Seeing the GP: Advice and tips for young people

Seeing the GP about sexual health

Here, people talk about:
•   where can young people find sexual health services and advice?
•   young people’s rights and confidentiality
•   young people’s experiences

Where can young people find sexual health services and advice?
Anyone with a concern about sexual health can see their GP, whether it’s about contraception, periods, STIs, pregnancy, cervical screening, or abortion. People can also speak to their doctor if they want to talk to someone about sex and sexuality. Sexual health services and advice are available from:

•   GPs
•   pharmacies
•   contraception clinics (family planning clinics)
•   sexual health clinics
•   STI testing clinics
•   genitourinary medicine (GUM) clinics
•   young people's services (e.g. charities)

A GP talks about the sexual health services that they usually provide.

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What sexual health services does the GP provide and from what age is it provided from?

Okay, so GP’s provide nearly all the contraceptive services, so helping people not get pregnant if they don’t want to get pregnant and really that’s from as early as they need that.

Okay.

They will also provide some testing for things like Chlamydia, which is a very widespread infection that can affect fertility, so that’s useful to screen for that and to treat it if you find it. GPs will also do testing if people have symptoms, take some swabs, try and find out what, if anything, is causing the symptoms, whether that’s ulcers or discharge or something that they think might be sexually transmitted.

Okay, and seeing as you brought that up and you said that anyone can come in for sexual health, to use the sexual health service, imagine it was a teenager and I know teenagers can only come in with an adult and they don’t want an adult with them, how would you go about that?

Yeah, that can be, can be difficult. So teenagers can come on their own if they want to. There’s rules that mean that GPs shouldn’t treat a child unless they know that that person understands exactly what’s going on.

Okay.

Okay, and there are various questions we have to ask ourselves about who needs to know. There are occasions when GPs will prescribe and treat for people, particularly over 14, if they understand what’s going on. It’s often better if parents do know but that’s not always possible.

Young people’s rights and confidentiality
When it comes to sexual health services, whether at a clinic or GP surgery, young people have the same rights as anyone else regardless of their age, sexuality, ethnic origin or gender.

Appointments with the GP are confidential regardless of a person’s age. Doctors and nurses have very strict rules on confidentiality so that everything a patient tells them, their personal details and medical records are kept completely private. However, a GP might encourage a patient to tell others (like a parent) about the problem, or they can speak to them on the patient’s behalf if they’d prefer. This is because sometimes it’s important for those looking after a person to know what’s going on as they might be able to help or support them. The doctor might encourage a young person to tell their parent or guardian, but should respect a patient’s wishes if they don’t want to. If a patient is under 16 and doesn’t want to involve their parents, the doctor can treat them without telling their parents as long as the young person fully understands the choices they’re making. In exceptional cases, though, like when a health professional thinks a young person might be in serious danger, they may need to pass information to police or social services. Even then they must talk to the person first before they tell anyone else, unless that would put someone at risk of harm.

Young people’s experiences
People often see the GP to get contraception. Emma usually went to get the contraceptive pill, while Aphra said she bought condoms when she was at university as she wasn’t in a serious relationship. Later, when she was, she went to the doctor and got the pill. She felt that sexual and mental health were young people’s biggest concerns when it came to their health:

Aphra bought condoms at supermarkets. They were given away freely at the university bars.

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Aphra bought condoms at supermarkets. They were given away freely at the university bars.

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I didn’t bother going to the GP for contraception. I just, whenever I needed it, I bought it at uni. It was just one of those things where I never got that feeling of being embarrassed going into a supermarket and just going, "This is what I need." And, because I wasn’t in a long term relationship really, I didn’t need to go onto the pill or anything like that, so it was very much just about being safe.

But also if I had needed it, it would have actually have been easier to go to the bars at the university because they give them out free there. So it was just one of those kind of things where some people probably did because it was a bit quieter, but it depends on how embarrassed you get about it really.

Hannah recalled the first time she went to see the GP about going on the pill. She was 16, went on her own, and felt nervous. She now goes routinely every six months:

Hannah realised she needn’t have worried about being judged or asked lots of questions. The GP gave her leaflets about other contraception too.

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Hannah realised she needn’t have worried about being judged or asked lots of questions. The GP gave her leaflets about other contraception too.

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When you went to get the pill the very first time, how did you feel going because –

Yeah obviously I was really nervous because I was 16 I think, so I was nervous because you do think of maybe a doctor as the same, in the same sort of breath as your mum and dad. So you worry that they’re going to, not judge you but yeah, worry that they’re gonna think things of you or ask you lots of questions, which at that age I’m sure you’re not really prepared to answer. So I was worried, but then after I was absolutely fine cos like, after you think oh that really wasn’t that bad, you know.

Can you remember the appointment, can you remember the kinds of questions that the doctor might have asked or anything like that?

I think the doctor asked why I wanted to go on the pill and why the pill specifically because there are obviously other contraceptives available. I think they asked if I had a boyfriend. They didn’t go into detail about amount of sexual partners or anything like that. But yeah I think they just wanted to know if I was actively having sex and why I wanted to go on the pill, yeah.

Did they give you any information about the other -

Yeah I got leaflets, I remember I did get leaflets about all the kinds of contraception and all the pros and cons and, and you know about risk of pregnancy, I guess that they’re not 100% effective and things like that, yeah.

Sarah found it ‘awkward’ asking for the pill the first time she went to the GP but said it’s no problem now that she’s older. Although she’d moved home several times, she always registered with a GP quickly so she could get the pill. She once ran out and couldn’t get an appointment when she needed one, so always books an appointment straight after the last one:

Sarah found it awkward asking the GP for the pill the very first time. She advises preparing what you’re going to say beforehand so you feel more comfortable.

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Sarah found it awkward asking the GP for the pill the very first time. She advises preparing what you’re going to say beforehand so you feel more comfortable.

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I think the first time I went I found it really, really awkward. I found it really awkward and it was really, really awkward but after that it’s been fine. And I think as I’m a bit older maybe, or just more used to things, the doctors, I don’t have a problem with talking to doctors about it. And it’s much more routine now...

So you mentioned the very first time you went that it was embarrassing. A lot of people might find that.

Yeah.

Can you talk a little bit about that and what might have been, what could have made that easier? Because a lot of people will be in that same kind of situation.

I think decide what you’ll say, you’re gonna say before you go in. Like I do that, sometimes I go into the doctors with like a mental list of like, I know you’re only meant to talk about one thing now, but like make sure you know what, how you’re going to phrase it, because if you go in and they’re like, “Okay how can I help you today?” or whatever, and you say something that’s a little bit weird, then it’s just a bit awkward.
I think it’s a lot easier if you maybe have a sentence as like saying, “I’d like to get the contraceptive pill.” Or whatever.

So slightly prepare what you’re going to…

Yeah.

…talk about.

I think that’s a good idea. Yeah, definitely.

Sarah advises booking an appointment in advance to avoid running out of the pill and messing up your cycles. If you do run out, it’s good to use other methods.

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Sarah advises booking an appointment in advance to avoid running out of the pill and messing up your cycles. If you do run out, it’s good to use other methods.

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I’ve had to wait like, for the pill I’ve had problems when it’s been like, in [place name]. I think I immediately thought you could get a doctor’s appointment within two to three weeks and you can’t. You have to like book an appointment when you need to see a doctor every three months, you have to book the appointment when you’re coming out of that appointment.

Oh for the pill.

For the pill.

Because you’re going in routinely to get more?

Yeah, yeah. So the first time that happened, I think I thought, “Oh I can get one within two weeks.” And then was thinking, “I’m gonna run out.” And I did run out. But that’s not the end of the world, like that was alright. That wasn’t serious medication. And if it had been serious medication, something else would have been an option. But no I’ve never been to A&E. I’ve only been to A&E for like, I broke my ankle once, but yeah.

So when you ran out of the pill?

Yeah.

If someone was in the similar situation…

Yeah.

…what would you advise them?

Use other methods of protection.

Till you get them?

Till you get the appointment. And keep it within rhythm with your cycles. So, if you ran out of the pill and have your period, and then wait until you’d normally start, like wait a cycle and then start again ‘cos it stops everything getting a bit mucked up. And take other forms of protection.

Aphra, who was on antidepressants, talked about going on the pill with her GP in an ‘honest and open’ way. The GP told her that the pill could help stabilise her ‘highs and lows’. The doctor talked to Aphra about the different kinds of contraceptive pill that she could take but she said ‘it was my decision to go on the pill’. Aphra sees the GP every six months for a repeat prescription and the nurse usually checks her blood pressure. Hannah also went every six months. Sometimes she sees the GP and other times the nurse.

Aphra saw a GP that specialised in sexual health. When she was in a relationship, it was good to go on the pill as well as use other protection if needed.

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Sex: Female

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It is one of those things where, when I did make the decision to go on the pill, partly to help with my depression actually because it balances out my mood. Then I felt really like it was easy to say to my GP, "Oh I've started seeing somebody and I think this is a good idea." And she immediately went, "Yeah, in your situation let's have no children."

And so it was really easy to arrange then and there's a specialist doctor in our surgery who really deals with all the contraception and all the sexual health issues. The other doctors can cover it, but she's the one with the most skills and she's had extra training. And so she can tell you all the statistics and all the facts off the top of your head. And it's very much that you're allowed to choose what's best for you, and if you don’t like something – they ask you to try it for a month or so, but you're more than welcome to go back and to ask for it to be changed or to try something different.

That’s good. So it's all at the GP's surgery which is easy to get to, and there you see the same GP, but is it a sexual health clinic or you just go to the GP?

You just go to the GP. So there is some instances where that GP will work in the quieter surgery. And, although I can't be certain, I'm pretty sure it is almost a clinic booked in terms of the receptionist's eyes, and everyone's there for the same things. But I only get the feeling of that because that surgery will be absolutely empty of everyone but women. But she has ordinary appointment times so you can be seeing her for anything. You know, from a sore throat to actually, you know, family planning.

And was it her suggestion or your own suggestion, or was it more of a discussion about going on the pill?

It was my decision because it had been kind of floated before that it might be something that they look at just because I was getting highs and lows with my hormones. But it wasn’t until I started seeing somebody that I went, "Actually now I think I want that extra protection." Especially because having anxiety, even though I use other protection, and I've changed boyfriends since, I used other protection again, there's always part of me that goes, something is going to go horribly wrong [laughs].

So it's a reassurance?

Yeah.

Whether Hannah sees the nurse or doctor, she gets a repeat prescription for the pill. She also has her blood pressure taken and her height and weight checked.

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Sex: Female

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So how often do you have to make an appointment then to?

Every six months.

So every six months and is it always the GP that you see or sometimes a nurse?

No. I see the nurse sometimes. I don’t mind who I see but obviously when I see the nurse, the nurse can’t prescribe me anything so I think then she has to get a signature from the GP for my pill. But usually I call in advance because I know in advance I’m gonna see, that I’m gonna need an appointment, so it’s usually with the GP but I have seen a nurse before.

And is it a different GP every time that you go every six months?

Usually it is, yeah, because they ask me do I mind and I say ‘No, I don’t mind.’

And what happens in the appointments when you go to get the pill?

So they ask me what the appointments for, obviously I guess they can’t see what I have booked in for a certain appointment, so I think they just think it’s a general appointment. So I, and I say I’d like, you know, a repeat of the pill and they’ll look on my file I guess and see what health issues or anything I’ve had in the past. And take blood pressure every time and check weight and height and things. And then yeah usually it’s just a straight forward repeat and I generally get up –

Every six months, yeah.

Yeah.

Is there a chemist nearby?

Yes there is, yeah a two to three minute walk.

Okay so that’s quite handy.

Yeah.

And when you see the nurse does she do the same kind of thing?

Yeah.

Like Aphra, Emma was always pleased with the contraceptive advice she’d been given by the GP. Both felt that the doctor told them about all the various options. Siobhan was on the pill but would have liked to have had an implant instead. Her GP didn’t offer implants and the nearest sexual health clinic was only open 12-3pm on Tuesdays, when she was still at school:

Siobhan would like it if her local surgery offered implants. The sexual health clinic does but is only open at certain times and is further away.

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Sex: Female

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Would it help if they had like a clinic just for young people?

I think that would be really good cos like the doctors would be used to working with young people more often. And it wouldn’t be so varied in what age they’re looking at. So they’d be able to use young person-friendly terms and work with them in a better way.

And how about if there was a drop-in clinic for young people? Like on say Tuesdays, 5 to 8pm is a clinic for young people. Do you think that would help?

Yeah, that would be really good cos obviously you can get there. Like when I were getting my contraceptive pills, like I couldn’t get the implant in because of the times the drop-in sessions were open at the sexual health clinic. Cos they were open at such difficult hours, like it was Tuesday, 12 till 3.

The

Sexual health clinic in [place name]. Like obviously I can’t get there at that time. So I can’t have the implant in my arm, so I have to stay on the pills.

So would you ever go to the GP for that?

I went to the GP first about it cos they put me on the Pill. But they said, “We don’t do the implant here. You’ll need to go to this place.” And it’s like, “Have you seen what times it’s open, you poo? I can’t go there, can I?”

Every day the same time?

Every day the same time, 12 till 3. And then I think it’s 8 till 10. But cos it’s in the middle of town and my school’s in [place name], it’s like, “Well, no.”

Would it be better if your GP’s surgery did that then?

Yeah, it would be a lot better. Cos then I could just go, have it in, and then I can, without having to prat about going into town and things like that. Or having to get a repeat prescription for the Pill as well as my like Serchiline.

So if you went to the GP for the, like the Pill, would you prefer to see the GP or one of the nurses?

I think I’d like to see like probably a female doctor first. Cos I specifically asked for a female doctor when I had that appointment.

Did you get a female doctor?

Yeah, I did that time. And then after that maybe like the nurse to administer the implant or whatever.

So that’s a bit inconvenient, isn’t it? So you really have to plan ahead in a way?

Yeah, I was gonna go and have the implant in my arm. But I have to book it for like holiday time, cos they don’t open on a weekend either.

Aphra lives in a village and felt that a lot of young people go to the GP for contraception if it’s easy to get to the practice (surgery or health centre). The nearest sexual health clinic to her is two bus rides away so hard to get to. For Hannah, though, it was quite easy to get to a clinic, and she’d been to see her GP and the family planning clinic about contraception.

Practice (surgery) nurses also help with contraception and sexual health services. Aphra and Sarah recalled seeing the nurse about the pill and Fran mentioned seeing the nurse for cervical screening (smear) tests and an STI test (test for sexually transmitted infections).

A nurse carried out Fran’s STI and cervical screening (smear) tests. Fran doesn’t like going to the doctors’ but this nurse was kind, jolly and talkative.

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I’ve been for a few like STI tests and stuff.

And has he [GP] been understanding, you could, do you feel…?

You go to the female. I don’t, I don’t like a man doing STI tests on me. It freaks me out.

So do you go to the nurse in the GP’s surgery?

Yeah.

So you just phone, you would just phone her?

Yeah, I had to have a smear test and stuff. But I don’t go to the doctor’s if I can help it. I don’t like the doctor’s. It’s just cos it reminds me, actually, no, that’s not true. Because I don’t think I’ve ever liked the doctor’s.

So when you’ve gone to see the nurse, has it been different nurses every time or. .

No, it’s usually the same nurse, and she’s really nice as well.

So what makes a good nurse there at the GP’s surgery? Cos you said she’s really nice.

I think it’s just kindness and genuinely being nice to people. It doesn’t hurt. Like you’ve been nice to me today, so I’ve been nice back. It doesn’t hurt to be nice to people.

So it’s just those…?

She’s just a nice person. Like she spends a lot of time going to dance classes and stuff. And she’s just like really into dance and she’s talkative, it’s just nice people, nice person.

So she just talks about normal things as well as what have you come in for, that kind of thing?

She’s really jolly, that nurse. But again I don’t think about her that much, no.

So when you’ve gone in, you’ve gone for things like smear tests, STIs? Does she ask lots of questions or do you feel that…?

Yeah, she just gets on with it, yeah.

And you feel quite comfortable?

Yeah, I like that like attitude, yeah.

Did you ever ask her any questions, did you ever want information about anything? Or do you more or less go there?

Just go and get it over with. I don’t like the doctor’s, even though they’re nice people. It’s not their fault. I just don’t like going to the doctor’s, yeah.

Aphra said that cervical screening (smear) tests can be unpleasant but they’re ‘worth doing to save your life’. Young people need to talk openly about them.

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I think the only one thing that is important, and is only important because it comes up in the news quite a lot recently, and because I'm involved in the cancer services, about smear tests. And I think more young people need to talk about smear tests really openly and know about it sooner, because the chances are that quite soon, as long as funding allows and pressure keeps mounting as it is for smear tests will be happening earlier than twenty five.

And obviously there's a lot of tragic cases of young people knowing there's something wrong and their doctor's not giving them a smear test. And I think that it's one of those things where it sounds awful and it sounds scary and young people don’t want to go and have it done. Well, being in Wales they come earlier, and so I can say quite safely that a smear test is about as unpleasant as it sounds. But it's absolutely worth doing to save your life.

And I think it's one of those things where we need to get away from those taboo areas about our health and just be prepared to talk about everything a lot more openly even if it's something we don’t necessarily like to think about.

Some people said they prefer seeing a GP of their own gender when it comes to sexual health. Kim usually didn’t mind if it was about the pill as she felt ‘that is what they’re there for, you know, they’ve had this a million times’. But she would feel more comfortable with a female doctor or nurse if it was ‘invasive or anything like, or embarrassing in my eyes’. Although she’d rather be seen by a female GP, she believed that all doctors were ‘there to help’. Fran disliked seeing a male doctor about anything personal, like cervical screening (smear) tests and STI tests, and Siobhan said she specifically asked to speak to a female GP when she wanted to talk about the pill.

Kim might feel more self-conscious seeing a male GP if she had to ‘show everything’. She wondered if that was about her, her upbringing or societal stereotypes.

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Kim might feel more self-conscious seeing a male GP if she had to ‘show everything’. She wondered if that was about her, her upbringing or societal stereotypes.

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Age at interview: 25

Sex: Female

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I’ve been to the GP before when I’ve wanted to try something different [contraceptive] and it’s been, you know, a man. And I think initially there is a, “Oh God, I’m away to talk to a man about contraception.” Which, I don’t know where that comes from. But it’s there sometimes. And then I think once you start talking about it with the GP, you realise that this is what they’re there for, you know, they’ve had this a million times. Hopefully they’ll be more, you know, willing to explore options.

I think sometimes I’ve heard that, oh, you know, like male GPs just like put you in a category and just give you one type of pill, for example. Whereas women might be a little bit more, “Oh, let’s see what you would do, you would do best within your lifestyle.” I personally haven’t had that experience. I think I’ve had a good, good experiences with men and women. But, as I say, I mean I haven’t really used GPs that often for those kinds of things. But yeah…

No, that’s great. So you said that there might be a stereotype of men sort of prescribing only one kind of contraception?

Yeah.

Do you think that men would feel the same way?

Yes, I think men would feel the same way. I mean obviously I’m not male so I can’t say. But I think it’s just, it’s inbuilt in us that you can show everything to a woman, whereas showing everything to a man means something different. Which is strange. Maybe that’s just me or my upbringing. I’ve no idea. Or societal stereotypes. [coughing]

But, you know, I think, I mean I, that’s coming from a place as well that I’ve never been in the scenario of having to strip down in front of a male doctor either. So, you know, if you ask me would I be open to that, I’m not, yeah, I think I would be. Cos they’re a doctor. Like they’re obviously there to help you be better or explore whatever it is you’re there for. But I think initially in your head you, you’re kind of like, “Please be a woman, please be a woman, please be a woman.”

Do they, do they ask you? Do you have a choice between a man or a woman? Or is it kind of just luck of the draw?

I think it depends on how quickly you want to be seen. Because I remember actually there being a box, I think there was a box that was like ‘see any doctor’ or ‘see female or male’, well, for the sexual health clinic anyway. So I did tick the female.

Could have that meant that you had to wait a bit longer?

Potentially, yeah.

More young people talk about their experiences of sexual health here.