Three Minutes to Change the World: Pushing a Sexual Health Rights Agenda for Youth in State Care (2012)

Three minutes is not a lot of time. After a few rehearsals, I found that three minutes is roughly the amount of time it takes to read out loud a page of single-spaced text. I was hoping to stretch my three minutes to three and a half, even four. But the timekeeper was on his game, so it looked like three minutes was all I was going to get.

I was at the first of two hearings that the Administration for Children's Services (ACS) in New York City had organized to allow for public comments on its Close to Home initiative. Close to Home sets forth plans for the transition of youth placed in non-secure placement from the Office of Children and Family Services (OCFS) custody to ACS custody, providing access to an array of New York City-based services and programs. Each of us had three minutes to weigh in on the plan, a near impossible time restriction given the plan's scope and implications for young people in state care.

I was there to testify on behalf of The Center for HIV Law & Policy (CHLP) and Teen SENSE, our national initiative to secure written guarantees of LGBTQ-inclusive sexual health services for youth in state care. I focused my comments on the need for written policies that ensure that sexual health care and sexual health education meet minimum standards and are available to LGBTQ and at-risk youth in state custody, but still – three minutes!

In three minutes, I had to point out to ACS that most young people in state custody are from the communities and populations that have been severely affected by HIV. Queer youth are significantly more likely to have lived in foster and group homes than their non-gay counterparts, and youth of color, low-income youth, and survivors of gender-based and other forms of violence are also overrepresented. In fact, a significant number of youth living with HIV pass through these state systems at some point, and have higher rates of other sexually transmitted infections (STIs) and unintended pregnancy.

And as it turns out, these young people have more need for but far less access to basic sexual health care and disease prevention services while confined. This represents a missed public health opportunity of huge proportion. It also is the legal and moral responsibility of foster care, detention, and other youth facilities to provide this care to the young people who must depend on them for their health and welfare. Child welfare and juvenile justice systems effectively assume the responsibilities of a parent. In the area of sexual health, most have been seriously neglectful parents, failing to recognize and respond to the very basic set of health needs of those in their charge.

In three minutes, I had to remind ACS that Teen SENSE had already done the work of writing policies and standards to guide sexual health care in youth facilities. Youth, community members, and experts in adolescent medicine, sexual health education, LGBTQ health, anti-violence, child welfare, and juvenile justice had created not only model policies on sexual health services and staff training, but also sets of standards that guide the implementation of these policies. These tools are health essentials on several levels. They outline the fundamental services and competencies that protect adolescents' health now and into the future. And they mainstream discussion and understanding of sex, sexuality, sexual orientation, and gender identity that build capacity for sound decision-making and strong interpersonal relationships. These tools help tackle homophobia and make youth facilities safer though naming and increasing awareness of violence and harassment, an all-too-frequent experience of queer kids in out-of-home care.

In three minutes, I had to tie everything together by describing these model policies and standards in the context of the Close to Home goals. No, three minutes is not a lot of time, but I think I managed.

It was gratifying to see ACS taking leadership on the needs of LGBTQ youth, and my testimony seemed to be well-received. We will follow up to make sure that the best possible policies are in place for the young people who need them. Meanwhile, our Teen SENSE work continues, with a focus on increasing the active, front-line involvement of young people who are both informed and persuasive on this topic. We are committed to helping build the next generation of HIV advocates.

Here is a short description of the Teen SENSE Model Policies and Standards we shared:

• Model Policy: Sexual Health Care for Youth in State Custody outlines the minimum requirements for sexual health care services, including health screenings and comprehensive sexual histories, HIV and STI services, pregnancy services, and ongoing care and discharge planning. The Teen SENSE Model Sexual Health Care Standards for Youth in State Custody sets forth in more detail the specific health services essential to an adequate care program.

• Model Policy: Sexual Health Education for Youth in State Custody outlines the minimum requirements for a sexual health education program, including basic information and resources on HIV and STIs, pregnancy, LGBTQ discrimination, drug use/harm reduction skills, and sexual harassment and abuse. The Teen SENSE Model Sexual Health Education Standards for Youth in State Custody sets forth in more detail the essential content goals and instructional elements of a comprehensive, LGBTQ-inclusive sexual health education program.

• Model Policy: Training for Youth Facility Staff: Ensuring Competence that Includes the Rights and Needs of LGBTQ Youth outlines the basic requirements for ensuring staff competence on sexual orientation and gender identify, particularly on the rights and needs of LGBTQ youth. Model Staff Training Standards: Focusing on the Needs of LGBTQ Youth delineates specific training goals, including the effects of stigma and discrimination on LGBTQ and HIV-positive youth, understanding the need for comprehensive health services and activities consistent with their interests and communities, and maintaining confidential, safe environments

For more information on Teen SENSE and the model standards and policies, or to become a Teen SENSE partner, contact Adrian Guzman at The Center for HIV Law & Policy at [email protected] or 212-430-6733.