Abstract
In an adult-centered and adultist culture, state interventions addressing violations of the rights of children and adolescents are grounded in a paternalistic view that limits their ability to exercise autonomy, despite international treaties that guarantee it. In Chile, there are protection and reintegration programs that intervene according to the needs identified at the family, community, and institutional levels, including health-related needs. This exploratory qualitative study analyzed 13 interviews with health professionals experienced in adolescent care, conducted in the Metropolitan Region between April 2022 and April 2023, identifying the coexistence of two care perspectives: a paternalistic one, centered on adult accompaniment, and another oriented toward fostering autonomy and the exercise of rights. The paternalistic perspective is based on perceptions of risk and trauma, which may restrict autonomy in sexual and reproductive health. The study suggests that healthcare workers should integrate an intersectional approach to ensure relevant and nonjudgmental sexual and reproductive health care, incorporating the relational dimension of autonomy, particularly for vulnerable and priority groups.