Sexual Health Procedure

This chapter was added to the manual in February 2017.

1. Provision of Information and Advice

Those responsible for the care of Children Looked After must make sure that they are provided with appropriate, accurate and up to date information and advice on matters relating to sexual health and relationships. Training on sexual health and relationships is available and it is the responsibility of Social Care staff to ensure that their skills meet the needs of the children they are supporting.

The parents of Children Looked After should be made aware that on placement in care the child or young person will receive information and advice according to their needs. The child/young person has a right to this information.

Children will be able to access confidential support around contraception and sexual health without the consent/notification of their parents.

Parents should be given the opportunity to discuss any concerns or specific needs of the child/young person so that support can give due consideration to the child's cultural and religious background. Any specific arrangements must be incorporated into the child's Placement Plan. The recording of information relating to sexual health issues is subject to the informed consent of the child or young person including details of what information will be shared with whom.

2. Puberty and Sexual Identity

All staff and carers must adopt a non-judgemental attitude toward children, particularly as they mature and develop an awareness of their bodies and sexuality.

The same approach must be adopted towards children who explore or are confused about their sexual identity or who have decided to embrace a particular lifestyle so long as it is not abusive or illegal.

Children who are confused about their sexual identity or indicate they have a preference must be afforded equal access to accurate information, education and support to enable them to move forward positively.

As necessary this must be addressed in Placement Plan, again subject to the informed consent of the young person.

3. Pornography

All materials published, circulated or available to children must promote and encourage healthy lifestyles and images of men and women that are positive and encouraging.

Children must be positively discouraged from accessing material that is potentially offensive or pornographic (including online).

If they obtain such material that is suspected to be illegal it must be confiscated and in extreme circumstances consideration must be given to reporting the matter to the Police.

Such an incident is an ideal opportunity to provide sex and relationships education.

4. Under Age Sexual Relationships

The legal age of consent to sex is 16 for all young people irrespective of their sexual orientation. A child under the age of 13 cannot consent to sexual intercourse.

Staff/carers should be mindful of their duty to consider the overall welfare of children and this may mean recognising that illegal activity is taking place and working to minimise risks and consequences. Staff/carers may not condone or permit exploitative or abusive behaviour and must take all reasonable steps to reduce or prevent it.

Staff/carers should endeavour to establish whether any relationship is mutually consensual and between two children of a similar age/maturity, and if so provide appropriate support around contraception and sexual health.

It is important that staff/carers recognise that under age sexual activity should not automatically trigger child protection procedures but this should be considered if there are concerns about sexual exploitation or the child is under the age of 13 years.

5. Contraception

Access to contraceptives will not be conditional on children giving information about their lifestyles and contraception will never be withdrawn as a punitive measure. Looked after children are entitled to the same level of confidentiality as any other young person unless it is deemed they are at risk of sexual exploitation or risk of significant harm.

Whilst not encouraging it, it is understood that children may engage in sexual activity; some before they reach the age of consent.

Staff/carers should identify local sources of professional help and information for children/young people and can accompany them to clinics if requested to do so.

Contraception for Children under the Age of 16 years old

It is not appropriate for anyone other than those who hold parental responsibility (parent or Service Manager of Social Care) to make a decision about a child under 16 years of age taking the contraceptive pill. 

If contraception is being considered for a child under the age of 13 years then the Designated Nurse for Children in Care should be informed and a multi-agency safety plan put in place.   

6. Pregnancy and Termination

If a child is suspected or known to be pregnant the social worker, staff and carers should talk openly to the child  about who should be informed and what support the child may require to promote her own and the unborn baby's welfare.

If the child consents then it is good practice for their parent(s) to be informed and be part of drawing up a suitable plan for the promotion of the welfare of the pregnant child and their unborn baby.

It is important to note that a child may be pregnant and not disclose this information to her Social Worker.

In all cases, consideration should be given to the welfare of the pregnant child and/or the unborn baby, including the likelihood of either suffering Significant Harm.

Any decision to terminate a pregnancy should be reached by the child/young woman. If she has a partner and wants him to be involved this should be supported.

Advice, counselling and support in making the decision must only be given by suitably qualified independent counsellors.

If the child woman decides to terminate the pregnancy, her social worker and staff/carers must ensure that adequate support is given throughout and afterwards to ensure the child's privacy is protected and any physical or emotional needs are addressed sensitively.

7. Working with Young Fathers

This can be a difficult area of work because the choice and responsibility in decisions relating to the baby lies with the mother. Regardless of how the mother views the situation, young fathers still need to be supported. The following points should be addressed:

  • What does the child/young man want his role to be?
  • Does this conflict with what the child wants? If so, how will this be managed?
  • How will you support him to deal with his thoughts, feelings, hopes and fears?
  • How can he play an active role in the baby's life?
  • Is the child/young man clear about his legal rights, choices and responsibilities in relation to his baby?

8. Child Sexual Exploitation

Child sexual exploitation is a form of child abuse. It occurs where anyone under the age of 18 is persuaded, coerced or forced into sexual activity in exchange for, amongst other things, money, drugs/alcohol, gifts, affection or status. Consent is irrelevant, even where a child may believe they are voluntarily engaging in sexual activity with the person who is exploiting them. Child sexual exploitation does not always involve physical contact and may occur online.

Children of any sexual orientation and ability may be abused through sexual exploitation.

Staff/carers need to be alert to any behaviour that might indicate that the child is involved in Child Sexual Exploitation or at risk of becoming involved. Any concerns need to be discussed with the child's social worker and child protection procedures followed.

9. Sexually Transmitted Infections

It is the absolute right of children and young people to have information and advice on safer sex, HIV, AIDS, hepatitis and other sexually transmitted infections. In providing such advice and guidance to children, it is important that they are made aware that there are many safer and pleasurable alternatives to penetrative sex, for example, stroking, exploration of erogenous zones, sucking, kissing, licking, or mutual masturbation.

Children/young people should be encouraged and supported to take responsibility for their own sexual well-being, acknowledging cultural diversity. The opportunity to discuss this with staff/carers and a variety of health professionals should be available.

With regard to sexually transmitted infections including HIV, children should be advised of clinics where anonymity and appropriate pre and post testing counselling are available. They should be made aware that, if they are tested by their G.P. then the results of this will be recorded in their medical notes and these may be available to prospective employers etc. in the future. There is, however, complete confidentiality at Genito-urinary Medicine (G.U.M.) clinics.

Only those immediate carers of the child/young person who need to know will be informed of any suspicion or the outcome of any tests and strategies or measures to be adopted.

Consent to Testing

The permission of the child aged 16 or over must be given before testing.

If a child under 16 has sufficient age and understanding, his or her permission must be given before testing.

10. Masturbation

It is accepted that masturbation is part of normal sexual behaviour but children must be positively encouraged to undertake such activities in private and in a manner that is not harmful to themselves or other people.