This article is part of Concentrate's Voices of Youth series, which features stories written by Washtenaw County youth with guidance from Concentrate staff mentors. In this installment, student writer Divya Reddy examines systemic and interpersonal barriers young people face in accessing health care, and community-centric ways to address those barriers. 

Young people across the country are facing serious barriers to accessing health care, ranging from confusing consent laws to a lack of confidentiality and respect in clinical environments. 

Although adolescence is a stage of critical physical and mental growth, oftentimes, health care systems are not designed to meet young people where they are. Based on interviews conducted with young people and public health experts, as well as professionals with organizations like Michigan Medicine's Adolescent Health Initiative (AHI) in Ann Arbor, this article examines systemic and interpersonal barriers young people face, and community-centric ways to address those barriers. 

The youth and expert perspective: Barriers to access 

For many teens, the biggest barrier is not just about logistics, like transportation or cost. It's about trust. Jeff Soukhojak, 18, a rising senior from the Saginaw Public School District, says he was once dismissed by a physician until his father repeated the exact same concern. 

"That lack of respect for me as a young person was really frustrating," he says. 

Soukhojak also emphasizes that fear around confidentiality often keeps youth from seeking care, especially for mental or sexual health issues. 

"Some kids don't know they can get STI testing without their parents being told," he explains. "That uncertainty can stop people from even going." 

Even in settings where services are technically available, young people may feel judged, misunderstood, or unsafe. 

"Seeing a poster showing support for LGBTQ+ people would have made a huge difference," Soukhojak says, recalling earlier years when he didn’t feel comfortable coming out. 

However, Soukhojak also pointed to a positive development: his school-based health center. 

"It’s right in the building, so there are no transportation issues," he says. "It’s confidential, and I believe it’s free too." 

For Soukhojak, the clinic represents a model of accessible care that works — one that’s physically close, youth-centered, and integrated into daily life. 

Kimberly Nelson, Ph.D., MPH, associate professor of community health sciences and associate professor of psychiatry at Boston University, is a clinical psychologist and epidemiologist whose research focuses on sexual health inequities among marginalized youth and adults. She also studies how legal frameworks (like minor consent laws) impact adolescents' access to confidential care, and has worked extensively with the Michigan Organization with Adolescent Sexual Health. Nelson notes that minor consent laws are often poorly understood, even by providers. 

"Many states allow youth to access services like STI testing or contraception without parental consent, but if the bill goes to a parent’s insurance, it can break confidentiality anyway," she says. 

This gap in protection, particularly around explanation of benefits forms, is one of the most significant and persistent barriers to youth autonomy in health care. 

Nelson emphasizes that while minor consent laws are designed to give youth safer options when parental involvement isn’t possible, the patchwork of regulations creates confusion and inconsistency. 

"Adolescents face multiple hurdles: finding a willing provider, ensuring confidentiality, and paying without alerting their guardian," she says. 

Moreover, recent waves of legislation dubbed "parental rights" laws are threatening to overwrite current protections for minor consent, leaving providers feeling scared and youth less likely to seek out care. 

Nelson also stresses the need for legal and systemic reforms: closing payment loopholes, clarifying confidentiality protections, and ensuring that providers are legally supported when honoring youth autonomy. 

"We don’t have a formal right to health care in the U.S., but it would be powerful if adolescents had a recognized right to confidential care," Nelson says. 

AHI’s approach: Youth-centered, equity-driven 

Lauren Vasquez, a senior program specialist at AHI, shares how their organization partners with clinics and schools all over Michigan, as well as the entire nation, to promote adolescent-centered care. AHI's quality improvement initiatives include the Adolescent Champion Model, a structured one-year process that supports clinics in changing policies, environments, and practices to better serve youth. AHI also provides resources, such as Sparks, which are 15-minute mini-trainings intended to prompt discussions around youth health care topics. AHI offers a set of toolkits and guides on confidentiality, trauma-informed care, and access and inclusion practices.  

"Youth-friendly care is age- and developmentally-appropriate, respectful, and empowering," Vasquez explains. "We assess what clinics are doing well and where they can grow. They implement changes like adding inclusive posters, offering same-day contraceptive services, and training staff to be nonjudgmental and affirming." 

Through the Champion Model, participating clinics collect data at both the beginning and end of the program, measuring youth satisfaction, staff knowledge, and health outcomes like screening rates. Over the course of a year, clinics complete Spark training on topics such as confidentiality, adolescent brain development, and cultural responsiveness. Clinics also receive customized implementation plans, technical assistance, and access to stipends to support changes in physical space, like creating private areas, installing phone chargers, or purchasing more welcoming decor, representative of all youth. 

"Physical spaces matter. Wi-Fi access, diverse imagery, discreet sexual health materials, and friendly front-desk staff all help," Vasquez says. "So do provider interactions – using correct names/pronouns, nonjudgmental behavior, clear communication, and cultural responsiveness. It’s about building trust so youth feel safe and heard." 

Clinics might also offer grab-and-go packs with condoms or menstrual products, infographics from AHI’s Spark training, anonymous feedback cards, or even thoughtful touches like plants, youth-friendly magazines, and inclusive décor. All of these elements signal that the space is youth-centered, welcoming, and designed with adolescent autonomy and comfort in mind.
 
Crucially, AHI also addresses the issue of minor consent and confidentiality directly. Each participating site is required to complete a Spark training on state-specific confidentiality laws, and receives youth-facing handouts outlining health care rights and when parental consent is (or isn’t) required. 

"A lot of youth and providers don’t know these laws," Vasquez says. "We work to make that knowledge accessible, so both sides can feel confident in those care decisions." 

Youth engagement is central to AHI's approach. Their youth advisory council, Representing Equity for Adolescent Change in Healthcare (REACH), is composed of young people ages 15 to 24 who play an active role in shaping programming and driving youth-led initiatives. Council members help develop resources and lead projects on topics like mental health, community violence, and racial justice. They also provide feedback on clinic assessment tools, present at conferences, and participate in peer-led education efforts. 

"We try to avoid tokenizing youth. Instead, we ask what they want to learn, how they want to lead, and support them in that," Vasquez says. "It’s about creating leadership opportunities on their terms, not just asking them to review something and check a box."

Solutions at the community level 

Across interviews, one theme remains clear: improving youth health care access requires change at both the system and interpersonal level. From clinics displaying LGBTQ+-affirming materials to staff taking time to explain rights and policies, small actions build trust. 

"Youth deserve care that meets them where they are," Vasquez says. "It’s not about equality. It’s about equity. We have to be willing to listen and adapt."

Divya Reddy (she/her) is a third-year medical student at the University of Missouri–Kansas City and the co-facilitator for the Michigan Youth Voice Council, a youth advisory council through MOASH. She is passionate about health equity and aims to advance accessible, affordable care through both clinical practice and advocacy.

Concentrate staffer Sarah Rigg served as Divya's mentor on this story.