The daily pill, called Addyi, modestly increased women’s interest in sex in clinical tests. The approval was praised by some women’s advocates as a milestone and condemned by others as irresponsible.
An advisory panel to the U.S. Food and Drug Administration recommended approval Thursday of what many call the “female Viagra” pill.
The panel voted 18-6 that the FDA grant approval to the drug, flibanseri, which is designed to boost a lack of sexual desire in premenopausal women.
However, the panel members who voted yes said full FDA approval should come with certain conditions.
By Christine Vestal
President Barack Obama hailed a landmark achievement in his State of the Union address last month: Teen pregnancies in the U.S. have hit an all-time low.
But the U.S. still has a teen birthrate of 31.2 per 1,000 teens, nearly one-and-a-half times the rate in the United Kingdom, which has one of the highest rates in Western Europe.
Colorado may have found a way to close the gap. The state’s teen birthrate dropped 40 percent between 2009 and 2013, driven largely by a public health initiative that gives low-income young women across the state long-acting contraceptives such as intrauterine devices (IUDs) and hormonal implants.
Colorado has a successful model for stemming teen pregnancies. But will state lawmakers continue paying for it?
The state saved $42.5 million in 2010 alone, an average return of $5.85 in avoided Medicaid costs for prenatal, delivery and first year of infant care for every $1 spent on the program.
More important, Hickenlooper said, the initiative “has helped thousands of young Colorado women continue their education, pursue their professional goals and postpone pregnancy until they are ready to start a family.”
According to program supervisor Greta Klingler, Illinois, Nevada, New Jersey, New York, Ohio, Virginia and Wisconsin have asked Colorado to share its techniques and lessons learned. Illinois is already adopting some of Colorado’s methods in a statewide Medicaid program for unwanted pregnancy prevention, she said. The U.S. Centers for Disease Control and Prevention is also seeking more details from Colorado.
Bill Albert, chief program officer at the National Campaign to Prevent Teen and Unplanned Pregnancy, pointed to the promise of state-based programs that rely on low-maintenance, highly effective methods of contraception coupled with good counseling.
“We’ve made progress, but if we’re going to continue making progress, efforts going forward will have to be as innovative and up-to-date as possible,” Albert said.
But Colorado’s program will end this June when its private grant runs out, unless lawmakers approve state funding to keep it going for another year. A $5 million funding bill was introduced this month with bipartisan sponsorship, but it won’t necessarily be an easy win, especially in the Republican-led state Senate. Continue reading
SEATTLE — Carlos Romero’s apartment is marked with remnants from his former life: a giant television from his days playing World of Warcraft and a pair of jeans the width of an easy chair. The remnants of that time—when he weighed 437 pounds—mark his body too: loose, hanging skin and stretch marks.
“I lift weights and work out and work hard, but there’s lasting damage,” said Romero.
Yet for all the troubles he had dating when he was obese—all those unanswered requests on dating web sites—shedding weight left him uneasy about how much to reveal.
Indeed, the stigma of obesity is so strong that it can remain even after the weight is lost. Holly Fee, a sociologist at Bowling Green State University, has conducted some of the only research on dating attitudes toward the formerly obese. In 2012, Fee published her findings in the journal Sociological Inquiry.
She found that potential suitors said they would hesitate to form a romantic relationship with someone who used to be heavy. “The big dragging factor in why they had this hesitation in forming this romantic relationship was that they believed these formerly obese individuals would regain their weight,” Fee said. Continue reading
By Lisa Gillespie
KHN / OCTOBER 1ST, 2014
Teenage girls who are given access to long-acting contraceptives such as IUDs or hormonal implants at no cost are less likely to become pregnant, according to a study in the New England Journal of Medicine released Wednesday.
The findings come just two days after the American Academy of Pediatrics recommended that health providers should consider IUDs and implants first when discussing contraception choices with teen girls.
Young women with access to these methods at no cost were almost five times less likely to get pregnant, five times less likely to give birth and four times less likely to have an abortion.
These pregnancies can also stunt education and income opportunities for teenage moms.
By Stephanie Stephens,
Health Behavior News Service
As many as half to two-thirds of women who’ve undergone hysterectomies or are older than 65 years in the United States report receiving Pap tests for cervical cancer.
This prevalence is surprising in light of the 2003 U.S. Preventive Services Taskforce guidelines recommending that women discontinue Pap testing if they have received a total hysterectomy without a history of cervical cancer and if they are over age 65 years with ongoing and recent normal Pap test results.
Performing these unnecessary tests can result in stress for the patient, increased costs, and inefficient use of both provider and patient time, concludes a new study in the American Journal of Preventive Medicine.
“During this time of health care reform, we could probably use our resources more wisely,” said corresponding author Deanna Kepka, Ph.D., M.P.H., assistant professor at the University of Utah’s College of Nursing and Huntsman Cancer Institute. Continue reading
Tips for the US Centers for Disease Control and Prevention
Going to college is an exciting time in a young person’s life. It’s the end of one chapter and the beginning of another. College is a great time for new experiences, both inside and outside the classroom. Here are a few pointers for college students on staying safe and healthy. Continue reading
From the Office of Research on Women’s HealthSexually
Sexually transmitted infections (STIs): also commonly called sexually transmitted diseases (STDs), are infections you can get by having sex with someone who has an infection. Continue reading
By Elizabeth Stawicki,
Minnesota Public Radio
“Minnesota Nice” might be the key to good health for seniors.
America’s Health Rankings Senior Report rated Minnesota the healthiest state in the nation for adults aged 65 and over — beating out Hawaii. And that retiree and snowbird haven, Florida? It came in 28th.
What could put Minnesota, which just weathered arguably the harshest winter in the country, ahead of those sunny climes? Volunteering is one factor. Continue reading
by Nina Martin
The past few years have been a period of unprecedented turmoil for the hospital industry.Now, a new report confirms that Catholic hospitals are emerging as one of the few clear winners — and the study adds its voice to a growing chorus of warnings about how church doctrine could affect women’s reproductive health care.
The report is by MergerWatch, a New York–based nonprofit that tracks hospital consolidations, and the American Civil Liberties Union. It traces the growth of Catholic hospitals across the U.S. from 2001 to 2011, the most recent year for which complete data is available.
It focuses on full-service, acute-care hospitals with emergency rooms and maternity units —settings in which Catholic religious teachings are most likely to come into conflict with otherwise accepted standards of reproductive care.
The report’s major finding is illustrated in the chart below: At a time when other types of nonprofit hospitals have been disappearing, the number of Catholic-sponsored hospitals has jumped 16 percent.
Over the last decade, only for-profit hospitals have fared better. The gains by Catholic providers are especially striking considering the sharp decline in the number of other religious-owned hospitals during the same period.
The numbers reflect the huge wave of hospital consolidations triggered by health care reform. For reasons that the report doesn’t delve into, Catholic hospitals have weathered those market upheavals better than other types of community hospitals—so well that they now make up 10 of the 25 largest health-care networks in the U.S.
Not surprisingly, the number of hospital beds at Catholic providers has also increased faster than at other types of nonprofit hospitals.
According to the report, Catholic acute-care hospitals now account for 1 in 9 hospital beds around the country, with much higher concentrations in some states, including Washington (the subject of this ProPublica story), Wisconsin, and Iowa.
(When other types of facilities are included, the Catholic share of hospital beds is closer to 1 in 6, according to this fact sheet.)
Keep in mind that these numbers are from 2011. Since then, according to the report, the largest Catholic health hospital networks, Ascension Health and Catholic Health Initiatives, have grown by another 30 percent or more.
“The trend we’ve identified is continuing and perhaps even accelerating,” Lois Uttley, MergerWatch’s director, said in an interview. “These large Catholic health systems are expanding aggressively, taking over other hospitals and smaller health systems, gobbling up non-Catholic hospitals, and gaining more financial power.”
However, the report’s immediate concern isn’t the hospitals’ economic clout, but rather the impact of Catholic health care policy, as embodied by controversial guidelines known as The Ethical and Religious Directives.
Issued by the U.S. Conference of Catholic Bishops, the ERDs govern medical care at all Catholic hospitals — and influence care at secular hospitals that merge or affiliate with Catholic providers.
The directives ban elective abortion, sterilization, and birth control and restrict fertility treatments, genetic testing, and end-of-life options.
Depending on the hospital and the local bishop, they may also be interpreted to limit crisis care for women suffering miscarriages or ectopic pregnancies, emergency contraception for sexual assault, and even the ability of doctors and nurses to discuss treatment options or make referrals.
A spokesman for the Catholic Health Association of the United States said he had not seen the report and could not comment. But in a statement responding to a recent New York Times editorial, the association provided a spirited defense of its member hospitals.
“Catholic hospitals in the United States have a stellar history of caring for mothers and infants. Hundreds of thousands of patients have received extraordinary care …There is nothing in the Ethical and Religious Directives that prevents the provision of quality clinical care for mothers and infants in obstetrical emergencies. Their experience in hundreds of Catholic hospitals over centuries is outstanding testimony to that.”
But Louise Melling, the ACLU’s deputy legal director and a coauthor of the new study, sees danger as Catholic hospitals expand their market share and the ERDs extend their reach as well.
She cites the case of a Michigan woman who was allegedly denied proper care for a miscarriage at a Catholic hospital in Muskegon because of its interpretation of the directives banning abortion.
In that case — the centerpiece of a high-profile lawsuit by the ACLU against the Catholic bishops last month — the hospital in question had been secular until 2008, when it was merged with a Catholic health care system.
“Ordinary people are not following hospital mergers and acquisitions,” Uttley said. “They don’t know who runs their hospital, especially if it doesn’t have a Catholic name. Even if it does have a Catholic name, people don’t know what that means.”
Archbishop Joseph Kurtz of Louisville, Ky., the newly elected president of the bishops conference, has called the lawsuit “baseless” and “misguided.” “A robust Catholic presence in health care helps build a society where medical providers show a fierce devotion to the life and health of each patient, including those most marginalized and in need,” he said.
The authors of the new report, titled “Miscarriage of Medicine: The Growth of Catholic Hospitals and the Threat to Reproductive Health Care,” assert that the risk to patients is especially great in areas where a Catholic hospital is the sole provider for an entire region.
The report also looks at how much money Catholic hospitals take in from Medicare and Medicaid—a total of $115 billion in gross patient revenues in 2011 — and urges the federal government to enforce laws that protect patients under those programs. (Back in 1999, when MergerWatch issued its first report on the role of religion in health care, the total billed by all religious hospitals — not just Catholic-sponsored ones—was $41 billion.)
One of the more surprising findings is the slightly below-average amount of charity care provided by Catholic acute-care facilities. The numbers are based on Medicare Cost Reports, financial and utilization data filed annually by every hospital, the report said.
ProPublica requested comment from the Catholic Health Association, and we’ll post it if it comes.
But the shift, if true, is a big change from the past, when Catholic hospitals were founded by nuns and brothers to minister to the poor, the report says.
During the month of October, Snohomish Health District will present a National Latino AIDS Awareness campaign aimed at engaging the Hispanic/Latino community in promoting HIV awareness through testing, prevention and education.
This year’s theme is “Commit to Speak”/“Comprométete a Hablar.”
In Washington state, 12% of all individuals currently living with HIV/AIDS are Latino – but Latinos only compromise approximately 9.4% of the total population.
The rates of new infections among Latino men were more than double that of white men. The rate of HIV infection among Latino women was nearly four times that of white women.
To address this disparity and increase awareness, staff from the Snohomish Health District will be offering free testing at community locations to members of the Latino and general communities who qualify based on their risk factors:
- Tuesday, Oct. 22, from 4 – 6 p.m. at Everett Sea Mar Behavioral Clinic, 5007 Claremont Way
- Tuesday, Oct. 22, from 1 – 5 p.m. at Monroe Sea Mar Behavioral Clinic, 14090 Fryeland Blvd. SE, Ste. #347
- Wednesday, Oct. 23, from 4 – 5 p.m. at Everett Sea Mar Behavioral Clinic, 5007 Claremont Way
- Wednesday, Oct. 23 from 9-11 a.m. at Everett Sea Mar Behavioral Clinic, 5007 Claremont Way
- Thursday, Oct. 24, from 4 – 8 p.m. at Everett Sea Mar Medical Clinic, 1920 100th Street SE, Bldng. B
- Friday, Oct. 25, from 12 – 4 p.m. at Monroe Sea Mar Medical Clinic, 17707 West Main Street
- Thursday, Oct. 31, from 1 – 4 p.m. at Marysville Sea Mar Medical Clinic, 9710 State Avenue
The Centers for Disease Control and Prevention states the impact of HIV on Hispanics/Latinos is not directly related to race or ethnicity, but rather to challenges faced by some communities, including less awareness of HIV status, poverty, access to care, stigma, migration acculturation (the process of adopting the cultural traits or social patterns of another group) and homophobia.
Learn more about the national awareness campaign from the AIDSinfo website, http://aidsinfo.nih.gov/education-materials/hiv-aids-awareness-days/169/national-latino-aids-awareness-day.
The Health District offers free and confidential HIV testing and counseling for high-risk individuals year-round, in our Everett clinic location, with test results in 30 minutes. Individuals with risk can also be tested for hepatitis A,B, C, and syphilis. For information about HIV/AIDS prevention and testing, call the Health District at 425.339.5298, or visit www.snohd.org.
According to the Washington State Department of Health, 730 people in Snohomish County are assumed to be living with HIV/AIDS.
Information from the US Centers for Disease Control and Prevention:
El VIH es un problema de salud pública en la comunidad latina1. En el 2009, los latinos representaron el 20% (9,400) de las infecciones nuevas por VIH en los Estados Unidos, aun cuando solamente formaban alrededor del 16% de la población total de los EE. UU. La tasa de infecciones por el VIH en los latinos en el 2009 fue casi el triple que la de los hombres de raza blanca (26.4 comparado con 9.1 por cada 100,000 habitantes).
- En el 2009, los hombres latinos representaron el 79% (7,400) de las infecciones nuevas en toda la población latina y la tasa de infecciones nuevas entre los hombres latinos fue dos veces y media más alta que la de los hombres de la raza blanca (39.9/100,000 comparado con 15.9/100,000).
- En el 2009, los hombres latinos que tuvieron relaciones sexuales con hombres (HSH)3 representaron el 81% (6,000) de las infecciones nuevas por VIH entre los hombres latinos. Y a su vez representaron el 20% de todos los HSH. Entre los HSH latinos, el 45% de las infecciones nuevas por VIH correspondió a hombres menores de 30 años de edad.
- Aunque las mujeres latinas representaron el 21% (2,000) de las infecciones nuevas en los latinos durante el 2009, su tasa de infección por el VIH fue más del cuádruple que en las mujeres blancas (11,8/100,000 comparado con 2,6/100,000).
Estimados sobre infecciones nuevas por el VIH en los Estados Unidos para las subpoblaciones más afectadas, 2009
Esta gráfica no incluye las subpoblaciones que representan el 2% o menos de la epidemia general en los EE. UU.
- En algún momento de su vida, 1 de cada 36 hombres latinos recibirá un diagnóstico de VIH, al igual que 1 de cada 106 mujeres latinas
- En el 2009, los latinos representaron el 19% de los 42,959 diagnósticos nuevos de infecciones por VIH en los 40 estados y las 5 jurisdicciones dependientes de los EE. UU. que cuentan con sistema de notificación de infección por VIH de forma confidencial basada en el nombre.
- En el 2009, se estima que 7,442 latinos recibieron un diagnóstico de sida en los EE. UU. y las 5 jurisdicciones dependientes. Esta cifra ha disminuido desde el 2006.
- Para finales del 2008, se calcula que 111,438 latinos habían fallecido en los Estados Unidos y las jurisdicciones dependientes con diagnostico de SIDA. En el 2007, el VIH fue la cuarta causa principal de muerte en latinos de 35 a 44 años de edad y la sexta en los latinos de 25 a 34 años en los EE. UU.
Desafíos para la prevención
Varios factores contribuyen a la epidemia del VIH en las comunidades latinas.
- Los factores de la conducta de riesgo relacionados con la infección por VIH varían de acuerdo al país de origen.Los datos indican que los porcentajes más altos de infecciones con el VIH diagnosticadas en hombres latinos se atribuyen a contacto sexual con otros hombres, independientemente del país de origen, pero los hombres nacidos en Puerto Rico tienen un porcentaje considerablemente más alto de infecciones por el VIH atribuidas al uso de drogas inyectables (UDI) que los hombres latinos nacidos en otros países.
- Los hombres y mujeres latinas tienen más probabilidad de adquirir la infección por VIH como resultado del contacto sexual con hombres. Las mujeres latinas podrían no estar conscientes de los factores de riesgo de su pareja masculina.
- El uso de drogas inyectables continúa siendo un factor de riesgo entre los latinos, especialmente para los que viven en Puerto Rico. Además, los usuarios ocasionales y crónicos de alcohol o estupefacientes tienen más probabilidad de practicar conductas sexuales de alto riesgo, como son las relaciones sexuales sin protección debido a que están bajo la influencia de las drogas o el alcohol.
- Tener ciertas infecciones de transmisión sexual (ITS)puede aumentar, en forma significativa, la posibilidad de que una persona contraiga la infección por el VIH. Una persona que tiene la infección por el VIH y ciertas ITS tiene más posibilidad de infectar a otros con el VIH. Las tasas de ITS permanecen altas entre los latinos.
- Los factores culturales pueden afectar el riesgo de infección por el VIH. Es posible que latinos eviten hacerse pruebas del VIH y buscar consejería o tratamiento para la infección por temor a la discriminación o la estigmatización o debido a su estatus migratorio. Los roles tradicionales de los hombres y las mujeres y el estigma contra la homosexualidad pueden dificultar la prevención.
- Una mayor aculturación adoptando la cultura estadounidense tiene efectos tanto negativos (adopción de conductas que aumentan el riesgo de adquirir la infección del VIH) como positivos (comunicación con las parejas sobre las relaciones sexuales más seguras o de menor riesgo) en las conductas relacionadas con la salud de los hombres y mujeres latinos.
- Los factores socioeconómicos, como la pobreza, los patrones migratorios, el bajo nivel de estudios académicos, la falta de seguro médico, el acceso limitado a la atención médica, o las barreras del lenguaje, contribuyen a las tasas de infección por VIH en los latinos. Estos factores pueden limitar la concientización de los latinos sobre los riesgos de infectarse con el VIH y las oportunidades para participar en consejería, pruebas de detección y tratamiento.
- Debido al miedo a ser descubiertos y deportados, los inmigrantes indocumentados pueden ser menos propensos a recibir servicios de prevención del VIH, a hacerse pruebas de detección o a recibir atención médica y tratamiento adecuados si es que son diagnosticados positivos o que viven con el VIH.
In support of National Gay Men’s HIV Awareness Day, the Snohomish Health District will host a free evening of information and testing from 4-7 p.m., Tuesday, Oct. 1 in Suite 108 at the Rucker Building, 3020 Rucker Ave., Everett, Wash.
The event is directed to gay and bisexual men who are at risk for HIV infection and other sexually transmitted diseases. No appointment needed. The event includes door prizes and light refreshments, and every man screened will receive a financial incentive.
Snohomish County currently ranks third in the state for new HIV cases, following King and Pierce counties. Recent data show that 58 percent of all new HIV cases in Washington State are among men who have sex with other men (MSM). Gay and bisexual men make up less than 10 percent of the population, but account for almost 60 percent of the burden of HIV disease.
The Health District also will offer free testing to qualified men for Hepatitis C and syphilis, and vaccine for Hepatitis A and B. Both the Hepatitis C and HIV tests are “rapid” antibody tests, requiring only a drop of blood pricked from a finger.
Test results will be available within 30 minutes. The tests are anonymous and confidential.
New prevention tool: Pre-exposure prophylaxis –PrEP
Information about a new HIV prevention tool will be shared by Michael Louella, outreach coordinator for the AIDS Clinical Trial Unit in Seattle.
Pre-exposure prophylaxis, or PrEP, is when HIV-negative individuals take a pill to prevent HIV infection.
The medicine currently is used to treat HIV, and has now been approved for this treatment by the Centers for Disease Control and Prevention, and the Food and Drug Administration.
Research studies show that PrEP can lower the risk of HIV transmission when used with other prevention measures, such as condoms.
For more information about HIV testing and risk, please call David Bayless, 425.339.5238.
Nearly 1 in 5 people living with HIV don’t know they have it.
Many other STDs (such as chlamydia, herpes, and gonorrhea) are also unknowingly spread and left untreated.
Because of this, the CDC recommends all adolescents and adults between the ages of 13-64 get tested for HIV at least once in their life, as a routine part of medical care.
More frequent testing should be considered if you have had unprotected sex or multiple partners.
Remember, doctors don’t test for STDs as part of your routine checkup, so be sure to speak up!
If you think you should be tested, schedule an appointment with your doctor or a clinic this week.
About the Monday Campaigns:
The Healthy Monday Tips is produced by a national health promotion initiative called the Monday Campaigns.
In one study, they reviewed the scientific studies that looked at ways to get people to adopt healthy habits.
In that review, they found that one of the most effective ways to keep people on track is simply to remind them from time to time to stick to it.
But when would be the best time send those reminders?
Fry and Neff decided to look at Monday, which many of us consider the start of our week.
To better understand how we thought and felt about Monday, they reviewed the scientific literature as well as cultural references to Monday in movies, songs, books and other forms of art and literature, even video games.
They noted that a number of scientific studies have found that we may suffer more health problems on Monday. For example, a number of studies find that Americans have more heart attacks and strokes on Monday.
There is also evidence that we have more on-the-job injuries on Monday, perhaps because we are not quite back into the swing of things, or are still recovering from our weekend.
Fry and Neff also found that while many of us, facing the return to work, may dread Mondays, Monday is also seen as a day for making a fresh start.
Fry and Neff concluded that Monday might be a good day for promoting healthy habits. Calling attention to the health problems linked to the first day of the work week, such as heart attacks and on-the-job injuries, makes Monday a natural day to highlight the importance of prevention.
And the Monday’s reputation as a day to make a fresh start offers the opportunity to help people to renew their efforts to adopt healthier habits.
Fry and Neff’s findings are put into practice by the Monday Campaigns, which helps individuals and organizations use Monday as a focus for their health promotion efforts, providing free research, literature and artwork, and other support.
To learn more about Healthy Mondays:
- Visit the Monday Campaigns website: www.mondaycampaigns.org
By Julie Rovner, NPR News
The Obama administration’s actions this week on emergency contraception have left many women’s health groups sputtering with anger.
But what really has some of the President Barack Obama’s usual allies irritated is the fact that the moves are in direct contrast to speeches he made in just the past week.
Recall that on Tuesday the Food and Drug Administration defied a federal judge’s order to make the morning-after pill available over-the-counter to women of all ages by approving a more limited scheme. On Wednesday, the Justice Department formally appealed the federal judge’s ruling.
Yet only last Friday, Obama became the first sitting president to address Planned Parenthood’s national conference.
His spirited defense of reproductive rights included this statement: “We shouldn’t have to remind people that when it comes to a woman’s health, no politician should get to decide what’s best for you.”
And on Monday, he said this to the National Academy of Sciences: “[I]n all the sciences, we’ve got to make sure that we are supporting the idea that they’re not subject to politics, that they’re not skewed by an agenda, that, as I said before, we make sure that we go where the evidence leads us.”
But now, many women’s health advocates say the administration isn’t putting its actions where the president’s rhetoric has been.
“It doesn’t square and that is what’s so disappointing,” said Nancy Northup. She’s president and CEO of the Center for Reproductive Rights, one of the groups involved in the emergency contraception lawsuit against the administration that’s prompted this week’s activity.
“There couldn’t be a clearer record than there is in this case that emergency contraception is safe and effective for all ages, that we had not one but two administrations who continued to put what they judged as the politics of the issue about contraception ahead of what’s doing right for the public health,” she said.
Health and Human Services Secretary Kathleen Sebelius overrode the FDA’s decision to remove the age restrictions in 2011. She said she was worried that the youngest teens wouldn’t understand how to use the product safely.
But that’s not a concern for the nation’s pediatricians, who support full over-the-counter access to the drug.
“We get derailed over and over again in people’s ethical and moral concerns about whether teens should be sexually active, and not that this is a safe drug that can be and should be available to all women of reproductive age,” said Dr. Cora Breuner.
She’s a professor of pediatrics at the University of Washington and co-author of the American Academy of Pediatrics position paper on Emergency Contraception.
Women’s health advocates say even the steps the FDA did take this week — to lower the age for sale of the drug without a prescription from 17 to 15 — doesn’t do much, because they still have to show identification.
“15- and 16-year-olds are much less likely to have an actual government ID with your birth date on it,” said Susan Wood, a public health professor at George Washington University and a former assistant commissioner for women’s health at FDA. “So that … doesn’t really expand access to that age group very much.”
In fact, what really worries the women’s health groups is that idea that this fight that has already gone on for more than 10 years, now could stretch out years longer.
This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.
Developmentally delayed teens are at a much higher risk of sexual assault than their non-delayed peers; the numbers are both depressing and well-validated.Despite the high rates of sexual assault in the teenage population, developmentally delayed teens are at even greater risk. The reason is simple: they are seen as an easy target, and there are predators out there looking to take advantage of them.
“Developmental delay” is a vague term (and is starting to become replaced by the phrase “intellectually disability”), encompassing Down Syndrome, autism, and other conditions that may be genetic or acquired. The range of developmental delay spans from teens who cannot communicate in any fashion with their caregivers, to articulate teens who plan to graduate high school and seek higher education or employment. Obviously, discussion and education for a delayed teen is not a one-size-fits-all task.
For the most delayed teens, unfortunately, there is no way to give them information to help protect themselves. It’s vital that anyone who looks after a delayed teen has had a thorough background check, either through a facility or when you hire them directly. Teens who go to public schools are cared for by employees with in-depth, although not infallible, surveys of their background. If your teen attends a private school or day care facility, sit down with the director and ask about how they ensure the safety of their clientele. Your teen should be spending most of their day in a group activity with one or more staff present. Having trust in whoever works with your teen can help relieve your mind, but it’s also important to keep a keen eye out for something that feels wrong.
If your teen can communicate, you may be able to provide helpful knowledge and skills. Of course, you have to modify this advice to fit your teen’s level of cognition and understanding. A good rule of thumb is: if your teen asks questions, answer them. If your teen seems to be getting confused or frustrated, simplify.
Any teen who can grasp the concept should receive an education on sexuality appropriate to their level. Sit down with a book like Where Do I Come From? and discuss the basics of bodies and sexuality. They should learn about male and female organs, what sex, pregnancy, and childbirth involve, all about privacy and personal space, and that it’s normal to feel sexual feelings.
Most developmentally delayed teens will have strong sexual urges, like their non-delayed peers, and society in general is uncomfortable with this. People tend to think of delayed teens and adults as either “innocent”, with no sexuality whatsoever, or fear their sexual urges as “uncontrollable.” Like non-delayed teens, in the vast majority of cases, neither is true. Even if it makes you feel uncomfortable, the best way to discuss sexual matters with developmentally delayed teens is to approach their sexuality in a calm and informed manner.
Delayed teens should know that nobody is allowed to touch them sexually without their consent, and they are never allowed to touch anyone sexually without the other person’s consent. Tell them that if somebody tries, you want them to say a resounding no (delayed teens are often taught to obey those with authority, so stress that it’s okay to say no in this situation) and tell a trusted adult immediately. If no trusted adults are around, they should run and/ or call 911 if possible. Encouraged them to tell someone, even if it’s a secret, or they’re worried they’ll get into trouble. Be clear that your teen will never get in trouble for telling someone about their concerns.
Some parents are tempted to describe all sexual contact as “bad” for their teen. Understandably, they are nervous about their teen getting into a sexual situation. However, being touched in a sexual way can feel good, and if a teen doesn’t know that about this, they may not stop a situation because it doesn’t feel like the terrible thing they’ve been told about. Giving your teen a realistic view of sex can help them make healthy decisions, now and in the future.
Of course, some developmentally delayed teens will want to consent to sexual contact with someone. The question of whether a developmentally delayed teen can consent to sexual activity is very tricky, and obviously a lot depends on the level of delay. Encourage your teen to come to you with questions about sex, and tell you if they are thinking of starting a sexual relationship with someone. It won’t be an easy discussion if this happens, but it will be a valuable one.
A few resources: This book is written for parents of Down Syndrome children, but has good information for anyone. This short article is a good introduction. This longer piece is written for educators, but might be useful for parents as well, and the multiple links at the end are to great organizations that deal with this kind of issue. If you have access to Seattle Children’s Hospital, many providers in Adolescent Medicine have skill and experience working with developmentally delayed teens and their families around issues of sexuality.
What questions, success stories, or good advice do you have?
About Jen Brown, RN, BSN
Teens never cease to amaze me with their strength, creativity, and new perspectives! Throughout my career, I’ve enjoyed helping teens and their parents tackle health concerns and navigate social issues. Nursing is my second career; my first degree was in biology from Carleton College, and a few years later I went to the University of Virginia for their Second Degree Nursing Program. Recently I began a graduate program at the University of Washington.