Morning Roundup: Gardasil Also Effective in Men

Beth Saunders

HPV vaccine is just as effective in men at preventing genital warts, more children getting health care with CHIP, Spain keeps marriage age at 14 (and what's it like in your state?), and the Vatican is setting up an HIV/AIDS conference.

HPV vaccine is just as effective in men at preventing genital warts, more children getting health care with CHIP, Spain keeps marriage age at 14 (and what’s it like in your state?), and the Vatican is setting up an HIV/AIDS conference.

  • Studies are showing that Gardisil is just as effective in men at preventing genital warts caused by HPV as it is in women. HPV can cause cervical, anal, oral, and throat cancer in those infected. Public health officials believe the best way to cut the incidence of cervical cancer is to immunize both young men and women – and this study may convince parents of both sexes that it’s a good idea.
  • Health and Human Services Secretray Kathleen Sebelius announced that since the passage of reauthorization two years ago, more than 2 million additional children have had access to health care under Medicaid or the Children’s Health Insurance Program (CHIP). The two programs serve 42 million children who would not otherwise have access to health care. (Remember the fight that the program should not expand?)
  • Despite pressure from the UN, Spain will keep its minimum marriage age at fourteen. To get married at that young age, a child must have the permission of family and a judge. Between 2000-2008, 326 children under the age of fifteen were married in the country. The UN recommended that Spain raise the minimum age to sixteen. In the United States, a girl of 13 and a boy of 14 can be married in New Hampshire with parental consent, and in Mississippi, there is no minimum age with parental consent, and a girl of 15 and a boy of 17 can marry without parental permission. There are all sorts of exceptions – see the complete list for yourself.
  • The Vatican is working to set up a conference on the prevention of HIV and the care of those infected. It is also developing guidelines for Catholic healthcare workers who work with HIV/AIDS patients. The conference and guidelines are a result of the Pope Benedict condom flap from last year.

Feb 3

Commentary Sexual Health

Parents, Educators Can Support Pediatricians in Providing Comprehensive Sexuality Education

Nicole Cushman

While medical systems will need to evolve to address the challenges preventing pediatricians from sharing medically accurate and age-appropriate information about sexuality with their patients, there are several things I recommend parents and educators do to reinforce AAP’s guidance.

Last week, the American Academy of Pediatrics (AAP) released a clinical report outlining guidance for pediatricians on providing sexuality education to the children and adolescents in their care. As one of the most influential medical associations in the country, AAP brings, with this report, added weight to longstanding calls for comprehensive sex education.

The report offers guidance for clinicians on incorporating conversations about sexual and reproductive health into routine medical visits and summarizes the research supporting comprehensive sexuality education. It acknowledges the crucial role pediatricians play in supporting their patients’ healthy development, making them key stakeholders in the promotion of young people’s sexual health. Ultimately, the report could bolster efforts by parents and educators to increase access to comprehensive sexuality education and better equip young people to grow into sexually healthy adults.

But, while the guidance provides persuasive, evidence-backed encouragement for pediatricians to speak with parents and children and normalize sexual development, the report does not acknowledge some of the practical challenges to implementing such recommendations—for pediatricians as well as parents and school staff. Articulating these real-world challenges (and strategies for overcoming them) is essential to ensuring the report does not wind up yet another publication collecting proverbial dust on bookshelves.

The AAP report does lay the groundwork for pediatricians to initiate conversations including medically accurate and age-appropriate information about sexuality, and there is plenty in the guidelines to be enthusiastic about. Specifically, the report acknowledges something sexuality educators have long known—that a simple anatomy lesson is not sufficient. According to the AAP, sexuality education should address interpersonal relationships, body image, sexual orientation, gender identity, and reproductive rights as part of a comprehensive conversation about sexual health.

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The report further acknowledges that young people with disabilities, chronic health conditions, and other special needs also need age- and developmentally appropriate sex education, and it suggests resources for providing care to LGBTQ young people. Importantly, the AAP rejects abstinence-only approaches as ineffective and endorses comprehensive sexuality education.

It is clear that such guidance is sorely needed. Previous studies have shown that pediatricians have not been successful at having conversations with their patients about sexuality. One study found that one in three adolescents did not receive any information about sexuality from their pediatrician during health maintenance visits, and those conversations that did occur lasted less than 40 seconds, on average. Another analysis showed that, among sexually experienced adolescents, only a quarter of girls and one-fifth of boys had received information from a health-care provider about sexually transmitted infections or HIV in the last year. 

There are a number of factors at play preventing pediatricians from having these conversations. Beyond parental pushback and anti-choice resistance to comprehensive sex education, which Martha Kempner has covered in depth for Rewire, doctor visits are often limited in time and are not usually scheduled to allow for the kind of discussion needed to build a doctor-patient relationship that would be conducive to providing sexuality education. Doctors also may not get needed in-depth training to initiate and sustain these important, ongoing conversations with patients and their families.

The report notes that children and adolescents prefer a pediatrician who is nonjudgmental and comfortable discussing sexuality, answering questions and addressing concerns, but these interpersonal skills must be developed and honed through clinical training and practice. In order to fully implement the AAP’s recommendations, medical school curricula and residency training programs would need to devote time to building new doctors’ comfort with issues surrounding sexuality, interpersonal skills for navigating tough conversations, and knowledge and skills necessary for providing LGBTQ-friendly care.

As AAP explains in the report, sex education should come from many sources—schools, communities, medical offices, and homes. It lays out what can be a powerful partnership between parents, doctors, and educators in providing the age-appropriate and truly comprehensive sexuality education that young people need and deserve. While medical systems will need to evolve to address the challenges outlined above, there are several things I recommend parents and educators do to reinforce AAP’s guidance.

Parents and Caregivers: 

  • When selecting a pediatrician for your child, ask potential doctors about their approach to sexuality education. Make sure your doctor knows that you want your child to receive comprehensive, medically accurate information about a range of issues pertaining to sexuality and sexual health.
  • Talk with your child at home about sex and sexuality. Before a doctor’s visit, help your child prepare by encouraging them to think about any questions they may have for the doctor about their body, sexual feelings, or personal safety. After the visit, check in with your child to make sure their questions were answered.
  • Find out how your child’s school approaches sexuality education. Make sure school administrators, teachers, and school board members know that you support age-appropriate, comprehensive sex education that will complement the information provided by you and your child’s pediatrician.

School Staff and Educators: 

  • Maintain a referral list of pediatricians for parents to consult. When screening doctors for inclusion on the list, ask them how they approach sexuality education with patients and their families.
  • Involve supportive pediatricians in sex education curriculum review committees. Medical professionals can provide important perspective on what constitutes medically accurate, age- and developmentally-appropriate content when selecting or adapting curriculum materials for sex education classes.
  • Adopt sex-education policies and curricula that are comprehensive and inclusive of all young people, regardless of sexual orientation or gender identity. Ensure that teachers receive the training and support they need to provide high-quality sex education to their students.

The AAP clinical report provides an important step toward ensuring that young people receive sexuality education that supports their healthy sexual development. If adopted widely by pediatricians—in partnership with parents and schools—the report’s recommendations could contribute to a sea change in providing young people with the care and support they need.

News Human Rights

Feds Prep for Second Mass Deportation of Asylum Seekers in Three Months

Tina Vasquez

Those asylum seekers include Mahbubur Rahman, the leader of #FreedomGiving, the nationwide hunger strike that spanned nine detention centers last year and ended when an Alabama judge ordered one of the hunger strikers to be force fed.

The Department of Homeland Security (DHS), for the second time in three months, will conduct a mass deportation of at least four dozen South Asian asylum seekers.

Those asylum seekers include Mahbubur Rahman, the leader of #FreedomGiving, the nationwide hunger strike that spanned nine detention centers last year and ended when an Alabama judge ordered one of the hunger strikers to be force-fed.

Rahman’s case is moving quickly. The asylum seeker had an emergency stay pending with the immigration appeals court, but on Monday morning, Fahd Ahmed, executive director of Desis Rising Up and Moving (DRUM), a New York-based organization of youth and low-wage South Asian immigrant workers, told Rewire that an Immigration and Customs Enforcement (ICE) officer called Rahman’s attorney saying Rahman would be deported within 48 hours. As of 4 p.m. Monday, Rahman’s attorney told Ahmed that Rahman was on a plane to be deported.

As of Monday afternoon, Rahman’s emergency stay was granted while his appeal was still pending, which meant he wouldn’t be deported until the appeal decision. Ahmed told Rewire earlier Monday that an appeal decision could come at any moment, and concerns about the process, and Rahman’s case, remain.

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An online petition was created in hopes of saving Rahman from deportation.

ICE has yet to confirm that a mass deportation of South Asian asylum seekers is set to take place this week. Katherine Weathers, a visitor volunteer with the Etowah Visitation Project, an organization that enables community members to visit with men in detention at the Etowah County Detention Center in Gadsden, Alabama, told Rewire that last week eight South Asian men were moved from Etowah to Louisiana, the same transfer route made in April when 85 mostly Muslim South Asian asylum seekers were deported.

One of the men in detention told Weathers that an ICE officer said to him a “mass deportation was being arranged.” The South Asian asylum seeker who contacted Weathers lived in the United States for more than 20 years before being detained. He said he would call her Monday morning if he wasn’t transferred out of Etowah for deportation. He never called.

In the weeks following the mass deportation in April, it was alleged by the deported South Asian migrants that ICE forcefully placed them in “body bags” and that officers shocked them with Tasers. DRUM has been in touch with some of the Bangladeshis who were deported. Ahmed said many returned to Bangladesh, but there were others who remain in hiding.

“There are a few of them [who were deported] who despite being in Bangladesh for three months, have not returned to their homes because their homes keep getting visited by police or intelligence,” Ahmed said.

The Bangladeshi men escaped to the United States because of their affiliations and activities with the Bangladesh Nationalist Party (BNP), the opposition party in Bangladesh, as Rewire reported in April. Being affiliated with this party, advocates said, has made them targets of the Bangladesh Awami League, the country’s governing party.

DHS last year adopted the position that BNP, the second largest political party in Bangladesh, is an “undesignated ‘Tier III’ terrorist organization” and that members of the BNP are ineligible for asylum or withholding of removal due to alleged engagement in terrorist activities. It is unclear how many of the estimated four dozen men who will be deported this week are from Bangladesh.

Ahmed said that mass deportations of a particular group are not unusual. When there are many migrants from the same country who are going to be deported, DHS arranges large charter flights. However, South Asian asylum seekers appear to be targeted in a different way. After two years in detention, the four dozen men set to be deported have been denied due process for their asylum requests, according to Ahmed.

“South Asians are coming here and being locked in detention for indefinite periods and the ability for anybody, but especially smaller communities, to win their asylum cases while inside detention is nearly impossible,” Ahmed told Rewire. “South Asians also continue to get the highest bond amounts, from $20,000 to $50,000. All of this prevents them from being able to properly present their asylum cases. The fact that those who have been deported back to Bangladesh are still afraid to go back to their homes proves that they were in the United States because they feared for their safety. They don’t get a chance to properly file their cases while in detention.”

Winning an asylum claim while in detention is rare. Access to legal counsel is limited inside detention centers, which are often in remote, rural areas.

As the Tahirih Justice Center reported, attorneys face “enormous hurdles in representing their clients, such as difficulty communicating regularly, prohibitions on meeting with and accompanying clients to appointments with immigration officials, restrictions on the use of office equipment in client meetings, and other difficulties would not exist if refugees were free to attend meetings in attorneys’ offices.”

“I worry about the situation they’re returning to and how they fear for their lives,” Ahmed said. “They’ve been identified by the government they were trying to escape and because of their participation in the hunger strike, they are believed to have dishonored their country. These men fear for their lives.”