Seeing the GP: Advice and tips for young people

Sexual health services that young people can use

Here, people talk about:

•   who offers sexual health services and advice?
•   getting contraception from a clinic
•   what happens at a sexual health clinic?
•   confidentiality

Who offers sexual health services and advice?

Sexual health services are free and available to everyone regardless of age, sexuality, ethnic origin, gender or disability. Sexual health services and advice are available from:

•   GPs
•   pharmacies
•   contraception clinics (family planning clinics)
•   sexual health clinics
•   STI (sexually transmitted infections) testing clinics
•   genitourinary medicine (GUM) clinics
•   young people’s services (e.g. charities that work with young people)

Not all clinics offer the full range of sexual health services so it’s always best to check what they do beforehand. Aphra felt that sexual and mental health were the most important health issues for young people. Living in a village, most young people she knew locally went to the GP about sexual health because the nearest clinic was two bus rides away:

Getting to the sexual health clinic can be a problem. Aphra feels comfortable talking to her GP about sexual health. It’s got easier as she’s got older.

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What do you think are the main issues that affect young people – reasons for maybe for going to GPs?

I think a lot of young people do go to the GPs for contraception especially if it's convenient to get to, because otherwise for where I live, the nearest kind of sexual health clinic is two bus rides away. So it's not going to be easy for most people to get to. And it's one of those things where when you drive, it's easy to pop into, but otherwise it can be a real problem. But I do think that they go generally for stress quite a lot, and just for feeling ill and getting kind of almost the common ailments – sports injuries and things like that.

I think probably if it wasn’t for sexual health that stress and depression would be one of the more prominent things locally just because all the young people are under so much pressure. If they're not going into further education then they're joining the world of work. And there's an awful lot of them that are constantly told they're not good enough almost. And so they struggle to find jobs, or they're only working in warehouses, but they have terrible conditions so they swap jobs every six weeks. And people go, "Oh can't you hold down a job?" Well actually if you tried to do a twelve hour shift in an office at ten at night, I don’t think that you'd stay either.

So anxiety and depression is a big thing and sexual health as well?

Yeah.

In terms of sexual health, you mentioned the nearest sexual health clinic would be two buses away?

Yeah.

So it's quite hard to get to. Would you feel comfortable talking about issues with your GP about sexual health or?

Yeah, I think I'm really honest and open about it. I think it's one of those things where, maybe when I was sixteen/seventeen I'd be a bit more awkward and a bit more embarrassed.

Getting contraception from a clinic

Some people we talked to went to a clinic to get contraception or contraceptive advice. Hannah and Sarah recalled feeling nervous or awkward the first time they went to see the GP about contraception, though it was fine and they said looking back they needn’t have worried. With hindsight, Hannah said she’d have preferred going to a family planning clinic at that age because they had sessions specifically for people under 21.

The family planning clinic offered more tests than Hannah’s local surgery. Young people might feel more comfortable going there than to their doctor.

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There is a family planning clinic which was further away but I knew that it was available. And I had been there as well after going to the GP I think. They offer more tests and things at the family planning clinic and they have, I think also like under 21 sessions I think, which makes you feel a bit more comfortable as well if you’re like 16 or 17, yeah.

Had that been nearer would you have gone there or would you always prefer to have gone to the GP?

I’m not sure if I prefer either at that age, I can’t remember. Now I prefer to go to the GP but yeah, probably I might have preferred the clinic at that age mainly because I would, my friends would go with me and they’d have an appointment as well so we could sort of go together. And again there was, you know, a young person’s session so I guess I felt more comfortable at the clinic.

Later, Hannah went to her GP surgery and spoke to a nurse about contraceptive implants. She felt frustrated afterwards, though, and looked online for more information. A few days later, she went to a sexual health clinic.

If the nurse had explained the pros and cons of each option, Hannah wouldn’t have had to go to the clinic. She later decided against having an implant.

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If the nurse had explained the pros and cons of each option, Hannah wouldn’t have had to go to the clinic. She later decided against having an implant.

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There’s just one time I went to the GP because I wanted to have an implant fitted. I can’t remember why the reason, why I wanted an implant then I think because, I think probably I would forget to take my pill quite regularly which obviously is terrible. So I think I wanted an implant because I think it was sort of I had it, you know, it lasts for however long and I don’t have to remember to do anything.
And then when I went to the, I think I saw the nurse actually and she, I think she was like ‘Oh why do you want to have the implant, you know I think you should-,’ I think that she suggested I had the coil and I didn’t want that. I really wanted it [the implant], and she said just go away and think about it. So I left a bit frustrated then because I think once you have something in your head, you want it done straight away. So I think I left feeling frustrated and, in the end, I didn’t get it, so because I decided it wasn’t the right thing for me, so yeah.

Did you look for more information about it?

Yeah, I looked online and I also went to like a clinic, you know, a health, a sexual health clinic. And they, the clinic said I could have it but they didn’t have an appointment for it so I changed my mind at that time anyway, so....

So when you first went you spoke to the nurse at the local surgery, in a way she, she slightly put you off it?

Yeah, definitely.

Then you went home, how long did you think about it and then think no I’ll go to the sexual health clinic?

Just a few days I think yeah, cos I think I waited until the clinic had, because they had certain opening times, so I think certain days. I think I just waited until, I think I waited like three or four days and then I went to the clinic.

So this, what you called earlier the family planning clinic which is like a bus ride away or two bus rides away.

Yeah.

So you went there and you talked to somebody else. What kind of information did they give you?

They, again they gave me the sort of all the pros and cons, the risk of pregnancy with all of them. But I think that when they asked me what I wanted to get out of it, it obviously wasn’t the best option for me. But I guess at the time I didn’t wanna hear that it’s not the best for me because I wanted that for, I can’t really remember why but that was for whatever reason I wanted that, the implant. And it probably wasn’t the best option for me, but yeah I didn’t want to hear that.

Do you think if there was more information about the different options – the pill, the coil, the implant and everything – at the doctors surgery, would that be helpful at all?

Yeah, I probably wouldn’t have gone to the clinic at that point. If I had been told then, I think, about all the options, even though I knew all the options, I think if the nurse had then gone through them at that point and said pros and cons of each in regards to me, then I probably would have listened to her.

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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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.

What happens at a sexual health clinic?

Anyone can make an appointment to go to a sexual health clinic (sometimes called a GUM clinic – genitourinary medicine clinic). Sometimes there’s a drop-in clinic, which means people can just turn up without making an appointment. People visiting a sexual health service for the first time are usually asked to fill in a form with their name and contact details. They don’t have to give their real name or tell staff who their GP is if they don’t want to. People can visit any sexual health clinic – it doesn’t have to be one in their local area. Brook, a popular sexual health service for young people, can only be used by under 25s. Appointments aren’t usually necessary as they work on a ‘drop in’ basis.

As part of the consultation (appointment), a person may be asked some personal questions, such as their medical and sexual history, what methods of contraception they use, and other questions about their sex life and sexual partners. Questions include:

•   when they last had sex
•   whether they had unprotected sex
•   whether they have any symptoms
•   whether they think they might have an infection
•   how many sexual partners they’ve had
•   whether they have sex with men or women or both

Staff at the clinic were good and put Kim at ease. They asked her general questions such as her age, occupation, and symptoms.

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Staff at the clinic were good and put Kim at ease. They asked her general questions such as her age, occupation, and symptoms.

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Age at interview: 25

Sex: Female

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Have you got any experience of family planning clinics, sexual health centre?

Sexual health centre? Yes, yeah, I’ve been to one before.

And can you tell me a little bit more about your experiences?

Yeah.

What you were there for and what you liked, what you didn’t like.

Yeah, I was just there for a general screening after some unprotected sex. And I found it very efficient. The lady I saw was really nice, made me feel very at ease. You know, it was quite good, well, I thought it was quite good with, at the reception. You know, it was kind of like they got all the information they needed from you without being, like personally invasive. Cos obviously it’s a sexual health clinic, so you don’t wanna be broadcasting anything too personal. And the wait, it’s like again I had to wait a while, but I think like it’s just something people accept. And maybe we shouldn’t accept it, but [laughs] with all kind of NHS services it seems that that’s the way it is.

And I guess with health, because things can escalate so quickly with other people or, then it is understandable. But, no, that was, that was a fine experience. I mean it wasn’t greatly enjoyable, but that’s sexual health, isn’t it? So . .

Was it a centre specifically for young people? Or was it for any ages?

Oh, I think, I think, no, it was just sexual health for over, like over 18s I think. But I couldn’t, I couldn’t actually be specific. Cos I literally just Googled like sexual health in [place name]. So…

Was that how you found out about them? You --

Yeah.

-- used the internet?

Yeah.

And when you went there, did you have to fill out a questionnaire or --

Yes.

-- when you registered?

Yeah.

So what kind of things did they ask?

So they asked me kind of general symptoms as to why I was there. Also my kind of alcohol history, well, not history but, yeah, like what you, what you do, what you drink. My occupation I think and age and like the kind of demographic stuff, ethnic origin and that crap. And that was about it I think.

Staff at the sexual health clinic were very welcoming and understanding. Ish’s friends had been there before and recommended it.

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To be honest, in [place name] I only used one [sexual health clinic] and for me, those are very, very welcoming and a lot understanding. I mean, they know that the situation, like even if you just go for a regular STD test, they don’t know that when you walk through the door. So they will treat you as welcoming and they do treat you with a lot of understanding that you might be coming here with something that’s really embarrassing for you. So no matter what, they always treat everyone the same. In my eyes, that’s what I experience. So I had friends who went to that same place and they all said great things about it. So every time something happened, you know….

Is it common for you to ask your friends for advice on what places to go to, whether it’s GP or sexual health centres, anything?

Yeah, definitely. I do tend to ask them, the first people, especially my friends that I trust. It’s like, I try to go to the same place that they already went and they had a good experience. Yeah, I will go to the same one probably.

And the receptionist in there, how have your experiences with the receptionist been? I assume you typically have to check in with the receptionist first.

Yeah, I mean the same thing. They’re still welcoming and nice no matter what the situation is.

If someone needs to be tested for STIs (such as chlamydia or gonorrhoea), they may need to give a blood or urine sample or have a swab taken. Getting tested and treated for STIs is straightforward and confidential. Most infections can be treated with antibiotics. Anyone can ask to see a male or female doctor or nurse but they might have to wait longer than usual for one to become available.

Kim doesn’t usually mind if a GP is male or female. At the sexual health clinic, though, she asked for a female doctor because the appointment would be ‘quite personal’.

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Kim doesn’t usually mind if a GP is male or female. At the sexual health clinic, though, she asked for a female doctor because the appointment would be ‘quite personal’.

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Age at interview: 25

Sex: Female

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How was the doctor at the sexual health clinic? Were they easy to speak to, approachable, friendly?

Yeah, she was really nice actually. I think personally from that point of view, if it was a male, I wouldn’t have felt the same. And, yeah, because I had to get quite, quite personal with her. But, no, she was really nice. And like, you know, she, I think sometimes you get doctors where, especially in the sexual health clinic, where they almost are quite, what’s the word? Nervous about saying certain words [laughs]. And I think when that happens it makes you a little bit nervous about saying certain words and describing certain things with your genitals and your relationships and stuff like that.

But I was fortunate that in that scenario she was really nice and just kind of said things how they were. Which I liked. And, you know, obviously didn’t probe for unnecessary questions. And just got on with it I think. Efficient.

So sexual health is an area you think that gender perhaps makes more of a difference?

Absolutely, 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.

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’re kind of like, “Please be a woman, please be a woman, please be a woman.”

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.

Aphra has no preferences in terms of seeing a male or female doctor. For her it’s more important to be seen and be given good care.

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Did it matter whether the doctor was male or female?

Not for me. I think that whether it's an STI test I've got to go for, or whether it's, ‘I'm just going for an appointment’, I'm very kind of matter of fact about my health. I think if I'm going along, it's more important that I get seen to and I get a decent service. So it never really kind of makes me feel uneasy. And quite often as well, if it's things like going to the GUM clinic for an STI test, I'm going that’s kind of what got me into this mess anyway, I really…now is not the time to be embarrassed.

With some tests, the results – and treatment if it’s needed – are available on the same day. For others, there might be a wait.

Confidentiality

When it comes to sexual health services, young people have the same rights whether they’re under or over 16, regardless of their sexuality, ethnic origin, gender, or disability. All information about a person’s visit is treated confidentially. This means that their personal details and any information about the tests or treatments they’ve had won’t be shared with anyone outside the sexual health service without their permission. 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.

A GP talks about confidentiality at doctors’ surgeries and sexual health clinics.

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Confidentiality plays a big role within the GP service. So how do you go about confidentiality and when is it an important issue?

Yeah, I mean it’s important all the time. The basic rule is that: whatever the patient tells the doctor stays with the doctor. It gets complicated when you have people under 16 because their parents have responsibility for them. But doctors must act in the best interests of the child. And if the 14 year old understands exactly what’s going on and is adamant that they don’t want their parents to know, then there may be cases when things like contraception might be prescribed without necessarily alerting the parents.

Okay, is there a situation when you have to inform the parent about their child?

There are situations where you may want to let other people know that’s going on particularly if you’re worried about the welfare of that child. So if, for example, a 14 year old was having a relationship with a much older person, then you may think that that child needs some help. It raises something called safeguarding issues about whether that child might be being exploited. So in that situation you would talk to the child about it but you would probably need to break that confidence.

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