Young People and Inequalities – Recommendations for a Post-2015 Development Agenda
By REALIZING SEXUAL AND REPRODUCTIVE JUSTICE (RESURJ)*
Beginning at the age of nine or ten and continuing at least until the late teens, adolescents’ sexual thoughts, emotions, desires, attitudes, and behaviors develop rapidly. At the same time, young people experience rapid physical maturation and changing relationships with their families, friends, and peers. During this critical moment of transition, they need accurate and complete information about their bodies, their rights, and how to optimize their sexual and reproductive health and well-being without feeling they are being inappropriate or could be judged.
There are currently 1.8 billion young people in the world between the ages of 10 and 24, many of whom do not yet have access to the comprehensive sexual and reproductive health services and sexuality education that they need. They often don’t know how their bodies function, what their right to bodily autonomy is, and how their sexual feelings, thoughts, preferences, and behaviors are related to their health. As a result, many young people throughout the world are vulnerable to unintended pregnancies, HIV and other STIs, coerced sex, early and forced marriages, and other violations of their human rights. Moreover, young people who are of diverse sexualities, sexual orientations and gender identities are more at risk of suffering from acts of violence, including corrective rape, for example.
There are two primary reasons why governments should prioritize adolescent and youth sexual and reproductive rights and health in the Post-2015 development agenda. First, it is a human rights imperative to recognize that adolescents have human rights and are entitled to the tools and support necessary to lead healthier lives into adulthood. Second, “demographic momentum”, the phenomenon that the population will continue to increase despite reduced fertility rates, is likely to contribute to over 50% of future population growth in low and middle income countries in upcoming decades. Sustained investment in empowering adolescents and young people and providing them with quality sexual and reproductive health services and comprehensive sexuality education will likely stabilize population growth by providing them with the information and means to make informed and autonomous decisions about their sexual and reproductive lives.
The statistics on adolescent girls’ sexual and reproductive ill health are staggering:
- One in three girls in resource-poor countries is married by the age of 18 and one in seven is married before her 15th birthday, often without consent.
- Young women aged 15-24 in sub-Saharan Africa are up to eight times more likely than young men to be HIV positive.
- Although girls between the ages of 10 and 19 account for only 10% of all births worldwide, they account for 23% of the overall burden of disease due to complications during pregnancy and childbirth.
- 215 million women, including those under 18, who are already married or living in unions (and many more millions who are single) are having sex and do not want to be pregnant, but do not have access to contraceptives of their choice.
- More than 40% (8.7 million) of the 21.2 million unsafe abortions in developing countries in 2008 occurred among young women aged 15–24 years.
- Pregnancy and child-birth complications are the leading cause of death for adolescent girls in low and middle-income countries—with 50,000 dying every year. Sixteen million adolescent girls aged 15 to 19 years give birth annually and an estimated 3 million undergo unsafe abortions.
- 71 million young adolescents are still not in school, and less than a quarter of young people complete secondary school
- About 140 million girls and women worldwide are currently living with the consequences of feminine genital mutilation. FGM is mostly carried out on young girls sometime between infancy and age.
- In Africa, an estimated 92 million girls 10 years old and above have undergone FGM.
- Young people, and particularly young women, are three times as likely as adults to be unemployed and when employed, they are often underpaid.
As adolescents and young people navigate through this transition, they are experimenting with their sexual feelings and preferences and face major challenges when seeking health care if they identify as lesbian, gay, bisexual, transgender or are questioning.
- Young LGBTQI people have more difficulties in achieving proper healthcare, particularly in societies where they experience greater stigma and discrimination generally. Not being financially or socially independent, young people can be ignored or treated in inappropriate ways by healthcare professionals who are not properly educated in specific aspects of treating and working with LGBTQI youth.
- Trans young people are not usually given all of the medical and social options available to them as practitioners only understand the binary gender system. Therefore, their option is often limited to transitioning fully into the opposite sex.
- Discrimination or the perception of discrimination in healthcare settings leads to alienation of LGBTQI young people and an inability to ask for treatment and support which in turn can have devastating consequences, leaving LGBTQI youth extremely vulnerable.
- They are financially dependent, less educated and susceptible to victimization and discrimination and its consequences such as social exclusion by peers, running away from home, homelessness etc.
- Assumptions from healthcare professionals that patients are heterosexual and in- formation that is not inclusive of different sexual orientations or gender identities can exclude LGBTQI youth and deny them access to the information and support they require to maintain health and wellbeing and access appropriate treatment.
These facts show that adolescents, and particularly girls as well as those of diverse sexualities, need accurate information and knowledge about their bodies and their rights, negotiation skills to navigate relationships, and confidential and non-judgmental health care in order to make informed decisions about their sexual and reproductive lives. However, legal and social restrictions in many countries make it nearly impossible for adolescents to have this knowledge and exercise their rights. Barriers include parental and spousal consent laws, concerns around privacy and confidentiality, stigma and discrimination, and limited access to health care services due to limited mobility, school and work schedules and cost.The case for investing in funding and programming directed at adolescent girls is clear from a technical standpoint: evidence shows that enabling adolescents and young people to receive comprehensive sexuality education and access sexual and reproductive health services can have positive health outcomes and contribute to development and poverty eradication.
As the international community develops a framework for the future, the human rights and health of adolescents and youth, particularly of girls and young women, should be a top priority. The Post-2015 development agenda should ensure sustained action and accountability for:
- Universal access to quality, comprehensive, integrated sexual and reproductive health services, counseling, and information, with respect for human rights, and with an emphasis on equality, equity and respect for diversity.
- Comprehensive sexuality education and other programs that empower young people to know their bodies and to exercise their human rights.
- Respect, promotion and protection for sexual and reproductive rights.
- Young women’s leadership at all levels and in all types of decision‐making processes that affect their lives.
* Realizing Sexual and Reproductive Justice (RESURJ) is a global alliance of younger feminist activists who work across generations to secure young people’s and women’s sexual and reproductive rights and health. RESURJ works with local, regional and global networks to advocate for funding, policies and programs that ensure equitable access to sexual and reproductive health services, protection of sexual rights and reproductive rights, the achievement of gender equality and non-discrimination, and the meaningful participation of young people’s and women’s movements across Africa, Asia, Latin America, Europe and the Middle East.
You can find the full discussion here