Also available in [PDF] format.

Young people are fighting hard every day to make our world a better place. From immigration reform and climate change to the Black Lives Matter movement, young people are front and center, pushing for policy change on issues that impact their daily lives – and the reproductive and sexual health, rights and justice movement is no different. Our society owes it to them to recognize young people’s rights to honest sexual health information; to accessible, confidential, and affordable sexual health services; and to the resources and opportunities necessary to create sexual health equity for all youth. In service of this goal, Advocates for Youth surveyed over 125 of our core youth activists who are active participants in Advocates’ youth programs around the United States and the global south, to identify their priorities and needs. We conducted in-depth follow-up conversations with over 20 of them.

The result is our 2017 Youth Policy Agenda, which lays out young people’s vision for a society that they deserve. As the United States transitions into a new Presidential Administration, Congress, and state legislative sessions, Advocates for Youth and our youth activists are committed to making this vision a reality.

A Framework Grounded in Centering Young People

Advocates’ Youth Policy Agenda is a blueprint, driven by the unique perspectives of our youth activists and centered in the belief that young people’s sexuality is not only a natural and healthy part of human development, but a part of their identity that should be celebrated and embraced. When it comes to addressing our nation’s gaps in sexual health, such as unintended teen pregnancy rates or access to medically accurate and confidential information and services, including those most impacted by the issue is critical. Doing so creates more inclusive and effective decision-making processes while achieving better health outcomes through more relevant intervention policies and programs. When it comes to bold and innovative ideas to addressing sexual health barriers, young people are part of the solution, not the problem. If we want better health outcomes for our communities then we must center young people.

This Youth Policy Agenda recognizes that one’s race and ethnicity, nationality, immigration status, gender identity or expression, sexuality, location, and many other factors impact one’s ability to access medically accurate, confidential, and culturally responsive sexual health resources and services. It is crucial to take an intersectional approach to policy advocacy – i.e. an approach that acknowledges that many different and related system of oppression, domination, and discrimination overlap or intersect – because our country’s history with race, gender and class is a long and complicated one, where the bodies of young people, LGBTQ (lesbian, gay, bisexual, transgender, queer/questioning) individuals and communities of color are often controlled by others and members of these communities are criminalized simply for existing.

Coercion tactics and forced sterilization practices during the 1970s by the federal government targeting young women and communities of color led to 100,000 to 150,000 young women being sterilized each year. As an immediate response to Roe v. Wade, the Hyde Amendment made it illegal to use federal funding to fund abortion care targeting low-income communities and women of color, ultimately making abortion inaccessible to many in 1976. In 1996, Welfare reform spurred funding for abstinence-only-until-marriage programs, which deny young people life-saving information about contraception options, encourage harmful gender stereotypes, and stigmatize LGBTQ young people. Today, 43 states have some form of Parental Notification and Involvement (PNI) laws, which require parents to be notified and/or provide consent for minors to receive reproductive and sexual health services, threatening the safety of young people by forcing them to disclose health decisions, regardless of the threat of violence or abuse in their homes. These examples are part of a laundry list of policies and programs that have detrimental effects on young people in communities across the country and around the world. Policymakers must use an intersectional lens to recognize the diversity of lived experiences of young people, ensure that the policies that impact young people’s daily lives reflect that diversity, and achieve real change in youth reproductive and sexual health.

The Youth Policy Agenda is the culmination of Advocates for Youth and youth activists from across the country and the global south working in partnership to outline the policy priorities and recommendations for the policymakers that make decisions on our lives every day. We are committed to working with policymakers, at all levels of government, to implement an agenda that makes progress in five priority areas. These critical categories are based on what young people need in order to have the opportunity to lead sexually healthy lives and to become sexually healthy adults.

Young People Need:

• Inclusive, shame-free culturally responsive and LGBT-inclusive comprehensive sexuality education and information;
• Independent and confidential access to the full range of sexual and reproductive health services;
• Institutions and communities that provide safe and supportive environments and equitable distribution of opportunities and resources;
• Intersectional policies that fully address the diversity of their backgrounds, identities and experiences and centers the most marginalized;
• A society that views sexuality as normal and healthy and treats young people as a valuable resource.

Young People Need Inclusive, Shame-free Comprehensive Sexual Health Education and Information

To build empowered, healthy lives, young people need accurate and complete information about their health and rights, as well as confidence in their own safety and the support of the communities around them as they develop and express their identities, desires, and needs. They need a society that is not afraid to recognize youth sexuality as a normal and natural part of becoming adults.

When sexuality is approached with silence and shame, young people face violence, increased risk of negative health outcomes, unhealthy relationships, and bullying and discrimination. Yet, much of our federal, state, and local funding for sex education programs is designated for abstinence-only-until-marriage programs that reinforce shaming messages. Even when school districts do invest in more comprehensive approaches to sex education, teacher training is often lacking or nonexistent.

Instead, we must provide young people with honest, age appropriate, comprehensive sexual health education, in school as well as in our families and communities. This means that we equip young people with an understanding of their own and other’s bodies, gender identities and expressions, and sexual orientations, of how to build healthy relationships and practice consent. It means teaching about safer sex options such as condoms and contraception methods, HIV and STI testing and treatment, and PEP and PrEP. And it means teaching about the full range of pregnancy options, including parenthood, adoption and abortion care.

To serve all young people, we must include and affirm the experiences of young immigrants, people of color, youth with disabilities, who are survivors of sexual assault, who identify as LGBTQ, and those who are young parents. This requires recentering the conception of how to provide sex education around the needs of the specific young people in a given program: our programs must be culturally responsive (i.e. they must be able to learn from and relate respectfully to students in and across cultures and communities), and linguistically inclusive. They must be trauma-informed, with a specific understanding of the trauma experienced by survivors of sexual assault, and the trauma historically faced specifically by communities of color and by LGBTQ individuals. Most importantly, our sex education programs must be built with and for communities that they are intended to serve. And they must be taught by adults who young people can trust: adults from their communities, who model a diverse range of life experiences, can assure them of confidentiality when possible, and build spaces in which youth can feel safe.

Thus, Advocates for Youth and our activists call on policymakers to:

• Pass laws such as The Real Education for Healthy Youth Act to provide federal funding for sex education programs that are comprehensive, culturally responsive, and inclusive. This funding must include teacher training, and incentivize programs designed within communities and with youth input.
• Protect and expand federal funding for evidence-informed programs that currently exist, such as the Teen Pregnancy Prevention Program, and the Personal Responsibility Education Program, as well as CDC’s Division of Adolescent and School Health. Stop providing funding, such as that provided through the federal Title V State Abstinence Education Grant Program, for programs that focus exclusively on promoting abstinence-only “sexual risk avoidance”, and that fail to educate students about contraception and safer sex methods, and reinforce harmful gender stereotypes.
• Pass state laws requiring that school districts teach sex education that is comprehensive, culturally responsive, and LGBT- inclusive, and provide sufficient training for teachers. State policymakers should look to The Comprehensive Model Sex Education Legislation, updated in fall 2016 by Advocates for Youth, Planned Parenthood Federation of America, The Sexuality Information and Education Council of the U.S., and the American Civil Liberties Union for guidance.
• Pass school district policies to provide age appropriate sex education from Kindergarten through 12th grade, that is comprehensive, culturally responsive, and LGBT-inclusive. School districts should commit to implementing these policies by developing or adapting curricula with input from the local community and young people themselves. For more information on what model policies and curricula should look like, please contact Advocates for Youth.

 

Young People Need Independent and Confidential Access to the Full Range of Sexual and Reproductive Health Services

 

Young people deserve to be able to access the full range of health care services they need, independently and without worrying about affordability or that their privacy will be violated. They should be able to trust those that provide services, as well as the accuracy and quality of the services they are receiving. And they should be able to rely on the guidance of trusted adults and other credible resources so that they do not have to face health care decisions alone.

When we do not empower young people as decisionmakers for their own health, when they view health care services with suspicion and fear, they may delay or forgo care, leading to higher rates of unprotected sex, unintended pregnancy, untreated STIs, and other negative health outcomes. Yet, our health care system leaves many young people without health insurance coverage or an easily accessible place to find services. For services that young people are able to access, state and federal law often fails to protect their privacy or respect their right to make their own choices. And many health care providers do not provide services in ways that make all of their young patients feel safe and supported.

Instead, we must build a health care system that is affordable and easily accessible for young people. We must ensure young people both over and under the age of majority are able to access quality HIV and STI testing and treatment and PrEP; the full spectrum of reproductive healthcare services including all contraception options, prenatal care, maternity care, and abortion; mental health services; services for sexual assault survivors; and trans-related healthcare services for trans and gender nonconforming young people.

In accessing the services they need, young people should be supported in involving their parents and loved ones. They should also be able to trust that their privacy will be respected, and be assured that including parents or other loved ones in their health care choices is not a requirement for receiving care. At the same time, we must ensure that medical professionals are equipped to provide the advice and support young people need: that they are ready to serve LGBTQ young people without judgment, ready to counsel youth on contraceptive and pregnancy options without coercion. We must provide the resources to support medical professionals from a range of communities, and who can serve different communities in the way that works best for the patients they serve.

Thus, Advocates for Youth and our activists call on policymakers to:

• Protect the gains made in ensuring health care coverage for all, by retaining the Affordable Care Act, as well as extending quality health insurance coverage to all young people, no matter their income or immigration status. Requiring that all health insurance – regardless of the employer, school, or other entity providing that insurance – provide meaningful coverage of all necessary health services including contraception and abortion care, including by passing the Equal Access to Abortion Coverage in Healthcare Act.

• Protect and increase federal funding for vital health services programs, particularly the Title X Family Planning Services Program and the Ryan White HIV/AIDS Program, to increase the population these vital programs are able to serve. Pass federal and state protections, such as Advocates for Youth’s MY Access Act, to end federal and state requirements of parental notification and consent for young people under 18 seeking health care and guarantee the confidentiality of young people seeking health care regardless of age or reliance on parents for health insurance coverage.
• Provide federal and state funding to expand the training that health care providers receive both before and while they practice medicine to include all relevant reproductive health services, cultural competency, and specific training on serving adolescent and young adult patients.
• Pass federal and state protections to ensure that pharmacies, medical providers, and hospitals cannot claim religious beliefs as a reason to deny people reproductive or other health services.
• Maintain and expand U.S. funding for vital health services around the world, including funding for the United Nations Populations Fund and other family planning programs, and funding for the President’s Emergency Plan for AIDS Relief. Truly fulfill the promise of U.S. global health funding by lifting harmful restrictions, including the Global Gag Rule and the Helms Amendment, which ban funding to international nongovernmental organizations who provide or even discuss abortion care.

Young People Need Institutions and Communities That Provide Safe and Supportive Environments and Resources

Our homes, schools, and communities should be spaces where young people can thrive free from fear that they will experience harassment, violence, or sexual assault at the hands of their peers or of adults, including police. If they have faced violence, harassment, or assault, youth need to know where they can turn for trusted help or guidance, and they deserve institutions and communities that will embrace and include them rather than treat them with stigma or shame.

When young people fear bullying and harassment in their communities; when schools, law enforcement and the judicial system don’t invest in young people but instead treat them as targets; when young people are isolated from any trusted resources or community, we are denying them the resources and support to build healthy lives. Yet, our high schools and colleges fail to adequately support survivors of sexual assault. LGBTQ young people report staggeringly high rates of bullying, harassment, depression, and homelessness. And schools systems continue to rely on institutional structures for discipline, such as Zero-tolerance policies, that turn classrooms into pipelines to prison, especially for Black youth and other youth of color.

Instead, our society has a responsibility to create accepting spaces and institutions that treat young people with understanding, dignity and respect. This means building inclusive and culturally appropriate resources for young people, including for young parents and survivors of sexual assault. It means giving teachers, health care providers, and other adults who work with young people the tools and training to be trusted allies for those they work with and for. And it means supporting young people in organizing their own spaces and advocating for themselves.

Thus, Advocates for Youth and our activists call on policymakers to:

• Support young parents through federal, state, and school policies that provide for flexible attendance, child care, transportation, lactation accommodations, and continued opportunities to participate in regular academic and extracurricular programs.
• Ensure that schools implement federal Title IX protections against sexual assault and for sexual assault survivors to the fullest extent of the law, including by adopting affirmative consent policies, and undergoing training to provide culturally responsive services to survivors. Pass policies on the federal, state, and local levels that empower youth to speak up and combat rape culture, not that further criminalize responses to sexual assault.
• End the School to Prison Pipeline and the criminalization of youth of color by reforming zero-tolerance policies and punitive discipline policies at the federal, state, and local levels, and investing in restorative justice programs. Implement effective anti-bullying policies at the state, district, and school level, as well as specific supports for LGB and trans* and gender nonconforming youth.
• Pass federal, state, and local protections for young people against dangerous “conversion therapy” practices that pressure or coerce young people to change their sexual orientations, gender expressions or gender identities.
• Support student organizations, such as Gay Straight Alliances and Sexual Assault Response Teams, and other efforts by young people to organize and advocate for their own vision of a better world, such as Movement for Black Lives organizing, the water protectors with Standing Rock youth, and the tireless fighting of the DREAMers, through providing resources and creating permissive school policies on the secondary and postsecondary level, as well as staunchly defending the First Amendment of the United States.

Young People Need Intersectional Policies that Fully Address their Diversity of Backgrounds, Identities and Experiences

Young people come from all different backgrounds, identities, and experiences. An agenda that fully meets the needs of the diversity of young people should respect and value the differences experienced by these young people in their community, their state and their country. Specifically, we must recognize the vast obstacles many young people face in order to access health care as young immigrants and youth of color. Social, economic, and cultural barriers limit the ability of young people from many backgrounds to receive accurate, adequate information on sexual health, and culturally and linguistically competent education and services.

Rates of HIV and other sexually transmitted infections (STIs) as well as rates of unintended pregnancy are disproportionately high among youth of color. Adequate studies that document the reproductive health care experiences and needs of this diverse group of young people are few, and there are even fewer studies disaggregating data by ethnicity within broader communities. Lack of research prevents health care providers from adequately treating youth of color – particularly LGBTQ youth of color – and prevents public health advocates from developing sufficient educational materials and programs focused on the needs of this diverse and growing population.

Immigrant youth face numerous barriers due to either their immigration status, or the status of their families, a general lack of culturally and linguistically appropriate services, and state and federal laws that prevent them from accessing safety net services in their communities. When local, state, and federal policies continue to exclude immigrant youth from accessing necessary resources in their communities, and programs like Deferred Action for Childhood Arrivals (DACA) leave young people uncertain of their future in the country, it is difficult for young people to think about their health care needs, or those of their families. In addition to the exclusion of DACA recipients from the ACA, young new permanent residents face legal barriers to health coverage eligibility during their first five-year of their permanent resident status.

Instead, we must invest in young people and provide them with health care services that are not only easy to get to, but are also culturally, linguistically, and economically accessible. All young people in the United State deserve legal immigration status and access to equitable health care. Young people in the United States are a diverse group, and depending on their identity, many are disproportionately at risk of negative health outcomes, confronting many different forms of health inequity. In order to serve this growing and important part of the United States population, we must listen to and address their needs.

Thus, Advocates for Youth and our activists call on policymakers to:

• Pass the LGBT Data Inclusion Act and expand the scope of the Youth Risk Behavior Surveillance System (YRBSS) to gather specific data on the state of immigrant youth and youth of color, their health care needs, barriers to preventive care, and immigration status, to help address health inequity among those who are disproportionately at greater risk of negative health outcomes.
• Pass the Youth Access to Sexual Health Services Act to provide communities with federal funding to support partnerships and programs that give young people of color, immigrant youth, LGBTQ youth and otherwise marginalized or vulnerable young people medically-accurate and age-appropriate information and skills on how to access and obtain sexual health care and related services.
• Pass federal policies such as the Health Equity & Access Under the Law (HEAL) for Immigrant Women & Families Act, to ensure all lawfully present immigrants can access affordable coverage for which they are otherwise eligible, and allow immigrant women and their families to receive the health care they need, creating healthier communities and a stronger economy.
• Promote Reproductive Justice – which is, in the words of our partners, Forward Together, “the economic, social and political power and resources to make healthy decisions about our bodies, sexuality and reproduction for ourselves, our families and our communities in all areas of our lives” – as part of federal, state, and local policies affecting youth of color, immigrant youth, survivors of assault and LGBTQ young people.

Young People Need A Society that Views Sexuality as Normal and Healthy and Treats Young People As A Valuable Resource

Cultural beliefs and attitudes play a significant role in the promotion of young people’s sexual and reproductive health. Stereotypes and misperceptions around young people can affect the development, implementation and evaluation of sexual health programs and policies, which is why a shift in our society’s dysfunctional approach to youth sexual health is crucial. To most effectively improve youth sexual health we need our society to shift its culture away from one that stigmatizes young people and their sexual development, towards a culture that celebrates and embraces youth sexual development as a normal and healthy part of life.

Policies and programs that use stigmatizing language not only prevent young people from getting the life-saving information they need but also impact their ability to access resources. Legislation such as “no promo homo” laws, that ban teachers from discussing LGBTQ communities and relationships in any positive way – or at all – shame LGBTQ youth and further stigmatize their families. When legislators use language that stigmatizes young people and reinforces harmful gender roles and stereotypes, it creates additional barriers for young people to access information for their reproductive care that go beyond health care systems and into the classroom. When young people hear stigmatizing language in school about their sexual orientation, gender identity and other identities it creates a hostile school environment that impacts their academic performance.

Policymakers must work in partnership with young people and welcome them to the table, not only to include their unique perspective as a community that is directly impacted by sexual health policy but also because it leads to more inclusive and more effective health outcomes.

Thus, Advocates for Youth and our youth activists call on policymakers to:

• Pass legislation that uplifts young people’s lived experiences by using inclusive, shame-free and affirming language in legislation when speaking to reproductive and sexual health information.
• Repeal state and local education laws, such as “no promo homo” laws, that foster unsafe and hostile school environments, leaving LGBTQ students more vulnerable to bullying and harassment.
• Intentionally integrate young people in the policy and program development processes around efforts intended to reach and serve young people by developing guidance and requirements for federal, state and local agencies to ensure the participation of young people in grant review processes, advisory councils, task forces, etc.
• Invest in building a pipeline of leadership for young people so that they can play an integral role in informing policy and educating the public about issues directly impacting their communities. Organizations such as the Congressional Black Caucus Foundation, Congressional Asian Pacific American Caucus, and the Congressional Hispanic Caucus Institute deeply invest in young people of color by providing leadership development for our country’s next generation of leaders. At a time when policymakers are often more divided than collaborative, continuing to create a pipeline of leadership for young people is critical. Policymakers must continue to fund these programs and ensure that young people are at the table.

A Path Forward

Young people have been leading the movement for sexual and reproductive health, rights and justice for years, fighting everyday to make our world a better place. No election cycle can take that away. They are resilient, they are visionary, and they deserve policymakers who will work with them to build a society in which all young people are valued, respected, and treated with dignity; sexuality is accepted as a healthy part of being human; and youth sexual development is recognized as normal. This Youth Policy Agenda lays a path for how policymakers can begin this work, and Advocates for Youth and our youth activists will fight tirelessly to ensure that you do.

For more information, please contact the Public Policy department directly:

Diana Thu-Thao Rhodes, Director of Public Policy, diana@advocatesforyouth.org

Abbey Marr, State Policy Analyst, abbey@advocatesforyouth.org

Sophia Kerby, State Policy & Partnerships Manager, sophia@advocatesforyouth.org

Ariel Cerrud, Senior International Policy Manager, ariel@advocatesforyouth.org

Nimra Chowdhry, Policy and Law Fellow/Analyst, nimra@advocatesforyouth.org