I was talking with another midwife the other day, and she gave me the perfect idea for a SHEis.com article. She brought up the subject of teenage girls and the baffling patchwork of rules that govern what young women are allowed to do, and what they aren’t.
She brought up the HPV vaccine. In many places, girls as young as 12 can consent to it independently, even if their parents object. They can also get STI testing, birth control, or even abortion care, all without adult involvement. But those same girls? They can’t walk into an R-rated movie without a parent. They can’t vote. They can’t legally sign themselves out of school.
They are, in the eyes of the law, both capable and incapable. Both autonomous and not. Both adult enough to decide… and too young to know better.
It got me thinking: where else do we see this?
Turns out? Just about everywhere.
This isn’t a morality piece. I’m not here to debate what choices are right or wrong. I’m here to point out the glaring inconsistencies in how we define adulthood, and how our society somehow manages to trust and mistrust young people in all the wrong places.
Let’s take a closer look.
Medicine & Health Autonomy: The Crown Jewel of Age Inconsistency
If there’s one area where age rules become especially strange and inconsistent, it’s medicine, specifically women’s and adolescent health.
Let’s start with the basics: In many states, minors can consent to reproductive health care without parental approval. That includes things like:
- STI testing and treatment
- Birth control (including long-acting reversible contraception)
- Emergency contraception
- Pregnancy testing
- HPV vaccination
- Abortion services (depending on state law)
These rules are based on the idea that teens should be able to protect themselves from sexually transmitted infections and unintended pregnancy without fear of judgment, delay, or punishment. In practice, that makes sense because when barriers are too high, teens often don’t receive any care at all.
But then… we swerve.
Those same girls? They can’t:
- Get their ears pierced at the mall without a parent
- Take a Tylenol from the school nurse without a signed form
- Schedule a dental cleaning on their own
- Legally drive themselves to the clinic in many cases
So, you can get an IUD inserted without telling your mom, but not ibuprofen during 4th period without her signature?
You can consent to a medical abortion at 16, but not schedule your own sports physical?
Where is the logic in that?
Autonomy (When Convenient)
The inconsistency here isn’t just legal. It’s philosophical.
We hand young women the responsibility of sexual decision-making while denying them authority over the rest of their bodies. We say, “You’re old enough to make major medical decisions about reproduction,” and in the same breath, “You still need permission to get a flu shot at Walgreens.”
We want them to be mature enough to navigate complex risk-benefit calculations, but too immature to manage their own MyChart portal.
If you’re confused, you’re not alone. I work in this space every day, and I even have to double-check which laws apply where. And I’m licensed. What chance does a scared 15-year-old have?
The Impact on Care
Here’s the kicker: when autonomy is conditional, care becomes inconsistent.
- A teen might qualify for confidential STI testing, but not be able to pick up her own lab results without a guardian’s login.
- A patient might be allowed to request birth control, but not be able to refill it without showing an ID she doesn’t have.
- A young woman might qualify for an abortion without parental consent, but be forced by policy to undergo counseling designed for adults.
And that’s before we get to insurance access, state-by-state discrepancies, or the wild circus of judicial bypass.
It’s no wonder many teens don’t seek care at all. We’ve created a system that expects them to behave like adults in the doctor’s office, then treats them like children the second they step outside.
What Are We Really Saying?
If you zoom out, the message young women are receiving is clear, even if it’s unspoken:
- “We trust you to make this decision about sex. But not about Advil.”
- “We’ll let you take responsibility for your reproductive life. But not your basic medical maintenance.”
- “You’re mature enough for choices with lifelong consequences. But not old enough to reschedule your Pap smear.”
In other words: You’re autonomous… when it’s politically convenient.
You’re mature… when it fits the policy.
You’re responsible… when we don’t want to be.
And if that sounds cynical, welcome to women’s health in the USA.
From Cervixes to Courtrooms: The Inconsistencies Don’t Stop Here
If these contradictions in health care feel wild, they’re just the beginning.
Because once you start looking for inconsistencies in how we treat young people, particularly teenage girls, you start seeing them everywhere. The rules shift depending on the setting, the stakes, and what we’re trying to protect: the child, the parent, the institution, or ourselves.
So let’s zoom out for a minute. If we can’t agree on when someone is “old enough” to decide what happens to her own body, how do we decide when she’s “old enough” to be punished like an adult?
The Criminal & Legal System: Adult Enough to Incarcerate
In Texas, you can be charged and tried as an adult at age 17.
Depending on the charge, even younger teens can be waived into the adult system.
And once you’re there? You’re in it. Adult sentencing. Adult courtrooms. Adult records.
But that same 17-year-old?
- Can’t vote
- Can’t serve on a jury
- Can’t sign a legal contract
- Can’t get a tattoo
- Can’t buy a pack of cigarettes
You’re old enough to go to jail.
But not old enough to help choose the lawmakers who create the laws you broke.
Not old enough to sit on the jury that convicts you.
Not old enough to rent an apartment when you get out.
This isn’t just about legal definitions. It’s about how we assign maturity and how often that assignment has more to do with convenience than consistency.
When a young person messes up, we’re quick to say, “They should have known better.”
But when that same young person asks to make a decision about their health, their body, or their future?
Suddenly we decide: “Not yet.”
Military & Firearms: Grown Up When Convenient
So far, we’ve looked at how the system flips regarding health and justice. But there’s another arena where age lines blur faster than policy papers can keep up: military service and the right to bear arms.
And once again, the contradictions don’t just exist; they’re institutionalized.
In the U.S., you can enlist in the military at 17 with parental consent. At 18, you can sign up on your own. That means you’re old enough to be trained, deployed, and handed a rifle. You’re old enough to risk your life.
But not old enough to legally have a beer when you get home from boot camp.
You can be issued military-grade weapons.
But in many states, you can’t legally buy a handgun until you’re 21.
You also can’t rent a car. Or buy a pack of cigarettes. Or walk into most bars.
We trust 18-year-olds to serve in combat.
But not to order a drink.
The disconnect isn’t about maturity.
It’s about which system wrote the rule, and what it needed at the time.
Service vs. Trust
We trust young people enough to put them in uniform.
We trust them with national security.
We trust them to follow orders with life-and-death consequences.
But we don’t trust them to order a margarita.
The messaging? Confusing at best. Hypocritical at worst.
“Thank you for your service, soldier. Now hand over the drink.”
This one hits close to home for me. Both of my brothers joined the military at 18, Mike in the Air Force and John in the Army. They each went on to serve more than 20 years.
I still remember how proud my dad was when they came home from basic training. He wanted to take his sons out, show them off to his friends, and buy each of them a beer. But of course, that wasn’t allowed.
They could train to kill for our country. They could be sent into danger. But they couldn’t sit in a local bar and have a beer with their proud father.
Even as a 14-year-old girl watching that unfold, I remember thinking, This isn’t right.
And I still feel that way.
My brother Mike passed away a few weeks ago, and maybe that’s why this part of the article hits me harder now. I keep thinking about how young they both were, how ready to serve, how proud my dad was, and how senseless that restriction felt.
Sometimes contradictions aren’t just policy problems. They’re personal reminders of how little sense our systems often make.
And if the rules around service and adulthood seem confusing, wait until we get back to the classroom, where expectations and autonomy rarely match either.
Education & School Policies: High Expectations, Low Autonomy
We’ve looked at how teens are trusted to make major medical decisions, face adult legal consequences, and even serve in the military. Yet, they still can’t do things like buy cigarettes or legally order a drink. These contradictions show up across healthcare, law, and national service.
You might expect that school, the environment supposedly preparing teens for the “real world,” would offer a more consistent framework.
Spoiler: it doesn’t.
By high school, students are told to start acting like adults. They’re preparing for college, balancing academics and jobs, facing decisions with real consequences, and being held accountable when things go wrong.
But their actual autonomy? Still incredibly limited.
Consider this:
- A student can be suspended or expelled for breaking school policy.
- Their grades and behavior can permanently impact their future.
- Some school districts even involve law enforcement in routine discipline cases.
But those same students often can’t:
- Keep over-the-counter medication in their backpack.
- Choose what books they want to read for class.
- Leave class to use the restroom without explicit permission.
- Opt out of standardized testing without parental involvement.
And yes, these contradictions aren’t just theoretical.
- A 17-year-old student in Texas was suspended for carrying his asthma inhaler after having an attack the week before. It violated school policy because the inhaler hadn’t been turned in to the nurse’s office.
He was old enough to take the SAT, but not trusted to manage his own breathing.
- In Georgia, a high school junior was disciplined for having ibuprofen in her purse. It was for her migraines. There was no parental form or doctor’s note, so she got a suspension.
She was old enough to hold a part-time job, but not old enough to manage a headache.
- Another student with a medical condition was given detention for using the bathroom without a teacher’s permission, even though she had asked and been denied.
So yes, she’s responsible enough to handle a chronic health condition, just not during fourth period.
When Expectations Outpace Autonomy
None of this is about whether rules should exist. Of course, schools need structure. But when you look at the bigger picture, the messaging is clear:
We expect teens to take responsibility for themselves until they try to.
The moment they step out of line, we call them mature enough to be held accountable.
But when they make a decision for their own well-being, we often decide they’re still too young.
It’s not about whether they’re right or wrong.
It’s about whether the rules make sense.
And more often than not… they don’t.
Pop Culture, Ratings & Social Media: Safe for Teens… Until It’s Not
By the time you reach high school, you’re expected to make decisions about your education, health, and sometimes even your legal standing. But when it comes to pop culture and digital life?
Suddenly, you’re fragile again.
Teenagers are exposed to more content, influence, and information than ever. And yet, the rules governing what they can or can’t access feel like they were written by someone who’s never actually met a teenager.
Consider this:
- A 14-year-old can consent to birth control in many states…
But can’t see an R-rated movie without an adult. - A teen can legally seek treatment for an STI…
But might be blocked from watching a YouTube video that mentions it. - They can manage a social media account that exposes them to sex, violence, and targeted advertising…
But can’t open a bank account without a parent.
And don’t get me started on the inconsistencies across platforms. TikTok might ban a video for saying “vagina,” while simultaneously showing a barely-dressed influencer to a 13-year-old who just searched “homecoming dresses.”
It’s whiplash.
One minute, teens are told to be empowered.
The next, they’re told to cover their eyes.
What Are We Protecting Them From, Exactly?
Pop culture has always struggled to define what’s “appropriate” for teens. But when the legal system, school rules, and healthcare policies already send mixed messages, the entertainment world reinforces that confusion.
You can be adult enough to seek abortion care…
But not mature enough to watch Bridesmaids without an adult present.
You can be criminally responsible…
But still need permission to download certain apps.
It’s not that there shouldn’t be limits. It’s just… why these limits?
Why now?
Why here?
Like everything else we’ve looked at, the logic is inconsistent at best, and completely incoherent at worst.
Final Thoughts: Let’s Stop Pretending This Makes Sense
Look, I get it. Sometimes, there are legitimate reasons why teenagers need to make adult decisions. Examples could include:
- If a girl is pregnant as a result of incest.
- If a teen has an STI because of abuse.
- If someone needs to leave a dangerous home before turning 18.
Those situations are tragic and real and absolutely deserve thoughtful, compassionate solutions. I am not disregarding them.
But that’s not what this article is about.
What we’re talking about here is the everyday, inconsistent patchwork of age-based rules that govern everything from healthcare to homework to Hollywood movies. And when you lay it all out like this? Even a fifth grader could tell you it doesn’t make sense.
We’ve built a system of laws, rules, and policies intended to protect young people…
But often just confuse them.
And honestly? Confuse the adults in their lives, too.
Yes, I know this piece reads a little like a rant and is a little all over the place. That’s fair.
But maybe it should.
Because it shouldn’t be controversial to say that we can do better.
We can build systems that are logical, consistent, and easy to understand, while still allowing for exceptions when needed.
We can draw clearer lines. We can assign real meaning to what it actually means to be an “adult.”
And maybe, just maybe, we can stop asking teenagers to follow rules that contradict each other at every turn.
Do I know the perfect solution? No.
But I do know this:
If the rules don’t make sense, people stop respecting them.
And once that happens, nobody wins.
– Stay Strong! Jaelin –
Additional Reading
- Drawing Legal Age Boundaries: A Tale of Two Maturities – American Psychological Association
- Is 18 and 21 Illegal? Legal Implications and Age-Based Laws – LegalClarity
About the Author:
Dr. Jaelin Stickels, DPN, CNM, APRN, is a deeply passionate and highly skilled Certified Nurse Midwife and the owner of Holistic Heritage Homebirth in Houston, Texas. With over a decade of midwife experience, Jaelin has had the privilege of helping several hundred (almost 900) women welcome their babies into the world. In addition to her advanced practice licensure training, she has additional advanced training in twin and breech births, making her one of only a few with these skills in her area. Jaelin approaches every birth with expertise, compassion, and a deep respect for the birthing process.
Jaelin’s journey into midwifery began with a profound love for supporting women through the incredible experience of pregnancy, labor, and postpartum. Since 2010, she has been dedicated to walking alongside families during these transformative moments, offering guidance, support, and care tailored to each individual’s unique needs. She is a big believer in informed consent and ensures clients are given the best evidence-based information to make the best decisions for themselves and their families.
Married to her high school sweetheart Ted (aka Chef Ted) since 1984, Jaelin is the proud mother of three grown children and the delighted grandmother of one amazing granddaughter. When she’s not assisting in births, Jaelin finds joy in going to the movies with her husband, quilting, and cherishing time with her family. Known by the other midwives in her practice (Holistic Heritage Homebirth) affectionately as the “Birth Hog,” she brings an unmatched dedication and enthusiasm to her work—no one loves birth quite like she does.
Find out more about Jaelin’s Homebirth Practice (Holistic Heritage Homebirth) in Houston, TX
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