ACOG Committee Opinion No. 758: Promoting Healthy Relationships in Adolescents.

Obstetrician-gynecologists have the opportunity to promote healthy relationships by encouraging adolescents to discuss past and present relationships while educating them about respect for themselves and mutual respect for others. Because middle school is a time when some adolescents may develop their first romantic or sexual relationships, it is an ideal timeframe for obstetrician-gynecologists and other health care providers, parents, and guardians to play a role in anticipatory guidance. Creating a nonjudgmental environment and educating staff on the unique concerns of adolescents are helpful ways to provide effective and appropriate care to this group of patients. Obstetrician-gynecologists and other health care providers caring for minors should be aware of federal and state laws that affect confidentiality. Obstetrician-gynecologists should screen patients routinely for intimate partner violence along with reproductive and sexual coercion and be prepared to address positive responses. Furthermore, obstetrician-gynecologists should be aware of mandatory reporting laws in their state when intimate partner violence, adolescent dating violence, or statutory rape is suspected. Pregnant and parenting adolescents; lesbian, gay, bisexual, transgender, queer or questioning (LGBTQ) individuals; and adolescents with physical and mental disabilities are at particular risk of disparities in the health care system. The promotion of healthy relationships in these groups requires the obstetrician-gynecologist to be aware of the unique barriers and hurdles to sexual and nonsexual expression, as well as to health care. Interventions to promote healthy relationships and a strong sexual health framework are more effective when started early and can affect indicators of long-term individual health and public health.