Using evidence-based best practices to deliver sexual and reproductive health care to adolescents can improve health outcomes and support healthy behaviors, communication, and relationship development.
AAP policy and resources provide key strategies for delivering adolescent-centered sexual and reproductive health care in clinical settings. Considerations for care delivery are outlined below.
Frankie Heightchew-Howard, Youth activist
As caretakers, it is necessary to work with underrepresented communities without bias. This does not mean to work with the mindset that we are all the same: it is necessary to be conscious of the unique care that may be required for different communities.
To provide adequate care for people who are LGBTQ2S+, first create a space in which patients feel as comfortable as possible. Due to the long history of medical abuse within underrepresented communities, particularly within reproductive and sexual health, there is a lot to unpack and conquer in just this step alone. Receiving sexual and reproductive healthcare is one of the most vulnerable positions to be in, and when patients have accumulated traumas related to their sexuality and/or gender, this becomes even more complex. It is important that sexual and reproductive health spaces establish themselves in their community as a source of support to queer people.
Ask, and be willing to listen to each patient’s unique needs and wants, and not make assumptions about what care they need. In this work, it is important to remember that sexuality does not equate to the genitalia of a person's partner or partners, that trans people may not be out to all people around them and may use different names and pronouns with other people you may interact with, and to be careful not to alienate queer patients, they are not research subjects. We each have a duty to learn and develop our understanding of trauma-informed care, and of the health needs and wants of patients who are LGBTQ2S+. It is a primary responsibility to be able to provide proper care to all patients and to be constantly learning and engaging with their worldview.
Steps that can be taken to make spaces where youth who are LGBTQ2S+ receive sexual and reproductive health services feel safer include: providing gender-neutral bathrooms; introducing yourself using your name and pronouns and not requesting this of patients, instead allowing them to share if they feel comfortable; and adding preferred names and pronouns to EHR systems and paperwork and ensuring all staff are trained to use these. Be aware and make connections with local resources for people who are LGBTQ2S+ and where they could be referred them for specialized care. Report any discriminatory behavior, as there is no space in health care for bigotry. Get comfortable with the most current language being used within the LGBTQ2S+ community, because language is important. Signal to patients in as many ways as possible that you are their advocate, and that the space they are in is supportive. The people providing our care should reflect the world around us, Advocate for hiring from within the communities you serve. No true radical change can be made for a group of people without said group involved.
American Academy of Pediatrics