Our access to reproductive health care is disappearing at an historic pace. Foster youth are particularly vulnerable to poor sexual health and are disproportionately affected by bad policies. We must recognize and address the inequalities in reproductive health care that advance young people's experiences.
The child welfare system has a history of ambiguous and contradictory sex education policies. A recent award-winning research series published by Imprint, “The High-Stakes Silent System,” found that most states provide little or no guidance to caregivers and caseworkers about sexual and reproductive health. has become clear. This groundbreaking analysis critiqued policy documents in all 50 states and interviewed numerous experts, youth development, and advocates.
In the absence of clear guidance on sex education, caregivers and caseworkers are given free rein to impose their personal and religious values on how young people receive or receive sex education. “The lack of policies creates a confusing situation for social workers, group home workers and foster parents,” said Elizabeth Aparicio, a public health social worker at the University of Maryland. She said, “There's a sense of, 'Maybe someone else is doing this.' I don't know how, and I don't know if I'm going to hurt them.”
The American Academy of Pediatrics recommends that all children and adolescents receive age-appropriate instruction to understand their bodies. Most children receive sex education through complementary settings such as school, home, and trusted health care providers. Youth in foster care may miss out on these opportunities due to changes in placement, complex living situations, or trauma. When foster care is an unsafe environment, uninformed youth may be particularly at risk of abuse.
Foster youth experience higher rates of abusive relationships, teen pregnancy, and sexually transmitted infections. Despite a national decline in teen pregnancies, the number of pregnant teens in foster care continues to rise. Girls in foster care are five times more likely to become pregnant than girls of the same age. In youth foster care, the incidence of dating violence increases three times as much. More than half of foster teens surveyed did not know that condoms reduce the risk of HIV/AIDS and other sexually transmitted diseases.
“This is a culmination of failures in our education system and in our child welfare system when it comes to sexual health education,” said John Barton, a former foster child and project manager at California nonprofit organization John Barton Advocates for Youth. said Sarah Powter.
There is widespread confusion over who makes decisions for young people when their biological parents lose custody but retain legal rights. Some state policies impose restrictions on foster youth that are inconsistent with the rights of minors, such as requiring judicial approval for foster youth to access contraception. “These findings highlight the full range of barriers young people in care face in accessing reproductive health care that their peers do not.” said Amy Dworsky, a recognized youth foster care expert at the University of Chicago. “In some states, the situation appears ripe for litigation, as youth in foster care do not appear to have the same rights to reproductive health care as non-foster care youth. It looks like.”
Comprehensive sex education improves adolescent sexual health attitudes, behaviors, and outcomes.
Recent research shows that policies that take inclusive and identity-affirming approaches reduce dating and intimate partner violence, promote gender and sexual diversity, and prevent child abuse. I did. Trauma-informed policies are critical for youth who have experienced abuse. Sexuality in the child welfare system is often depicted through the lens of victimization and perpetration. Shame-based curricula further traumatize and stigmatize youth. Trauma-informed sex education requires recognition of past abuse, the need for healing, and safe, consensual relationships.
Adopted youth need better sex education now.
States must take responsibility for updating their fragmented and outdated child welfare sex education policies. The current political climate will further exacerbate disparities for the most vulnerable young people. We must enable our foster youth to understand their bodies and protect their sexual health.
Megan Wills Kullnat is a pediatrician in Redmond, a Bloomberg Fellow, a Master of Public Health candidate at the Johns Hopkins School of Public Health, and a foster parent.
