Reproductive Health Care is Foundational to Thriving
A Discussion with Youth Leaders and Reproductive Health Advocates
The YTFG Well-being investment agenda, updated in 2021, makes a clear statement about the importance of reproductive health as part of the physical health and safety domain of well-being and well-becoming. Specifically, the framework says that “young people should have access to and use accurate information to make health-related decisions and meet health needs, including those often not covered: reproductive, dental and vision”.
YTFG funders and the young people who participated in the development of the framework recognize that young people in under-served communities, particularly those involved in public systems, have historically lacked access to a wide range of reproductive health services that are critical to their well-being. Reproductive health refers not only to abortion, but the broad continuum of services that are responsive to all young people’s and their diverse needs, including STI prevention and treatment, contraception, comprehensive sexual health education, gender affirming care, and healthy relationships.
This vision – of a world in which all young people have equitable access to services and freedom to make decisions about their reproductive health – experienced a serious setback when the Supreme Court overturned Roe v Wade and a constitutional right to abortion. To better understand the landscape for young people in the post Dobbs world, YTFG, Grantmakers for Thriving Youth, and Grantmakers for Girls of Color hosted a webinar in June 2023. The webinar highlighted the many ways that the Dobbs decision has put a chilling effect on any progress we’ve made on reproductive health access for young people in recent years.
Young people who participated in the webinar shared that the pervasive impact of Dobbs on young people has been fear. Fear that Dobbs is just the tip of the iceberg, and that more and more rights will be stripped away given the current political environment. As Daniel Bisuano (one of our YTFG Fellows) and Addison Moore shared, if they can take away the right to abortion, it’s clear to young people that the right to same sex marriage, contraception, trans health and lots of other rights are on the line. The state restrictions on the right to gender affirming care for young people only perpetuates the fear that these rights are being eroded more and more every day.
What’s more, shared Daniel and Addison, Dobbs has heightened distrust among young people about which adults they can rely on to give them full and accurate information about reproductive health. For those in states that are moving to protect access to reproductive health services, it impacts future decisions about where they can live. For those who are seeing access stripped away, it presents a whole host of other problems that only exacerbate existing inequities about who and from where young people can get the full range of reproductive health services they need for their overall well-being.
So what can funders do Daniel and Addison, along with Jeannette Pai-Espinosa with the Justice and Joy National Collaborative and Rebecca Gudeman with the National Center on Youth Law, provided some concrete recommendations for funders interested in well-being for young people:
Take a broad and intersectional view of reproductive and sexual health access – for too long, funders have shied away from funding this support for young people because they – and/or their boards - equate reproductive health with abortion. Yet reproductive health is so much more. It’s about prevention, education, protection from disease, gender affirming care, and healthy relationships. And the lack of access can have a direct and negative impact on all the other well-being outcomes that funders are squarely behind, including education, workforce, family preservation, healthy birth outcomes, and more.
Fund peer supports – armed with accurate and lifesaving information, young people can be supports to other young people who may not have any other place to turn for information and education. Peer mentors / ambassadors can share information about where to go for services, which adults or organizations can be trusted, and how they can and should protect themselves from harm. For instance, the Reproductive Health Equity Project for Foster Youth has produced a podcast series that shares information for young people and caregivers by young people. These types of efforts can be lifesaving.
Support organizations to partner with young people around services and advocacy – organizations that support young people shouldn’t make assumptions about what reproductive health services they need and how those services are best received. Funders can support organizations to partner with young people to determine the approach that works best in each community, and facilitate advocacy to fill gaps in the community. In states with more restrictive laws, advocacy organizations can work with young people to build their advocacy skills, in hopes of building a stronger base for mitigating the negative impact of restrictive laws. Funding for these intergenerational partnerships should also reflect the intensity of staff support that’s needed to support young people, including staff training, travel money, clothing for young people, stipends, and more.
Support trusted community people – in many communities, it is individuals, not organizations who are quietly and effectively supporting and advocating for young people around reproductive health issues. These individuals not be working in or affiliated with nonprofit organization. Funders can support these individuals through intermediaries so they can continue to do their good work with young people, while also receiving support to grow their movements. This is particularly important for communities of color that may have cultural norms around how they provide information, education, and services.
Support to deal with the full range of issues young people are facing. When young people seek out reproductive health services, their needs may be symptoms of larger issues they’re facing. As Jeannette Pai-Espinosa put it “no one lives a single-issue life” and organizations need flexible funding that allows them to deal with the full range of challenges for young people, including domestic violence, homelessness, and more.
Support messaging and narrative change – Messaging that has allowed many of the laws to become more restrictive needs to be countered with messaging that is more powerful and effective in addressing the unique needs of systems involved, gender diverse and gender expansive, and other marginalized young people. Having a supportive community of trusted adults and peers is the only way that young people can get the information they need to protect themselves from poor reproductive health outcomes, which has a ripple effect on all the other well-being domains we care about. Broader narrative change can also help shift societal views of reproductive health care as a key component of the right that individuals have to equitable health outcomes.
As a network of funders that care about the overall well-being of young people, reproductive health has not been a central part of our learning agenda. This webinar reminded us that it is young people who advocated for the inclusion of reproductive health services in the revised well-being framework, and it is young people who remind us that these issues are not just about “bodies that can get pregnant.” This experience has been an important reminder that we need to view this issue more expansively, and for all young people, with all the unique identities, experiences, and aspirations they hold.
For more on the webinar, see the Grantmakers for Thriving Youth webpage that houses the webinar recording, as well as helpful resources on this issue.