consent varies by state. In Oregon it is 15. “

And I suppose some of them get it in the black market.

As for puberty blockers being entirely harmless, not sure that is true. They slow (change) brain and bone development. That seems just ugh to me.
 
To GuitarStev: this book is based on research that came about when the researcher found a sudden explosion of female to male transitions  taking place among adolescent girls. There  is a cultural current to some of this. Dr. lisa Littmann did the original research which points out the sudden increase in numbers, the clumping aspect of trans kids in peer groups, the overall social phenomena.

Uh, wow.  That book definitely has an agenda and is not a neutral source.  Abigail Shrier is not a doctor, she is an investigative journalist with a definite conservative agenda.  Do you have sources that actually come from the medical community or just hitpieces?

As for increases in numbers: it is finally becoming much more social acceptable to be Trans.  So of course more people are going to be willing to claim that title if it no longer comes with the baggage of being denied healthcare/thrown out of your house by your family/ostracized from the job market.   The internet also makes it a lot easier to connect with other folks who are experiencing the same medical issues as you are.  We should be happy that we are enabling people to explore their gender identities safely--and lowering the amount of suicides due to gender dysphoria.

I dont advocate wholesale denial of confidential healthcare to teens. I can see that it would have pros and cons, that’s all. Most broad social actions do.

I have watched  many ftm Youtube videos, both transitioners and detransitioners. Those young people present an array of ideas about appropriate transitioning but there sure seems to be a lot of regret oit there.

There is no ONE single view in professional circles. The medical  community has an uneven record of success in this area, and cureent medical research says what exactly? That it is better to render girls sterile and with permanent changes to their body than counsel them through a suicidal phase?

Believe me, I have no idea what I would do with a teenager in this situation and am so glad I didnt have to deal with this or any of the myriad other issues offspring present.

i AM am skeptical that rigid ideas of gender roles is overall a good thing, especially when held by adolescent girls. I thought that was a major tenant if feminism, that gender identified interest and abilities and etc are largely a social construct.

This book provides an alternate point of view to the overwhelming narrative on social media about transitioning. Clearly there are many parents scared and sad about what their daughters are going through, and many of them do not trust that medical professionals know the right thing for their kid. I feel sorry for the parents and children caught up in this.

[CodingHare]

I dont advocate wholesale denial of confidential healthcare to teens. I can see that it would have pros and cons, that’s all. Most broad social actions do.

I have watched  many ftm Youtube videos, both transitioners and detransitioners. Those young people present an array of ideas about appropriate transitioning but there sure seems to be a lot of regret oit there.

There is no ONE single view in professional circles. The medical  community has an uneven record of success in this area, and cureent medical research says what exactly? That it is better to render girls sterile and with permanent changes to their body than counsel them through a suicidal phase?

Believe me, I have no idea what I would do with a teenager in this situation and am so glad I didnt have to deal with this or any of the myriad other issues offspring present.

i AM am skeptical that rigid ideas of gender roles is overall a good thing, especially when held by adolescent girls. I thought that was a major tenant if feminism, that gender identified interest and abilities and etc are largely a social construct.

This book provides an alternate point of view to the overwhelming narrative on social media about transitioning. Clearly there are many parents scared and sad about what their daughters are going through, and many of them do not trust that medical professionals know the right thing for their kid. I feel sorry for the parents and children caught up in this.

I'd be hesitant to give more credence to the parent's opinion on what transitioning means for these young men (trans men are men) than their children's own voices.  Hormonal blockers are the typical treatment for children under 18, at which point they become adults able to legally make the choices that make sense for their own health.  Lack of support is a major health risk for trans kids in general.

I understand that a child transitioning causes a lot of consternation in the parents too--but the child's health needs to be centered, not their parent's opinions.  I think we agree on that much actually.

[Kris]

To answer both questions:

The book Irreversible damage: The Transgender Craze Seducing our Daughters by Abigail Shrier talks about, to Kris’s point, varied use of “T” in girls including minors. It may not be the norm but they are getting it.  From page 167 “In 2007, there was one gender clinic in the United States. Today, there are well over 50; Planned Parenthood, Kaiser, and Mayo all disperse testosterone, too. Many do so on a first visit on a ‘informed consent’ “basis with no referral or therapy required. The age of medical consent varies by state. In Oregon it is 15. “

And I suppose some of them get it in the black market.

As for puberty blockers being entirely harmless, not sure that is true. They slow (change) brain and bone development. That seems just ugh to me.
 
To GuitarStev: this book is based on research that came about when the researcher found a sudden explosion of female to male transitions  taking place among adolescent girls. There  is a cultural current to some of this. Dr. lisa Littmann did the original research which points out the sudden increase in numbers, the clumping aspect of trans kids in peer groups, the overall social phenomena.

Uh, wow.  That book definitely has an agenda and is not a neutral source.  Abigail Shrier is not a doctor, she is an investigative journalist with a definite conservative agenda.  Do you have sources that actually come from the medical community or just hitpieces?

As for increases in numbers: it is finally becoming much more social acceptable to be Trans.  So of course more people are going to be willing to claim that title if it no longer comes with the baggage of being denied healthcare/thrown out of your house by your family/ostracized from the job market.   The internet also makes it a lot easier to connect with other folks who are experiencing the same medical issues as you are.  We should be happy that we are enabling people to explore their gender identities safely--and lowering the amount of suicides due to gender dysphoria.

Yeah, it's... not great. I just checked the ebook out of the library. Poorly sourced, alarmist language. Lots of "someone I talked to" and Youtube videos as sources. This is a book that would be used as a negative example in a "Critical Thinking 101" course about how to evaluate reliable sources.

[Chris22]

How can they require people to pay for medical procedures they didn't know about?  That's going to be tough for parents to swallow and for hospitals to collect.   

Certainly not the same thing, but when I was in college they would not release any information about my grades, etc, to anyone but me unless I signed a release allowing them to send information home to my parents. My parents calmly suggested I was welcome to keep my grades private if I was willing to also pick up my $10k/yr room and board bill (I had a full tuition scholarship, parents covered R&B).  I signed the release.

[iris lily]

To answer both questions:

The book Irreversible damage: The Transgender Craze Seducing our Daughters by Abigail Shrier talks about, to Kris’s point, varied use of “T” in girls including minors. It may not be the norm but they are getting it.  From page 167 “In 2007, there was one gender clinic in the United States. Today, there are well over 50; Planned Parenthood, Kaiser, and Mayo all disperse testosterone, too. Many do so on a first visit on a ‘informed consent’ “basis with no referral or therapy required. The age of medical consent varies by state. In Oregon it is 15. “

And I suppose some of them get it in the black market.

As for puberty blockers being entirely harmless, not sure that is true. They slow (change) brain and bone development. That seems just ugh to me.
 
To GuitarStev: this book is based on research that came about when the researcher found a sudden explosion of female to male transitions  taking place among adolescent girls. There  is a cultural current to some of this. Dr. lisa Littmann did the original research which points out the sudden increase in numbers, the clumping aspect of trans kids in peer groups, the overall social phenomena.

Uh, wow.  That book definitely has an agenda and is not a neutral source.  Abigail Shrier is not a doctor, she is an investigative journalist with a definite conservative agenda.  Do you have sources that actually come from the medical community or just hitpieces?

As for increases in numbers: it is finally becoming much more social acceptable to be Trans.  So of course more people are going to be willing to claim that title if it no longer comes with the baggage of being denied healthcare/thrown out of your house by your family/ostracized from the job market.   The internet also makes it a lot easier to connect with other folks who are experiencing the same medical issues as you are.  We should be happy that we are enabling people to explore their gender identities safely--and lowering the amount of suicides due to gender dysphoria.

Yeah, it's... not great. I just checked the ebook out of the library. Poorly sourced, alarmist language. Lots of "someone I talked to" and Youtube videos as sources. This is a book that would be used as a negative example in a "Critical Thinking 101" course about how to evaluate reliable sources.

The original research by Dr. Littman was heavily criticized for using surveys of parents. So yes, there is that point of view. But her main idea was looking at the sudden onset of dysphoria, and she wanted to know from parents how long these kids had felt they were  boys. The traditional ideas of body dysphoria is that trans people Feel something is off from a very young age. Getting objective information about the mindset of 4,6,8 year olds from their parents seems reasonable to me.

I wonder why this research was so ferociously attacked?  Anybody can read the story of  Brown University backing out of it, apologizing, reviewing the research, changing presentations of it, but not changing conclusions.

It’s pretty clear to me that there is an agenda being pushed in this subject area and that agenda is not Littman’s.  it just seems so odd because this is such a troubling area. Why not get real data? Why is real data scary? If it’s not real data then debunk it.

Or maybe, this  like many other human science research just isnt that reliable. And to that I say: no kidding.

[PDXTabs]

This is normal. It's meant to allow kids to get birth control and mental health treatment without having to tell their parents. Imagine if your kid needed an std test but was too afraid to tell you that they'd had sex. You would still want them to get the test, right? They can give you permission to see their records, or parts of them.

Yes, but it's also a moving target. I think that when I was a kid in OR it was 15 years of age.

Also, in the state of WA it's illegal to leave your 13 year old alone in your car, so the juxtaposition of the two laws is a little insane. Which is not me complaining about the privacy law.

[Metalcat]

This is normal. It's meant to allow kids to get birth control and mental health treatment without having to tell their parents. Imagine if your kid needed an std test but was too afraid to tell you that they'd had sex. You would still want them to get the test, right? They can give you permission to see their records, or parts of them.

Yes, but it's also a moving target. I think that when I was a kid in OR it was 15 years of age.

Also, in the state of WA it's illegal to leave your 13 year old alone in your car, so the juxtaposition of the two laws is a little insane. Which is not me complaining about the privacy law.

I don't see how these are related.

Where I practice, doctors still need parental consent for everything unless in their professional opinion they think it's necessary.

What this protects most is the subject matter of what is *said* in medical appointments or non critical medical findings that teens might want kept private. Even if a parent brings their teen to the doctor, and is actively involved in their care, the teen is still entitled to be able to ask their doctor about personal things that they don't want their parents reading about.

Even a child with loving, involved parents should be entitled to privacy as to what they talk about with their doctors. If it turns out to be something that requires treatment, then where I work, we still have to talk to the parents.

A teen should be allowed to talk to their own doctor about their own body without their parents having default access to the details of every single conversation.

[PDXTabs]

This is normal. It's meant to allow kids to get birth control and mental health treatment without having to tell their parents. Imagine if your kid needed an std test but was too afraid to tell you that they'd had sex. You would still want them to get the test, right? They can give you permission to see their records, or parts of them.

Yes, but it's also a moving target. I think that when I was a kid in OR it was 15 years of age.

Also, in the state of WA it's illegal to leave your 13 year old alone in your car, so the juxtaposition of the two laws is a little insane. Which is not me complaining about the privacy law.

I don't see how these are related.

Where I practice, doctors still need parental consent for everything unless in their professional opinion they think it's necessary.

...

They're both age limits to do things that teenagers are capable of in the state of Washington. IDK, as a frequent Washington voter they seem pretty related to me. Also, I made it clear that I'm 100% okay with the privacy law.

EDIT - as a slight aside I grew up in OR where the age of consent for medical stuff is still 15 (except when it's 14).

[ixtap]

To answer both questions:

The book Irreversible damage: The Transgender Craze Seducing our Daughters by Abigail Shrier talks about, to Kris’s point, varied use of “T” in girls including minors. It may not be the norm but they are getting it.  From page 167 “In 2007, there was one gender clinic in the United States. Today, there are well over 50; Planned Parenthood, Kaiser, and Mayo all disperse testosterone, too. Many do so on a first visit on a ‘informed consent’ “basis with no referral or therapy required. The age of medical consent varies by state. In Oregon it is 15. “

And I suppose some of them get it in the black market.

As for puberty blockers being entirely harmless, not sure that is true. They slow (change) brain and bone development. That seems just ugh to me.
 
To GuitarStev: this book is based on research that came about when the researcher found a sudden explosion of female to male transitions  taking place among adolescent girls. There  is a cultural current to some of this. Dr. lisa Littmann did the original research which points out the sudden increase in numbers, the clumping aspect of trans kids in peer groups, the overall social phenomena.

Uh, wow.  That book definitely has an agenda and is not a neutral source.  Abigail Shrier is not a doctor, she is an investigative journalist with a definite conservative agenda.  Do you have sources that actually come from the medical community or just hitpieces?

As for increases in numbers: it is finally becoming much more social acceptable to be Trans.  So of course more people are going to be willing to claim that title if it no longer comes with the baggage of being denied healthcare/thrown out of your house by your family/ostracized from the job market.   The internet also makes it a lot easier to connect with other folks who are experiencing the same medical issues as you are.  We should be happy that we are enabling people to explore their gender identities safely--and lowering the amount of suicides due to gender dysphoria.

I dont advocate wholesale denial of confidential healthcare to teens. I can see that it would have pros and cons, that’s all. Most broad social actions do.

I have watched  many ftm Youtube videos, both transitioners and detransitioners. Those young people present an array of ideas about appropriate transitioning but there sure seems to be a lot of regret oit there.

There is no ONE single view in professional circles. The medical  community has an uneven record of success in this area, and cureent medical research says what exactly? That it is better to render girls sterile and with permanent changes to their body than counsel them through a suicidal phase?

Believe me, I have no idea what I would do with a teenager in this situation and am so glad I didnt have to deal with this or any of the myriad other issues offspring present.

i AM am skeptical that rigid ideas of gender roles is overall a good thing, especially when held by adolescent girls. I thought that was a major tenant if feminism, that gender identified interest and abilities and etc are largely a social construct.

This book provides an alternate point of view to the overwhelming narrative on social media about transitioning. Clearly there are many parents scared and sad about what their daughters are going through, and many of them do not trust that medical professionals know the right thing for their kid. I feel sorry for the parents and children caught up in this.

If you are concerned about regrets, you should know that the single most common reason for "detransitioning" is parental pressure and more than half choose to go through with it later on.

Transitioning saves lives. Until we live in a genuinely gender neutral society, where everyone can where what they choose and play with the toys of their choosing and get the same pay, that will probably continue to be true.

[maizefolk]

Is there a large group of young people transitioning to another gender?

The last study I read (which was Canadian) indicated that less than a quarter of one percent of the general population identified as trans.  The one trans person I knew in my entire time going through elementary and high school (at four different schools in four different cities) took an awful lot of shit from other students and occasionally teachers.  Enough that she certainly had to be VERY certain of what she was doing.

Large is a word that means different things to different people.

But to put it in the context of your number of 1/4th of one percent of the general population in Canada, about 2% of US high school students currently identify as trans* and another roughly 2% say they're not sure if they're trans or not yet. Together that would be about 600,000 teenagers who either identify as trans or are considering identifying as trans.

Or put another way you were a teenager again today, you'd likely know several dozen classmates who identify as trans instead of only one (assuming your high school was about the same size as mine).

But I agree with malcat that this is a largely separate issue from whether or not parents get access to their teenagers' medical records.

*Source: https://www.thetrevorproject.org/2019/01/24/new-federal-survey-shows-2-of-us-high-school-students-identify-as-transgender/

[Metalcat]

Is there a large group of young people transitioning to another gender?

The last study I read (which was Canadian) indicated that less than a quarter of one percent of the general population identified as trans.  The one trans person I knew in my entire time going through elementary and high school (at four different schools in four different cities) took an awful lot of shit from other students and occasionally teachers.  Enough that she certainly had to be VERY certain of what she was doing.

Large is a word that means different things to different people.

But to put it in the context of your number of 1/4th of one percent of the general population in Canada, about 2% of US high school students currently identify as trans* and another roughly 2% say they're not sure if they're trans or not yet. Together that would be about 600,000 teenagers who either identify as trans or are considering identifying as trans.

Or put another way you were a teenager again today, you'd likely know several dozen classmates who identify as trans instead of only one (assuming your high school was about the same size as mine).

But I agree with malcat that this is a largely separate issue from whether or not parents get access to their teenagers' medical records.

*https://www.thetrevorproject.org/2019/01/24/new-federal-survey-shows-2-of-us-high-school-students-identify-as-transgender/

Yeah, I find it super weird that this trans issue got shoehorned into this debate.

If there's a jurisdiction where kids can transition without their parents' consent, and without adequate professional counselling first, then that's a totally separate issue to debate.

But this law has NOTHING to do with parental consent. It has to do with privacy of primarily what is discussed during medical appointments. Because up to 90% of what goes into a lot of doctors' medical notes is what the patient said, what questions were asked, etc.

[Roland of Gilead]

Some good points here.  Me being without children, I didn't really understand all the factors.

It sounds like a reasonable thing in most cases but does shift some of the burden of protection from the parents to the doctor.  (which might not be a bad thing either).

[Kris]

Is there a large group of young people transitioning to another gender?

The last study I read (which was Canadian) indicated that less than a quarter of one percent of the general population identified as trans.  The one trans person I knew in my entire time going through elementary and high school (at four different schools in four different cities) took an awful lot of shit from other students and occasionally teachers.  Enough that she certainly had to be VERY certain of what she was doing.

Large is a word that means different things to different people.

But to put it in the context of your number of 1/4th of one percent of the general population in Canada, about 2% of US high school students currently identify as trans* and another roughly 2% say they're not sure if they're trans or not yet. Together that would be about 600,000 teenagers who either identify as trans or are considering identifying as trans.

Or put another way you were a teenager again today, you'd likely know several dozen classmates who identify as trans instead of only one (assuming your high school was about the same size as mine).

But I agree with malcat that this is a largely separate issue from whether or not parents get access to their teenagers' medical records.

*https://www.thetrevorproject.org/2019/01/24/new-federal-survey-shows-2-of-us-high-school-students-identify-as-transgender/

Yeah, I find it super weird that this trans issue got shoehorned into this debate.

If there's a jurisdiction where kids can transition without their parents' consent, and without adequate professional counselling first, then that's a totally separate issue to debate.

But this law has NOTHING to do with parental consent. It has to do with privacy of primarily what is discussed during medical appointments. Because up to 90% of what goes into a lot of doctors' medical notes is what the patient said, what questions were asked, etc.

I mean trans kids are the moral panic of the hour, right? If you’re freaking out about kids today, it’s likely you’re hyper-focused on this almost to the exclusion of everything else.

It has nothing to do with the issue, but it does get a crap ton of bandwidth.

[Abe]

This is in line with accepted practice amongst most medical societies and ethicists for reasons others have highlighted. Primarily, in the US at least teenagers are felt to have autonomy over their bodies except in certain life-threatening situations (I.e. cannot refuse emergency treatment for major trauma if the parent consents). As part of this framework, they are also entitled to the right to privacy in most situations. If I were to see a teenager and they did not want the specifics of their care discussed with the parent, I would be ethically obligated to not provide details. This decision is an extension of that practice, and it has been upheld several times. The age of majority is separate from age of consent for medical treatment in many states.

Regarding payment: the responsible party does not automatically have access to a patient’s chart, under federal law. They are responsible for the bill but cannot be provided additional information about protected medical information beyond that necessary to pay said bill and be aware of the charges. I.e. they can know a CT scan was done, but they do not have authorization to request the results without the patient’s consent, unless they are the legal guardian or healthcare power of attorney. And even then they may not automatically have permission, as demonstrated in this law.

[Roland of Gilead]

I was told yesterday by a friend that children in Washington who seek care under this policy actually do not have to pay for it, regardless of the income of their parents.   The state covers the costs.

[Jenny Wren]

I have kids. One is an adult now, but back when they both still went to the pediatrician it was around age 10 that I would be asked to step outside for a few minutes. There are a lot of bottom feeding, horrible people that shouldn't be parents, and this was to give the kid a bit of safety to tell the Doc about anything - from abuse to curious questions about sex - that the kid wouldn't or couldn't say to me.

These rules don't mean your kid is going to get a nose job without your consent or that the doctor is going to bill the parents for $10,000 in snake oil. It's simply to ensure the safety and health of the child. To say otherwise just goes to show how paranoid and distrusting of every single thing our society has become.

Where I grew up I could get birth control, etc long before 18- this was in the US, in the late 80s/early 90s so these aren't new regulations and laws. Good thing, too, or there would have definitely been an unwanted pregnancy. If my mother had known I even so much as kissed a boy, I would have been paddled and sent away, so I really had no one to go to except for friends and my family doctor. The visit was likely covered by my parents insurance as a normal physical/gyno appointment, but I distinctly remember buying the pills out of my own money every month so my parents wouldn't be billed. 

[iris lily]

Yeah, I find it super weird that this trans issue got shoehorned into this debate.

If there's a jurisdiction where kids can transition without their parents' consent, and without adequate professional counselling first, then that's a totally separate issue to debate.

But this law has NOTHING to do with parental consent. It has to do with privacy of primarily what is discussed during medical appointments. Because up to 90% of what goes into a lot of doctors' medical notes is what the patient said, what questions were asked, etc.

My first post about trans children, minors, getting medically prescribed drugs did not explicitly state “without knowledge or consent of their parents.” I can see your confusion because I didn't make  it clear, this medical treatment is without parental involvement.  I assumed ...well. It is wrong of me to assume.

Parental concern and being shut out of medical decisions with their trans children is a core idea of Shirer’s book.

Sure that is good for some kids and for others, not so much. The right parents would bring an important context to treatment. The wrong parents might do further harm to the kid.

You said “where I practice, doctors still need parental consent for anything, unless in their professional opinion it is necessary.”

I don’t know what that means. Is there a missing “not” in that sentence? Your physicians need parental consent for treatment? Always? Sometimes? Can make exclusions?

Sure I understand that consultation is protected with privacy standards, I am asking about treatment, specifically, drugs.

[Metalcat]

Yeah, I find it super weird that this trans issue got shoehorned into this debate.

If there's a jurisdiction where kids can transition without their parents' consent, and without adequate professional counselling first, then that's a totally separate issue to debate.

But this law has NOTHING to do with parental consent. It has to do with privacy of primarily what is discussed during medical appointments. Because up to 90% of what goes into a lot of doctors' medical notes is what the patient said, what questions were asked, etc.

My first post about trans children, minors, getting medically prescribed drugs did not explicitly state “without knowledge or consent of their parents.” I can see your confusion because I didn't make  it clear, this medical treatment is without parental involvement.  I assumed ...well. It is wrong of me to assume.

Parental concern and being shut out of medical decisions with their trans children is a core idea of Shirer’s book.

Sure that is good for some kids and for others, not so much. The right parents would bring an important context to treatment. The wrong parents might do further harm to the kid.

You said “where I practice, doctors still need parental consent for anything, unless in their professional opinion it is necessary.”

I don’t know what that means. Is there a missing “not” in that sentence? Your physicians need parental consent for treatment? Always? Sometimes? Can make exclusions?

Sure I understand that consultation is protected with privacy standards, I am asking about treatment, specifically, drugs.

To clarify: I always need to have parental consent for treatment of a minor unless I deem it necessary to withhold that information for the sake of the child. The burden for me to withhold that information is very high and opens me up to litigation.

So yes, I can make an exception, but there's no fucking way I'm doing so without consulting a lawyer first. I will not do it lightly. That's just my jurisdiction and my area of treatment though. I very rarely feel the need to withhold consent from a parent, but I very frequently discuss things with teens that they don't want shared. There's a HUGE difference.

As for this law, it has NOTHING to do with consent. It only has to do with medical records. Those are completely separate issues. That's why I find it so weird that you are even asking about treating trans kids without their parents' knowledge because what has been posted has nothing to do with that.

Issues of privacy of records and issues of treatment consent are entirely separate issues. That's why it seems that you are shoehorning your trans concerns into a debate where what you are concerned about isn't even relevant to the rule in question.

[iris lily]

Yeah, I find it super weird that this trans issue got shoehorned into this debate.

If there's a jurisdiction where kids can transition without their parents' consent, and without adequate professional counselling first, then that's a totally separate issue to debate.

But this law has NOTHING to do with parental consent. It has to do with privacy of primarily what is discussed during medical appointments. Because up to 90% of what goes into a lot of doctors' medical notes is what the patient said, what questions were asked, etc.

My first post about trans children, minors, getting medically prescribed drugs did not explicitly state “without knowledge or consent of their parents.” I can see your confusion because I didn't make  it clear, this medical treatment is without parental involvement.  I assumed ...well. It is wrong of me to assume.

Parental concern and being shut out of medical decisions with their trans children is a core idea of Shirer’s book.

Sure that is good for some kids and for others, not so much. The right parents would bring an important context to treatment. The wrong parents might do further harm to the kid.

You said “where I practice, doctors still need parental consent for anything, unless in their professional opinion it is necessary.”

I don’t know what that means. Is there a missing “not” in that sentence? Your physicians need parental consent for treatment? Always? Sometimes? Can make exclusions?

Sure I understand that consultation is protected with privacy standards, I am asking about treatment, specifically, drugs.

To clarify: I always need to have parental consent for treatment of a minor unless I deem it necessary to withhold that information for the sake of the child. The burden for me to withhold that information is very high and opens me up to litigation.

So yes, I can make an exception, but there's no fucking way I'm doing so without consulting a lawyer first. I will not do it lightly. That's just my jurisdiction and my area of treatment though. I very rarely feel the need to withhold consent from a parent, but I very frequently discuss things with teens that they don't want shared. There's a HUGE difference.

As for this law, it has NOTHING to do with consent. It only has to do with medical records. Those are completely separate issues. That's why I find it so weird that you are even asking about treating trans kids without their parents' knowledge because what has been posted has nothing to do with that.

Issues of privacy of records and issues of treatment consent are entirely separate issues. That's why it seems that you are shoehorning your trans concerns into a debate where what you are concerned about isn't even relevant to the rule in question.

I sincerely  do not understand how the two issues are entirely separate. Entirely? No, I can’t grok it. But if this thread covers only and specifically and not even possible anything other than medical records, and it is not ok to discuss related issues, ok then. Thread police have spoken.

I understand that consultation, what the child talks about with his/her physician, is confidential. That is always confidential. Got it. It is talking, it is health advice. There is  no surgery no drugs no hands on treatment. Those interactions with kids and dr are protected by privacy law.

I do not understand how treatment—surgery, drug administration, etc. can take place in absence of parental knowledge but requiring their consent. This concept is confounding to me. A parent is expected to sign off on surgery without being told what the surgery is for? How does that even work?

I guess I wont know because my question is out of line and off topic.

[MudPuppy]

Seeing the patient’s health record would show you what the patient talked with the provider about. Treatment is an entirely separate issue. All this does is keep the parent out of the chart once the patient is 13. You’re panicking over nothing.

[Wrenchturner]

I'm not so convinced that someone can "pause puberty".  And there are concerns about fertility and bone density consequences with regard to puberty blockers.  Parents definitely make impositions on a child's identity all the time.  This is a tough one.

[Metalcat]

Yeah, I find it super weird that this trans issue got shoehorned into this debate.

If there's a jurisdiction where kids can transition without their parents' consent, and without adequate professional counselling first, then that's a totally separate issue to debate.

But this law has NOTHING to do with parental consent. It has to do with privacy of primarily what is discussed during medical appointments. Because up to 90% of what goes into a lot of doctors' medical notes is what the patient said, what questions were asked, etc.

My first post about trans children, minors, getting medically prescribed drugs did not explicitly state “without knowledge or consent of their parents.” I can see your confusion because I didn't make  it clear, this medical treatment is without parental involvement.  I assumed ...well. It is wrong of me to assume.

Parental concern and being shut out of medical decisions with their trans children is a core idea of Shirer’s book.

Sure that is good for some kids and for others, not so much. The right parents would bring an important context to treatment. The wrong parents might do further harm to the kid.

You said “where I practice, doctors still need parental consent for anything, unless in their professional opinion it is necessary.”

I don’t know what that means. Is there a missing “not” in that sentence? Your physicians need parental consent for treatment? Always? Sometimes? Can make exclusions?

Sure I understand that consultation is protected with privacy standards, I am asking about treatment, specifically, drugs.

To clarify: I always need to have parental consent for treatment of a minor unless I deem it necessary to withhold that information for the sake of the child. The burden for me to withhold that information is very high and opens me up to litigation.

So yes, I can make an exception, but there's no fucking way I'm doing so without consulting a lawyer first. I will not do it lightly. That's just my jurisdiction and my area of treatment though. I very rarely feel the need to withhold consent from a parent, but I very frequently discuss things with teens that they don't want shared. There's a HUGE difference.

As for this law, it has NOTHING to do with consent. It only has to do with medical records. Those are completely separate issues. That's why I find it so weird that you are even asking about treating trans kids without their parents' knowledge because what has been posted has nothing to do with that.

Issues of privacy of records and issues of treatment consent are entirely separate issues. That's why it seems that you are shoehorning your trans concerns into a debate where what you are concerned about isn't even relevant to the rule in question.

I sincerely  do not understand how the two issues are entirely separate. Entirely? No, I can’t grok it. But if this thread covers only and specifically and not even possible anything other than medical records, and it is not ok to discuss related issues, ok then. Thread police have spoken.

I understand that consultation, what the child talks about with his/her physician, is confidential. That is always confidential. Got it. It is talking, it is health advice. There is  no surgery no drugs no hands on treatment. Those interactions with kids and dr are protected by privacy law.

I do not understand how treatment—surgery, drug administration, etc. can take place in absence of parental knowledge but requiring their consent. This concept is confounding to me. A parent is expected to sign off on surgery without being told what the surgery is for? How does that even work?

I guess I wont know because my question is out of line and off topic.

I really don't understand what you aren't understanding, you keep talking about treatment when this law is about access to records.

If a teenager comes to me for an appointment, I have to ask their parents for consent for me to do anything to them. Their parents have full knowledge of any tests or treatment. However, they do not have access to the notes that I wrote about the appointment, which may contain a lot of information that is private and not strictly necessary for the parents to know for the sake of consent.

The medical records being accessible has NOTHING to do with whether or not I require consent to treat the teen. The quote from the OP only addresses access to the records of the appointments and has nothing to do with whether or not consent was needed for treatment in the first place.

So if a teen girl comes in with oral herpes and requires a valtrex prescription, I have to ask her parents for consent to prescribe it, but I don't need to tell them that she's worried she got it from performing oral sex. I do have to write in my note about her oral sex concern and what I explained to her, but her parents can't read that note. They just know she has a cold sore and that she's getting a prescription to help it resolve quicker.

Most of my patients never access their own notes, much less the notes of their young children. I don't even legally have to show any patient their own notes unless they submit a written request at least 24 hours in advance. We didn't have online records access like some places do now.

So you can have laws that allow treatment to be done without parental consent, but that's an entirely separate legal issue.

I hope that's somehow more clear???

[MudPuppy]

I'm not so convinced that someone can "pause puberty".  And there are concerns about fertility and bone density consequences with regard to puberty blockers.  Parents definitely make impositions on a child's identity all the time.  This is a tough one.

It’s done as treatment for precocious puberty in cisgendered children all the time, and considered relatively safe.

[MilesTeg]

I think a lot of the folks who are against this are either:

(1) really good, but naieve, people who can't understand why a teenager should have privacy from their parent/guardian.

(2) really bad people who are the kind of people that this law is specifically made to protect teens from.

And this is a problem that is not just about medical information. When I was a teen one of my friend's family were jehovah's witnesses. When they tried to force my friend to drop out of school when it "was time for girls to focus on being wives and mothers" she had to get legally emancipated to prevent that abuse.

Rolling back around to the topic, a doctor is the type of person an abused child might reach out to to get the help they need to extricate themselves from a bad situation, so protecting the conversations they may have with them is paramount.

Parents don't own their children. The law MUST protect children from parents that think they do and abuse their legal authority.

[TrMama]

We have a very similar setup in BC. It's called mature minor consent and it starts at 11. Since my kids are 12 and 14 it comes up every time they get a covid test. When I call to make an appointment for testing, I have to hand the phone to the teen for them to give their consent to be tested. Then when it's time to access their results I simply give the tester my cell# instead of the teen's #. I do this with the consent of the teens. Their take is that they don't want to have to take on the boring administration of their health info. They prefer for me to make the appointments, remind them the day of, drive them there and deal with any resulting insurance admin. In the words of my 12yo, "Mom, I still sleep with a teddy bear. I shouldn't be managing my own health info." Although after reading some of the stuff here I'll make sure they have all their doctors and dentists numbers added to the contacts list on their phones just in case.

Mature minor consent is also relevant during school vaccinations. Regardless of what I write on the consent form that goes out before the scheduled vaccination day, the teens can either decline a vaccination I signed the consent form for, or they can consent to receive a vaccine if I tried to prevent them from getting it. The end result is that we have lots of conversations in our house about how important it is to get medical treatment (vaccines, medicine, surgery, etc) when it's in your best interest even if the procedure itself is unpleasant.

I'm finding the side discussion on transgender teens, by people who don't even have kids, to be very weird. Perhaps I should postulate on how single people should run their lives and what medical treatments they're entitled to?

[iris lily]

Seeing the patient’s health record would show you what the patient talked with the provider about. Treatment is an entirely separate issue. All this does is keep the parent out of the chart once the patient is 13. You’re panicking over nothing.

I am not panicking. What a silly emotion to ascribe to me. Keeping parents out of a minor’s medical chart/records along with boyfriends, girlfriends, social workers, teachers, interested neighbors, internet strangers, etc. seems fine to me.

There are other things related to minors and healthcare that we’re not allowed to talk about in this thread that may not always be so great.  I didn’t understand that even though posts 2, 5, 8 and probably others do. It was probably the “ phalloplasty” surgery comment that triggered my initial wrong-speak.

But OK not allowed. Got it.