A 15-year-old girl comes to see her GP alone asking for the contraceptive pill. She says she has a 16-year-old boyfriend and does not want her parents to know. What should the GP do?

The tension here is between respecting a young person's confidentiality and autonomy, and the natural instinct to involve her parents and protect her.

The starting point is that young people under 16 can consent to their own treatment if they're Gillick competent¹ — they understand what's proposed, including the risks and alternatives. For contraception specifically, the Fraser guidelines apply²: she understands the advice, she can't be persuaded to tell her parents, she's likely to have sex anyway, her health may suffer without contraception, and it's in her best interests.

The GP should encourage her to talk to a parent or another trusted adult, because support at home is valuable. But if she refuses and she's competent, the GP should respect that. If young people think their GP will tell their parents, they may simply stop seeking help³ — which is riskier.

At the same time, the GP needs to think about safeguarding. She should gently explore the relationship — whether it's consensual, whether there's any pressure, how old he really is. A 16-year-old boyfriend is a small age gap, but if there were signs of coercion or exploitation⁴, or a much older partner, the GP would have to act to protect her, even if that meant sharing information with safeguarding services.

She should also discuss condoms to protect against infections, and offer follow-up.

So if she's competent, meets the Fraser criteria and there are no safeguarding concerns, I think the GP should prescribe the pill and keep her confidence — while leaving the door open to involving her parents later.