Because this issue also connects with medical care, the situation in Australia is very different. Here, we don't have school clinics. I do remember a medical centre at my university, but there is no need at schools. A school nurse - some schools have them, ALL schools have a staff member designated to dispense medication according to strict guidelines which include parental permission and details about who prescribed the medication and in what dosage. A waiver has to be signed and medication taken to the school personally by parent/caregiver and handed in at the office. No medication to be taken to school by the child.
In the community - a child over a certain age (I think it's 13, I'm not sure) can take him/herself to the doctor and request confidentiality. The child would need to provide their Medicare number (and preferably their Medicare card, which is generally in parental custody). A child could ask for confidentiality. In practice, I don't think it happens much and a child that young asking for confidentiality would be needing to give really good reasons and would be counselled by the doctor.
There was a move by the government a few years ago, still possibly to be resurrected, to bring in a Medicare card for each person which was also an ID card and also had a microchip to be updated at each doctor visit (no matter who treated you) with updates of your medical history. This would mean that if a child went to a different doctor to get contraception, the new doctor would still have access to details about the medical history which might perhaps indicate if there were any medical conditions or concerns which would make hormonal contraception inadvisable.
In Australia, a girl wanting to go on the Pill has to have a Pap smear and breast check. Some doctors aren't as scrupulous about it, they may prescribe first, but she would only get about three months' supply before the doctor would INSIST on a Pap smear, even if the girl says she's not having sex (I'm speaking from experience here!)
This would put off really young girls only wanting to go on the Pill because it's 'cool' or some other stupid reason.
A girl going on the Pill before, say, 15 - the biggest risk is that she will stop growing sooner. The hormones of puberty are what triggers girls to stop growing, over the next few years. The later puberty in boys is why boys are taller in adulthood, on the whole. Hormonal treatment too early isn't good for a girl. But neither is pregnancy. The hormones of pregnancy will do far more to change her body long-term. Given a choice, the Pill is far safer.
But if a girl under 15 is wanting contraception, I would be worried for her in many other ways. She really isn't mature enough to make such a decision for herself and the whole situation really needs to be examined, for her physical and emotional health. But in the meantime, if she needs it to stop getting pregnant, I would give her the Pill. It's all very well to preach celibacy - it IS an ideal - but if the kid is not celibate, slam some precautions into place pronto and ask questions later. Preferably not too much later; say, 5 minutes at the most.
Education is important. Commonsense is important. Careful medical supervision is important. Ideally, parental involvement is important, but we can't judge all parents by our standards. Kids need to be safe. How do you protect the girl who is being molested by the father figure in her life? If the girl has independent access to this sort of health care, she has access to someone who is in a position to find out what is going on. In such a case, she would need to have the parental permission to see the school clinic. Hopefully, the school clinic would be staffed with someone who can ferret out the problem and deal with it at the base level, rather than a band-aid contraception.
Kids this age with access to contraception - it's a worry. But the big worry is that unfortunately, some kids will benefit if this is in place and will suffer more if it is not.
How do you fix the underlying problem that makes setting up a clinic like this a viable option?
I do wonder if this media story isn't a bit of a beat-up. In setting up a school health clinic, it's easier to say, "Here is a health clinic, we will treat whatever comes through the door," than to say, "But of course, since these are children of Middle School age we won't even consider discussing contraception, post-natal care, geriatric medicine and hip replacements." Because once you start putting restrictions in place for obvious stuff, people start thinking, "What about this? What about that?"
I don't know many medical centres which have restrictions on what they treat, other than ones which are in common with the country's acceptable standards of good practice.
I do think in this case, a school chose to set up a health centre. Along with that, came this whole package they'd never considered since, for Middle School, it's beyond what most people find acceptable.
I don't read this as a general invitation for kids to cram in, clamouring for condoms and contraceptive pills to be handed over, thanks to the marketing campaign - rather, I see this as an attempt by a school to do something good for the students, to give them access to good health services, and it's blown up in their faces.
There will HAVE to be a doctor overseeing any prescribing. ANY doctor who prescribes a contraceptive Pill for a 12 year old girl would have a great deal of explaining to do. Who will fill the prescription? At some level, SOMEONE would talk and the doctor would be in deep doo-doo if he can't justify it legally.
Of course we want our children to abstain from sex until they are married. But unfortunately, in this day and age they would increasingly be in the minority. We taught our kids as best we could and had to accept that we had done our best but our girls made up their own minds when they were 18. Chastity belts are illegal. Locking up your daughter is illegal. And if, at 18, they choose to have sex, it's THEIR legal decision. All we can do is hope they have enough sense to take precautions - and if we have taught them to be responsible and honest, they (hopefully) will do so.
If we are so determined that our daughters will not have sex before marriage, that we fail to educate them about the ethics, the health issues and the social aspects of sexual matters, we are doing it wrong. Again, speaking from experience - that's what MY parents did. All it did was make me more vulnerable to exploitation.
Education about sex and availability of contraception will not in itself cause promiscuity. All it will do is provide resources to try to help the kids who will be doing it anyway.
The issue of parental permission/involvement in medical issues at this age - I think that is another matter. There are many areas in the health systems of your country and mine, where we meet these sort of paradox problems. Maybe a "Big Brother" type of health care card/records is the way of the future, where a patient's records are always available to the consulting doctor. It is scary, it would need a lot of safeguards to avoid abuse of such a system by unscrupulous administrators, but it WOULD avoid some tragedies too.
Marg
