(Last reviewed 05/01/2025)
Standards and Regulations
Fostering Services National Minimum Standards (England) 2011:
• **Standard 1 – **The child’s wishes and feelings, and the views of people important to them.
• **Standard 6 – **Promoting Health and Well-being.
Training, Support and Development Standards for Foster Care:
• **Standard 2 – **Understanding your role as a foster carer.
• **Standard 3 – **Understanding health and safety and health care.
• **Standard 5 – **Understanding the development of children and young people.
Relevant Legislation and Guidance
In the UK, several laws and policies safeguard the sexual health of looked-after children. These rules make sure young people in care can easily get the right sexual-health services and education.
• The Children Act 1989 (with later updates, including the Children Act 2004) – says a child’s welfare must come first in every care decision. Local authorities must give looked-after children the care and services they need—including sexual-health services—to meet their physical, emotional, and psychological needs.
• The Care Planning, Placement and Case Review (England) Regulations 2010 – set out how local authorities plan, review, and manage children’s care. They stress the importance of health care, including sexual health.
• Every looked-after child must have a Personal Education Plan (PEP) and a health-care plan that covers sexual health, including access to relationships and sexual-health education.
• Sexual Offences Act 2003 – protects children from sexual exploitation and abuse. It recognises that children in care are especially vulnerable and requires local authorities to act to prevent sexual abuse and exploitation.
• The Children and Families Act 2014 – aims to improve the well-being of children and families. It promotes easier access to health services, including sexual-health services, and supports relationships and sex education (RSE) in schools, including for children in care.
• Looked After Children (England) Regulations 2001 – require regular reviews of the care, education, and health needs of children in care, including routine checks on sexual health and emotional well-being.
Introduction
The agency is committed to helping the children in its care build healthy relationships that support their overall health and development. Being looked after must never create barriers to accessing services, information, education, or personal support about sexual health. Foster carers can find detailed guidance on their role in supporting children and young people to build healthy relationships below.
Supporting a young person to understand their developing sexuality is essential. Young people need to feel positive about their sexuality, which can be especially sensitive if they have experienced abuse. Building a positive sexual identity requires accurate information to guide decisions. Foster carers play a vital role in creating trusting relationships where children can express themselves.
Talking about sex and relationships is important because it helps young people to:
• Explore values and attitudes;
• Make informed choices about their behaviour, personal relationships, and sexual health;
• Prepare for independent living;
• Build social skills, including assertiveness and negotiation, which they can apply in other areas of life and which help them recognise and avoid potentially harmful relationships;
• Build self-esteem;
• Make informed choices about their behaviour, personal relationships, and sexual health.
The role of the child/young person’s social worker and foster carer
Agency foster carers and Supervising Social Workers share age-appropriate information with the children and young people in their care by:
• Using simple, clear language and answering questions without judgement;
• Discussing body changes and feelings before they occur and preparing children and young people for them. This includes sharing the knowledge young people need to make safe, positive choices about sex and relationships;
• Exploring a wide range of values and attitudes;
• Providing opportunities for children and young people to make informed choices within age-appropriate boundaries;
• Talking about the emotional implications and responsibilities of entering a sexual or romantic relationship;
• Emphasising the need to treat sexual partners with respect and never as objects;
• Sharing leaflets and other information, and signposting the direct health care available to young people through local health and health-promotion services;
• Explaining the risks related to sexual health and providing accurate information about sexually transmitted infections, including HIV and AIDS;
• Responding sensitively if a young person shares that they are gay, lesbian, bisexual, or questioning their sexuality or identity;
• Offering practical support to challenge prejudice from others;
• Recognising that religion and culture can strongly influence young people’s attitudes and values towards sex and relationships;
• Understanding the needs of children and young people with disabilities, recognising that society may overlook their sexual identity and that reliance on others can increase vulnerability;
• Discussing the responsibilities and the emotional and practical implications of becoming a parent.
It is not appropriate or helpful for foster carers or Social Workers to share personal sexual information about themselves.
What is Sexual Health?
The World Health Organisation defines sexual health as:
“The integration of the physical, emotional, intellectual and social aspects of sexual being in ways that are enriching and enhance personality, communication and love.”
To enjoy good sexual health, a person needs to feel at ease with themselves, with how they communicate, and with how they experience their relationships. They also need to recognise how each of these areas affects their own wellbeing.
Sexual Health and Relationships Policy
a) Privacy
Each child placed with foster carers deserves the same level of privacy they would have in their family home, while carers always keep the child’s safety and welfare in mind.
Everyone has a right to privacy at home, and every foster child needs personal space.
• Ideally, every child should have a private spot in their room—such as a cupboard or drawer—and carers should avoid unnecessary intrusion.
• All children should have privacy when using the toilet, bathing or washing, where this matches their age and needs.
A child’s right to privacy does not give permission for sexual relationships or activity that is not allowed. Although this boundary may feel less clear in a foster family or for a child moving toward independence, foster carers must explain their role and the household rules as soon as the child arrives.
b) Personal friends and relationships
Every child in foster care should be free to start, end or decline personal relationships.
Foster carers offer appropriate support by:
• Allowing for the natural ebb and flow of friendships and relationships.
• Recognising that some relationships may be sexual.
• Accepting that friends or partners may be heterosexual, lesbian or gay.
Carers aim to ensure relationships are safe and not abusive. Any worries must be shared with the child’s Social Worker and the Supervising Social Worker.
If a child’s relationships raise concerns, carers must remain professional and caring, focusing on the child’s needs and safety. They should discuss any worries with their Supervising Social Worker and the child’s Social Worker.
People have the right to explore friendships and relationships and to say “no” at any time. Foster carers are responsible for supporting the young person through these choices.
c) Values
Every child has the right to their own moral values. Foster carers must respect each child’s religious, political, ethnic and cultural beliefs, provided these do not break the law. Even if a carer’s views differ, they must still respect the child’s values and challenge discrimination or racism.
Carers should stay aware of how the child’s beliefs may shape their behaviour. Children may feel tension between the values of their birth family and those they develop later in life.
Regardless of personal beliefs, it is important that everyone:
• Respects themselves.
• Respects others.
• Takes responsibility for their own behaviour.
• Considers the impact of their actions on friends, family and the wider community.
By modelling these principles, carers help children learn about sexual health and relationships in a healthy, unbiased way.
d) Safety
Every child has the right to be protected from abuse and unwanted attention, whether from carers, other looked-after children or anyone else.
Foster carers must safeguard the children they look after and know how to act if they suspect abuse.
Carers should create an environment where everyone feels valued and help each child recognise their own worth. This builds confidence and empowers children—especially those who are more vulnerable—to stand up for themselves.
Carers’ relationships with children must be caring, respectful and sensitive, yet remain professional. Carers should use appropriate language and behaviour and follow guidance on touch and intimate care. Additional details on intimate care for children with disabilities appear in the Disabilities section.
e) Taking the child’s background into account
When addressing personal or sexual-relationship issues, carers must consider the child’s ethnic origin, cultural background and religion. For instance, some faiths have specific teachings on contraception.
f) Confidentiality
Children, carers and Social Workers can feel anxious about confidentiality, so everyone needs clear boundaries. Children should understand why carers might need to share certain information and why keeping some matters secret is sometimes impossible.
Occasionally, sharing confidential information is necessary so the child can receive care, treatment or support. If a confidence must be broken, the carer should explain to the child why and how this will happen and support them throughout.
Confidentiality issues often arise around sexual health, especially if someone may be at risk of infection. If a carer is concerned, they must contact their Supervising Social Worker or the child’s Social Worker for a formal discussion.
Whatever the child’s age, carers must keep personal information confidential unless doing so would endanger the child or others. Carers should discuss confidentiality boundaries with every child in their care. Children must know that if their safety or someone else’s safety is at risk, the carer will inform Children’s Social Care, in consultation with the Supervising Social Worker.
Carers should share information about a child’s sexual health or relationships with other professionals only when absolutely necessary, and with the child’s agreement wherever possible. Carers must provide only the minimum information required and involve the child as much as they can.
Carers must also tell the child whether the information will be passed on or recorded and who will have access to it, and ensure that all records are kept securely.
If a child prefers not to discuss certain issues with their carers or Social Worker, they can speak confidentially and independently with doctors, nurses or other specialist services.
A child’s sexual orientation does not affect their entitlement to full confidentiality.
g) Dealing with young people under the age of consent
If a child under the age of consent needs help
The agency recognises that foster carers can feel worried when they know a child below the age of consent is sexually active, especially if there may be a risk of pregnancy or a sexually transmitted infection (STI).
Carers should guide the child toward trusted health professionals—such as doctors or nurses—who can offer advice, support and services. If carers need help locating these services, they should speak with their Supervising Social Worker or the child’s Social Worker.
Confidentiality and young people
There is no single law that covers confidentiality in this situation. When a child talks with a health professional about sexual health or relationships, the child must agree to any treatment or contraceptive service.
If the child needs treatment
A health professional will decide the child can consent when the child shows they understand:
• They can choose to have—or not have—treatment.
• The purpose, consequences and possible risks of any treatment they choose.
• What might happen if they decide against treatment.
Condoms and contraceptive advice
Some trained professionals can provide condoms or contraceptive advice to under-16s, but only after confirming that:
• The young person fully understands the advice.
• The young person is mature enough to weigh the moral, social and emotional aspects.
• The young person is very likely to begin—or continue—sexual activity whether or not condoms or advice are given.
• Without condoms or advice, the young person’s physical or mental health would probably suffer.
• Providing condoms and/or advice without parental consent is in the young person’s best interests.
The Social Worker decides what information, if any, needs to be shared with the young person’s parent(s).
h) If the child’s relationship concerns their foster carer
If a foster carer feels uneasy about a relationship involving a child under 16—for example, a 14-year-old girl in a sexual relationship with a 25-year-old man—they must contact their Supervising Social Worker as soon as possible.
Both Social Workers and foster carers should keep up-to-date, accurate details about support services for young people with sexual-health concerns. Carers must also ensure that any child accessing this information receives the help they need to use it safely.
5. Working with Parents
Why working with parents is so important
The Children Act 1989 stresses partnership with parents and states that a child’s welfare is paramount.
If a child’s parent is unhappy about the foster carer discussing sexual matters
When a parent objects to their child receiving information on relationships and sexual health, the child’s Social Worker and Supervising Social Worker will support the carer and the child to decide what is in the child’s best interests.
Looked-after young people come from many cultural and religious backgrounds, and carers may need to adapt conversations accordingly. However, every child has the right to this information, and no child should be denied it because of their background.
6. Sex Education and Learning about Relationships
a) What children need to know
Children and young people should have written information on sexual health and relationships that matches their cultural and religious background, age and understanding. This information must be translated or interpreted into the child’s first language where needed.
b) Learning about what the child is taught at school
Carers benefit from knowing what schools teach about sex and relationships at different ages. Because school programmes vary, carers should ask teachers and Social Workers what is taught and when. This helps carers fill any gaps in knowledge and support children who miss lessons.
c) About starting sex education – children under 10
Evidence shows that children delay first sexual activity when they learn accurate facts early. Parents and carers should begin age-appropriate conversations from the child’s earliest years to prevent fear and confusion caused by misinformation. Children under 10 need:
• Correct names for body parts and clear information on how the body works.
• Preparation for puberty—why bodies change, and how to manage periods and wet dreams.
• Guidance on appropriate and inappropriate touching.
• Support to talk about feelings and emotions.
• Help to discuss different kinds of relationships.
Children must know they can ask questions without fear of blame or criticism. Carers who feel unsure about answering should speak with their Supervising Social Worker.
d) Children and young people over the age of 10
Young people over 10 still need accurate, ongoing information—especially boys, who may feel sex education is not for them. They need space to discuss:
• How their bodies work and the correct names for body parts.
• Conception, contraception and STIs, including HIV and AIDS.
• The importance of personal relationships, self-respect and respect for others.
• Ways to manage relationships and resist unwanted sexual pressure.
• How to find confidential help and advice about sexual health and identity.
Carers should consider each child’s individual needs and seek support from their Supervising Social Worker or the child’s Social Worker when required.
7. Dealing with Pregnancy
a) Confidentiality
A young person who thinks they—or their partner—might be pregnant needs to talk openly. They will face difficult choices and need steady support, so they must feel safe discussing this without immediate confidentiality worries (see the confidentiality section for guidance).
If sharing information is in the young person’s best interests, the carer must explain why and how the information will be shared, ensuring the young person understands.
b) Making decisions
If a pregnant foster child is considering termination, a family-planning clinic can refer her for counselling. Some young people cope well at first but may need support later. The child’s Social Worker will guide decision-making and the foster carer may be asked to offer additional support.
8. Dealing with Sexual Exploitation
Children of any sexual orientation can be drawn into situations where they receive money, gifts, drugs or other benefits in exchange for sex—this is sexual exploitation. Because of stigma, children may stay silent and miss out on help.
Carers must build open, non-judgemental relationships so children trust them enough to share their experiences. When exploitation is suspected, carers must seek guidance from their Supervising Social Worker or the child’s Social Worker and use specialist resources. (See the Safeguarding Policy and Child Sexual Exploitation Policy for full details.)
9. Sexuality and Disabilities
a) Physical disabilities
Children and young people with physical disabilities experience the same feelings, interests and worries about sexuality as their peers. Carers should discuss sexual health and relationships fully and openly.
Often, social and psychological factors—not the disability itself—affect relationships. Limited independence can reduce chances to meet others. Carers may need extra training and support to feel confident discussing intimate matters and must understand clear boundaries around physical help, intimate care and sexual behaviour. Any concerns should be discussed early with the child’s Social Worker or Supervising Social Worker.
b) Learning disability
Young people with learning disabilities have the same rights to sex-and-relationships education and confidentiality as everyone else. Modern practice moves beyond protection-only messages to include information on sexuality, opportunities to practise skills and explore attitudes, so children can make positive choices.
Carers should learn what the child’s school covers so they can reinforce clear messages at home. They will also need specialist training, advice and tailored resources—provided by the agency—to meet each child’s abilities and needs.
10. Supporting Gay, Lesbian, Bisexual and Transgender (LGBT) Children and Young People
a) Understanding LGBT children and young people
Foster carers must recognise and respond to the needs of any gay, lesbian, bisexual or transgender (LGBT) children and young people in their care. As with every other child, carers should support LGBT children and young people to make informed and safe choices about their relationships. Training and support are available to help carers understand these young people’s feelings—especially their views on same-sex relationships—and to guide them in building relationships safely.
b) Negative attitudes
Foster carers must avoid any negative attitudes toward a person’s sexuality. Negative attitudes include:
- Hurtful comments.
- Slang or derogatory words for gay, lesbian, bisexual or transgender people.
- Jokes that belittle someone’s sexuality.
c) Access to information
Foster carers should make sure LGBT children and young people have the same information as their peers—through one-to-one chats, leaflets, books, and contact with support groups or agencies. Sharing details of outside groups does not replace direct conversation; children must feel able to talk openly with their carers without fearing disapproval of their sexuality.
d) Why foster carers need to show a tolerant attitude in front of all children and young people
Carers must never assume that every child is heterosexual. They must make it clear that bullying of gay, lesbian, bisexual or transgender people—verbally, emotionally or physically—will not be tolerated. This creates an atmosphere in which LGBT children feel safe and confident asking for help, advice and reassurance.
11. Supporting Children Who Have Been Sexually Abused
a) The special problem of children who have been abused
All children are entitled to sex education, and carers must be especially sensitive to those who have experienced sexual abuse. These children often need extra understanding and attention to process past harm and replace negative messages with positive ones.
b) Support and training for foster carers of children who have been abused
Children who have been sexually abused may need specialist help. The department provides specific training, and foster carers should discuss their training needs with their Supervising Social Workers.
c) Supporting children who have been sexually abused and may display inappropriate sexual behaviour towards other children
Sometimes children who have been abused show inappropriate sexual behaviour toward others. When this happens, the foster carer should:
- Tell the child immediately that the behaviour is not acceptable.
- Encourage healthier sexual attitudes and actions.
- View the child as someone needing help and avoid labelling them a “sexual abuser.”
- Discuss the incident with the child’s Social Worker and the Supervising Social Worker as soon as possible.
Children who harm others sexually still need the same sexual-health and relationship education as their peers, and they may also require specialist help.
13. Legal Matters
a) Heterosexual health
The age of consent for heterosexual and female same-sex sex in England, Scotland and Wales is 16 years. Consent for anal intercourse is 18 years. Additional points:
- It is illegal for a man or boy to have sexual intercourse with a girl under 16, though the girl herself commits no offence.
- A boy under 16 can commit an offence involving sexual intercourse, but prosecution is unlikely unless he is much older than the girl or she did not consent.
- Sexual intercourse with a girl under 13 is a far more serious offence and can carry a maximum sentence of life imprisonment.
b) Homosexual health
The age of consent for male homosexual sex is 16 years across the UK. However, the law states that consenting gay sex is an offence unless it happens in private and both partners are at least 18.
c) The legal position of people with learning difficulties
A young person with learning difficulties who is under the age of consent is legally protected in the same way as any other young person under that age.
d) The Children Act guidance and regulations say
“The needs of different young people must be considered in sexual education: the fact that young people with mental or physical disabilities have sexual needs should be acknowledged….”
e) Sexual Offences Act 2003
Does the Sexual Offences Act 2003 allow health professionals and others to give confidential sexual-health advice and treatment?
Yes. The Act makes it clear that a person does not commit an offence when acting to:
- Protect the young person from sexually transmitted infection.
- Protect the young person’s physical safety.
- Prevent the young person from becoming pregnant.
- Promote the young person’s emotional well-being by giving advice.
This applies only if the person is not seeking sexual gratification or encouraging illegal activity. The exception covers health professionals and anyone acting to protect a child—teachers, advisers, magazine columnists, parents, relatives and friends.
Those providing contraceptive treatment to under-16s without parental consent must still assess competence case by case and work within the Fraser Guidelines.
Gillick competency and Fraser guidelines
Gillick competency and Fraser guidelines help practitioners balance listening to a child’s wishes with the duty to keep them safe.
How is a child deemed Gillick competent?
When deciding if a child can consent to treatment, practitioners consider:
- Age and maturity.
- Mental capacity.
- Understanding of the treatment, including benefits, risks and long-term impact.
- Awareness of possible consequences of refusing treatment.
- Understanding of the advice and information given.
- Knowledge of alternative options.
- Ability to explain the reasons for their decision.
Because understanding can vary, competence is assessed case by case.
What are the Fraser Guidelines?
Advice or treatment about contraception and sexual health can be given to an under-16 without parental consent if:
- The child is mature and intelligent enough to understand the proposed treatment.
- The child cannot be persuaded to involve their parents or allow the doctor to inform them.
- The child is likely to begin or continue sexual intercourse with or without contraception.
- The child’s physical or mental health is likely to suffer without the advice or treatment.
- The advice or treatment is in the child’s best interests.
Confidential advice for young people under 16
Young people—including those under 13—have the same right to confidentiality as adults. Confidentiality may be breached only in exceptional circumstances where health, safety or welfare is at grave risk; the decision is based on the level of harm, not the child’s age.
Does the Sexual Offences Act 2003 make normal teenage sexual activity illegal?
The Act targets abusive or exploitative activity. While it criminalises sexual activity between under-18s and under-16s, mutually agreed sexual activity within normal adolescent behaviour is not usually prosecuted if there is no exploitation.
When staff or carers are aware of illegal underage sexual activity, they should:
- Help minimise the risk of pregnancy or infection.
- Support the young person to reduce emotional harm and to stop the activity.
For young people over the age of consent, the shared living environment of a foster or residential home often makes sexual activity there inappropriate. If a sustained relationship develops, professionals must decide how to manage it. Any child-protection concerns, including exploitation through prostitution or pornography, must follow multi-agency child-protection procedures.
Personal beliefs—about termination, or gay and lesbian relationships—should not influence the information given. The Directorate’s role is to provide neutral information so individuals or families can decide for themselves, with support. Carers will receive the support they need to maintain this stance.
What are sexually transmitted diseases (STDs)?
Sexually transmitted diseases (STDs), or sexually transmitted infections (STIs), are infections passed from one person to another through sexual contact—usually vaginal, oral or anal sex, but sometimes through other intimate contact such as skin-to-skin touching (for example, herpes and HPV).
Types of STDs include:
- Chlamydia
- Genital herpes
- Gonorrhoea
- HIV/AIDS
- HPV
- Pubic lice
- Syphilis
- Trichomoniasis
What causes sexually transmitted diseases (STDs)?
STDs can be caused by:
- Bacteria.
- Viruses.
- Parasites.
Who is affected by sexually transmitted diseases (STDs)?
STDs can affect anyone. Health problems can be more severe for women, and an infected pregnant woman can pass the infection to her baby.
What are the symptoms of sexually transmitted diseases (STDs)?
STDs do not always cause symptoms, or the signs can be mild. A person can have an infection without knowing it and still pass it on to others.
If symptoms do appear, they can include:
- Unusual discharge from the penis or vagina.
- Sores or warts on the genital area.
- Painful or frequent urination.
- Itching and redness in the genital area.
- Blisters or sores in or around the mouth.
- An unusual vaginal odour.
- Anal itching, soreness or bleeding.
- Abdominal pain.
- Fever.
How are sexually transmitted diseases (STDs) diagnosed?
- Some STDs can be recognised during a physical exam or by looking at a sample (swab) taken from the vagina, penis or anus under a microscope.
- Blood tests are used to diagnose other types of STDs.
- Testing is important because many STDs do not cause obvious symptoms.
What are the treatments for sexually transmitted diseases (STDs)?
- Antibiotics can cure STDs caused by bacteria or parasites.
- STDs caused by viruses cannot be cured, but medicines can reduce symptoms and lower the risk of passing the infection to others.
- Correct and consistent use of latex condoms greatly lowers—though does not completely remove—the chance of catching or spreading STDs.
- The safest way to avoid infection is to choose not to have anal, vaginal or oral sex.
- Vaccines are available to prevent HPV and hepatitis B.
Can sexually transmitted diseases (STDs) be prevented?
- Using latex condoms correctly every time you have sex greatly lowers—but does not completely remove—the risk of catching or spreading STDs.
1a. If someone is allergic to latex, they can use polyurethane condoms. - The most reliable way to avoid infection is to choose not to have anal, vaginal or oral sex.
List of sexualities
- Allosexual – Anyone who experiences sexual attraction; can also identify as gay, lesbian, bisexual, pansexual or another orientation because allosexuality refers only to experiencing attraction.
- Androsexual – Attracted to people with a masculine identity or presentation; sometimes used for attraction to people with penises.
- Asexual – Generally does not feel sexual attraction to any gender; may still feel romantic attraction and may choose to have sex in some situations.
- Autosexual – Feels sexual attraction primarily toward oneself.
- Bi-curious – Exploring or beginning to explore bisexuality; some people feel the term can be biphobic.
- Bisexual – Feels romantic, sexual or emotional attraction to more than one gender; may overlap with pansexuality.
- Closeted (in the closet) – Someone who is LGBTQIA+ but has not publicly shared this, often for safety or to avoid discrimination.
- Demi-sexual – Experiences sexual attraction only after forming a strong romantic or emotional bond; part of the asexual spectrum.
- Fluid – Experiences sexuality or sexual identity as changing over time or in different settings.
- Gay – Feels sexual, romantic or emotional attraction to people of the same gender; some women prefer the term lesbian.
- Gray-sexual – Experiences sexual attraction rarely or with low intensity; falls in the “gray area” of the asexual spectrum.
- Gynesexual – Attracted to women or people with a feminine identity or presentation; sometimes used for attraction to people with vaginas or breasts.
- Heterosexual (straight) – Attracted only to people of a different gender.
- Heteroflexible / Homoflexible – Mostly heterosexual (heteroflexible) or mostly homosexual (homoflexible) but occasionally attracted to other genders.
- Homosexual – An older term for attraction to people of the same or a similar gender.
- Lesbian – A woman (or feminine-leaning non-binary person) who is attracted to women.
- Pansexual – Attracted to people regardless of sex or gender identity.
- Queer – An umbrella term for anyone in the LGBTQ+ community, reclaimed to express diversity in sexual and gender identities.
- Questioning – Exploring or uncertain about one’s sexual identity or gender.
- Sapiosexual – Finds intelligence the primary basis for attraction, rather than sex or gender.
- Sex-repulsed – Feels repelled or uncomfortable with sex or sexual behaviour; on the asexual spectrum.
- Skoliosexual – Primarily attracted to people who are trans or non-binary (not cisgender).
- Spectra-sexual – Romantically or sexually attracted to a wide range of sexes, genders and gender identities.
Resources
- The Mix – Advice and information on safer sex.
- Brook – Free, confidential advice.
- Family Planning Association – Detailed Q&As.
- NHS – Guide to sexual health.
- Terrence Higgins Trust – Information on STIs and advice on HIV.
- HIV Aware – Myths and facts about HIV.
