The Instituto de Liderazgo Simone de Beauvoir and Balance Promoción para el Desarrollo y Juventud in Mexico, together with Realizing Sexual and Reproductive Justice (RESURJ) and Columbia University’s Mailman School of Public Health, have produced this paper1 to give an overview of the social, economic and environmental situation in Mexico related to adolescents and young people. It attempts to make the case for attention and investment in their health, development and human rights in order to meet the Sustainable Development Goals (SDGs) by 2030. This paper can serve as a tool for activists, decision makers, academics, researchers, and evaluators who are interested in advancing the health and human rights of adolescents and young women in Mexico for the decades to come.
Poverty rates in Mexico are high and inequality has worsened across population differences in gender, age, ethnic background, and geography. In 2008, over 50 million Mexicans (47.4% of the total population) did not have income sufficient to satisfy their needs, with significant gender-based inequality (2.5 million more women than men lived in poverty). Half of Mexico’s residents are 26 years old or younger, and 29% of the total population is younger than 14 years old. Approximately 75% of Mexico’s indigenous population lives below the poverty line. These statistics make clear that Mexico must address the massive gender and wealth inequalities that hinder the country’s development in order to become a more just and stable society.
Mexico has Universal Health Coverage through its Social Protection System on Health (SPSS), providing financial health coverage for over 52.6 million people. Mexico is a Federal Republic, which means that State and Federal law might be different, particularly in regulating reproductive rights. In Mexico City, interruption of pregnancy is legal in the first trimester, while in 18 other States abortion is criminalized except in cases of rape, fetal malformations, or to save the life of the woman. Mexican women, particularly adolescents and indigenous women, face barriers to accessing sexual and reproductive health information and services, including contraceptives. These barriers include the lack of availability of contraceptives; violence, stigma and discrimination by health care providers due to age, ethnicity, gender identity, marital and health status; lack of education and information on human sexuality, prevention of unwanted pregnancies and sexually transmitted infections.Over 60% of young people had their first sexual relation before turning 19 years old and did not employ any contraceptive method. Mexico has the highest rate of adolescent pregnancy in all of the countries of the Organization for Economic Cooperation and Development (OECD). Maternal mortality is high in Mexico, particularly among adolescent girls and older women living in rural areas or of indigenous origin. In 2012, a national Observatory on Maternal Mortality registered 1,073 maternal deaths. These deaths have their root causes in income inequalities, lack of access to quality health care and discrimination against women. Maternal deaths can be prevented by ensuring non-discrimination in accessing health care; the provision of safe abortion services; quality pre-natal care; skilled birth attendance; and emergency obstetric care. Education and knowledge on sexual and reproductive health and rights is very low in poor rural areas and among indigenous communities, where unintended pregnancies and sexually transmitted infections are higher than the national average. Comprehensive sexuality education programs are not uniformly implemented across the country although legislation is in place to provide this information and education on gender equality and human rights starting at age 11.
In order to meet SDG 3, “ensure healthy lives and promote well-being for all at all ages”, it is imperative that Mexico aims to achieve the sexual and reproductive health and rights of adolescents and indigenous women, including by taking all steps to eliminate maternal mortality and morbidity, preventing and treating HIV and other STIs, providing safe abortion services, and access to modern methods of contraceptives within the existing universal health insurance scheme.
In order to meet SDG 4, “ensure inclusive and equitable quality education and promote life-long learning and opportunities for all” it is vital that Mexico implements existing comprehensive sexuality education programs within the country’s 31 states that teach gender equality and human rights.
Approximately one in three Mexican women report having suffered some form of violence during their lifetime, and about half of women above 15 years of age who are married or in union report intimate partner violence. Around 60% of women who are trying to migrate to the United States report having experienced some form of sexual abuse and/or tracking, placing them at high risk for acquiring sexually transmitted infections including HIV and unwanted pregnancies. Women of reproductive age throughout the country report widespread incidence of obstetric violence, including forced sterilizations; insertions of long-term contraceptive methods without their consent; forced caesarian sections; and violence and discrimination by health care offcials during routine check-ups including in pregnancy and childbirth. Currently, the Mexican government is not protecting women against violence. Even though there is a national Law that promotes Women’s Access to a Life free from Violence, there is a lack of transparency and effectiveness in its implementation.
In order to meet SDG 5, “achieve gender equality and empower all women and girls”, Mexico must address the diverse inequalities and forms of discrimination that girls and young women experience. This includes ensuring the total access of women to their legal and social protection that guarantees their human rights; streamlining of all policies and programs to eliminate violence against women established by the National Evaluation Council; develop multiple tools to change harmful gender stereotypes and implement comprehensive sexuality education programs; and eliminate the structural, legal, social and economic barriers that hinder women’s human rights.
Restrictive policies and a discriminatory climate place additional barriers to ensure the human rights and health of disabled, lesbian, gay, bisexual, and transgender (LGBT), young people living with HIV (fewer tan 50% of pregnant women with HIV receive antiretroviral therapy), sex workers, and indigenous people in Mexico. Marriage for same-sex couples was legalized in Mexico City in 2010, and, in 2003, a federal act passed that prohibits discrimination in employment and occupation on the basis of sexual orientation (not gender identity). Recognizing the discrimination that these populations face throughout the country is urgent. Although there is a National Council to Prevent Discrimination, there are no local bodies to guarantee the same.
In order for Mexico to meet SDG 10, “reducing inequality within and among countries,” it must eliminate discriminatory laws, policies, and practices as well as promoting new laws, policies, and actions that challenge the stigma and violence generated by these. This includes legal reform that prohibits discrimination on the basis of sexual orientation, preference, or gender identity; legal recognition of same sex marriage in every State; and ensure that all States have local organisms to prevent and eradicate all forms of discrimination against all people.
Adolescents and young people are diverse, with different needs and interests based on their gender, context, ability, wealth, age, health, nationality or other status. Despite these variations, these age groups are going through similar transitions across the world: from childhood to adulthood, economic dependence to autonomy, and sexual initiation to maturity. Investing political will and financial resources in the health and human rights of 10-24 year olds may be one of the better ways to achieve peaceful, sustainable and stable societies.
Two policy recommendations are likely to influence progress in the decades to come:
1. Dissemination and use of sex and age disaggregated data by five year cohorts (10-14; 15-19; 20-24)
2. Create and sustain comprehensive and accurate sexuality education programs that teach gender equality and human rights, and that is accessible and affirming for all children and youth in and out of schools.
Young women and men in their multiple diversities are critical to the achievement of sustainable development. Our hope is that the information and recommendations in these papers will foster better development outcomes and the achievement and protection of human rights for adolescents worldwide.