Berkeley Parents Network: Gynecologists for Teens

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Gynecologists for Teens

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Questions

Gynecologist for 18 year old daughter
Shown the door at daughter's OB-GYN appointment
ObGyn for 17-year-old daughter

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Gynecologist for lesbian teen

Gynecologist for 18 year old daughter

Nov 2011

Can anyone recommend a sensitive and caring primary care physician &/or a gynecologist for an 18 year old girl? Preferably in the Berkeley/ElCerrito/N Oakland area. Current pediatrician has been good, but now seems out of tune and impatient with issues such as school stresses, severe menstrual cramps. Anon

I can't say enough good things about Dr. Ahsan at the OB/Gyn practice on Telegraph. She's young, hip, easy to talk to and very caring. My 21 year old daughter and I both go to her. The number for that practice is: 510-845-8047. Happy Patient

Shown the door at daughter's OB-GYN appointment

March 2011

I wonder if anyone else has had this exerience with their teenage daughter. Recently, I brought my 16 year old to my OB-GYN to consult and get tested about a discharge she was having. I have a very close and collaborative relationship with my daughter's pediatrician and I was expecting something similar with the gynocologist appointment. What a shock, when I was ''shown the door'' and told that my daughter has the right to privacy and that they will only share things with me, like test results, medication precriptions, etc., if my daughter gives explicit permission. I was hurt and confused and couldn't even get my gyn. doctor to explain further to me. All she said was that, after 12 years old, that's how it is... privacy laws. Now, if you're like me, I have always been closely involved in my daughter's life, inclulding medical and health issues. I really wonder why this is any different and why the teen is basically ''set up'' to be against the parent. The doctor actually ''commiserated'' with my daughter making me out to be the ''intrusive and over-bearing mother'' for simply being concerned about my daughter's health. It doesn't make sense to me and was very hurtful. I wonder if anyone else has had a similar expereince. Bewildered and Hurt

I share your desire to help with all your daughter's health needs, but she is 16 now, and it is time for you to separate yourself. It is best for your daughter's health if she feels totally free to share anything she wants with her doctor. No matter how much you think you are your daughter's friend, you are still her mother. Give her, and the doctor, a break. She needs to learn to take care of her own health, and to develop her own, grown-up, relationship with a doctor. The doctor is absolutely doing the right thing. You should not be so hurt or feel ''excluded''. What is so darn great about going to the GYN??? Try to imagine that you are secure about this, and try to have a sense of humor about being called ''overbearing''. If you can't laugh about that accusation with her, then maybe it IS time for some self-reflection.

My daughters are in their early 20's now. The more you encourage independence now, the better off your daughter will be in coping with life. You are there when she needs you, that is enough. We should not infantilize our children--it hurts them in so many ways. That said, I do sympathize. It is a hard thing for me and I am still going through it. But if you let her be independent, you will be surprised at how competent she can be, and your life will be better for it. an overbearing mom on a leash

Just as you expect the right to confidentiality with your women's health practitioner, your daughter has the same right. She is 16. She has the right to privacy to freely discuss anything with the gynecologist that might be going on sexually. This may be why her pediatrician refers patients out for this exam, because parents such as yourself have a history of involvement, and this needs to be a confidential visit, and he is dodging potential conflict with you. Kids will say what they think their parents want to hear if they are present at these office visits - not what they may need to talk about. An analogy is asking a woman about domestic violence with her S.O. present - you don't get the truth. Your daughter is nearly a legal adult. She will discuss with you what she is comfortable sharing with you. Developing healthy boundaries is a good thing, mom. Did you want to discuss your developing sex life and possible desire for contraceptives with your mother when you were 16? Few do. I would not worry about it. Yes you come off as intrusive, but if you look at this as her growing up and helping develop healthy boundaries, you can learn to let go. women's health NP

Do you remember being 16? Would you have wanted to talk about your vagina in front of your mother? It's definitely time to give your daughter a little privacy, or at least the option of it. My mom, who was very old-school and conservative, understood that in 1975 when I was 16, and I think she was happy that I felt I could talk to the doctor freely. My daughter is 19, and we have always been very close. She usually tells me lots and often confides, but I totally respect that any competent doctor has to insist that the teen have a chance to talk to the doc without fear of parental retribution. Doctors can't assume that the teen can speak freely in front of you, they have to create a safe place by making mom step out of the picture for at least a few minutes. Don't worry, if your daughter wants you there to hold her hand, as mine wanted sometimes, the doctor will ask you to come back in. XYZ

Our pediatrician also sees children alone [without parents] after, I believe, the age of 14. I think this makes complete sense, whether at a pediatrician's or ob/gyn's office. Put yourself in your daughter's shoes and give her some privacy. She's almost an adult. anon

Unfortuanately, due to health privacy laws (passed, I recall, so that children can easily have abortions without any parental knowledge) that is the way it is these days. You cannot even email the doctor and have a discussion about any health concerns you and your 12-year old child may have unless your child agrees to sign away their ''privacy.'' You have no choice, my dear, but to consider it part of your child's separation from you. If you want to know something -- ask her. She may or may not tell you. The End.

The first time it happens you may get all weepy. After than, you realize it is important to have a discussion with your teen regarding doctor appointments, e.g. have a list a questions for the doctor, think about what kind of questions they will ask you regarding symptoms, take notes, etc. Teach her how to take responsibility for her health so when she goes off to college in 2 years, she'll know what to do. YourMomma

The gynecologist is only following the laws of California, which indicate that for those ages 12-17 that there is confidentiality given to the teen about topics related to sex, drugs, and mental health issues (there are a few exceptions to this rule--you can look up the law). The doctor cannot tell the parent anything about what the doctor and teen talked about without the teen's explicit permission.

So this is not something thought up by the gynecologist to make your life difficult--this is a privacy law put into place by the state of California to make sure that teens have access to full medical information in these areas so that they can get appropriate help or treatment if needed.

Now it would have been nice for the gynecologist to have given you a pamphlet about this, perhaps. But the key issue here is that your daughter is getting medical care by a professional and that professional is interested that she gets the care she needs. So if you want to know what they discussed, you will have to ask her. Anonymous

It doesn't sound like the situation was well handled but the legal details are correct. I've taken care of adolescents for 25 years and have my own 17 year old so I have definitely been on both sides of the door. In general for teenage exams it's recommended that the parent be in the room at the beginning of the history taking and contribute as necessary, IF THE TEENAGER SAYS s/he wants the parent there. Then the parent is invited to step out so the teen can have some privacy for exam and talking. I explain to parents that what the teenager reveals to me is generally protected/confidential information (unless they are a danger to themselves etc, being abused etc). If the teen insists that the parent stay, then the parent can stay for the whole exam, but realistically I consider the history more suspect because it is not common that teens discuss their drug use and sexual activity in accurate detail with a parent there.

When I recently took my 17 year old son to the doctor he told me the not very exciting reasons he (obstensively) wanted to see the doctor. When they called him into the room I asked him if he wanted me to come and he said no. (He'd said yes, every visit age 12-16). He will leave home soon, and he is entitled to private conversation with a clinician; I want him to have a trusting relationship with his doctor so there is another adult he'll trust if he gets into trouble....

It sounds like the mechanics could have been handled better, but if your daughter wants you to know what they discussed she can tell you, or she can invite you to stay next time. --Been on both sides of the door MD

I remember very well the shock of realizing that, legally speaking, my 16-year-old daughter's health was no longer any of my business--not her sexual health, anyway; I was still allowed to hold her hand during immunizations!--although it sounds as if your gynecologist was not as gentle or humorous as mine. I'm sorry you had to go through this; it is pretty upsetting, even though I understand that some sexually active minors need protection from abusive parents. (I was also tempted to snarl, ''Fine, you pay for the damned exam, then!'' but decided not to.)

Something I did to help myself feel better was to suggest to my gynecologist that she write up or order brochures to give parents, explaining California's medical privacy laws and the ways in which they protect minors. By the way, when I did have a question about my daughter's sexual health, I learned to phrase it in such a way that my gynecologist could legally answer me: e.g., ''If a teenage girl is taking the pill and her boyfriend is using condoms, and they practice monogamy, would you say that is adquate protection against pregnancy and STDs? Would you recommend anything else?''

I also tried to bear in mind that all this was yet another a step toward my girl's inevitable adulthood and independence, and it's good to accept that. Not easy, but good. Anonymous

I think your expectations are unreasonable for several reasons. First, your daughter does deserve privacy. If she shared your feelings about your ''closeness'' in these matters, she could have invited you into the examination room. She declined. Second, the GYN knows (and if you think about yourself as a teen, I'm sure this will resonate) that s/he is more likely to get complete, frank, and truthful information from your daughter about her sexuality, needs for contraceptives, etc., if you aren't in the room. Third, you are misinterpreting the ''commiserating'' as ''the teen [being] basically 'set up' to be against the parent.'' This excellent doctor is building trust with a patient (your daughter) and teaching her that she is responsible for her own body. Fourth, you are confusing ''being concerned about my daughter's health'' with your self-perceived right to know everything about her. They are not the same thing. You took her to the doctor when it was necessary; that is your responsibility as a concerned parent. Believing that such an action should entitle you to be present during her exam is misguided.

Your daughter is 16. She'll be leaving home within a couple of years. A concerned parent wants their child to learn the skills necessary to take care of her/himself in the world. Managing one's health responsibly is one of those things that must be learned. I'm frankly concerned that your relationship with your daughter's pediatrician meets your standard for ''very close and collaborative''; your daughter has the same right to privacy there as at the GYN's office, and given your expectations it sounds as though her rights are being violated by her pediatrician. Ever since my daughter was 11 (she is now 13) I have asked her whether she prefers that I be present in the exam room during doctor's appointments. So far she has wanted me to stay, but I have no expectation that I am entitled to be there. I let her and her pediatrician talk; I speak up only when there is something my daughter doesn't know or if her doctor addresses me directly.

My very loving mother was much like you, and expectations were different when we were growing up (I'm in my late 40's). She would have taken me to her gynecologist had I asked, but I didn't want her involved. At 15, when I had a discharge, I went to a teen health center for treatment. I got birth control (before I needed it), and generally took responsibility for my own reproductive health care. You are fortunate that this GYN cares enough to do the same for your daughter. Not a helicopter Mom - just a loving one

These are the reproductive right we all fought for in the 70's Personally, I would get another doctor. My daughter's doctor put the decision on her - She asked, ''do you want your mom in here.'' Simple, non-confrontational. My kids pediatricians started doing this around puberty. But I would always have a consultation with the Dr. at the end of the appt. mom

I'm with the doctor on this one. As a teen, if I had felt like every last detail of my GYN exam was going to be shared with my mother (or my father, for that matter) I would have been completely mortified. I certainly wouldn't have felt comfortable sharing information with the doctor, and I might not have even gone through with the appointment. It's in your daughter's best interest that she develop a relationship of trust with ALL of her health care providers, and that both of you come to view her health as being her responsibility, not yours.

All teens are adults in training. As a parent, I feel like it's vitally important of them to get good advice from trusted adults -- but not necessarily their parents. Aunts, uncles, doctors -- good, responsible advice comes from many sources. Mom

I discovered this when we switched to Kaiser and my daughter was 12 - she had to sign a waiver giving permission for me to have contact with her doctor!

I was livid - I drive, I pay, I am responsible for her care but I can not be a part of the care decisions without her permission. The law exists to protect those young adults who can not share with their parents and need a trusted adult and while I understand the reasoning, and even want that for my daughter if she didn't feel safe coming to me I absolutely hate the result.

Not sure there is anything we can or should do - it has changed the dynamic a little. I ask my daughter if it is ''okay'' with her if I come into the exam room and we have spoken about her need to be responsible about her health knowing that I am now an advisor not a director, but no matter how hard I work at understanding the situation it just makes me mad! Good luck! Maggie

It may come as a surprise to you but your doctor is doing the right thing. A 16 year old has a right to privacy and her doctor is obliged to protect her privacy. My sons pediatrician started interviewing and examining my son in private when he was 6 or 7. I feel reassured that my son knows he has a doctor who will respect and protect his privacy, someone he can talk to in confidence. Mom of a teen

Hi mommy of a teen daughter - lots of people have written in on this topic and i pretty much agree with everything that was said about the importance of privacy for your teenager, so i won't repeat...but i wanted to just share a couple of personal experiences and you can make what you will of them.

1. from my experience as a mom - when my son turned 12 and the doc asked me to step out of the room for the first time during his physical, i felt sadness and anxiety about letting go of knowing everything that was going on with him, just as you described. but my son clearly felt more comfortable and the doc was very kind about it, so it didn't feel traumatic like your experience. i wish for you that your daughter's gyn could have handled it differently so you would have felt less pushed out.

2. from my experience as a teenager - when i was 13 and having a routine physical, the doc listened to my lungs and asked me if i smoked. i DID smoke, but i lied and told him ''no'' because i didn't want my mom to know. i don't remember if she was in the room or not, but the main thing is that i didn't trust he would keep the information private, thus a teaching moment was lost between me and my doctor. i went on to smoke for 15 years and struggled to quit over and over. could that have been avoided if i'd told the truth to that doctor and he talked to me about quitting then? who knows? but i wish i'd felt comfortable enough to tell the truth and give him a chance to help me.

3. also from my experience as a teenager - when i was 14 or 15 i had a vaginal infection and i did tell my mother. i didn't know what it was and i was scared i'd caught some horrible disease from a boyfriend. she rushed me to the ER (weird, i know, but that's another story...). in the ER she stayed in the room with me while the doc talked to and examined me. i was too embarassed and scared to answer any questions at all in front of her, so i mostly stayed silent. they ended up treating me as they would a rape victim with all the tests, a full pelvic, etc. - when in reality all i probably needed was a kind-hearted and informational conversation and a prescription for monistat.

i've never written in to this list before, but when i saw your letter i couldn't help identifying both with your very real hurt and bafflement at being shut out of a part of your daughter's life AND i also couldn't help remembering what it felt like to be a teenage daughter with a very real need for privacy and good medical care...so i wanted to share this. hope it helps. anon

ObGyn for 17-year-old daughter

May 2008

I just found out that my 17 yo daughter has had sex for the first time. I wasn't too happy about who and how it happened. I found out mainly because she came down with a UTI which was a blessing. I am not at all sure she used proper safety even though she claimed she did. She is going off to college in Aug and I want to be sure she has a through GYN exam before she leaves and gets education about safe sex and birth control from a professional. Any recommendations of good Obs who have worked with your teen daughters? AD

I would recommend she get the pelvic exam by someone she knows and trusts. How about her regular doctor? IF that person is a man, then I would suggest finding a woman to do it. Maybe the nurse practitioner in the office or another female doctor in the practice? Also, you might ask her to consider getting those HPV (prevention of certain cervical cancers) injections starting now before she goes off to college. It takes several months for the whole course (3).

That said, I liked my old GYN before she moved her practice and had a REALLY BAD billing experience at her new office. Dr. Angeline Thomas, she's really thorough and gentle. (510) 845-4200. Good luck! anon mom

I recommend Dr. John Girard, who works in a group with offices in Berkeley and Orinda. I have a young daughter who was quite sensitive about going to see a GYN specialist, but who was absolutely delighted with Dr. Girard. He has a good sense of humor and immediately put her at ease. My wife was so happy with him that she switched from her own GYN and now sees Dr. Girard. Robert

I think my ObGyn would be really great for a teen girl - Dr. Arzou Ahsan in Berkeley. There are a lot of reviews for her and the others in her practice on the BPN website - click here. I think all the ObGyns in that practice are women, if that makes a difference for your daughter.

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