Sexual health services should promote sexual wellbeing by adopting a positive attitude towards young people’s sexuality and relationships. A young person is someone under the age of 16 years, or under aged 18 years if the local authority is responsible for their care.

All sexual health service providers must ensure that their services are confidential, of high quality, and easily accessible and welcoming to young people. Confidentiality is particularly important to young people. Services must offer and advertise the fact that information will only be shared in cases where it is necessary for safeguarding.

The Sexual Offences (Scotland) Act 2009 was not intended to prosecute mutually agreed sexual activity between two young people of a similar age unless it involves abuse or exploitation. However, there have been occasions where it has created fear and confusion among young people and professionals about the right to confidentiality. It is important that health professionals continue to be confident in advising and providing services to young people in accordance with the latest national and local guidelines on confidentiality and information sharing. The law must protect young people from abuse, but it should not be an obstacle to their ability to get help and advice when they need it. Where young people are accessing sexual health services, it is crucial that professionals do not confuse child protection issues with the normal sexual development of young people. In the case of doubt, advice should always be sought by the local NHS Child Protection Advisor. The legal age of capacity in Scotland is 16, however, those under 16 can consent to medical treatment (which includes contraception) provided they are capable of understanding the nature and possible consequences of treatment.

If the under-age sexual activity involves children under the age of 13 years, the concerns must be passed on in accordance with local child protection procedures.

Sexual health clinicians should be mindful of the increasingly sexualised society in which young people live. For example, sexual discrimination and bullying is commonplace on social media sites such as Facebook. Internet pornography, to which most young people have access, whether voluntary or involuntary, displays high levels of violence, degradation, abuse and oppression, particularly to women. Condom use in pornography is rarely observed. Consequently, young people are exposed to mixed messages about human sexuality and behaviour, which can be detrimental to their wellbeing. This may result in vulnerability to exploitation and abuse within sexual relationships. Sexual behaviours should never result in exploitation, oppression, physical or emotional harm, and young people require support to recognise the signs and manage their sexual relationships. Professionals have a duty of care to ensure that the young person’s wellbeing needs are addressed and to assess whether the sexual activity is of an abusive or exploitive nature.

This guideline, when used in conjunction with the West of Scotland Guideline for Young People on Common Sexually Transmitted and other Infections, should help clinicians provide sexual health care which meets the needs of young people who are sexually active.