When Should My Child Have Their First VIsit With A Women’s Health Provider?

Parents will often ask when they should schedule a wellness visit for their kids with ovaries. The American College of Obstetricians and Gynecologists (ACOG) recommends that adolescents first see a GYN provider when they're between the ages of 13 and 15, but this can also vary depending on your child’s needs. This is typically a visit with a primary relationship building purpose.

This is a great way for your child to develop a relationship with a women’s healthcare provider, so they have a safe resource and place to share personal information in the future. Having a GYN provider is important if your child has a uterus, but timing can depend on you and child’s needs. If your child is already seeing a pediatric provider or family medicine provider that can offer reproductive medical care and your child feels good about getting GYN care from that provider, great!

Having a GYN provider in your child’s corner is especially important if your child has problems with their period, is sexually active (or planning to be soon) or has a family history of pelvic pain disorders like endometriosis or PCOS or is experiencing frequent urinary infections or abnormal vaginal discharge. “Well- woman visits” are annual wellness exams that focus on reproductive health, but typically include a full physical exam (except for genitals unless truly needed), discussions on sexual health, periods, and mental health. Wellness visits are a part of preventative health, and aren’t typically made with a specific concern in mind. 

A focused appointment should certainly be made if your child is having period pain and cramping not controlled by over the counter medications, heavy menstrual flow, saturating tampons and pads every hour or is frequently skipping periods or bleeding more frequently. During the first 2 years of periods, they can be irregular, sometimes skip a month, or sometimes heavier or lighter, but if you have concerns or questions scheduling an assessment is recommended. 

I love supporting teens, and I know I’m creating a safe place when they ask about concerns with their anatomy or development. Sometimes that looks like a patient being concerned that she may not have a clitoris (she did), or wondering about options for LGBTQI family building as they age, or wondering about the process of gender affirming hormones, or sexual pain or STI transmission, or rumors they’ve heard about birth control or concerns about their family history. These visits can absolutely shift to answer any questions and be tailored to specific needs. 

 I love these visits for all of the information I get to share, but also for the “practice conversations” patients share with me. “Practice Conversations” are what I call incredibly important statements of self disclosure that you can have again and again over your lifetime, but sometimes the first few times are very important practice. Having a listener respond in a supportive way is so important, because it increases our ability to self advocate, trust ourselves, and decrease the negative impact if someone doesn’t respond well later. Sometimes that can look like sharing stories about fears or identities or relationships, and young people benefit from having a supportive affirming medical provider just like any adult.   

I enjoy being a safe place for teens to ask questions, but if we aren’t starting the visit with specific concerns, I always like to cover general screening recommendations based on age and risk factors, and then discuss options for trauma informed care and how to advocate for true informed consent when it comes to medical decision making. 

What About Pelvic Exams?

I do not perform pelvic exams at a first visit unless a patient prefers I do so, and I do not recommend pelvic exams unless there is a medical need and it will give us information that can change our plan of care. And of course, all touch, even from medical providers, requires your child’s consent without coercion. Current guidelines recommend a first pap smear at 21yrs old, and then pap smears every 3 yrs until 30 years old, and then guidelines change again. 

How Should You Choose a Women's Health Care Provider?

It’s important that your child sees someone who takes the time to make her/him/them feel as comfortable as possible. You should involve your child in this decision, so you can choose a provider that can support them long term. 

Some Questions to Ask Your Child

Ask your child what type of health provider they would prefer:

• Would she prefer her provider to be a certain gender? Age? 

• Would they like to stick with the pediatrician or family doctor she has seen before (if they provide women's health care), or see someone new?

• Does your child need a provider well versed in LGBTQI healthcare?

• Would she like to see the same person as you, or does she prefer to confide in someone who has no connection with you?

WA State Confidentiality Guidelines for Minors

Many teens want a parent present during a visit or for a portion of the visit, or another support person. Both are welcome during visits, but parental guardians and teens should know that in WA state reproductive healthcare has confidentiality protections in place for minors. This means that for certain concerns, your child may not need parental consent, and can have full confidentiality. These can vary based on the specific service. For example minors at any age can receive medical counseling and treatment for birth control, abortion services, or prenatal care. Mental health care can be obtained if the patient is at least 13 years old, and a patient can receive treatment and testing for STIs if they are at least 14 years old. 

For some parents, that may make them uneasy, but for some it can be a relief to know that your teen has a provider they can call with confidential questions related to birth control, pregnancy, and other sexual health and mental health concerns. I aim to provide the type of healthcare I would have wanted as a teen, and the type of healthcare I’d want my loved ones to receive. That looks like leaving healthcare visits feeling seen, educated and empowered with evidence based options.