Comprehensive, LBGTQ-Inclusive Comprehensive, LBGTQ-Inclusive Sexual Health Care for Youth in State Sexual Health Care for Youth in State

Custody as a Human Right: Custody as a Human Right: The Teen SENSE Initiative The Teen SENSE Initiative

The Center for HIV Law and PolicyThe Center for HIV Law and PolicyAdrian Guzman, J.D., M.P.H.Adrian Guzman, J.D., M.P.H.

Issue: Lack of Mandatory Policies to Meet Issue: Lack of Mandatory Policies to Meet Sexual Health NeedsSexual Health Needs

Consensus: Comprehensive Sexual Health Care of Youth Consensus: Comprehensive Sexual Health Care of Youth in State Care is ain State Care is a State obligation: Necessary for the health and well-being of youthState obligation: Necessary for the health and well-being of youth Opportunity: Unique opportunity to reach high-risk youth and Opportunity: Unique opportunity to reach high-risk youth and

provide them with sexual medical care and sexuality education to provide them with sexual medical care and sexuality education to promote self-awareness and long-term healthpromote self-awareness and long-term health

Despite this consensus policies are: Despite this consensus policies are: InconsistentInconsistent VagueVague Unofficial, ad hoc, and optionalUnofficial, ad hoc, and optional

No focused efforts to change public policy on this issue on No focused efforts to change public policy on this issue on a large scalea large scale

The Teen SENSE InitiativeThe Teen SENSE Initiative

Goal: Nationwide state mandates and standards for the Goal: Nationwide state mandates and standards for the provision of comprehensive sexual health care for youth in provision of comprehensive sexual health care for youth in state custodystate custody

Multidisciplinary coalition to create model policies and Multidisciplinary coalition to create model policies and standards and to lead advocacy for comprehensive, standards and to lead advocacy for comprehensive, LGBTQ-inclusive:LGBTQ-inclusive: Sexual health careSexual health care Sexual health educationSexual health education Staff training to ensure competence that includes the rights and Staff training to ensure competence that includes the rights and

needs of LGBTQ youthneeds of LGBTQ youth Legal framework establishing affirmative right of Legal framework establishing affirmative right of

adolescents to comprehensive sexual health careadolescents to comprehensive sexual health care Local implementation efforts engaging policy makers and Local implementation efforts engaging policy makers and

agency headsagency heads

Redefining Sexual Health CareRedefining Sexual Health Care

Sexual Health Care that Sexual Health Care that Meets the full range of sexual health needs of youth in state facilitiesMeets the full range of sexual health needs of youth in state facilities Inclusive of all sexual orientations and gender identitiesInclusive of all sexual orientations and gender identities

Sexual Health Education that isSexual Health Education that is Comprehensive, scientifically soundComprehensive, scientifically sound Inclusive of needs of all sexual orientations and gender identitiesInclusive of needs of all sexual orientations and gender identities Culturally appropriateCulturally appropriate

Staff trainingStaff training To understand, respect, and respond to the health and safety needs of To understand, respect, and respond to the health and safety needs of

all youth regardless of sexual orientation and gender identityall youth regardless of sexual orientation and gender identity

Rights-based: Youth Rights Road MapRights-based: Youth Rights Road Map Demonstrates urgency and an unmet affirmative rightDemonstrates urgency and an unmet affirmative right Demonstrates need for mandated, consistent standardsDemonstrates need for mandated, consistent standards Fills critical resource gap, useful for broad range of advocatesFills critical resource gap, useful for broad range of advocates

Cultivating Local LeadershipCultivating Local Leadership

Local engagement and leadership is necessary for changeLocal engagement and leadership is necessary for change Local interdisciplinary network with a common goal and strategyLocal interdisciplinary network with a common goal and strategy Youth participationYouth participation

CHLP role:CHLP role: Providing framework for national initiative-policy and standards leadProviding framework for national initiative-policy and standards lead Organizing a national advisory boardOrganizing a national advisory board Organizing and mobilizing local actorsOrganizing and mobilizing local actors Providing legal expertiseProviding legal expertise

Current status: Current status: Breakthroughs with Juvenile Justice Coalition, ACSBreakthroughs with Juvenile Justice Coalition, ACS Roundtable meetings with local leaders; multi-state networksRoundtable meetings with local leaders; multi-state networks Groundwork for collaboration on sexual health education and staff Groundwork for collaboration on sexual health education and staff

trainingtraining New national partnersNew national partners

Model StandardsModel Standards

First set of Teen SENSE Model Standards released in First set of Teen SENSE Model Standards released in January 2012:January 2012:

Model Sexual Health Care Standards for Youth in State Model Sexual Health Care Standards for Youth in State CustodyCustody

Model Sexual Health Education Standards for Youth in Model Sexual Health Education Standards for Youth in State CustodyState Custody

Model Staff Training Standards: Focusing on the Needs of Model Staff Training Standards: Focusing on the Needs of LGBTQ YouthLGBTQ Youth

Endorsed by over 20 agencies, organizations, and Endorsed by over 20 agencies, organizations, and universities across the United Statesuniversities across the United States

Model PoliciesModel Policies

First set of Teen SENSE Model Policies outlining the First set of Teen SENSE Model Policies outlining the elements of essential sexual health services released in elements of essential sexual health services released in April 2012April 2012

Model Policy: Sexual Health Care for Youth in State Model Policy: Sexual Health Care for Youth in State CustodyCustody

Model Policy: Sexual Health Education for Youth in State Model Policy: Sexual Health Education for Youth in State CustodyCustody

Model Policy: Training for Youth Facility Staff: Ensuring Model Policy: Training for Youth Facility Staff: Ensuring Competence that Includes the Rights and Needs of Competence that Includes the Rights and Needs of LGBTQ YouthLGBTQ Youth

77

Conclusions and Lessons Drawn (1)Conclusions and Lessons Drawn (1)

There is both an obligation and an opportunity to meet the There is both an obligation and an opportunity to meet the needs of disproportionately affected communities by needs of disproportionately affected communities by focusing policy advocacy efforts on the institutions in which focusing policy advocacy efforts on the institutions in which they are disproportionately representedthey are disproportionately represented Focus on immediate and long-term sexual health of communities Focus on immediate and long-term sexual health of communities Address the multiple factors that compound riskAddress the multiple factors that compound risk Consider and redefine the role these institutions play in heightening Consider and redefine the role these institutions play in heightening

or reducing riskor reducing risk

Interaction of legal analyses and policy advocacy is vitalInteraction of legal analyses and policy advocacy is vital Establishment of legal entitlements can be an important motivating Establishment of legal entitlements can be an important motivating

carrot or stickcarrot or stick

Conclusions and Lessons Drawn (2)Conclusions and Lessons Drawn (2)

Interdisciplinary collaborations are necessary to address the Interdisciplinary collaborations are necessary to address the multiple factors affecting the long-term health of multiple factors affecting the long-term health of communitiescommunities Multidisciplinary teams of experts in intersecting fields must Multidisciplinary teams of experts in intersecting fields must

collaborate to develop model policies and strategiescollaborate to develop model policies and strategies Coordinating expertise and strategy can enable these teams to bring Coordinating expertise and strategy can enable these teams to bring

state agency heads to the table to make voluntary changesstate agency heads to the table to make voluntary changes

Creating standards and frameworks that can be used Creating standards and frameworks that can be used locally, nationally, and internationallylocally, nationally, and internationally

Conclusions and Lessons Drawn (3)Conclusions and Lessons Drawn (3)

Redefine sexual health care and the way it is understood by Redefine sexual health care and the way it is understood by consumers, providers, and policymakersconsumers, providers, and policymakers A comprehensive view of sexual health care that is rights-based and A comprehensive view of sexual health care that is rights-based and

recognizes the importance of social, cultural, environmental, and recognizes the importance of social, cultural, environmental, and economic factorseconomic factors

Provide best policies by recognizing and tapping into the vital factors Provide best policies by recognizing and tapping into the vital factors that shape the health of individuals and communitiesthat shape the health of individuals and communities

Characterize sexuality education and a safe, respectful environment Characterize sexuality education and a safe, respectful environment as part of an essential right to health careas part of an essential right to health care

Provide strategic advantagesProvide strategic advantages

National initiatives work best when local implementation is National initiatives work best when local implementation is undertaken by local leadersundertaken by local leaders Create model policies and strategies that can be adapted to other Create model policies and strategies that can be adapted to other

jurisdictions with similar systems and institutionsjurisdictions with similar systems and institutions Local actors sharing resources create strong networks for changeLocal actors sharing resources create strong networks for change

Challenges AheadChallenges Ahead

Changing state bureaucracies that are largely hidden from Changing state bureaucracies that are largely hidden from public scrutiny, defensive, homophobic, and sex-phobicpublic scrutiny, defensive, homophobic, and sex-phobic Systemic change may depend on the voluntary actions of slow-Systemic change may depend on the voluntary actions of slow-

moving, conservative, politically driven bureaucraciesmoving, conservative, politically driven bureaucracies Optimally balancing the Optimally balancing the ““carrotscarrots”” with with ““stickssticks””

Funding for projects that are long-term, and in which Funding for projects that are long-term, and in which change is incremental, is scarcechange is incremental, is scarce

Cultivating local leadership with limited fundingCultivating local leadership with limited funding Making progress at a pace that is commensurate with the crisis Making progress at a pace that is commensurate with the crisis

requires significant investmentrequires significant investment Collaborators are overburdened and under-funded, and ability to Collaborators are overburdened and under-funded, and ability to

dedicate significant efforts without new funding is circumscribeddedicate significant efforts without new funding is circumscribed

Applying human rights framework in US-based advocacyApplying human rights framework in US-based advocacy

Teen SENSE is possible through a founding grant Teen SENSE is possible through a founding grant

for the Teen SENSE initiative from thefor the Teen SENSE initiative from the

M.A.C. AIDS Fund M.A.C. AIDS Fund

and with additional support from and with additional support from

The Arcus Foundations Gay and Lesbian Fund The Arcus Foundations Gay and Lesbian Fund

Broadway Cares/Equity Fights AIDS, Broadway Cares/Equity Fights AIDS,

and the Elton John AIDS Foundation. and the Elton John AIDS Foundation.