Building Partnerships to Support and Expand Youth Access to Reproductive Health Care

When building a new partnership to address sexual and reproductive health in your community, follow 6 key steps to set your strategic priorities and identify collective goals and measures of success:

Promoting equitable access to sexual and reproductive health services for youth is a broad goal, with work that can be done across many domains and settings. In this resource, we have focused on 3 key priorities: comprehensive sex education, contraception, and abortion.

There are many ways that clinicians, public health professionals, community leaders, educators, youth, and families can advance access to sex education, contraception, and abortion in their communities. Some practical strategies are outlined below.

Practical ideas for working with schools.

• Schools play a critical role in advancing and supporting the sexual and reproductive health of students.
• Most school-based sexual and reproductive health priorities fall under two key domains:
  • Sex education.
  • School-based health services.
• Promoting comprehensive sex education in schools:
  • Speak to your local school board/school administration about the important role that schools can play in providing youth with the knowledge and skills they need to achieve healthy sexual development.
  • Share information on the broad benefits of comprehensive sex education.
  • Share the SIECUS Guidelines for Comprehensive Sex Education, which provide a framework for the key concepts, topics, and messages that a strong sex education program should include.
  • Share the CDC Health Education Curriculum Analysis Tool (HECAT) to assess and improve the health education – including sex education—curriculum used by the school district.
  • Partner with schools to ensure that youth with disabilities have access to a developmentally appropriate sexual education that includes knowledge building around sexual victimization, safer sex practices, consent, and respect through their Individualized Education Programs or as part of the typical curriculum.
  • Encourage schools in your community to adopt evidence-based, comprehensive sex education programs for youth in grades K-12. Examples of these programs include:
    • Family Life and Sexual Health (FLASH).
    • Get Real: Comprehensive Sex Education that Works.
    • In•clued LGBTQ2S+-focused sexual health education.
    • Promoting Health Among Teens! Comprehensive Abstinence & Safer Sex (PHAT).
    • Rights, Respect, Responsibility.
• Promoting delivery of clinical sexual and reproductive health services in schools:
  • Advocate for sexual and reproductive services in the context of a full spectrum of physical and mental health services for all students which promotes a holistic approach to health and does not identify or stigmatize the school-based service as being solely related to sexual activity.
  • Speak to your local school board/school administration about the important role of schools in providing clinical sexual and reproductive health services to students.
  • Understand the promote the critical roles of school nurses and school-based health centers in improving sexual and reproductive health.
  • Share information on evidence-based programs to promote sexual health in schools, including:
    • Condom availability programs.
    • On-site sexual health services:
      • STI and HIV testing and treatment.
      • Contraceptive services.
      • Health guidance and counseling.
  • Developing a referral guide to link students with youth-friendly services in the community.
  • Building relationships with healthcare providers to promote collaborative care.
  • Information campaigns for students and parents to promote sexual health.
  • Resources and tools for coaches and youth advocates

• Work with schools to promote student-centered, trauma-informed practices when educating and caring for youth:
  • Systemic racism, unconscious bias, and discriminatory policies have caused disparities in experiences with school discipline. For example, students who are Black or American Indian/Alaska Native, and students with disabilities are disproportionately more likely to be suspended or expelled for behavioral challenges.
  • Systemic racism and societal inequities can impact the health and experiences of youth from communities of color, causing intergenerational trauma.
  • Students can experience trauma both inside and outside the school settings, which impacts their health, academic achievement, and social-emotional well-being.
  • Trained educators and school support professionals can promote diversity, equity, and inclusion and build supportive school environments that foster health and positive outcomes for all students.
  • Utilizing trauma-informed practices in schools can help educators and administrators recognize symptoms of trauma and respond accordingly to help students succeed and thrive in school.

Practical ideas for working with the juvenile justice system.

• Talk with the leadership and staff of local juvenile detention facilities about the importance of ensuring access to sexual and reproductive health services for justice-involved youth.
• Work with juvenile detention facilities on best practices for sexual and reproductive health services, including:
  • Ensuring detained youth receive the same level and standards of healthcare as youth accessing care outside of the juvenile justice system.
  • Encouraging sex education for youth living in detention settings including:
    • Counseling on safe sex practices.
    • STI and HIV prevention.
    • Barrier methods.
    • Contraception, including hormonal contraception, long-acting reversible contraception (LARC), and emergency contraception. In the US, there is a history of forced sterilization among individuals who are incarcerated; therefore, any contraception should only be given once non-coerced consent has been obtained from the patient.
  • Promoting reproductive health care for youth living in detention settings, including:
    • Assessment of youth sexual behaviors and practices.
    • STI and HIV screening and treatment.
    • Trauma counseling.
    • Access to the range of contraception options, including LARC.
    • Emergency contraception as needed.
    • Pregnancy screening.
    • Pregnancy options counseling, including information on abortion, adoption, or parenting.
    • Provision of appropriate pregnancy and post-partum care.
    • Providing menstrual products to youth who need them.
  • Providing gender-affirming care in detention settings, including:
    • Continuation of hormone therapy without interruption for transgender youth.
    • Management of medical and surgical transgender care following accepted standards developed by professionals with expertise in transgender health care.
    • Providing gynecological, family planning, and obstetrical care when clinically indicated, regardless of gender identity.
  • Utilizing trauma-informed care in detention settings.
  • Providing access to wanted abortion for young people.
  • Recognizing and responding to the unique health needs of justice-involved youth with chronic medical conditions and developmental needs.
• Share relevant resources from the American Academy of Pediatrics (AAP) and National Commission on Correctional Health Care (NCCHC):
  • AAP: Advocacy and Collaborative Care for Justice-Involved Youth.
  • NCCHC: Women’s Health Care in Correctional Settings.
  • NCCHC: Transgender and Gender Diverse Health Care in Correctional Settings.
• Encourage transition-planning for youth, with a focus on ensuring that reproductive health care, including contraception and pregnancy care, continues without interruption.

Practical ideas for working with the child welfare system.

• Connect with local leadership and staff from the child welfare system, group homes, and foster care agencies, about the importance of ensuring uninterrupted, confidential access to sexual and reproductive health care services for youth living in foster care.
• Require the use of trauma-informed care when working with youth and families in the child welfare system.
• Work with child welfare personnel on best practices for sexual and reproductive health services, including:
  • Ensure that all clinicians who care for the patient are reminded that the confidentiality afforded to youth living with their families should be the same as youth living in foster care.
  • Requiring an initial comprehensive health assessment—to include STI screening, pregnancy screening, and assessment for physical and sexual abuse, exploitation, and trafficking —no later than 30 days of a new placement, and a follow-up assessment within 60-90 days.
  • Gaining the adolescent patient’s consent to share the following:
    • Incorporating the results of health assessments into the child’s court-approved social service case plan.
    • Educating foster caregivers, caseworkers, birth parents, adoptive parents, and youth about the child’s health and treatment plan within the guidelines of the law. Information which is protected should not be shared unless express permission is granted by the patient.
  • Advocating for the provision of health services—including sexual and reproductive health services—in the context of a medical home.
  • Addressing the unique sexual and reproductive health needs of children and adolescents with special health care needs involved in the child welfare system.
  • Understanding and addressing the impact of trauma, toxic stress, abuse, neglect, and ongoing uncertainty, transitions, and loss on child and adolescent health.
  • Building collaborative partnerships between the practice, caseworkers, foster parents, family of origin, and other professionals to promote integrated care for sexual and reproductive health needs.
• Support caseworkers in having the capacity to provide access to age-appropriate, medically accurate, culturally sensitive information about:
  • Gender identity.
  • Prevention of unplanned pregnancies.
  • Sexual development.
  • Sexual and reproductive health care.
  • STI prevention and treatment.
  • The full spectrum of contraception options.
  • The full spectrum of pregnancy options, including abortion, adoption, and parenting.
  • Trauma.
  • Trauma symptoms/stress responses.
  • Trauma-informed care.
• Educate child welfare leaders, staff, and families about common barriers to sexual and reproductive health services for youth in the welfare system and support them in addressing these barriers. Common challenges include:
  • System losing track of youth’s insurance eligibility or medical card and residence when transitioning between placements.
  • Youth needing support in scheduling medical appointments.
  • Stigma around sexual and reproductive health services.
  • Transportation barriers.
  • Placement in families/group homes that prohibit or confiscate contraception.
  • Placement in families/group homes that limit pregnancy options, including abortion.
  • Mistrust of the medical system.
  • Lack of confidentiality.

Encourage transition-planning for youth aging out of the foster care system, with a focus on ensuring that reproductive health care, including contraception and pregnancy care, continues without interruption.

Practical ideas for working with youth- and parent-focused organizations.

• Engage with the leadership of youth- or parent-focused organizations to talk about the importance of youth having information to medically accurate, age-appropriate information about their gender and sexuality.
• Work with groups to identify evidence-based sex education curriculum or programming to incorporate into organizational activities.
• Offer to host an educational session for parents or youth about a topic related to sexual and reproductive health, such as consent, healthy relationships, STI prevention, or gender identity.
• Connect with leadership of a youth- or parent-focused organization about opportunities to advocate together to increase youth access to comprehensive sex education, contraception, or abortion in your community. Advocating together with representatives from multiple sectors gives you a stronger voice than advocating alone.

Practical ideas for making your voice heard.

• Engage with your AAP chapter or the local chapter of other medical groups (eg, physician or pharmacist organizations, nursing organizations, professional associations) to engage your colleagues in advocacy efforts to promote access to sexual and reproductive health services for youth.
• Write a letter to the editor, an op-ed in your local paper, or a blog to highlight the importance of youth access to sexual and reproductive health services, and strategies to expand this access.
• Participate in advocacy activities that support youth access to comprehensive sex education, contraception, and abortion.

The Reproductive Health Access Project (RHAP) is a project that is run for young people by young people that works to increase education and access to sexual and reproductive health services. Youth who work as peer educators at the RHAP clinic presented during the AAP Summit on Youth Access to Reproductive Health Care and a synopsis of their program is included as a case study.

This program offers free pregnancy testing, STI testing, and treatment, various methods of birth control, counseling, comprehensive sex education, menstrual products, gender-affirming clothing items, among many other essential services. Our program is incredibly special because it works by listening to young people first, spotting where there are gaps or barriers to services, and then working to fill those gaps and overcome those barriers. For example, RHAP saw some of the barriers were cost, transportation, confidentiality, and access to education, so we created a clinic system where all those barriers are addressed. Young people will come to our clinic, see our peer educators for a sex education session where we talk about all the services, they have access to, answer questions, and hear whatever they wish to share before they see a provider. This allows young people who often have never been to an appointment for sexual and reproductive health-related services to get all the information they need to make a decision that is right for their life and to be able to advocate for themselves whenever they see a provider. I think that part of our advocacy that makes us unique is how our clinic system works to put the power in the hands of the young people.

There are many opportunities to partner with organizations who have existing expertise and structures to expand youth access to sexual and reproductive health care in your community.

A selection of organizations that provide programs and resources for community-based sexual and reproductive health activities is listed below. This list is not intended to be exhaustive, and inclusion of programs should not be interpreted as official endorsement by AAP.

Abortion Care Network

• Abortion Care Network (ACN) is the national association and network for independent community-based abortion care providers and allies.
• ACN fights to protect access to abortion care and keep independent clinics open to continue providing essential health care for communities.

Advocates for Youth

• Advocates for Youth works to promote adolescent reproductive and sexual health programs and policy.
• Programs include youth leadership, activism, educational resources, curricula, and building the capacity of youth serving professionals.

Association of American Indian Physicians

• The Association of American Indian Physicians (AAIP) works to provide educational programs and services to American Indian and Alaska Native communities.
• Learn more here: https://www.aaip.org/

Black Women’s Health Imperative

• Black Women’s Health Imperative is dedicated to improving the health and wellness of our nation’s Black women and girls through signature programs and special initiatives.
• Core components of BWHI programs include reproductive justice, shared lived experiences, training in policy and advocacy, and anti-racism strategies.

Bold Futures

• Bold Futures advocates for reproductive health care policy change, research, place-based organizing, and culture shift by and for people of color in New Mexico.

B.Y.E LLC

• Bringing You Excellence (B.Y.E) LLC operates through a trauma-informed lens and encourages the prioritization of wellness over productivity in the workplace.
• B.Y.E works with philanthropic and government partners providing advocacy curriculum and SRH programs.

Center for Reproductive Rights

• Center for Reproductive Rights is a global human rights organization of lawyers and advocates working to ensure reproductive rights are protected in law as fundamental human rights.

El Rio Health

• The El Rio Reproductive Health Access Project (RHAP) works to improve access to sexual reproductive health care and education through peer-designed initiatives.
• SRH services include STI’s/HIV counseling and treatment, and free confidential peer-led walk-in teen clinics.

Feminist Women's Health Center

• Feminist Women’s Health Center provides safe and affordable abortion and reproductive health services to all without judgement.
  Services include Sexual Health + Wellness, Trans Health Initiative, Abortion Care, Birth Control Options, and Emergency Contraception.

Geoffray Strategies

• Geoffray Strategies is a consulting firm offering policy and strategy solutions for healthcare clients.

Guttmacher Institute

• Guttmacher Institute works to advance sexual and reproductive health care and rights worldwide through high-quality research, evidence-based advocacy, and strategic communications.

Gyrls in the H.O.O.D Foundation

• Gyrls in the H.O.O.D (Healthy, Optimistic, Outstanding, and Determined) Foundation is on a mission to increase positive reproductive health outcomes for young people living in urban Chicagoland areas.

Howard Brown Health

• Howard Brown Health is rooted in LGBTQ2S+ freedom, providing reproductive health care and social justice for communities.
• Services include, and are not limited to, OBGYN services, Trans & Nonbinary services, HIV/AIDS case management, and sexual harm response program counseling.

If/When/How

• If/When/How helps to ensure all people can decide if, when, and how to create and sustain families and to actualize sexual and reproductive wellbeing. They work to support the advancement of reproductive justice in our legal system.

Ignite Young Asian People Power

• Asian American Organizing Project (AAOP) – Ignite Young Asian People Power empowers young Asian people in Minnesota to create systems change for an equitable society.
• Programs include civic engagement, gender justice campaigns and youth action teams.

In Our Own Voice: National Black Women’s Reproductive Justice Agenda

• A national/state partnership designed to amplify Black voices in the fight to secure reproductive justice for all.
• This organization partners with eight Black women’s reproductive justice organizations to educate and mobilize Black people on abortion access, comprehensive sex education and contraceptive equity.

Jane's Due Process

• Jane’s Due Process helps young people in Texas navigate parental consent laws and confidentially access birth control and abortion care.
• Services include case management, legal support, and stigma-free sexual and reproductive health care.

Midwest Access Project

• Midwest Access Project works to ensure every person has access to high quality, comprehensive sexual and reproductive health care in their community.
• Services include individual clinical training, and provider and community education.

National Association of Nurse Practitioners in Women's Health

• National Association of Nurse Practitioners in Women’s Health (NPWH) is a national professional membership organization leading the way for women’s health care across their lifetime.

National Family Planning and Reproductive Health Association

• National Family Planning and Reproductive Health Association (NFPRHA) is a membership organization representing providers committed to helping people get family planning education through training and advocacy.

National Latina Institute for Reproductive Justice

• National Latina Institute for Reproductive Justice (the Latina Institute) fights for the fundamental human right to reproductive health care and justice. They center and amplify Latina/x voices, mobilize communities and drive policy change.

National Network of Abortion Funds

• National Network of Abortion Funds works with members to remove financial and logistical barriers to abortion access and care.

Northwest Portland Area Indian Health Board

• The Northwest Portland Area Indian Health Board (NPAIHB) is a tribal advisory organization serving the forty-three federally recognized tribes of Oregon, Washington, and Idaho.
• NPAIHB is engaged in many areas of Indian health, including legislation, health promotion and research.

Physicians for Reproductive Health

• Physicians for Reproductive Health is an organization of doctors using evidence, training, and organized action for fundamental health care rights.
• They focus on abortion care, equitable access to contraception, comprehensive sex education, and defending/improving American’s access to care services.

Power to Decide

• Power to Decide provides trusted, high-quality information on sexual health and contraceptive methods to allow young people to make informed decisions.

Preterm

• Preterm works to advance reproductive health and justice by providing safe, respectful, and accessible abortion and sexual healthcare.
• Preterm is Ohio’s only independent, non-profit abortion clinic.

Red River Women’s Clinic

• The Red River Women’s Clinic offers abortion care and family planning services to the Fargo-Moorhead area, all of North Dakota, Northwestern Minnesota and South Dakota.
• Services include abortion care, birth control education, emergency contraception, STI testing, pregnancy testing and miscarriage management.

Resources for Abortion Delivery

• Resources for Abortion Delivery (RAD) protects abortion access by investing charitable resources in the U.S. independent abortion sector.

SIECUS: Sex Ed for Social Change

• SIECUS advocates for the rights of all people to access and enjoy accurate and comprehensive sex education, information, and related health services.
• SIECUS creates policy briefs, advocacy tools, and hosts events related to sex education.

Sistersong

• Sistersong is a Southern based, national membership organization with a purpose to create a network to improve institutional policies and systems that impact the reproductive health of marginalized communities.

Society for Adolescent Health and Medicine (SAHM)

• SAHM is a multidisciplinary organization working to improve the health and well-being of adolescents through advocacy, clinical care, health promotion and research.

Society of Family Planning

• Society of Family Planning fights for equitable abortion and contraception informed by science.

South Asian Sexual and Mental Health Alliance (SASMHA)

• SASMHA seeks to celebrate the diversity of South Asian experiences and interrogate oppressive cultural values and traditions.
• Programs include Sexual and Reproductive Health, Racism & Anti-Blackness, and LGBTQ2S+ Issues & Sexuality.

Southcentral Foundation

• Southcentral Foundation works together with the Native Community to achieve wellness through health services.

Southern Birth Justice Network

• Southern Birth Justice Network works to make reproductive health care accessible to all – especially communities that are Black, Brown, youth, immigrant, indigenous, LGBTQ2S+, and low-income

Unite for Reproductive and Gender Equity (URGE)

• URGE is driven by young leaders through campus chapters and Community Activist Networks. Members educate their communities and advocate for local, state, and national policy.
• Programs include integrated voter engagement, reproductive justice leadership and abortion positive campaigns.

Whole Woman’s Health

• Whole Woman’s Health offers compassionate, affordable abortion care in-clinic and online and provides high-quality reproductive healthcare and advocacy for SRH rights.

Young Women’s Freedom Center

• Young Women’s Freedom Center works to empower trans and gender-expansive young people who have been disproportionately impacted by incarceration, racist and sexist policy, and/or the underground street economy.

Cross-sectoral partnerships with health professionals, educators, community members, youth, and families are essential to promoting youth access to education and health services in their communities.

The first step in promoting access to sexual and reproductive health care in your community is to check in with partners who are already doing this type of work. Identify individuals and community organizations who are working on health equity and sexual and reproductive rights in your community or state. Consider the following types of organizational partners:

• Schools or school districts across all grade levels.
• Colleges, universities, and vocational settings.
• Student organizations.
• Organizations representing educators or school health personnel and their state chapters.
• Parent-teacher associations.
• Faith-based or religious organizations.
• Community leaders.
• Tribal elders.
• Youth groups (including peer-education groups, school clubs, youth advocates).
• Organized extracurriculars, such as Boys and Girls Clubs, 4H Clubs, or Scout troops.
• Sports organizations.
• Group and residential care organizations.
• Juvenile justice system.
• Foster and adoptive groups for parents.
• Elected officials.
• Organizations serving youth with special health care needs or disabilities.
• Organizations that support LGBTQ2S+ individuals.
• Health clinics, including county or community health centers.
• City or county health departments.
• Your local chapter of the American Academy of Pediatrics.
• National and local chapters of reproductive health organizations, including:
  • Advocates for Youth.
  • Black Women’s Health Imperative.
  • Center for Reproductive Rights.
  • National Latina Institute for Reproductive Justice.
  • Planned Parenthood.
  • Power to Decide.
  • SIECUS: Sex Ed for Social Change.
  • Sistersong.
  • South Asian Sexual and Mental Health Alliance.
  • Unite for Reproductive and Gender Equity.

Promoting health equity in cross-sectoral partnerships:

When building partnerships to advance sexual and reproductive health, it is critical to center the needs and experiences of populations facing disparities in access to care. Deliberate, proactive work is needed to achieve equitable access to the full range of sexual and reproductive health services—including comprehensive sex education, contraception, and abortion.

Youth have disparate opportunities and experiences in their schools and communities, due to social drivers of health, family and community resources, and structural factors such as systemic racism, social inequities, and discrimination.

To promote equity in sexual and reproductive health care, it is critical to engage meaningfully with community members and organizations that serve youth and families from diverse cultures. Sustained engagement with community partners can help reduce barriers to care and increase utilization of sexual and reproductive health services, ultimately impacting health and reproductive outcomes.

Public health scholars have outlined important considerations for authentic engagement around health issues with community partners, including:

• Be aware and acknowledge differences in lived experience.
• Center the perspectives and needs of the population-of-focus.
• Consider cultural factors and strengths of the population-of-focus.
• Practice humility in learning from diverse partners.
• Develop strategies and action plans collaboratively with community members, health professionals, policy makers, and other key partners.
• Consider co-creating messages and materials that are culturally and linguistically tailored for the community.
• Communicate regularly and openly.