This chapter has been adapted with the permission of Lincolnshire Safeguarding Children Board.
This chapter was substantially updated in November 2019 and should be re-read.
There are two parts to this document: Part One is a Protocol and should be followed and embedded within Agency processes and the Part Two is broader Guidance/information that Practitioners may find useful when supporting young people who are sexually active. Both Part One and Part Two are relevant to all Practitioners working with children and young people.
In relation to Part One (Protocol):
Cases of underage sexual activity must be handled sensitively by Practitioners. The Sexual Offences Act 2003 sets out the Law in relation to all children and young people under the age of 16 who legally cannot consent to sex, but makes a separate distinction for children under 13 for whom any sexual activity should be considered to put a child at risk of serious harm. However, it is recognised that most young people aged over the age of 16 will have a healthy interest in sex and sexual relationships.
Therefore Part One is designed to assist staff to identify where sexual relationships may be abusive and whether a child or young person may need the provision of protection or additional services in relation to sexual activity. Sexual relationships can be abusive for a number of reasons, but the primary association is the presence of a power imbalance.
The following information, based on the Sexual Offences Act 2003, provides an outline of the Law in relation to children and young people under the age of 18 years old.
The legal age that a young person can consent to sexual activity is 16; but it is not clear cut in all circumstances.
Sexual activity with a child under the age of 13 is illegal, as according to Law, s/he is not considered able to consent to such behaviour; therefore any type of sexual activity, is considered as risk of significant harm to the child. (See Section 5, Sexual Offences Act 2003).
In all cases where a Practitioner becomes aware that a child under the age of 13 is sexually active they must discuss it with the Safeguarding Lead in their Agency, or their Line Manager and make a referral to Children’s Social Care and/or the Police.
Brook’s online Traffic Light Tool distinguishes between healthy and harmful sexual behaviours by the age of the child or young person. You can use this as a guide if you are concerned about any sexual behaviours of someone you are supporting. You should consider the maturity and developmental age of the child/young person when using the tool.
Sexual activity with a young person under 16 is also an offence. However, the Law does not intend to prosecute mutually agreed teenage sexual activity, between two young people of a similar age unless there is evidence of abuse or exploitation. This can only be ascertained through the use of professional curiosity and the sharing of information to inform an assessment of the risk. (See Safeguarding Children from Child Sexual Exploitation Procedure).
Consideration should be given in every case of sexual activity involving a young person aged 13 - 15, as to whether there should be a discussion with other Agencies, and whether a referral should be made to Children’s Social Care and/or the Police.
Sexual activity with a young person over the age of 16 is not an offence; however young people under the age of 18 are still offered protection under the Children Act 2004 and can still suffer Significant Harm as a result of sexual exploitation and abuse. The support and protection they are entitled to should not be downgraded as a result of their age.
Young women and men over the age of 16 but under the age of 18 are deemed unable to give consent if the sexual activity is with an adult in a position of trust or a family member; as defined by the Sexual Offences Act 2003. It is also illegal for someone to have sex with a person who has a mental disorder that impedes choice (see Mental Capacity Act 2005).
If a Practitioner is concerned that a child or young person may be experiencing, or is at risk of, child sexual exploitation then they should complete the Pan Bedfordshire Child Exploitation Risk Identification Tool.
The Government has recently revised the definition of Child Sexual Exploitation:
Child sexual exploitation is a form of child sexual abuse. It occurs where an individual or group takes advantage of an imbalance of power to coerce, manipulate or deceive a child or young person under the age of 18 into sexual activity (a) in exchange for something the victim needs or wants, and/or (b) for the financial advantage or increased status of the perpetrator or facilitator. The victim may have been sexually exploited even if the sexual activity appears consensual. Child sexual exploitation does not always involve physical contact; it can also occur through the use of technology.
Like all forms of child sexual abuse, child sexual exploitation:
(See Child sexual exploitation: definition and guide for practitioners, DfE, 2017 for further information)
Non consensual sex is rape, whatever the age, sexuality, gender (including transgender) of the victim.
Guidance issued by the College of Policing states that 'if a victim is incapacitated through drink or drugs, or the victim, or his or her family, has been subjected to violence or the threat of it, they cannot be considered to have given true consent and, therefore offences may have been committed'. 
In these circumstances the following may be helpful for practitioners to be aware of:
When working with children and young people, it must always be made clear to them at the earliest appropriate point that absolute confidentiality cannot be guaranteed. This is because there may be some circumstances where their needs can only be safeguarded by sharing information with others. This could include parents/carers, other practitioners and the child/young person should be informed.
This discussion with the child/young person may also prove useful as a means of emphasising the gravity of some situations.
On each occasion that a child or young person is seen, consideration should be given to whether their circumstances have changed or whether further information is disclosed which may lead to the need for referral or re-referral.
In some cases urgent action may need to be taken to safeguard the welfare of a young person. However, in most circumstances Practitioners will need to complete and Early Help Assessment with the child/young person and/or family to explore the circumstances further. If on completion a need is identified that requires other practitioner's involvement then a Team Around the Child (TAC) can be initiated (See Early Help and Team Around the Child).
The following factors should be considered when assessing whether a child or young person is at risk of harm because of involvement in sexual activity:
The Early Help Assessment (EHA) process has been designed to help Practitioners assess needs at an early stage and then work with the child young person, their family and other Practitioners and Agencies to meet these needs. As such, it is designed for use when:
If you have any of these concerns complete an Early Help Assessment with the child and family. If on completion a need is identified that you are unable to address as a single Agency, you will need to initiate a Team Around the Child (TAC) (please see Early Help Assessment (EHA) Procedure).
If you are unsure what action to take you could have a consultation with an Early Help Advisor. Advisors can be contacted via Children's Services Social Care.
If you believe a child or young adult under the age of 18 years might be suffering, or is likely to suffer significant harm (including any mistreatment or abuse), please contact the relevant Children's Social Care. If it is outside normal office hours you can contact the Emergency Duty Team on 0300 300 8123. If your referral is assessed as a safeguarding concern then you will be required to complete the Safeguarding Referral Form as written confirmation of your referral. Send this via secure email (or post) to the locality area team as directed by the call advisor at the time of referral. If your concern is in relation to an unborn child then you should follow the Pan Bedfordshire Procedure and Guidance in relation to Pre-Birth Planning and Assessments Procedure.
For all Safeguarding Children Policies and Procedures go to the Pan Befordshire procedures or consult your own Agency’s Policies and Procedures.
When relationships are healthy they help people to thrive.
If a young person has been abused is can be difficult for them to talk about it. Often people feel worried about what will happen if they speak out. Sometimes people who have been abused are fearful that they won't be believed. Some young people may not recognise that they are a victim of abuse.
Always make sure the young person is aware of the confidentiality statement prior to entering into any discussion so it understood that the information may need to be shared with someone else if a crime has been committed or the young is at risk of harm.
Most people have more than one sexual relationship during their life. Going out with different people helps determine what people want from a relationship. Good relationships are based on respect, trust, and good communication regardless of who the relationship is with.
Being in a relationship with someone should be a positive experience. It probably won't be perfect all the time but a relationship should never make anyone feel bad. No-one should EVER feel like they are not able to be ‘who they are’ in a relationship.
Good communication allows individuals to have a deep understanding of each other and helps to prevent misunderstandings. It is important that partners express to each other anything they are not comfortable with; whether related to sex, family and friends, personal space, money or time.
In a healthy relationship with boundaries, both partners respect each other and allow each other to spend time with friends and family.
Using technology to check on a partner is a form of abuse.
There are many organisations that can offer support, and who are there to help:
Recent research commissioned by the Office of the Children's Commissioner has examined young people's understanding of sexual consent. The researchers found that for many young people, both consent and coercion were ‘slippery concepts’. Many of the young people were unclear that consent was something which still had to be sought and given even when in a sexual relationship. When discussing sexual assault, young people drew on stereotypes of rape as an act committed by strangers. Many young people reported that they were unsure if being coerced into sex when drunk constitutes rape. The researchers also identified that 13 to 14 year olds are the age group that is least likely to recognise non-consensual sex than older age groups. 
What young people say about building a relationship with them?
What young people say about talking about sex?
What young people say about asking specific questions?
For practitioner to help young people understand that sexual consent is where a person has the freedom to agree to sexual activity they can show them this video which will help them understand what consent means by instead of initiating sex they are making a cup of tea (see Tea and Consent).
 Coy, M et al. (2013) "Sex without consent, I suppose that is rape": How young people in England understand sexual consent. A report commissioned for the Office of the Children's Commissioner's Inquiry into Child Sexual Exploitation in Gangs and Groups. (London Metropolitan University: Child and Woman Abuse Studies Unit) p68
Contraception refers to the methods that are used to prevent pregnancy. Some methods of contraception (condoms) can also be used to prevent some sexually transmitted infections (STIs).
Emergency Hormonal Contraception (EHC) can be used after unprotected sex, to protect from pregnancy. This is often referred to as 'the morning after pill'. Some EHC can be taken up to 5 days after unprotected sex or an emergency coil can be fitted up to 7 days after unprotected sex. There is always a risk of sexually transmitted infections (STIs) after unprotected sex however some pharmacies offer Emergency Hormonal Contraception free of charge, call iCaSH on 0300 300 3030 to find out which pharmacies offer this service.
Contraception is free on the NHS and is available from a range of places including Young People’s Services, GP Surgeries, Genitourinary Medical Clinics (GUM) or Sexual Health Clinics and Family Planning Services. The ‘C Card’ scheme offers free advice and condoms to young people between the ages 13-19 (25 LDD) for information on contraception including ‘C Card’ visit. See Bedfordshire Condom Card Scheme or Luton Sexual Health C-Card.
An STI, or sexually transmitted infection, is any kind of bacterial or viral infection that can be passed on through unprotected sexual contact. Anyone can get an STI as it doesn’t matter how many partners you have had, or how many times a person has had sex.
STIs don’t always have noticeable symptoms so after having unprotected sex testing is always recommended to prevent further spread of infection or long-term harm.
To protect from STIs it is advised that a barrier method should be used every time a person has any type of sexual contact. Condoms and femidoms are the methods of contraception that protect against pregnancy and STIs. Even if you're using another method of contraception, like the pill, to protect against pregnancy, you should still use a barrier method as well.
Chlamydia is one of the most common sexually transmitted infections in the UK. In England, it is recommended that those under 25 years who are sexually active get tested for chlamydia every year, or when a person has a new sexual partner.
A young person can feel nervous about being tested but most infections are easily treated if identified at an early stage. The young person should be supported to attend a Sexual Health Clinic and be reassured that staff at Sexual Health Clinics are non-judgemental, professional and supportive. Advice will also be given on protecting the young person in the future. Online testing is also available for anyone over the age of 16.
HIV is a virus that damages the body's immune system so it cannot fight off infections. It is most commonly transmitted through vaginal or anal sex without using a condom.
Over half of those living with HIV are heterosexual. It is a myth that HIV only affects men who have sex with men.
AIDS (Acquired Immune Deficiency Syndrome, sometimes referred to as ‘late stage HIV’) is the final stages of HIV infection when the body can no longer fight off life threatening infections. With early diagnosis and regular effective medication most people with HIV will not go on to develop AIDS.
Often a person with HIV won’t have symptoms for many years but in that time, HIV will multiply and cause progressive damage to the immune system. Testing often and as early as possible is recommended.
HIV is passed on by blood and some bodily fluids, so to get HIV, one of these fluids from someone with HIV, has to get into the blood.
HIV is most commonly transmitted by sex without a condom. Around 95% of all people living with HIV in the UK most likely acquired their infection through sex without a condom.
YOU CAN GET HIV FROM:
YOU CAN’T GET HIV FROM:
Everyone should be tested. Delaying testing and treatment will allow the virus to damage the immune system. It also means the virus could easily be passed to someone else.
HIV can be tested for four weeks after exposure to the virus. The test does not detect the virus itself but the antibodies that your body has developed to fight it. The most common way of testing for HIV involves taking a small sample of blood for analysis. In some cases this is sent away to a laboratory and results come back in a few days. Same-day tests are also available and can give an instant result.
It is also possible to test a saliva sample or to test blood taken from pricking the finger with a needle.
If no sign of infection is found, the test results are ‘negative’. If the infection is detected, the test results are ‘positive’. All positive results should be tested again to confirm as a ‘false positive’ may occur. This can happen, for example, when antibodies fighting another infection are detected but wrongly identified as being antibodies fighting the HIV infection.
False negatives are also possible and are most likely to happen in the window period between infection and the antibodies reaching a high enough level to be detected (around four weeks).
HIV testing is free on the NHS and can be provided at GUM or sexual health clinics, clinics run by charities and some GP surgeries
If someone has/possibly been exposed to HIV within the last 72 hours (three days), it is possible to take anti-HIV medication called PEP (post-exposure prophylaxis) which may stop the person becoming infected.
This is sometimes described as being like the morning after pill (emergency hormonal contraception) for HIV. But this is misleading as PEP is a 28-day treatment of powerful drugs. It is only recommended after high-risk of exposure (for example if a partner is known to be HIV positive).
The Children’s HIV Association have released a good practice guide to supporting children living with and affected by HIV, which includes how a school can be HIV friendly, how to manage disclosure, confidentiality, and a links to other school policies, including first aid procedures.
Everyone reacts differently to finding out they’re pregnant. The young person may feel very happy or may feel shocked or worried. Most people need time to think about their situation and will require information about what to do next.
If a young person thinks they might be pregnant but is not sure, it is important they take a pregnancy test as soon as possible. For young people 13-19 years (25 LDD) free pregnancy testing is part of the ‘iCaSH Scheme; to find the nearest venue see iCaSH Bedfordshire and Luton Sexual Health.
If the young person is less than 24 weeks pregnant (a doctor will confirm) there are two options available and the young person has the right to choose any one of them:
The legal limit for termination in England, Scotland and Wales is, in most cases, is under 24 weeks’ gestation.
For some people, making a decision about what to do can be difficult. However easy or hard the decision, it is the young person’s decision to make. The more the young person feels they have made their own choice, the better they will feel about it. It is important that the practitioner has assessed that the young person has the capacity and competence to make this decision. Please refer to NSPCC, Gillick competency and Fraser guidelines or for young people 16 years and over to the Mental Capacity Act.
Information available to the young person should include the following:
For more information:
All children and young people are potentially at risk of harm, though some groups – for example, children and young people who have a disability – may be at increased risk of sexual exploitation.
Every young person with special educational needs and/or physical disabilities has a unique set of needs. Open communication and good quality sex and relationships education can protect young people from harm; enable them to make informed decisions and help them look after their sexual health when they eventually start having sex.
Both the 2015 report ‘Overprotected, Unprotected’ commissioned by Barnardo’s and the NSPCC recommended that ‘all educational establishments should provide high quality, age appropriate sex and relationships education; including same sex relationships, with information adapted and made accessible.’ If not delivered as part of the curriculum, young people with SEND are less likely to have access to sexual health information or develop an understanding of sexual relationships.
The Disability Discrimination Act states:
Mental Capacity Act states:
The Mental Capacity Act applies to young people aged 16 years and over.
There are a range of sexual behaviours that reflect safe and healthy sexual development. They are:
If you are concerned that behaviour is outside safe and healthy development you can get help from a specialist organisation who will advise you. These include:
Sexual Health Services are free and confidential, and available to everyone; regardless of sex, age, ethnicity, disability and sexual orientation.
If a Professional is referring a young person with a disability or special educational requirement or needs an interpreter, it is useful to let the Sexual Health Service know so they can make arrangements in advance of their attendance.
It is important for the Professional within the Sexual Health Service to establish if the young person:
Everyone has the right to get all the information they need so that they can make informed choices about what's right for them. They also need to know when the Law will make those choices. iCash services are free and confidential and open to all.
Sexual Health Services can support young people to make informed choices about their sexual health and well-being as well as providing access to contraception; screening for sexually transmitted infections and signposting to other support services when necessary.
Caring for a young person with special educational needs and/ or disabilities can present a range of different support requirements and concerns for parents or carers. These can include concerns about the individual’s capacity to consent to make sexual decisions; addressing inappropriate behaviours, or not being able to form or sustain relationships.
Other services may need to be contacted if Healthcare Professionals believe that the young person or another person is at risk of harm; such as physical or sexual abuse. However, if this is the case, it should be discussed with the young person during their visit.
If the young person needs to have an examination, this should be undertaken by an appropriately-trained Professional and the young person should be offered a chaperone; in accordance with Agency protocols.
There are support services across the Country offering advice and information to children and young people. You can contact:
For detailed information on supporting young people: SENDirect.
Only valid for 48hrs