Can a restrictive law serve a protective purpose? The impact of age-restrictive laws on young people's access to sexual and reproductive health services.

This article explores the purpose, function and impact of legal restrictions imposed on children's and young people's involvement in sexual activity and their access to sexual and reproductive health services. Whilst there is no consensus on the age at which it is appropriate or acceptable for children and young people to start having sex, the existence of a minimum legal age for sexual consent is almost universal across national jurisdictions, and many states have imposed legal rules that place restrictions on children's and young people's independent access to health services, including sexual health services. The article draws on evidence and analysis from a recent study conducted by the International Planned Parenthood Federation in collaboration with the Coram Children's Legal Centre, UK, which involved a global mapping of laws in relation to sexual and reproductive rights, and exploratory qualitative research in the UK, El Salvador and Senegal amongst young people and health care providers. The article critically examines the social and cultural basis for these rules, arguing that the legal concept of child protection is often founded on gendered ideas about the appropriate boundaries of childhood knowledge and behaviour. It concludes that laws which restrict children's access to services may function to place children and young people at risk: denying them the ability to access essential information, advice and treatment.

Evolving capacity and decision-making in practice: adolescents' access to legal abortion services in Mexico City.

The rights of adolescents and young people in international law and agreements have evolved significantly from a focus on protection to a recognition of "evolving capacities" and decision-making ability. Unclear policies and regulations and variations in actual practice may leave providers with little clarity on how to support adolescent decision-making and instead create unintended barriers. This study in Mexico City in 2009 explored whether regulations and clinical attitudes and practice were supporting or hindering the access of adolescent girls aged 12-17 to information regarding abortion and to abortion services. We surveyed abortion clinic directors and staff, and adolescents arranging or just having had an abortion, and sent mystery clients to clinics to ask for information. While providers were generally positive about adolescents' ability to decide on abortion, they had different understandings about the need for adult accompaniment and who that adult should be, and mystery clients seeking information were more likely to receive complete information if accompanied by an adult. Clarification of consent and accompaniment requirements is needed, and providers need to be made aware of them; adolescents should have access to information and counselling without accompaniment; and improvements in privacy and confidentiality in public sector clinics are also needed. These all support complementary concepts of protection and autonomy in adolescent decision-making on abortion.