There are conceptual and ethical challenges to defining adolescents’ autonomy to access health care, and these can lead to health care norms and practices that could be maladjusted to the needs and preferences of adolescents. Particularly sensitive is access to sexual and reproductive health care services (SRHS). Yet, while there has been substantial conceptual work to conceptualize autonomy (e.g., as independence), there is a lack of empirical research that documents the perceptions of adolescents regarding on how they access or wish to access health care services. The main objectives of this research were to (a) understand how adolescents in Colombia interpret the concept of “autonomy,” (b) describe how these adolescents articulate their autonomy (i.e., preferences) in accessing SRHS, and (c) analyze the ethical issues emerging from these data. Forty-five semi-structured interviews were conducted with participants aged 14 to 23 years old in the Departments of Antioquia and Valle del Cauca in Colombia. Our study showed that participants’ understanding of autonomy was context-based and highly dependent on personal experiences, and these influenced their choice in how to access SRHS. Seen through the ethical lens of a reproductive justice framework, our results highlight the unequal opportunities for adolescents in terms of autonomy to access SRHS.

在定义青少年获得医疗保健的自主权方面存在着概念上和伦理上的挑战，这些挑战可能导致医疗保健规范和实践可能会因青少年的需求和偏好而发生错误调整。获得性保健和生殖保健服务（SRHS）尤其敏感。然而，尽管已经进行了大量的概念性工作来将自治概念化（例如，作为独立性），但仍缺乏实证研究来记录青少年对他们如何获得或希望获得医疗服务的看法。这项研究的主要目的是（a）了解哥伦比亚的青少年如何解释“自治”的概念，（b）描述这些青少年在获得SRHS时如何表达其自治（即偏好），以及（c）分析道德这些数据中出现的问题。在哥伦比亚的Antioquia和Valle del Cauca部对年龄为14至23岁的参与者进行了45次半结构化访谈。我们的研究表明，参与者对自主权的理解是基于上下文的，并且高度依赖于个人经历，并且这些影响了他们在获取SRHS方式方面的选择。从生殖正义框架的伦理视角来看，我们的研究结果突出表明，青少年在获得SRHS的自主权方面机会不平等。