Violence Hurts Us All: The Public Health Impact of Violence on Both Young Women and Young Men

Gina Desiderio

February is Teen Dating Violence Prevention Month, and with the marketing for this awareness campaign, we often hear about girls and women as the victims of violence.  However, it’s also important to remember that the number of young women AND men exposed to childhood maltreatment, interpersonal violence, and family violence in the United States is staggering—and we only see the tip of the iceberg.  The significant and long-lasting impact on young people’s sexual, reproductive, and parenting behaviors, for BOTH women and men, is irrefutable.

As many as two thirds of young women who become pregnant as adolescents are sexually and/or physically abused at some point in their lives—either as children, in their current relationships, or both, according to several studies.  A substantial number of adolescent mothers are in violence, abusive, or coercive relationships just before, during, and/or after their pregnancy.

Some young women become pregnant directly because of interpersonal violence, through incest, sexual abuse, or through violence that includes contraceptive sabotage.  Others become pregnant indirectly through circumstances or conditions associated with prior sexual or physical abuse.  For example, abused children may remain in an unsafe living situation where they are likely to be exposed to additional sexual advances.  They may experience emotional or psychological damage that makes them especially vulnerable to coercive or violent partners when they leave home.  As adolescents, they may be depressed and self-medicate with drugs or alcohol, putting them at higher risk of early pregnancy, compared to adolescents not abused as children.

Similarly, men have reported their experiences of maltreatment before the age of 18 at alarming rates.  A troubling aspect of the male experience of child maltreatment and family violence is that male survivors tend to report their victimization less frequently than females.  Male survivors may interpret their experiences of maltreatment as a failure to protect themselves and reporting it as a public admission of this failure.  As well, in many places in the world, such victimization holds the social stigma of being associated with homosexual behavior.

“Boys will be boys”—it is a common refrain, one often heard when boys engage in aggressive play, resort to violence to settle conflicts, use drugs or alcohol, or display sexually aggressive or inappropriate behavior.  For some young boys, these negative and risky behaviors develop into bigger problems in adolescence and adulthood.  While we may hypothesize many reasons for boys’ behavior, one that is often not given enough consideration is the effect of exposure to child maltreatment and family violence.  Exposure to child maltreatment and family violence is linked with certain behavioral outcomes in males, including higher rates of adverse and/or health compromising sexual behaviors among adolescent and adult males, such as sexual violence perpetration, having multiple partners, condom non-use, contracting a sexually transmitted infection (STI) including HIV/AIDS, involvement in a teen pregnancy, and abusive parenting behaviors.

It is time to expand our thinking with regard to males and violence, to let go of outdated and harmful stereotypes and misperceptions about masculinity and male gender identity and to begin to work toward a society that recognizes young men’s real potential as agents of sexual, reproductive, and public health.

Healthy Teen Network developed three publications addressing the issue of childhood maltreatment, interpersonal, and family violence among young men and women:

  1. Interpersonal Violence and Adolescent Pregnancy: Prevalence and Implications for Practice and Policy
  2. Boys Will Be Boys: Understanding the Impact of Child Maltreatment and Family Violence on the Sexual, Reproductive, and Parenting Behaviors of Young Men
  3. Widening Our Lens: A Comprehensive Strategy to Address the Impact of Child Maltreatment, Interpersonal, and Family Violence on Youth

To move forward, we must address the components laid out in the first two research reports, and in the comprehensive strategy, Widening Our Lens, in order to:

  1. Reframe the issue of violence against young men and women using a public health approach;
  2. Reduce the adverse impact of exposure to child maltreatment, interpersonal and family violence on the sexual, reproductive, and parenting behaviors of young men and women; and
  3. Ultimately, help ensure the development of healthy relationships among all youth.

There is much to be done to change the way society views and deals with young survivors of violence.  Professionals and volunteers in the field must be sensitive to this change in thinking about child maltreatment, interpersonal, and family violence as they diagnose, treat, and manage the consequences of such violence among youth.  It is only with such a comprehensive public health approach that we can begin to break the cycle of child maltreatment, interpersonal, and family violence and the damage to society that accompanies these tragedies.

Let us heed this call to action and strive to ensure that every young person has the opportunity to feel accepted and supported, to reach his or her potential, and to live a full, healthy, and rewarding life—for we are all affected.

How do you work to reduce the adverse effects of exposure to violence on the sexual, reproductive, and parenting behaviors of young men and women, to help ensure the development of healthy relationships among all youth?

Gina Desiderio is the Director of Marketing and Communications at Healthy Teen Network.

Cultural Norms When It Comes to “The Talk”

Saras Chung

Research shows that parent-adolescent communication about sex can protect against risky sexual behaviors in teens. So what happens to those who, by cultural nature, do not receive such warnings?

Know a teen of Latino or Asian immigrant parents? Did you know that you might be the ONLY person who talks to them about sexual development? It’s true. As a child of Korean immigrants myself, it was culturally painful and taboo to discuss the already sensitive topic of sex out loud, let alone with my parents. Even as a 30-year old woman with two kids of my own, the thought of having this conversation with my parents still makes me cringe.

Blame the parents? Partly, but really, it’s cultural. The National Longitudinal Study of Adolescent Health found that Latina and Asian mothers were less likely to talk to their children about sex than other ethnicities. Although family relationships are vitally important to Asian Americans, ironically, dialogues on sensitive topics such as sexual feelings, intercourse, pregnancy, HIV, and drugs are rare in families. Instead, these types of messages may be conveyed in indirect, implicit, and nonverbal ways easily understood by their Asian American children. Of course, this research is not the case for every single Asian American or Latino you work with, as families may vary on levels of acculturation, but it is something to keep in mind as you work with young teens of this ethnic background.

My own enlightenment came from my mother in a passing comment…so passing that if I blinked my eyes, I might have missed it: “Don’t become pregnant… Stay away from boys.” As a young adolescent, this is about as far as the conversation went. For all logical purposes, I could have believed that just by being around a boy could get me pregnant. “Lucky” for me, the lack of pertinent education at home was fully supplemented by whispers amongst school friends and my seventh grade health class (think graphic slide shows of sexually transmitted infections given by the school nurse). However, even amongst the formalized education, none held as much weight as my own mother’s cautionary words to stay baby-free until marriage…“or else.”

What can be done? How do we work within the cultural norms of ethnically diverse frameworks? The positive side of this story is that research finds that compared to whites, Asian American youth were more concerned about their parents’ opinions regarding dating and relationships. If you happen to be working with large numbers of immigrant populations, why work against the system? Though it is imperative to provide formal sex education in our schools and communities, it is even more important to find ways to sensitively encourage and support all parents, especially those with ethnic minority backgrounds, to have “the talk” with their teen.

Ways to encourage dialogue with parents and teens of ethnically diverse backgrounds:

  1. Utilize existing frameworks. Meet parents where they are at. Champion individuals who can reach parents on a grassroots level to discuss the importance of such conversations. If this means finding advocates at local churches, community centers, or associations, do so. Many ethnic minorities have local newspapers that are dedicated to covering information to their community.
  2. Engage schools to help you spread the importance of such messages. Bring fliers in the appropriate language for schools to disseminate to students.
  3. Work with local church youth workers to work with parents on the importance of communication.

Understand that culturally, messages to parents must respect the sensitivity to the topic. Just because you might be comfortable discussing the topic of intercourse and protection does not mean that parents are as well. Enabling parents to feel prepared and supported is your best tool.

-Saras Chung, MSW is a Research and Operations Manager at Wyman.

References
Meneses, LM, et. al. Racial/ethnic Differences in Mother-daughter Communication About Sex. J Adolesc Health 2006; 39:128-131.
Wen-Chu Chen, E., Yoo, GJ. Encyclopedia of Asian American Issues Today. Volume 1. Edith Wen-Chu Chen and Grace J. Yoo 2010. Santa Barbara, CA.

Photo by Kristie Cromie

Free Will for All?

Shelby Emmett

Under the Affordable Care Act, employers are required to pay for preventative care services—including birth control. The administration announced late January that churches and houses of worship would be exempt from providing free birth control coverage to their employees. The First Amendment of the United States Constitution protects citizens from a government establishment of religion, and also guarantees our free exercise thereof. The exemption upset many members of the religious community, in large part because it required religious hospitals, universities, and charities to still comply with the mandate under the 2010 health care law.

On February 10, 2012, the Administration changed course and amended the regulation. Now, employers who object to providing contraception do not have to pay for it or be involved with it in any way. Instead, insurance companies will be required to reach out to women of these employers, and cover the cost of contraceptives instead of the employer.

Healthy Teen Network supports access to effective contraception for all and believes it is necessary to help people of all ages exercise control over their reproductive choices. We applaud President Obama for finding a compromise that allows for this access. We embrace the faith community as important partners in promoting healthy sexual and reproductive behaviors and hope this compromise will promote partnership on their part as well. We recently met a long-time, progressive Black minister who justifies his pro-choice stance by saying that “the greatest gift God gave to us is the gift of free will.” Does this compromise support free will for all?

Shelby Emmett, JD is the Policy and Legal Coordinator at Healthy Teen Network.

What’s in a Ribbon?

Gina Desiderio

Last week, the Susan G. Komen Foundation announced Planned Parenthood would no longer be eligible to receive grants to provide breast cancer screenings to women. After a tremendous backlash against Komen, and an outpouring of support for Planned Parenthood, Komen reversed its decision, announcing that Planned Parenthood would again be eligible for grant applications. In the fallout ensuing from Komen’s decision, and a lack of clear or consistent reasoning behind the initial decision, we are left to conclude that the decision was made, not for the good of women and their health, but rather tied to political motivations and the issue of choice.

The controversy surrounding the pink ribbon, however, and what it means to support it, is not new. In September 2003, Ms. Magazine published an article, “Think Before You Pink,” suggesting we should be more discriminating in how we donate funds because the funding may not always go to the cause we expect. Komen has been under fire in the past for using its funds to sue other nonprofits who use its language, “for the cure,” as well as campaigns with questionable partners whose products do nothing for overall health, let alone breast cancer prevention or treatment. Critics call into question the value in pursuing treatment and detection as primary goals, rather than prevention. The ribbon, itself, with its pink color and ties to feminine stereotypes, is suspect, as Barbara Ehrenreich, a breast cancer survivor, analyzes as she is involuntarily inundated with pink while undergoing treatment.

As Komen backpedals from this decision, trying to regain its lost public support, both emotional and financial, and restore its image as a nonprofit foundation serving women, I’m stuck reflecting on the ribbon as a symbol, and its role in activism and raising awareness for a cause. Komen wasn’t the first to use a ribbon, but the pink ribbon is arguably the most omnipresent ribbon. Google any cause, however, and you’re likely to find a ribbon attached in an attempt to raise awareness and activism. The Komen fiasco made me wonder if there is a ribbon related to teen pregnancy prevention, or supporting pregnant and parenting teens. I’ve been working in the field of adolescent sexual and reproductive health for more than five years, and yet a ribbon didn’t immediately come to mind. A quick search revealed some links, buried halfway down the page, to a white ribbon for teen pregnancy prevention. Clearly, this symbol is nowhere near as successful as the pink ribbon.

And yet, what’s in a ribbon? Do we need a ribbon to help support the cause of teen pregnancy prevention and supporting pregnant and parenting teens? Will a pervasive symbol help motivate people to support our cause?

I don’t think so. Sure, the pink ribbon is a very successful symbol for Komen—you see a pink product, and you assume that if you buy it, you’ll be supporting women’s health. And who doesn’t want to support women’s health? Supporting the pink ribbon is a way to (at least appear to) support women without being controversial or addressing hot button topics like abortion or contraception. The Komen fiasco, last week, however, surfaced the fact that supporting Komen’s pink ribbon doesn’t necessarily mean supporting women’s health.

The ribbon is used as a symbol to promote awareness and activism, and yet many critics question this. We even have a new term emerging to indicate that wearing a ribbon may not necessarily do anything to help further a cause: slactivism. Formed from the root words, “slacker” and “activism,” Wikipedia informs us that “The word is usually considered a pejorative term that describes “feel-good” measures, in support of an issue or social cause, that have little or no practical effect other than to make the person doing it feel satisfaction.”

Does teen pregnancy prevention and supporting pregnant/parenting teens need a ribbon? Probably not. But at Healthy Teen Network, we consistently hear from our members and colleagues that framing the issue continues to be a challenge. It’s difficult to advocate for our cause. And sex education is certainly a hot button topic.

Those of us in the field of adolescent sexual and reproductive health have no doubt why we work for our cause. On our part, Healthy Teen Network envisions a national community where all adolescents and young adults, including teen parents, are supported and empowered to lead healthy sexual, reproductive, and family lives. This is a vision that seems to be tied to human rights, equity…and yet, the question of HOW we accomplish this vision is what so often becomes the debate, the controversy.

The good news is that we are making strides toward positive health outcomes for youth. Today, the Guttmacher Institute released the latest data on teen pregnancy rates for 2008. Approximately 7% of US teens became pregnant in 2008, with a rate of 67.8 pregnancies per 1,000 women, aged 15-19. The teen pregnancy rate has declined 42% from its peak in 1990, when the pregnancy rate was 116.9 per 1,000 women, aged 15-19.

However, what we also learn from this report is that we still have much work to do. Although pregnancy, birth, and abortion rates have declined across racial and ethnic groups, we continue to see persistent health disparities. Teen pregnancy rates among black and Hispanic youth continue to be 2-3 times as high as that of their non-Hispanic white peers.

Our field doesn’t need a ribbon, or more slactivism. We need more awareness and more support (specifically, more funding) for youth and sexual and reproductive health services and education.  A powerful symbol like the ribbon, marketed as effectively as Komen at least previously managed to do would be a great way to draw broader attention to our cause. But true activism, true advocacy, will go much further in supporting adolescents’ health and well-being, so that we may continue to see declines not only in teen pregnancy, birth, and abortion rates, but also declines in health disparities for marginalized youth.

Gina Desiderio is the Director of Marketing and Communications at Healthy Teen Network.

The Stages of Grief: Processing the Loss of Komen

Pat Paluzzi

My first reaction to the Susan G. Komen for the Cure Foundation announcement to de-fund Planned Parenthood was sadness. How could such a significant women’s organization turn on another significant women’s organization? Yet more politics on the backs of women—Komen, really?

I have supported both of these organizations fully throughout my life—I am a survivor and I have worked for the local Planned Parenthood on more than one occasion and therefore have firsthand knowledge of ALL the good work they do, including some 750,000 annual breast exams to women who might otherwise go without. So I initially tried to deny it was true, quickly followed by grief, then anger, and now acceptance. Komen will never receive my support again. Even with their decision to restore funding to Planned Parenthood, I am left with sadness, as if I have lost a friend.

How does one recover from such a sense of betrayal? Who will politics not touch? Who might turn on us next and how can we prevent it? Perhaps some collective grief counseling is in order!

Pat Paluzzi, DrPH, is President/CEO of Healthy Teen Network.

New Year, New You?

Are you still on track to achieving your New Year’s resolutions?  

Clair Swinburne

One of the biggest stumbling blocks we face when trying to achieve goals that we set is our thinking!

Our thinking is better described as our mental chatter. Well, our mental chatter often works against us when we are trying to achieve something. Let me give you an example: you are trying to do something you have never done before. You want to try this something new. But in your head your mental chatter is saying to you, ‘You’ll never do this. Why are you even trying this? This will never work. You can’t learn this.’ Then all the excuses roll in, justifying and confirming to yourself all the reasons why you cannot achieve or do this something new.

Your mental chatter is saying the opposite of what you want—your thoughts don’t match your desires! You want to be able to do this something new, but in your head you’re telling yourself that you won’t be able to do it. It’s like buying a ticket to go to a concert and then asking the taxi driver to take you to the cinema! You are giving yourself mixed messages. How can your brain truly understand your aims or your goals if you are giving yourself mixed messages?

Think about people who regularly achieve goals they set. Think about any story you’ve ever read about a successful person. There is always a similar thread to their stories. Self-Belief! Do they have this self-belief because they know exactly how to go about achieving their goal? No! Of course they don’t know how they are going to do it. Their self-belief comes from a thought! A thought that they decided to repeat over and over to themselves. That is all a belief is—a repeated thought. Beliefs don’t develop from truths they develop from repetition. What is the thought that they repeated to themselves?

‘I can do this’

Successful people do not give themselves mixed messages. They do not confuse their brains. They make it crystal clear what they want and match their thoughts to their desires.

You see, you’ve got to understand something about your thinking or your mental chatter. Although many of our thoughts run on like background noise and we regularly feel that we have no control over thoughts, the truth is we do. Although a thought may pop into your head out of your control, you decide whether or not to continue thinking that thought or you can choose to think something else. A good way to understand this is to think of yourself as the producer in a radio station who can choose and decide who gets the microphone. You decide which voice in your head gets the most air time—the positive one or the negative one! You have the control.

Remember, the thought of self-doubt might pop into your head every now and then, but if you recognize it for what it is, a negative thought from old thought processes, which will keep you from your goals, then you can replace it immediately with an affirming thought. An affirmative thought has been scientifically proven to be hundreds of times more powerful than a negative thought. And so, your affirmative thought will be more powerful than the negative one that crept into your head, and by choosing the affirmative thought, you are putting yourself back on track to achieving your goals.

The first step in achieving your goals: Match your thoughts to your desires! And so, I ask you again: Are you still on track to achieving your New Year’s resolutions? If you work with youth, how do you help them to realize their goals?

Clair Swinburne is the Author of “So What Do You Think?: A Guide for the Teenage Mind”

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