By Angela Diaz, MD, PhD, MPH, Director
On August 26, 1920, women in the United States gained the right to vote with the passing of the 19th Amendment. This happened because of the incredible hard work and relentless determination of a group of women (and men, but mostly women) who fought for women’s rights.
In honor of that accomplishment, we celebrate Women’s Equality Day every year on August 26. But in addition to celebrating the long way we’ve come, we also need to recognize the hard work we still have left.
If we want to move toward equality for all women, we have to make teen girls’ health a priority. Adolescents are at an important time in their life, yet their unique health needs are frequently ignored. This means that young women are entering adulthood without critical knowledge about their own bodies, healthy relationships and how to take care of themselves. In addition, they’re building their own identities, often without support and in the aftermath of trauma and violence.
Of course, these struggles are not relegated to girls. But women are more likely than men to be victims of dating violence and sexual assault, feel uncomfortable with their bodies, and bear responsibility for birth control AND what happens if it fails. These health issues need to be anticipated and addressed early. For these reasons (and plenty more!) women’s equality is impossible without teen girls’ health.
At Mount Sinai Adolescent Health Center, we often say that young people need to be healthy to make it in this world. This is why we provide an integrated model for teen health with free primary care, mental health, sexual health, dental, and optical services. Our care also includes special programs for young parents, HIV+ youth, trafficking survivors, LGBQ and transgender youth, and more. It’s only through addressing young people’s unique, individual health needs that we can create an equal world.
We can get there by providing…
1. Inclusive, comprehensive sex education
Girls need to understand their bodies—that they’re not shameful, embarrassing or wrong. They need to know how to take care of themselves.
To create an equal world, teen girls need inclusive, comprehensive, scientifically-based sex education. Parents and educators need to talk openly about puberty, sex (of all kinds, between all bodies), sexually transmitted infections (STIs), pregnancy, birth control, condoms, sexual identity, and more.
Parents and educators also need to talk about relationships—what do healthy relationships look like? What are red flags for abuse? Where can you turn to for help if you find yourself in an abusive relationship? Adults often assume that teens will automatically understand how to handle relationships, but that often isn’t true. Our current culture romanticizes unhealthy behaviors, and it takes honest conversations to unlearn these toxic norms.
2. Full, confidential access to sexual health care, including birth control
Birth control (including emergency contraception) and STI testing and treatment need to be free and accessible to everyone, no matter their insurance status or income. These services also need to be destigmatized, so that shame doesn’t keep teen girls from accessing them.
Young people also need to be able to access these services confidentially—when health care isn’t confidential, girls won’t risk their parents or others finding out, and stop getting sexual health services altogether. When girls don’t (or can’t) get these services, their health suffers.
3. Screening and treatment for trauma
Trauma affects every aspect of a young person’s life. It lives in the body, and can change the architecture of young people’s brains. These changes combined with toxic stress may make it difficult for young people to concentrate in school and express their emotions in healthy ways. Instead of being met with compassion and understanding, these young people are often disciplined, suspended, or even expelled. Black girls in particular are at risk of expulsion—they represent 42% of girls who are expelled. In addition, a shocking 82% of incarcerated women experienced severe physical or sexual childhood abuse.
To create an equal world, health care providers need to routinely screen young girls (and people of all genders) for trauma. Our health and education systems need to provide appropriate care and compassion to young trauma survivors, rather than making their lives even harder.
4. Support and encouragement for young parents
Young pregnant and parenting moms face stigma, isolation and often outright disgust. In trying to prevent teen pregnancy, educators and parents often resort to language like, “If you get pregnant, your life will be ruined.”
This means that when a teen girl becomes pregnant, they often believe this about themselves.
Instead, young mothers need emotional and material support—parenting classes, health care for them and their child, and childcare. Schools need to respect the rights and provide the support that pregnant and parenting teens need to succeed. This way, more young moms would feel respected, get the education they need, and know that they could still obtain their dreams.
5. Accessible, comprehensive transgender health care for young people
Women’s equality has to include ALL women. Access to health care helps transgender girls (and ALL trans youth) become their healthiest selves. This includes trans-affirming mental health services, puberty blockers, hormone-replacement therapy, gender-affirming surgeries, and doctor’s offices that are welcoming from the waiting room to the exam room.
While trans-affirming health care is important throughout an individual’s life, it needs to start early. Forty percent of transgender adults said that they had attempted suicide, and 92% of those who had tried to kill themselves did so before they turned 25.
Girls are full of promise and potential. When we provide them with the care they need, we are one step closer to giving them a truly equal future.
Angela Diaz, MD, PhD, MPH has led the Mount Sinai Adolescent Health Center for more than 25 years, overseeing its growth into the largest center of its kind in the United States. Dr. Diaz has long been a leading figure in public health advocacy in New York as well as nationally and internationally, advancing policies that break down the economic and social barriers to high-quality health and wellness care for young people. As a young immigrant from the Dominican Republic, Dr. Diaz was once a patient at MSAHC herself. She earned her medical degree from Columbia University College of Physicians and Surgeons. She also earned a Master’s in Public Health from Harvard University and a Ph.D. in epidemiology from Columbia University.
The Mount Sinai Adolescent Health Center is located in New York City. It provides comprehensive, confidential, integrated, judgment-free health care at no charge to over 10,000 young people every year. This column is not intended to provide medical advice, professional diagnosis, opinion, treatment or services to you or to any other individual, only general information for education purposes only.