Providing contraception and sexual health to under 16 year olds remains a controversial and emotive issue despite clear guidance and the fact that 20–30% of young people report having had their first experience of sexual intercourse by the age of 16 years old.Competent under 16 year olds have the ability to consent to medical treatment and the duty of confidentiality owed to them is as great as to any other individual. Contraception can be provided to under 16 year olds without parental consent provided certain criteria are met.Health professionals should maximise all opportunities they have to develop a relationship of trust with a young person and explore their contraception and sexual health in an open, non-judgemental and confidential manner.Effective hormonal methods combined with condoms, to prevent sexually transmitted infections, should be promoted and the realities of teenage sexual behaviour acknowledged if the UK high rate of teenage pregnancy is to be reduced.