Young people deserve more than just access to birth control. They deserve care that respects their voices, values, and lived experiences. When adolescents and young adults seek contraceptive care, the way they are treated can shape not only their health decisions, but their trust in the health care system as a whole. As a physician, I have seen firsthand that contraceptive counseling interactions can either affirm young people’s autonomy or undermine it.
That’s the message at the heart of a recent study published in JAMA Network Open, which I was proud to co-author. Our research examined whether adolescents and young adults are receiving person-centered contraceptive counseling and why that kind of care must be the standard, not the exception.
What is person-centered contraceptive counseling?
Person-centered contraceptive counseling means meeting young people where they are. It means listening without judgment, respecting their preferences, and providing clear, honest information about all contraceptive options so they can make decisions that are right for them—not their clinicians’ decisions, not their parents, but their own.
This approach recognizes that young people are experts in their own lives. It rejects one-size-fits-all counseling and instead centers autonomy, dignity, and informed choice.
What does research tell us about young people’s experiences?
Our study used new national survey data to assess whether adolescents and young adults experience key elements of person-centered contraceptive counseling, such as feeling listened to, respected, and fully informed about their options. We found meaningful gaps, with many young people reporting counseling experiences that fell short of these standards. But we also found that when adolescents and young adults felt heard, respected, and fully informed, they reported better overall experiences with care and greater satisfaction in their contraceptive method choice.
But not all young people reported these positive counseling experiences. Too many still encounter rushed appointments, pressure toward certain methods, or providers who dismiss their concerns. In fact, only one-third of young people in our study reported receiving person-centered contraceptive counseling. These gaps in care matter. When young people feel disrespected or unheard, they are more likely to disengage from care, putting their health and autonomy at risk.
Quality care must also be equitable care
Person-centered care is not just about quality, but also about equity. When person-centered counseling is treated as optional, it risks being lost in time-pressured, under-resourced clinical settings—precisely those serving young people facing the greatest barriers to care. Young people, particularly those from marginalized communities, already face significant barriers to reproductive health care, including stigma, misinformation, and limited access to youth-friendly providers. When counseling is not person-centered, those barriers are reinforced.
What will it take to do better?
If we want a future where every young person has the power to decide if, when, and under what circumstances to have children, we must act now. The findings from this study make one thing clear: expanding young people’s access to contraception must go hand in hand with improving the quality of their care. This requires action at every level of the system.
- Health care clinicians and systems must commit to person-centered counseling as a core standard of care—not an optional add-on—and invest in training, clinical workflows and accountability that centers young people’s voices and autonomy.
- Policymakers must protect access to comprehensive contraceptive care and reject policies that limit informed choice or undermine trust between patients and providers.
- Advocates and community leaders must continue to elevate young people’s lived experiences and demand care that is respectful, unbiased, and responsive.
- All of us can play a role by supporting organizations and policies that prioritize reproductive autonomy and by listening to what young people are telling us about their care.
Person-centered contraceptive counseling is more than the best practice for clinical care. It is essential to reproductive freedom. Ensuring that every young person receives respectful, informed, and individualized care is not optional; it is a prerequisite for a just and equitable health care system that strives to meet the needs of young people and support their sexual and reproductive health.