CONSISTENT OR CONFLICTING? SEXUAL HEALTH LEGISLATION AND YOUNG PEOPLE'S RIGHTS IN NEW ZEALAND(1).

• Author: Collins, Barbara

Abstract

This paper reviews current legislative provisions for young people to access sexual health services and sexual health education in New Zealand. The paper focuses specifically on access to contraceptive and abortion services, and school-based sexual health education. Current legislation is considered in light of its consistency in recognising the rights of young people to express their views and have these views considered.

INTRODUCTION

The sexual health of young people is of concern to policy makers around the world. In most countries, access to sexual health services and sexual health education are strongly contested areas of social policy. Strategies to improve adolescent sexual health have varied in their focus and breadth. In Britain, which has the highest rate of teenage pregnancy in Western Europe, the focus has been on reducing teenage pregnancy. A comprehensive action plan, which is part of a strategic agenda to reduce social exclusion, is designed to halve the British teenage pregnancy rate in 10 years' time (Social Exclusion Unit 1999). The action plan has a strong emphasis on the need to provide young people with clear and consistent messages on matters relating to sexual health.

The New Zealand Government is currently preparing a strategy to improve the sexual and reproductive health of all New Zealanders. The development and implementation of such a strategy, particularly components relating to young people, are likely to be contentious. In the past, much of the controversy has focused on the extent to which young people's sexual activity should be acknowledged and responded to, as well as the rights of young people to access sexual health services and education without their parents' knowledge or consent.

This paper outlines current legislative provisions for young people's access to sexual health services and school-based sexual health education. It suggests that current legislation is inconsistent and that this has potential to send mixed messages to young people.

BACKGROUND

Studies of adolescent sexual activity in New Zealand indicate that by age 15, 8.5% of New Zealand adolescents have had sexual intercourse, and in one third of cases this is unprotected. Girls aged 15 or less are more likely than boys of the same age to have had sex (Lynskey and Fergusson 1993). By 18 years of age, 58% of males and 68% of females report having sexual intercourse in the past 12 months. Sixteen per cent of these report intercourse before they were 15, and 30% before they turned 16 (Dickson et al. 1998).

Contraceptive use in adolescence tends to be erratic. When contraceptives are used, they are often methods that are less effective in preventing pregnancy. As a result, sexual activity results in pregnancy for many young women. In 1998, there were 34 births to women aged 14 or under, and 3,879 to those aged 15-19 (Statistics New Zealand 1999). In addition, many adolescent pregnancies are terminated by abortion. Of the 15,029 induced abortions in 1998, 2,897 (19.3%) were for young women aged 12-19 years (Abortion Supervisory Committee 1999). Between 1986 and 1995, the ratio of induced abortions to live births for those under 15 years of age was approximately 1:1 (Ministry of Health 1998). Within the OECD, New Zealand's birth rate in the 15-19 years age group is second only to the USA.

These data suggest that New Zealand has an urgent need to develop clear and consistent policies to reduce the adverse health, education and welfare consequences of adolescent sexual activity.

CURRENT LEGISLATION IN NEW ZEALAND

This section provides a brief review of legislative provisions for young people to access sexual health services and sexual health education in New Zealand.

Contraceptive Services

Until 1990, legislation in New Zealand restricted access to contraceptives and contraceptive services by people under 16 years of age. Section 3 of the Contraception, Sterilisation and Abortion Act 1977 had made it illegal to provide contraceptives or contraceptive advice to anyone under the age of 16 years, although the legislation included a number of people who were exempt from this restriction. These people included parents or guardians, registered medical practitioners, authorised representatives of any family planning clinic, pharmacists actioning prescriptions, social workers, counsellors and, in the case of a school, any person approved by a principal after agreement with the board of governors or school committee.

The 1990 repeal of Section 3 of the Contraception, Sterilisation and Abortion Act 1977 removed all restrictions on the advice and supply of contraceptives to those under 16 years of age. Young people of any age now have the right to access information about contraception and to be supplied with contraceptive products without parental consent.

Abortion Services

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